How JustAnswer Works:

  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.

Ask 911Doctor Your Own Question

911Doctor
911Doctor, Doctor
Category: Health
Satisfied Customers: 5094
Experience:  Board Certified Emergency Physician
19155615
Type Your Health Question Here...
911Doctor is online now
A new question is answered every 9 seconds

Hi, my aunt is suffering from cirrhosis and we are trying to

Customer Question

Hi, my aunt is suffering from cirrhosis and we are trying to determine how bad it is and what we can do to stop the situation worsening. The doctors are not be
Submitted: 1 year ago.
Category: Health
Expert:  911Doctor replied 1 year ago.

911Doctor :

I'm not sure if I can help but I will try.

911Doctor :

so this is non-alcoholic cirrhosis?

911Doctor :

as of yet undetermined cause?

Customer: That's right. She is a non smoker too.
911Doctor :

okay

911Doctor :

how did this come to her doctor's attention?

911Doctor :

what where her symptoms?

911Doctor :

it is easier to use the site if you type a sentence and send it so I can begin to think about an answer

911Doctor :

standing by

Customer: How this was uncovered was that she had her uterus removed. She used to have swelling on the foot only before the operation. After the operation there was leakage from her stitches roughly 7 days later. Then when she went to urinate she was bleeding and losing a lot of fluids. Then it started getting worse and the loss of fluid was excessive with foul smell. She was then admitted to hospital but then they asked to do a liver test. They uncovered that there was an ulcer on the liver. She was told to have medications and asked to go in for a recheck. The ulcer/lesion was gone but she was told that she had cirrhosis. Since then she has been trying to Eat healthily. Then she did a X-ray when the lesion and spleen anomaly were determined.
911Doctor :

hmmm

911Doctor :

two questions....

911Doctor :

1. is she still having symptoms?

911Doctor :

2. has she been studied for prior hepatitis infection?

911Doctor :

standing by

Customer: No, there is no swelling, no loss of fluids, minor itches and feeling a little weak. Has lost weight.
911Doctor :

okay

Customer: She wasn't studied for prior hep but hep isn't believed to be the case.
911Doctor :

I see

Customer: She is a single mother with no sexual activity either. She is divorced.
911Doctor :

I see

911Doctor :

so first of all let me tell you a bit about cirrhosis

911Doctor :

this literally means scarring of the liver

911Doctor :

it can be mild

911Doctor :

or it can be severe

911Doctor :

it sounds as if in her case it was found 'incidentally' in that she had an abscess/ulcer of the liver post operatively

911Doctor :

and some other post operative complications

911Doctor :

so the question is to what degree is her liver function compromised and then, what caused it

911Doctor :

as you can see

Customer: Apparently it has shrunk in size. So not sure if that is a bad indication.
911Doctor :

absent alcohol as a cause, hepatitis is usually to blame, and the first infection may have been 'subclinical', meaning, she may not have been that sick

911Doctor :

yes, that can indicate a more advanced stage

911Doctor :

is she jaundiced or retaining fluid at this point?

Customer: No, no signs of Jaundice or fluid retention.
911Doctor :

that's good

911Doctor :

how long ago was the surgery and why did they remove her uterus?

Customer: I believe in April. Uterus was removed because there was a tumour. That was done using a ultrasonography.
911Doctor :

probably something called a utering fibroid or 'leiomyoma'

911Doctor :

quite common

911Doctor :

unless this was found to be a cancerous tumor

911Doctor :

standing by

Customer: Not a cancerous tumour
911Doctor :

good

911Doctor :

fibroid.... that issue is now closed leaving the cirrhosis to figure out

911Doctor :

are they planning on doing a liver biopsy?

Customer: She was feeling weak, her feet used to swell so she went to check up. That's when they said she needed an operation to remove her uterus.
911Doctor :

I see

911Doctor :

so let's get to the meat of your question. what can I help you with regarding her current situation?

