So while in Socal I got another kick in the teeth

[DSRIGGS]

While doing surgery cleaning up my gut (and good gawd from the op report my abdominal cavity was a spaghetti factory of scar tissue and adhesions that Dr K cleaned up) Dr K didn't like how my liver looked so he biopsied a section. Well it came back and not great news.

I have non alcoholic fatty liver disease with moderate steatosis . ....AND the not so good part. I also have Stage 3 bridging fibrosis......yeah that pretty much sucks because that part is not reversible. Dr K said that it is likely due to years of morbid obesity and diabetes. I basically can't take aspirin, acetaminophen, NSAIDS or opiates the rest of my freaking life. For a guy with chronic pain (spinal and two effed up shoulders, not to mention gut pain) that really bites.

I have to talk to my PCP to let him know and devise go forward plan but I know my shoulders will need operated on at some point and there is no guarantee that the lysis of adhesion surgery will resolve my colon issue (hopeful but just dint know yet). So who knows what I can do in regard to future surgery.

The good news is that my liver function is good and the non fibrosis stuff is reversible.

Yep story of my life. Close one door and another dog is behind another door ready to take another hunk out of my ass.

 

[southernlady]

Scott, I'm sorry...things just keep hitting you. Who did you piss off in a previous life?

 

[DSRIGGS]

Apparently I was Attila the Hun.

Thanks and as always I guess I will have to figure out a way to manage.

 

[chevtow]

Man, I'll say a prayer for you. Gotta get better right??!! What happens if you take opiates occasionally? Will it destroy your liver? It's not my life so its easier for me to ask this question...... How many years of life will you lose to the liver issue if you continue to take meds? How many miserable painful years will you gain by not taking them? Risk vs reward. Worth living to 90 if it hurts every second? Just playing devils advocate. I hope they can figure something out

 

[hilary1617]

Sorry to hear that Scott.

Here's a good article on pain management for patients with full on cirrhosis that might be helpful. ---> https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2861975/

It seems that maintenance of kidney function and protein / nutritive state are critical to keeping the greatest variety of pain management options available where liver is compromised.

On a related note, if you choose the homeopathic remedy route, be very cautious - my doctor says he sees a lot of *new damage* in patients who start taking milk thistle and is now recommending avoiding it altogether.

Hang in there!

 

[Larra]

I agree with @hilary1617 about the homeopathic stuff. Most of it is useless, and the stuff that actually does something tends to be harmful. These products are not well regulated and often contain ingredients that aren't on the label, or differing amounts of the "active" ingredients. Not much quality control going on.
Talk with your pcp about opiates. They may still be an option if used carefully and without any Tylenol in them.

 

[DSRIGGS]

Man, I'll say a prayer for you. Gotta get better right??!! What happens if you take opiates occasionally? Will it destroy your liver? It's not my life so its easier for me to ask this question...... How many years of life will you lose to the liver issue if you continue to take meds? How many miserable painful years will you gain by not taking them? Risk vs reward. Worth living to 90 if it hurts every second? Just playing devils advocate. I hope they can figure something out

Yeah honestly I don't know the answer to any of those questions but they are all questions I have as well. My understanding is that this bridging stuff if basically internal structure hardening and that supposedly doesn't reverse and is made worse by stressing the liver by taking those drugs. I was doing some quick reading last night and found articles saying medical marijuana can actually help but of course if one is on liver transplant list that you get kicked off if on MM....so I am trying to figure out how serious this is and what I need to do in all aspects. Can't drink now I know that.

 

[DSRIGGS]

Sorry to hear that Scott.

Here's a good article on pain management for patients with full on cirrhosis that might be helpful. ---> https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2861975/

It seems that maintenance of kidney function and protein / nutritive state are critical to keeping the greatest variety of pain management options available where liver is compromised.

On a related note, if you choose the homeopathic remedy route, be very cautious - my doctor says he sees a lot of *new damage* in patients who start taking milk thistle and is now recommending avoiding it altogether.

Hang in there!

Thanks Hil! I actually read something about that as well when searching this thing. I am by nature skeptical of homeopathic stuff. Not that is can't work but I know it isn't regulated or peer reviewed in studies so even though pharma are scumballs in many cases, ..there is good work/data that they have prepared.

 

[DSRIGGS]

I agree with @hilary1617 about the homeopathic stuff. Most of it is useless, and the stuff that actually does something tends to be harmful. These products are not well regulated and often contain ingredients that aren't on the label, or differing amounts of the "active" ingredients. Not much quality control going on.
Talk with your pcp about opiates. They may still be an option if used carefully and without any Tylenol in them.

I am definitely going to talk to him about all of this. I read that even the processing of opiates without tylenol is an issue but I did read something about fentanyl and one other drug being the best opiates to use. So I shall ask and see what is said.. I am also going to talk to a pain doc about Medical Marijuana. If it is feasible I would do a pill or edible as I don't want to smoke anything.

Thanks

 

[galaxygrrl]

Bummer, I'm sorry. Hang in there.

 

[aaa]

I'm sorry to hear this.

 

[newanatomy]

I'll bet a lot of us have this same issue. Obesity is the gift that keeps on giving. I am sure you will find acceptable ways to cope. Keep us posted.

 

[DianaCox]

There is at least one drug (Cenicriviroc) in development for this disorder, and it has Phase IIb underway, presumably based on Phase I/IIa results which looked pretty good. Perhaps you could get hooked up with a liver specialist in Chicago: https://clinicaltrials.gov/ct2/show/study/NCT02217475?term=Cenicriviroc&rank=5&show_locs=Y#locn

Here is a description of the ongoing clinical trial: https://www.ncbi.nlm.nih.gov/pubmed/26944023

Here are the results of the animal model study:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4922569/
"Antifibrotic Effects of the Dual CCR2/CCR5 Antagonist Cenicriviroc in Animal Models of Liver and Kidney Fibrosis."
"CONCLUSIONS:
CVC displayed potent anti-inflammatory and antifibrotic activity in a range of animal fibrosis models, supporting human testing for fibrotic diseases. Further experimental studies are needed to clarify the underlying mechanisms of CVC's antifibrotic effects. A Phase 2b study in adults with NASH and liver fibrosis is fully enrolled (CENTAUR Study 652-2-203; NCT02217475)."

And here is a review of a variety of pharmacotherapeutics for this disorder:
https://www.ncbi.nlm.nih.gov/pubmed/27646933

Pain management is something else entirely - I'd think MM would be the best approach.

 

[Marquis Mark]

Damn, Scott... You really hit the bad news medical lottery. I hope, given some of your political posts, you can at least take some small measure of comfort knowing you are sticking it to the insurance company...

Hang tough,
M

 

[Susan in Tennessee]

Scott, definitely not easy news to hear! Take things one step at a time and don't let your mind go to all those places it's wanting to go.