AS-CI-TES, OH OH

DISCLAIMER

 I am not responsible for any throwing up you may do during this post.

 

Ascites, that lovely liquid you get when you have liver disease. Is it just one color?  Good question that you just asked. No. There are different colors which mean different problems. 

Now look at the above mentioned colors

I’ve had the cloudy/turbid color. Shows I had an infection. I’ve also had the pink or blood tinged. Meaning, mild trauma. The other color I had was the milky. Cirrhosis, thoracic duct injury.  Don’t be jealous, you too can get liver disease. 

Now for the fun and exciting PARACENTESIS. 

They stick that tube in your side/stomach area. The belly you see is not a pregnant belly, it’s full of fluid. 

I had my first foray (A sudden attack or incursion into enemy territory) into the world of getting that naughty liquid out of my stomach, on Oct 24, 2017. The last one I had was Jan 13, 2019. The largest amount of sludge was 10 liters. The smallest, 2.6. In all I had 23, yes you read that right, twenty-freaking-three para’s!!!!!!

Next we have the THORACENTESIS. 

This procedure hurts. They are pushing that tube in between your ribs. You don’t realize how hard is for you to breathe until some of the liquid is taken out. IF YOU EVER HAVE TO HAVE THIS PROCEDURE, make sure you go to your happy place. Breathe like you are delivering a baby. Deep breath in, deep breath out.  You will either get a pain in your arm, or like me, you will start coughing. TRY NOT TO COUGH. It is horrible. It is a non stop cough. You will feel like you might not make it. 

My first trip to thoracentesis land was Feb 2, 2018. My last one was Dec 5, 2019. The largest amount they took out was 4 liters. The smallest was 1.05. In all I had 13 of this procedure. 

Time for a story problem. I hate story problems.  I don’t care how many apples left New York, how many oranges left California. And the stupid question they ask. Where the the damn trains meet. Ok, breathing. My heart rate just went up. 

Back to the math. 

If you have 23 paracentesis with a grand total of 106.08 liters of sludge taken out, plus 13 thoracentesis with a grand total of 28.15 liters taken out, how many gallons does that equal?  

Do you have your answer?

28 Gallons of stomach gunk

7.5 Gallons of chest crap. 

Grand total:  35.5 freaking gallons!!!!!!

Imagine carrying all that liquid around in your body. Could you stand it?  Next time you go buy gallons of milk, hold at least two and walk around with them in your arms down by your belly, for as long as you can. Good times. 

Now get ready with your barf bag. Please, please my dear readers, I can’t stress enough. If you are showing signs of liquid build-up in your belly, get yourself to a doctor or ER room pronto!!!! 

This lady has ascites horribly bad. Open sores are not an option!! I’m surprised this lady was alive to take this photo. Notice her legs. They are normal size. She is not overweight. 

You can now gargle that nasty taste out of your mouth. 

Be sure to join me next week for:

All You Want To Know About Liver Disease But Are Afraid To Ask

Tests, Tests and More Tests

Welcome to your first day of medical school. I bet you can hardly wait. And what a great field of medicine you have chosen. Liver Transplantation. 

What does it take to get on the liver transplant list.  Tons of tests, that’s what. Let’s get started. Get your learning caps on, as always there will be a trick question. 

First you meet with the transplant surgeon. Last class we learned how much I enjoyed that one. Next you meet with the social worker. If you have a spouse in the room with you, they are asked to leave for a minute so they can ask the “are you in an abusive relationship” question.  No I am not so they let him back in. They go over most of the emotional issues that can arise. 

Then you meet with the financial person. They have called your insurance company to find out if they will cover you. They then tell you how much you will be responsible for.  If insurance doesn’t cover much they give you information on things you can do to get money donated. Fun times. 

After that, all the physical tests are ready for you to pass. First off they send you to the lab to get your BLOOD DRAW. Most the time when you get a lab draw they take two or three vials. Haha. They took 37 (it might have been 27, but that’s still a lot), vials of blood out of me.  I’ll have to ask my coordinator, (hey girl). Thought I would need a blood transfusion after that. You also get a URINE TEST.  As a woman, those are hard to direct your pee into that tiny cup. I have been known to drop that damn thing into the toilet.  Just sayin’. 

HEART TESTS

EKG and STRESS TEST. You will be asked to either walk on a treadmill on an incline, or ride a stationary bike. Here they determine the blood flow within your heart.  Since I had yet to recover from my hip replacement, they had me lay on a table and then injected a drug that mimics the effects of exercise. ECHO TRANSTHORACIC with BUBBLE STUDY. They inject saline after agitation with air to create micro bubbles that the ultrasound looks at in the right heart chamber and the coronary sinus.  

LUNG TESTS

X-RAYS. I especially like when they make you put your arms in the air. PULMANARY FUNCTION. This measures your lung size and air flow. HEPATOPUMANARY. Breathing test

LIVER TESTS

ARTERIAL BLOOD GAS TEST. Measures the oxygen and carbon dioxide in your blood. I will also mention that this one hurts. MRI or CT scan. Here they check for tumors and blood supply. LIVER BIOPSY. All things they can’t see from other tests. ULTRASOUND. Here they check for liver size, shape and circulation. 

MISC TESTS

TB TEST. DENTAL EXAM. If you have bad teeth they have to be fixed before you can get on the list. PROSTRATE or PELVIC EXAM. I told them I wouldn’t get a prostrate exam. That’s where I draw the line. MAMMOGRAM. COLONOSCOPY. 

