Cruisin with the Real"s

Cruisin with the Real"s
Joe and Nancy Grand Cayman 10-07

Loma Linda Medical Center

Loma Linda Medical Center
Where the magic happens........

Wednesday, June 4, 2008

Extreme Tiredness in Liver Disease

This was written by someone who was a caregiver for a cirrhosis patient prior to her transplant.

Tiredness is caused because the body is trying to heal. It is making adjustment (homeostatis) to try to do the functions the liver once did. The tiredness can be sudden and unforgiving. There is no choice but for the body to sleep.

There are poisons, or toxins, going into the blood now and building up causing changes in the way the body once functioned. Some of these poisons go pass the blood brain barrier and into the brain causing confusion. Medications and just the cirrhosis itself, can change the way food taste to the patient. Because of the build up of fluid in the body...especially in the abdominal area...this fluid puts pressure on the stomach and other organs; it also puts pressure on the diaphram making it difficult to breathe well.

The liver always made sure that the body had the nourishment it needed, that the special proteins where made, that the toxins were converted to non toxic substances, that certain vitamins were always available, that our food was broken down into simplier forms that the body could use and it even stored these for times when we did not eat. Add to this the emotional causes of this disease: wondering if there will be a tomorrow, wondering if those we love will be alright if we leave them, watching many of the dreams we had in life disappear, feeling guilty if we think we brought all this on ourselves, wishing things were different and hoping we don't become a burden to our families.

Now to the mental aspects. Because of the toxins going into the brain...we cannot think clearly and start to make wrong decisions. We don't see that in ourselves, it takes others to point this out. Suddenly, people may start to treat us like children and make all the decisions for us and start to tell us what to do, how to do it, and we wonder if they are joking or they are serious. AS you can see, this disease can take its toll on a person if they let it. Most liver patients with a disease like this one, are found to be mal nourished, not breathing well, depressed. They are watching all the things this disease can do to the body and they can look in the mirror and suddenly don't see themselves anymore. They look like a skeleton that is having twins. There normal color skin in now an orangish yellow. Their own body fluids are darker and their stools are so light. They may be taking on a feminine appearance. It is like living in a body that has come from another planet. Hello, Spock. I'm now a being from the planet Cirrhosis. Beam me aboard.

If a patient needs to sleep, it is good to do so. These sleep pattern changes are considered normal for someone with this disease. However, the caregiver should be sure that they obtain some sort of nourishment. Without nourishment...the body will not have energy to function or last. If they cannot eat, ask the doctor about supplements he recommends. Also ask about any vitamins they might need... however, these supplement drinks have enough for the patient. Always check with the doctor to be sure, as these supplement can contain things certain patients should not have...the doctor can tell this by blood work.

When the liver starts to deteriorate...the functions (of which there is over 500) go down also. Some organs try to make up for the load of work. The kidneys filter the blood so it is trying to adjust the sodium (salt) in the body also the potassium, it is trying to keep us from becoming dehydrated, it is filtering out the normal waste and is now adding onto that the toxins in the body that the liver no longer converts. It is becoming overwhelmed. If you notice, those who are placed on the transplant list...not only have their liver enzymes and liver functions being checked, but also their kidney functions. The liver goes into failure and the kidneys will shortly follow. Some patients may be placed on dialysis because of try to help the kidneys.

When someone says cirrhosis, everyone thinks it is only a liver problem...that is not effects many other organs also and it effects the body as a whole. Scar tissue does form in the liver causing the cells of the liver to die. The spleen can enlarge because of the back up of blood not being able to go through the liver and be rerouted into smaller vessels to try to return this blood to the heart. The stomach has pressure put on it from fluid build up. The heart has to adjust to slowed return of blood to it. The lungs cannot expand well with pressure up against the diaphragm and fluid can develop in them. The digestion of the food is altered since the bile may not be reaching the intestines. There is vitamin deficiency that develops and the homeostasis of the body become altered in many different ways. The mind (brain) becomes unclear because of poisons.

If you really look at Cirrhosis in the light of the entire body...even the skin is affected, you could say you have disease of the entire body. The hormones are changed, proteins are not made, the immune system starts to work overtime.

By the way, anyone who has cirrhosis should see about their teeth and also their eyes. We sometimes forget this. Those who have a transplant can have problems with these areas afterwards. I would like to suggest, that if you do vomit...try to wash your mouth out with water right away and brush your teeth. It isn't normal for the acid in your stomach to be in your mouth and can cause dental problems. Anyway you can neutralize the acid in the mouth is good...the doctor can tell you what to use. Another thing to think about is your bones. Ask your doctor about trying to protect your bones. He may start you on calcium, phosphorus, vitamin D and even do a Dexa scan to be sure you don't develop osteopenia. Many patients spend months in the house or in the hospital, with not eating properly... it can cause the bones to deteriorate also.

I hope this information is of some help to you.


Anonymous said...

Thank you,
You added light to my path..

Nancy said...

To anonymous,

Your comment made MY day! My hope is that some of what I experience and write about will help others!

Thank you!

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