Autoimmune Cirrhosis?

Dr. Barnes brought up with me the topic of autoimmune cirrhosis with respect to possible genetic instances--since I don't have the usual symptoms, but I have very little info on my ancestors' health problems--as in the case with Dad's and my generation. most people died before the health issues we have had a chance to show themselves. Barnes obviously is an expert on PBC, but he didn't pinpoint that with me. He's waiting to find out more from tests, and apparently doesn't see a rapid change coming or he wouldn't have scheduled my next MRI and consultation with him until the middle of September. If things change though I get in touch with him. I've noticed on some sites that techology is superceding bipsy--a needle poked into the abdomen--and more reliable--like the blood tests, MRI, etc. He did say however that I'm not near liver failure at the moment. I'm seeing D. Hoynes tomorrow and we'll talk about this--I've been lax about getting the regular things done--an order for a mamogram is on my bulletin board for last December, and I didn't go back to the opthamologist for more tests like I was supposed to.

Which is Better? The World-Class Hospital Near You--or Your Modest Local Hospital?

Something to think about when contemplating surgery or any other hospital procedure is whether a so-called "world-class" hospital is really better than your local hometown facility or the general medical center in a nearby city--like Akron for us. We live only 45 minutes from Cleveland Clinic, world famous for its state of the art medical treatment. World leaders and millionaires as well as ordinary people from all corners of the globe fly to Cleveland for treatment. It's also the go-to place for many locals and when Paul needed treatment for lung disease followed by lung cancer, the Clinic was first choice. The surgeon was top of the line and the operation a success--and yet the after care failed to impress us. Doubled with another patient in a small room after a day in the ICU, Paul was constantly exposed to people coming and going--professional and housekeeping staff attending both patients, plus friends and relatives visiting both. Who knows how many germs were walking right into the room as well.
A couple weeks later I had to rush Paul back to the Clinic where he was treated for pneumonia and kept there for several days. Hardly had we got him home than breathing difficulties, a temp of 102, and general weakness, recurred necessitating a trip in the Granger rescue unit to Medina Hospital where they eventually decided that what he had was C-Difficile, an infection contracted in hospitals! A disease specialist called in from Southwest General Hospital in South Cleveland identified the C-Diff--an infection that is virulent and often very hard to quell. Now, after a couple of weeks, Paul appears to be winning the battle and his strength is returning.
Cleveland Clinic didn't identify C-Diff. The Medina doctors did. Perhaps, because they were so focused on his lung, the Clinic did not look elsewhere to solve the problem. And Paul says the food at Medina Hospital is much better than the dreck they serve in Cleveland. Thank you Medina General Hospital!

Cirrhosis of the Liver Confirmed

Nearly a month gone since my last post. Time for an update. We are still alive. It's been two months since Paul had the cancer removed from his lung on April 15. Today it's hard to find any evidence that surgery took place--the incision is completely healed and has disappeared. But we were really such innocents when we tripped off to the Cleveland Clinic for that procedure. We anticipated that after about eight weeks of recovery, he would resume his normal life. We didn't take into account other factors but they did appear in the form of pneumonia, return trip to the Clinic, and then an ER rush to Medina Hospital for what we thought was another bout of pneumonia, only to learn (through the intelligent resources of a Southwest Hospital disease specialist) that what Paul had was C-Difficile--an aptly named infection because it's difficult to oppose--an infection contracted mostly in hospitals and passed most often by hand contact. C-Diff has a way of draining the patient's strength, stamina, and imune system and can only be combatted by one or two powerful anti-biotics. As of now though, Paul's made a lot of progress especially the last few days.

Medicare has provided him with visiting nurses and a physical therapist and they come twice a week. They report to his doctor on his progress and help him remain optimistic. Three days ago the tide seemed to be turning when he helped Philip build a railing from the house to the garage--one of those jobs he had put off for years--but really needs it now. Paul stood and supervised while Phlip did the carpentry work. We're all pleased with the result.

In the meantime, a visit to the Clinic last Friday confirmed that I do have some form of liver cirrhosis. The first sign of something wrong was from a blood test done earlier by fam physician who found elevated liver enzymes in the blood sample.Then a local specialist diagnosed from observations that it's liver cirrhosis. Also, a Clinic gastroenterologist, after doing an endoscopy, suggests in a letter to fam physicial that it's cirrhosis. Following that, Dr. David Barnes, Clinic liver and hepatitis specialist. sent a series of blood tests to the lab and read the MRI screening that seems to confirm the diagnosis. But the cause is still a mystery and more tests will be done. I'm not an alcoholic and I don't have hepatitis, and I'm not in pain. Autoimmune? Feel the same as I always have done.

The confirmation of cirrhosis stunned me to the point that I wasn't too swift in asking questions, but as soon as I hit the highway questions came up in my mind thick and fast. I was able to reach Dr. Barnes over the next couple of days and he was able to set my mind at rest to a large extent. Here are the things we discussed:

Liver cirrhosis doesn't equate with liver failure. I could die of something else before liver failure caught up with me.
He will continue to work and follow it.
Pain isn't typical.
Will arrange for a vaccination against hep A and B.
A biopsy can be given--it's the gold standard for diagnosis but he prefers not to unless necessary.
A cirrhotic lung's tissue is scarred. the tissue separates into nodules--spheres--looks like marbles in a bag.
Liver transplant at my age is not an option, although I got the feeling that he doesn't rule it out. I have a feeling though that the liver has to have failed before they do that?