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Ask Dr. Norm S. Your Own Question
Dr. Norm S.
Dr. Norm S., Doctor
Category: Medical
Satisfied Customers: 11231
Experience:  Over 30 years of experience in OB/GYN practice.
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How do I get seen detection of Heparental syndrome???

Customer Question

how do I get seen for early detection of Heparental syndrome???
Submitted: 1 year ago.
Category: Medical
Expert:  Dr. Norm S. replied 1 year ago.

Do you mean hepatorenal syndrome? Thank you.

Customer: replied 1 year ago.
my primary schedule me appt with a kidney doctor but the appt is so far out that my symptoms are getting worse. I been to the emergency rooms but they will not do the necessary checks (they send me home) . So what do I do? I think sodium is building up in my blood
Customer: replied 1 year ago.
Oh! you are OBGyn doctor??
Customer: replied 1 year ago.
hello
Expert:  Dr. Norm S. replied 1 year ago.

I'm sorry for the delay. I didn't know you had replied.

I am an OBGYN doctor.

What are your symptoms?

Why do you think sodium is building up in your blood? Thank you.

Customer: replied 1 year ago.
I feel cold on my arms and feet. I also have swelling just a little in my feet....
Expert:  Dr. Norm S. replied 1 year ago.

Do you have chronic liver disease that you know of?

Do you take any medications?

Do you have heart problems?

Customer: replied 1 year ago.
who can I talk too...it seem like with this disease you have to have full heparental syndrome and be admitted to ICU...I don't think mine is full yet but soon will be...how can I get test or look at by? The emergency rooms look at my blood work and say you are good and nuthing is wrong but I think there is more test that needs to be done
Customer: replied 1 year ago.
I use to be a heavy drinker for years....but the blood test and liver scans says my liver is fine. the symptoms of heparental is all there and the way I feel is horrible.
Customer: replied 1 year ago.
I take no medications but because of the drinking for years and I mean years that is why I have chronic liver disease. The only thing that is good I have stop drinking!
Expert:  Dr. Norm S. replied 1 year ago.

Hepatorenal syndrome occurs in people with chronic bad liver disease who then develop kidney failure.

Basic blood tests can detect if you have any kidney failure or liver problems.

I don't think you could have hepatorenal syndrome with a normal liver scan and normal blood tests.

Lots of things cause swelling and fluid retention. And many people have cold hands and feet.

I don't think you need to wait for a kidney specialist. I would recommend that you see an internal medicine doctor or a family doctor.

Customer: replied 1 year ago.
my blood pressure is low, which before it wasn't and there is a little damage to one of my valves but nuthing serious
Expert:  Dr. Norm S. replied 1 year ago.

Emergency rooms are often not very helpful except for emergencies.

Low blood pressure is usually better than high blood pressure, and is not usually a sign of disease.

Customer: replied 1 year ago.
my primary care doctor is saying nothing is wrong. Her and I have been back a forth with this issue. I have tricare so I have to wait until I am referral through her. Heparental syndrome have to types, Type 1 is a deterioration with in days or weeks...One day you are doing fine and then everything just crash
Customer: replied 1 year ago.
Ive been to four different emergency rooms, so I know they are not helpful. One symptom or indication of this disease is unstable blood pressure which drops low while standing up from sitting or lying down position.
Expert:  Dr. Norm S. replied 1 year ago.

With either type 1 or 2, you need to have chronic liver disease first. Then the types 1 or 2 relate to how quickly the kidneys fail.

As I mentioned, despite your history of heavy drinking, a liver scan and liver blood tests would detect whether you had chronic liver disease.

Blood pressure drop while standing is called orthostatic hypotension. It's fairly common and doesn't usually indicate serious disease.

There are many causes of orthostatic hypotension. Hepatorenal syndrome is way far down on the list.