Customer: She is going to do the CECT triple phase scan.
911Doctor :

okay

Customer: I'd like to know how bad the situation is with her Cirrhosis and what type is it? Based on the results from the x-ray is it a sign of cancer or signs of things to get worse?
911Doctor :

cirrhosis is rarely a sign or result of cancer

911Doctor :

whether things are to get worse or not depends on the cause.

911Doctor :

and this is what her doctors are trying to determine at this point

911Doctor :

standing by

Customer: I have more details from the X-ray if that helps.
911Doctor :

yes please

Customer: It was a USG that was done.
911Doctor :

okay

Customer: I have the photo of the result, would've been great if I could've shared that.
911Doctor :

what would be more helpful is the radiologist's interpretation of the study. do you have that?

Customer: Suggestion - chronic liver disease with focal lesion in right lobe.
911Doctor :

okay

Customer: Suggested triple phase Cect liver for further evaluation.
911Doctor :

okay

Customer: Splenomagaly
911Doctor :

so trying to read between the lines here....

911Doctor :

usually in advanced liver disease

911Doctor :

advanced cirrhosis

911Doctor :

the radiologist will say that it is advanced and then give estimated of the percentage of liver involved with cirrhosis

911Doctor :

so this is a fairly positive result I think

911Doctor :

also

Customer: Ok
911Doctor :

given her symptoms it would be reasonable to hope that this is not a rapidly progresSive process

911Doctor :

still

911Doctor :

there is much work to be done because we don't know the cause

911Doctor :

what will happen next is the CT scan, which will give more detail about the state of the liver, and, perhaps, a suggestion as to the cause

Customer: and a biopsy will help determine that?
911Doctor :

but usually the ultimate diagnosis will come from liver biopsy

Customer: Ok.
911Doctor :

where a small piece of the liver is studied under the microscope

Customer: So better to do a biopsy
911Doctor :

if she has HEMACHROMATOSIS, for example

Customer: And what about her diet? Anything that she should avoid or maintain? She was asked to just eat veg?
911Doctor :

this is where the diagnosis will be made

911Doctor :

there is no evidence that diet will play a part here though there is nothing wrong with eating a mmore healthy diet

911Doctor :

certainly she should avoid alcohol

911Doctor :

i would be surprised if they had not already checked for hepatitis C, which can be a bad disease to have

911Doctor :

but the other rarer causes of cirrhosis are probably still on the table

911Doctor :

such as hemachromatosis

Customer: But hep c is curable correct?
911Doctor :

so it is likely a biopsy will be the next step

911Doctor :

no, unfortunately, hepatitis C, in it's chronic form, is not curable

911Doctor :

there are treatments that will slow the disease

911Doctor :

but no cure as of today

Customer: How long can she expect to live if she is diagnosed with Hep C?
911Doctor :

the link above should be very helpful in that regard

Customer: Apparently they did blood tests and determined there was no hep c
911Doctor :

that's good

911Doctor :

as I said, I think this would have been done early as the tests are relatively easy to run

911Doctor :

so that leads rarer causes on the list

Customer: Is blood test a good way to determine hep c being there. Or the biopsy is the ultimate test?
911Doctor :

the blood test is good, a biopsy might still be necessary to rule out active infection or other causes that could be in addition... but if her blood test for hepatitis C is negative then this is not the cause.

911Doctor :

again,

Customer: So do the biopsy and then see what's what.
911Doctor :

which, towards the end of the article, talks about prognosis, diet, and treatment

911Doctor :

I think that is the likely scenario

911Doctor :

in some cases

911Doctor :

if cirrhosis is progressive

911Doctor :

a liver transplant is eventually needed

911Doctor :

though from what you have told me that is not something to be considered at this point

Customer: But at the moment what do you think the cirrhosis is at? Or yet to be determined?
911Doctor :

cirrhosis is present based on the xray and ultrasound findings

911Doctor :

the extent of it is to be determined

911Doctor :

the cause is to be determined, as is the treatment

911Doctor :

standing by

Customer: And the formation of lesion? Is that bad or can cause matters to get worse? Any treatment for that?
911Doctor :

do you mean the ulcer/abscess?

