ALBUMIN and EDEMA and COMPRESSION SOCKS - oh my!

[Rshc]

partner diagnosed decompensated cirrhosis 22.12.21 - stopped drinking the same day. Albumin 18 at diagnosis, 24 at best since now dipped again to 22. How long did people's albumin take to recover - is it normally so slow to improve - in contrast bilirubin gone from 256 to 58 since Dec. He is having an awful time with edema and fluid on stomach. I know he should be eating protein, I am really trying to shovel it in him! Is it a bad sign that his albumin isnt improving? He has had issues with low sodium but that has just hit 133 so can restart diuretics

ALSO - anyone used compression socks for edema? Any thoughts or recommendations?

thanks

[Cat-B]

As you know the answer is first class protein, I spent 3 weeks in hospital following my diagnosis, I ate little ( a ramekin) every 2 hours by the clock ( it was hard work asI never got hungry I ate high protein and high carbohydrates right up to the last snack in bed before going to sleep and I kept a dish and spoon next to the bed incase I woke up during the night or I ate it cold before getting out of bed. Has he had the ascites drained? I had to have 2 drains in hospital but never again ( nearly 6 years now and finally my liver function tests are almost completely normal) . If his ankles are swollen he needs to elevate them when sitting and try to get up and walk every 20-30 minutes ( diuretics help with this in the morning lol). Let me know if I can help any more, good luck ( it’s hard work and slow but just keep plodding on, it’s definitely worth it. I had a 10-20% 2 year survival when diagnosed and now it’s 100%, if I continue with the regime lol)

[Rshc in reply to Cat-B]

3 weekly drains. He is keeping legs up. Bloods generally improving - Drs seem happy but albumin not moving much. Is Albumin a sign that liver isn't recovering even though bilirubin coming down? I am giving him loads of Protein but I think we will do a week where we really focus on quality and smaller meals. Thanks for your help

[Cat-B in reply to Rshc]

No the low albumin is because his body is using all the protein faster then he can replenish it! X

[Lam1e in reply to Rshc]

When I had ascites and was being drained and the fluid taken reached a certain amount I was given IV albumin as part of the procedure. I can’t remember the exact amounts but it seemed to help me.

[ANU64]

I was taken off of compression socks because of edema.I was given albumin through a drip and the water fell off me.I had just gone through a bowel perforation at the time abd was really ill.xx

[Bashful_1]

You really need to get GP and a Nutritionist's advice on this because it is generally specific to the individual based on their individual Bio-Chemistry. I have provided my personal experience below, but your Partner's Bio-Chemistry will be different from mine, so you need to check first! Albumin is, generally, slow to build - it can take several months and your partner needs to be eating multiple Albumin-rich foods on a daily basis, not just relying on some meat or plant proteins, or having Albumin-rich foods one day and none the next. This is the bit where the GP and Nutritionist/Dietician have to provide agreement on the diet based on the results of monthly blood tests, including Kidney Function tests. The general rule for Cirrhosis is to eat little and often, so he should be looking to eat something between every two-to-three hours during waking hours. Assuming no specific Potassium, Phosphorous, Iron or Calcium issues (check!), the best sources of Albumin are beef, milk, cottage cheese, eggs, fish and Greek yogurt. Dairy can help a lot, especially full-fat dairy, but generally avoid anything that is low or reduced fat and stay away from cheese due to the Sodium content. You're probably starting to think of possible menu ideas already: Porridge made with full-fat milk, and topped with fruit and/or yoghurt for breakfast; couple of hours later, morning smoothie with full-fat Greek Yogurt, a couple of tablespoons of ground almonds (more protein) and whatever fruit he likes, tinned mango in it's own juice or frozen blueberries; for lunch, a baked potato and full-fat cottage cheese with a salad; a mid-afternoon snack might only be as little as a glass of full-fat milk with a couple of slices of cake, for example; for dinner, perhaps a two-egg omelette with filling of his choice, or beef or vegetarian chilli with kidney beans (plant protein), or chicken or fish curry with added chick peas (plant protein) and rice and full-fat yoghurt, followed by a high-fat, high-calorie pudding with full-fat cream or ice-cream and, say, fresh or tinned pears (not all fat is necessarily bad for him at this stage). I find the post-evening snack or supper the most difficult bit, but it is crucial that he eats before bed as both the brain and the liver will use up some protein while he sleeps. The key thing is that his Albumin levels consistently build each day, each week, each month. As the Albumin level rises it will improve the ability of the blood to transport essential minerals and nutrients around the body and this will then help reduce the Edema over time, but there are no hard and fast rules regarding time - everyone responds differently, in different ways and over different time periods. I'm sure you're also beginning to see the complexity in developing a varied high-protein, high-calorie, low-sodium, high-albumin diet - it is quite a challenge. Reducing the abdominal fluid from the Ascites is really all about limiting ADDED salt, not about eliminating salt completely. Don't be afraid to give him a toasted chicken sandwich because of the added Sodium in the bread, but don't add salt to the chicken or have bread with every meal. Sodium occurs naturally in almost all the foods we eat and we all need some level of salt in our body just to survive, but the greater the salt then the greater the likelihood that in his condition he will retain more of the fluid he consumes. So, no added salt and no high-sodium foods such as cheese or bacon, cooked ham etc...We're all here to support each other, so just reach out anytime you feel you need some help or advice, no matter what the issue. And remember, there is no such thing as a stupid question...Best wishes, David

[Rshc]

gosh this is so so helpful thanks a million.

[Louby1954]

I have used compression socks & find them very good for getting sewlling of feet Down. I had bottle green ones in hospital, sexy eh 😅

[jazzjam]

I can only agree withe the above. Very small meals many tines a day. My meals at the beginning were probably the size of a saucer for an espresso cup, so small. Each meal had protein and veg /salad or fruit. I was amazed at what a difference the protein made. I was actually given albumin by iv everyday for 5 days, again at the very beginning, within 2 weeks of being diagnosed. I look back now, when I go for my checkups and I walk up the 1 step how at the beginning of my journey with this, I couldn’t even get up that step I was so weak. Them small but many meals got me back going very quickly. All the very best 🌻

[Rshc in reply to jazzjam]

thank you, did you have edema? And fluid on stomach?