Customer: replied 1 year ago.
I really do hear you and believe what you are saying ...but I have pale stool, constipation, did have muscle jerks a lot but all my muscle has wasted away, dark urine with little output, clubbing finger nails, blue fingernails, pale skin, liver feel swollen, confusion, disoriented, forgetful, cardiac function is low, small testicles, men breast and a slightly bloated stomach.
Customer: replied 1 year ago.
I saw a video on youtube where this doctor who is a Gastro doctor (Gene Lesage) gave a great presentation of the disease. In the first five minutes he talks about a 42 Hispanic man who didn't have any symptoms of liver disease the month prior, but what you would call acute liver failure or alcohol hepatitis but all of sudden he had ascites, jaundice, slightly elevated liver enyemes, and creatine was less then 400. and he died of sepsis because his heart would not pump enough to or wouldn't could pump fast enough to fight sepsis so he died.
Customer: replied 1 year ago.
I know I mess myself up by drinking for all those years but just trying to be on top of things. I just read if it's caught early and may can be reverse. But just trying to see how to go about getting the proper diagnosis ....that is the problem
Expert:  Dr. Norm S. replied 1 year ago.

I can certainly see why you are concerned about liver problems and your general health.

I would recommend an internal medicine referral, but as long as you have a referral to a kidney doctor, he/she should be able to figure out what's going on.

Acute liver failure can occur, but it doesn't sound like you have that.

Customer: replied 1 year ago.
the road to the kidney doctor I will take...my primary care doctor is internal medicine and she thinks am crazy....she do listen but I guess if it's not in black and white doctors can't react on it. I gave her that video to watch, and I did it very nice and discretely but I bet she never look at it....
Expert:  Dr. Norm S. replied 1 year ago.

Kidney failure is pretty black and white. Blood tests will show a high creatinine and low creatinine clearance.

Liver failure can be a little harder to know, but both the scan and blood tests will usually show evidence.

Customer: replied 1 year ago.
But with all those trips to the ER they said my GFR was 60 to 70 percent ....My liver enyemes was the only thing elevated a litte. and they never said anything about my creatinine levels,
Expert:  Dr. Norm S. replied 1 year ago.

GFR is usually usually calculated using blood creatinine. A GFR is somewhat low, but would need to be repeated and also have urine evaluated for protein and blood to know if there is kidney damage.

Customer: replied 1 year ago.
ok..and don't sodium comes from the kidney too if it's not damage?
Expert:  Dr. Norm S. replied 1 year ago.

The amount and concentration of sodium in the blood is regulated through the kidneys, so healthy kidneys are necessary to have a normal amount of sodium in the blood.

Customer: replied 1 year ago.
I got reduction of arterial blood volume, In cease arterial vasoditation Impaired cardiac chronotropic function, decrease in cardiac output that is why on this video it says heparental syndrome can be reverse maybe in some patients if they don't get to the point of moderate sodium retention, serve water retention hypronatremia that leads into heparental syndrome..
Expert:  Dr. Norm S. replied 1 year ago.

I'm still pretty sure that you don't have hepatorenal syndrome. I would wait and see what the doctor finds.

Customer: replied 1 year ago.
I don't have it now but it is leading into it.....I feel it...I know it sound weird but everyone knows their body....but I will go to the kidney doctor and see what she says...my appt isn't until Feb. 7 ...and that is what scares me...so far away...I was trying to be proactive to see if there is anything or anyone else to ask or go to. That is why I hit you up for advice..I only hope and pray this is just all in my head. In November when this feeling came over me and hit my body I went to my primary dr with concerns and she said "Mark you are crazy, you don't have that" so when leaving her office I said yeah! what is wrong with you putting a dreadful disease like that on you, she's right. But every time I drove out of that parking garage I fell back into my own understanding about this. I just don't know.....
Expert:  Dr. Norm S. replied 1 year ago.

You have done the most important thing, which is to stop alcohol.

There are not very good treatments for hepatorenal syndrome other than liver transplantation.