Customer: The radiologist said isoechoic lesion has been found
911Doctor :

I thought you said that she had been treated for that and the subsequent studies showed that the lesion had cleared?

Customer: In the right love adjacent to gall bladder measuring 3.6 x 3.0 cm
Customer: The doctors did say it was ok but now the results show that it is present. Not sure if this is a reoccurrence.
911Doctor :

okay

Customer: She was given anti biotics for 7 days back then.
911Doctor :

so this is difficult

911Doctor :

liver cysts are common and benign

911Doctor :

this could be a simple cyst which is of no concern

911Doctor :

but

911Doctor :

the 3 phase liver C makes more sense

911Doctor :

as they will be looking at this area closely

911Doctor :

very hard for me to hazard a guess about this lesion

Customer: Hmmm
911Doctor :

but this makes biopsy more likely and more necessary if this is still therre.

Customer: Ok so do both CT and Biopsy
911Doctor :

I am obviously not calling the shots, but it would seem this would be the right way to go.

Customer: Understood.
Customer: She is having her blood work done again tomorrow.
911Doctor :

good

Customer: I am guessing we will have to close this topic today and reopen a new query should I have one again?
911Doctor :

yes, that would be a good idea. I am very interested in this case.

911Doctor :

would you like me to schedule a follow up with you?

Customer: That would be a good idea but I would have to pay again right?
Customer: It would not be covered under this session?
911Doctor :

I am only paid when positive feedback is received. so yes, you would pay to list another question, but would only pay me a second time if you felt my answer was a good one for you.

911Doctor :

though in a follow-up situation I might be mistaken. I am very sorry I am not sure about this.

Customer: Ok thanks Doc.
911Doctor :

you are most welcome

911Doctor :




Thank you so much for your question. It was a pleasure talking with you. If this answer has been helpful to you please consider leaving positive feedback. Should you require my assistance in the future simply start your question with ‘for 911doc’, and I am usually on the site most days.


Best


911Doctor :

I'm still here....

Customer: I hope I can follow up with you again.
Customer: May I know where you are from?
911Doctor :

we can certainly do that

911Doctor :

I live near Nashville TN

911Doctor :

and trained in Denver

Customer: :) thanks
911Doctor :

my pleasure

Customer: Thanks.
911Doctor :

have a good evening.

911Doctor :

If you leave positive feedback I will schedule a follow up

911Doctor :

if you leave the question open you can come back to it under the 'my questions' tab,

911Doctor :

though after some days the questions 'time out'

911Doctor :

I hope this helps

911Doctor :

good night, sir.

Customer: And you :)
911Doctor, Doctor
Category: Health
Satisfied Customers: 5094
Experience: Board Certified Emergency Physician
911Doctor and 4 other Health Specialists are ready to help you
Expert:  911Doctor replied 1 year ago.
Sir,
I have scheduled a follow up for Monday. No need to reply to this.
Best
Customer: replied 1 year ago.
Hello doctor, thank you for scheduling the follow up. Have had the report for the blood tests but nothing alarming. I have got the results but not sure what to look out for. However the doctor was surprised to see the lesion/tumour re-appear and requested the CECT scan to be done soon. The tests will be done at some point this week and the results should be back early next week. Thanks for all your help.
Expert:  911Doctor replied 1 year ago.

you are welcome.

please let me know what is found.

best

Expert:  911Doctor replied 1 year ago.
Sir,
When you have new information or new questions regarding the case we discussed (cirrhosis) please do let me know and we can resume our chat.
Best
911doc

JustAnswer in the News:

 
 
 
Ask-a-doc Web sites: If you've got a quick question, you can try to get an answer from sites that say they have various specialists on hand to give quick answers... Justanswer.com.
JustAnswer.com...has seen a spike since October in legal questions from readers about layoffs, unemployment and severance.
Web sites like justanswer.com/legal
...leave nothing to chance.
Traffic on JustAnswer rose 14 percent...and had nearly 400,000 page views in 30 days...inquiries related to stress, high blood pressure, drinking and heart pain jumped 33 percent.
Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
I will tell you that...the things you have to go through to be an Expert are quite rigorous.
 
