Varraces banded

[donaldsgirl]

Hi everyone, I am new here, and my question is, should I be in so much pain after having two varraces banded two days ago? It is agony to eat and drink and the pain also comes in spasams at other times. I am real very uncomfortable, but frightened to take much co-codamol. This was my first endoscapy and I didn't really expect any varraces.

[AyrshireK]

HI Donaldsgirl, I know you've found another post which provides answers to you. It is quite usual to suffer a bit of pain when eating after banding, stay on a soft diet until it starts to ease ...... I know that even liquid passing the banding site hurts (witnessed it so often with my hubby after his bandings). It should pass within a few days ......... the longest my hubby was ever sore was about 8 days. A bit of paracetemol is what hubby was told to take for post banding pain (the codeine content of co-cododamol could lead to constipation which you need to avoid at all costs).

Best wishes to you, Katie

[donaldsgirl in reply to AyrshireK]

Thank you so much Katie. I will try the paracetemol. Best wishes to you too.

[12Kanwar_r]

Is it possible to have aliver transplant from a living donor in cirrohsis ?

[AyrshireK in reply to 12Kanwar_r]

I don't know what the transplant procedure is in Sweden but in the UK a patient who has late stage symptoms of cirrhosis may be assessed for transplant during which they are thoroughly tested to see if (a) how poorly they are and whether transplant is indicated and (b) whether they are fit enough to actually undergo the procedure and the lengthy post-operative period and whether there are any potential counterindications to transplant. A multi-disciplinary team will then sit down and discuss the patient and all the various test results from the assessment and decide whether a transplant is indicated.

Part of the testing will be to assess what type of liver is would be appropriate for a patient to receive. This is done looking at body size and size of organ required - it's all to do with the pipework & plumbing (to put it into plain speak, a huge built guy needs a huge liver, a smaller person can only accept a smaller liver etc). Sometimes the severity of the ill health of the patient comes into play as to the type of organ they can receive. When my 165cm tall hubby was listed he was deemed suitable to receive a cardiac deceased donor organ, a brain deceased donor organ, a split liver or a live donation.

In a person with small stature it may be possible for them to receive a split liver and this can come by way of a split liver from a deceased donor (where the liver is split with the smaller portion going to a child recipient & larger to the smaller adult) OR it might be possible to get a partial liver transplant from a live donor. However, it all depends on how poorly the liver patient is and which type of donation the medical team feel is needed. In the UK live donation is at present restricted to family members making the donation, altruistic liver donation isn't yet very widespread and there are MASSIVE potential implications to live donation.

In the UK, live donation isn't a way of bypassing the organ donation system, a patient is still listed on the waiting list and doctors will always prefer a cadaveric liver over a live liver owing to the risk to the donor. To go through the procedure you still have to be assessed and listed as normal it's just that the possibility of a live donation might get utilised if a cadaveric liver isn't likely to come 'in time'.

I hope that answers some of your questions, obviously, my answer is based on the UK way of doing things but the body size/plumbing issue will come into play (I guess) wherever the operation takes place.

Katie

[12Kanwar_r]

That's very nice of you.and what are potential risks to a living donor ?

[AyrshireK in reply to 12Kanwar_r]

The live donor goes through a similar assessment to the liver patient to assess their overall health and mental health. They undergo a similar length operation to the donor. Massive abdominal wound, liver being cut in two, loss of gall bladder and alteration to liver 'pipework'. Risk of bleeding, risk of infection, abdominal weakness post operatively means they can't bend, lift or drive for sometime post op. Any massive operation has risks so there are risks with the anaesthesia etc. etc.

Hubby and I completely ruled it out when it was put to us as a potential option. He would need me to care for him and drive him post op - we live 100+ miles from our T/P unit so how would we get there for weekly or bi-weekly appointments if I was 'out of order' too. ALSO, the big one for us what "What if he survived but I didn't?"

The Scottish Liver Transplant Unit (which we attend) pioneered the live donation operation in the UK and they produce a leaflet which patients are given. The procedure, assessment process and such like are all detailed in it and it is available to download at:- nhslothian.scot.nhs.uk/Serv...

Hope that helps a bit.

Katie

[12Kanwar_r in reply to AyrshireK]

Does value of fibroscanresult 17.5 means that one has cirrohsis? I had been through fibroscan last week but my doctor is on vacation and i didn't hear from her yet but my value was 17.5kpa. am very worried,my wife has been crying every night that she will lose me.

[AyrshireK in reply to 12Kanwar_r]

I responded to your first post about your fibroscan result when you posted the other day. Really you need your doctor to discuss the result with you and what it means as the scores can differ depending on the underlying cause of your liver ill health.

You are early into your diagnosis in that you don't actually yet have a proper diagnosis. Do you know why your liver might be damaged? Has a cause yet been established.

Even early cirrhosis is now thought to be reversible if the cause of the liver disease can be either treated or the cause removed.

What symptoms are you currently displaying? People can live for many years with cirrhosis before it even starts to lead to symptoms and even then it can exist in a compensated state whereby it continues to carry out it's major functions. It is when it starts to go decompensated and is failing to carry out it's most important functions that the life threatening symptoms develop and it would be the presence of these which might lead doctors to think about transplant.

In my case, 5 years ago this very day my husband vomitted a huge amount of blood and I rushed him to hospital where over the next 3 weeks he spent time on the High Care Unit and we were told he had late stage cirrhosis. As a non-drinker and being uninformed about the many other causes of liver disease at that time it came totally out of the blue to hear he had cirrhosis and was so dreadfully poorly. He became really jaundiced, needed blood transfusions and all sorts but he pulled through. He had a biopsy which revealed he had suffered from an auto-immune liver disease (Auto-Immune Hepatitis) which had caused his own immune system to attack his liver.

Over the next couple of years he had to keep going to out patients appointments to have varices in his oesophagus banded and eventually in 2014 he was assessed for transplant although he has an absence (fortunately) of the more serious aspects of cirrhosis. His symptoms are now:- chronic fatigue (both physical & mental), he has sleep deprivation and although terribly exhausted on going to bed still can't sleep, he gets confused, has memory difficulties and concentration issues, he has no sexual desire or function (your liver takes to do with the regulation of hormones). His varices are currently all eradicated and he lost his spleen due to having to have aneursyms ebolised. His blood results are next to normal and after 10 months on transplant list he was taken off it again in May 2015 (as he was stable and too well for transplant).

He isn't jaundiced, has no ascites (thank goodness), minor HE and we just live the good days. 5 years ago I guess I was where your good lady is now, I came home from hospital thinking I wouldn't see him again. We got married within months of his eventual discharge from hospital and although YES he remains very poorly we do make the most of the better days and just have to write off the bad ones.

There is a lot in that post so I shall sign off now and head to bed myself - any further questions feel free to ask and we will try to help. You do need a proper discussion with your doctor though and to hear what plan of action they have in place to monitor and treat your condition going forwards.

All the best to you. Katie xx

[12Kanwar_r in reply to AyrshireK]

So kind of you Katie. I have a chronic hepatitis B which i had got at my birth time as my mom was a hepatitis patient.I have severe fatigue and my color is going utmost pale day by day restvi don't display any symptoms except for pain atmy stomach

[AyrshireK in reply to 12Kanwar_r]

Are you on medication for your Hepatitis B? You should be on some sort of anti-viral to control your Hep B and reduce it's damage on the liver.

Katie