SIX MINUTE WALK

This test was by far the hardest test for me to pass. It gives the doctors clues about your heart, lungs and blood vessels. You must be able to walk 380 yards in the 6 minute timeline. 380 yards equals 1140 feet which equals a quarter mile. I failed this test 2 times. I failed it one more time but that will be brought up in another chapter. 

Now it’s time for the trick question you all were waiting for me to give.  

How many tests does it take to get on the transplant list???

EIGHTEEN. Yes you read that right. If that was your answer, you have passed.

 Congratulations. 

 

Bedside Manners......Oh My

 

Surgery is not my friend. Three weeks after my hysterectomy, this is how my stomach looked. I looked very pregnant. I also was getting dehydrated. Of course, more times than not, when you need to talk to your doctor it’s the weekend. We headed to the Instacare in the hospital nearest us. They examined me and said that I wasn’t dehydrated, and wheeled me over to the ER. 

ER doc comes in and examines me. I just love the questions they ask. Especially how are your BOWEL movements. I said “well my POOP is kind of dark and looks like wet coffee grounds”. (don’t throw up its all good). He’s concerned that I might have sepsis. Sepsis occurs when chemicals release into the bloodstream. It can damage multiple organs. 

Remember when I showed the photo of the fluid they drew out of my chest sac, this is the fluid they drew out of my belly. Those bottles equaled 6.2 Liters. (1 1/2 gallons). I was admitted to the hospital. After testing the ascites, they determined I had Spontaneous Bacterial Peritonitis. Another infection. It was also determined that I had End End Stage Liver Disease. 

I had the most awesome doctor while there. He was actually the Head Doctor in Charge of all the doctors. Don’t exactly know what that title is. His bedside manner was so cool. He would pull up a chair, we’d sit and talk. We’d even try to crack each other up. He loved my purple hair, and he explained everything so well.  After 3 days of seeing me, he apologized that he needed to start doing his job, but was going to assign me one of his better doctors. See, so cool.  I was in the hospital for a week. With two more fluid draws taken from my body. 

Five days later I was back in the ER at the big Medical Center. I was having a hard time breathing. After running ultrasounds they found I had fluid in my plural area (around the lungs) and ascites in my belly. The fluid around the chest area makes it super hard to breathe. I was again admitted to the hospital. They sucked the liquid out of both places. I met the liver clinic doctors who  informed me they were going to take on my case. I was released 5 days later. 

Two weeks later I was in the Liver Clinic meeting with the Transplant  Surgeon. He was going to determine if I should be able to get on the transplant list. All I can say is his bedside manner was completely opposite of the doctor at the other hospital I told you about. 

 One of the first things he said to me was, “YOU A FATTY”. Yes to my face. He left the room to go out and get a measuring tape, proceeded to have me lie down, and measured how high off the table my huge ole stomach was. Then he said I needed to follow everything he told me to do and not to do. I said ok. Here were the 3 he told me I couldn’t do. 

1.  No being a prostitute. 

2.  No going to jail. 

3.  No getting a tattoo while in jail. 

WTH!!!!

 Do I look like a prostitute?  NO

Have I ever gone to jail?  NO

Do I have tattoos?  YES

Would I ever get one in jail?  NO

Needless to say, I left the clinic in tears. Not only because I was told I needed a Transplant and could actually die before ever getting one, but because of how his bedside manner was. 

This is the start of a wonderful journey. 

Holy Blood & Breathing Batman!!

Previously on “My Life” 

We saw me in the ICU. After they determined I didn’t need to be in there, they sent me to the orthopedic floor of the hospital. 

POW!

Why the orthopedic floor?  Well, because I had a hip replacement Duh.  Let’s discuss why that is not the best floor to be on when you are in a different crisis. The nursing staff are used to dealing with people that aren’t sick. People on that floor are just having rehab. Not this girl. I can’t breath without oxygen. I can barely walk myself into the bathroom. I’m so sick, no rehab is happening. I should have been on a surgery recovery floor. Those nurses are used to sick patients. 

HOLY QUIZ SECTION BATMAN!

While in the hospital, the liver team came in and “visited” with me. They informed me that my liver had not faired well during the surgery. They also said I needed to start going to a hepatologist. They are a branch of medicine that manages the liver, gallbladder, biliary tree and pancreas.  They gave me the name of a doctor to go see. 

 I had already been diagnosed with NASH

which stands for NONALCOHOLIC STEATOHEPATITIS

(a buildup of fat in the liver) so I knew my liver was already sick. This was when I had just lost my job, so we didn’t have any insurance. Which makes it very expensive to have any medical treatment. Thank goodness after a 3 year battle, I was able to get on disability.

 (Remember these medical terms, there will be a quiz later) 

BOOM

I was having such a hard time breathing, that I was sent home on oxygen. I was on it for 6 months. When you are on oxygen, DO NOT take it off while taking a shower. You will feel like you’re dying. 

BAM

A couple of months after finally getting off oxygen, we had a family reunion. It was in the beautiful canyons where we live. Of course those fabulous areas have the gross toilets. I usually try not to even use them. All of the sudden I felt like I was losing everything inside of me. I run in there and pass something that looks like this

The blood clot that exited my body was even bigger. WHAT THE!!! And of course, there was very little toilet paper. I did the best I could and told my family I had to leave. After the weekend I made an appointment with the gynecologist, she ran a test but told me she was pretty sure it was UTERINE CANCER. You read that right. Yay me.  She lined me up with an Oncologist Gyno, who confirmed that is was. Lucky for me it was only stage one. Oh and BTW, I had gone through menopause about 10 years earlier, so any kind of bleeding was super weird. She had to get permission from my hepatologist do give me a hysterectomy. He gave it, I had the surgery, went home the next day, at which time all hell broke loose.