 
 

What Customers are Saying:

 
 
 
  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
< Last | Next >
  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
  • I thank-you so much! It really helped to have this information and confirmation. We will watch her carefully and get her in for the examination and US right away if things do not improve. God bless you as well! Claudia Albuquerque, NM
  • Outstanding response time less than 6 minutes. Answered the question professionally and with a great deal of compassion. Kevin Beaverton, OR
  • Suggested diagnosis was what I hoped and will take this info to my doctor's appointment next week.
    I feel better already! Thank you.
    Elanor Tracy, CA
  • Thank you to the Physician who answered my question today. The answer was far more informative than what I got from the Physicians I saw in person for my problem. Julie Lockesburg, AR
  • You have been more help than you know. I seriously don't know what my sisters situation would be today if you had not gone above and beyond just answering my questions. John and Stefanie Tucson, AZ
  • I have been dealing with an extremely serious health crisis for over three years, and one your physicians asked me more questions, gave me more answers and encouragement than a dozen different doctors who have been treating me!! Janet V Phoenix, AZ
 
 
 

Meet The Experts:

 
 
 
  • Nurse Milli, RN

    Nurse (RN)

    Satisfied Customers:

    4043
    20 years experience in many areas of Nursing. Both Hospital and Private Practice experience.
< Last | Next >
  • http://ww2.justanswer.com/uploads/NU/nursescare4u/2013-3-31_03429_JApic.64x64.jpg Nurse Milli, RN's Avatar

    Nurse Milli, RN

    Nurse (RN)

    Satisfied Customers:

    4043
    20 years experience in many areas of Nursing. Both Hospital and Private Practice experience.
  • http://ww2.justanswer.com/uploads/agketch/2008-7-14_184046_drketchresized.jpg Dr. Ketch's Avatar

    Dr. Ketch

    Doctor

    Satisfied Customers:

    102
    Medical Degree, Former Assistant Professor at School of Medicine at Yale University
  • http://ww2.justanswer.com/uploads/FA/FamilyPhysician/2013-8-31_191624_JA550x500Photo.64x64.jpg Family Physician's Avatar

    Family Physician

    Doctor (MD)

    Satisfied Customers:

    5622
    Emergency Medicine and Family Practice for over 26 years
  • http://ww2.justanswer.com/uploads/drphophalia/2007-08-23_095626_dr._arun_phophalia.jpg Dr. Arun Phophalia's Avatar

    Dr. Arun Phophalia

    Doctor (MD)

    Satisfied Customers:

    17025
    MBBS, MS (General Surgery), Fellowship in Sports Medicine
  • http://ww2.justanswer.com/uploads/VA/VANP/2012-6-6_235535_Skye2.64x64.jpg A. Schuyler, NP's Avatar

    A. Schuyler, NP

    Nurse Practitioner

    Satisfied Customers:

    12170
    Board Certified NP, MS, RN. Private practice & hospitalist
  • http://ww2.justanswer.com/uploads/TA/tazechip/2012-6-7_135230_drpic.64x64.png Dr. Chip's Avatar

    Dr. Chip

    Doctor (MD)

    Satisfied Customers:

    10029
    Over 20 yrs of Family Practice
  • http://ww2.justanswer.com/uploads/neurosurg/2009-10-06_120923_profile.jpg Dr. Mark's Avatar

    Dr. Mark

    Doctor (MD)

    Satisfied Customers:

    6234
    U.S. Physician/Surgeon in Neurosurgery
 
 
 
Chat Now With A Health Professional
911Doctor
911Doctor
Health Professional
5094 Satisfied Customers
Board Certified Emergency Physician