Dear Dr McDougall,
Thank-you for all that you do which has influenced me enormously as someone who was diagnosed with Kidney Cancer 4 years ago. I never had the surgery recommended by the 6 surgeons I'd consulted with and this is in a large part to do with your work and those of others in your field.
Im emailing you regarding my mother who has liver cirrhosis which is decompensated, she has ascites and had one episode of Spontaneous Bacterial Peritonitis. I've tried to change her diet, which she largely has. Almost entirely plant based and relatively low fat, though she will indulge in some 'treats' which have a higher ratio of fat. She has unfortunately continued to decline having lost a remarkable amount of weight. She doesn't eat so much, has been prescribed high protein drinks (also high in fat) by the doctors to slow down muscular atrophy which she feels obliged to have. It's hard for me to prevent her having these now. For a long time she did, though her condition hasn't improved.
Her cirrhosis is presumed to be NAFLD. Recently I pushed for her to have be checked for hepatitis. The doctors at the hospital said she didn't have it.
Her hepatitis surface B antigen was negative.
Hepatitis B core antibody was indeterminate.
I thought this might warrant further investigation but I've been told there is nothing to treat here.
Do you have any thoughts / recommendations for someone in my mother's position?
She is the rock of our small humble family, without her we are lost. She's always been a charitable and loving member of society, it seems desperately unfair the suffering she is experiencing.
Any recommendation / suggestion you have will be greatly appreciated.
I understand you are busy, I'm grateful for any reply. I attach her latest blood results below in case it may be of interest.
Many Thanks and best wishes,
Lokesh
Report No.
J,17.5305950.N
Collected Date
18-May-2017 15:55
Received Date
18-May-2017 17:37
Title
Full blood Count FBC / Clotting Screen / Liver Function Test / Urea & Electrolytes
Clinical Details
cirrhosis
Sample Type
Sample Comment
Full blood Count FBC
Result
Value
Units
Ref. Range
Result Comment
Haemoglobin
91
g/L
115-160
White cell count
23.16
10*9/L
4.00-11.00
Platelets
217
10*9/L
150-400
Mean cell volume MCV
93
fl
78-100
Packed cell volume
0.27
0.37-0.47
Red cell count RBC
2.92
10*12/L
3.80-5.80
Mean corpusc Hb MCH
31.2
pg
27.0-32.0
RBC dist. width
15.5
11.5-15.0
Neutrophil count
6.83
10*9/L
2.00-7.50
Lymphocyte count
15.39
10*9/L
1.00-4.50
Monocyte count
0.72
10*9/L
0.20-0.80
Eosinophil count
0.24
10*9/L
0.04-0.40
Basophil count
0.00
10*9/L
<0.10
Large unstained cell
0.00
10*9/L
<0.60
% Hypochromic cells
1
%
Set Comment:
Clotting Screen
Result
Value
Units
Ref. Range
Result Comment
Prothrombin time
12
s
9-14
INR
1.1
Derived Fibrinogen
>4.5
g/L
1.6-5.9
APTT
29.9
s
23.5-37.5
APTT Ratio
1.0
0.8-1.2
Set Comment:
High Fibrinogen results may indicate inflammatory response and are not reflective of any specific pathology.
Liver Function Test
Result
Value
Units
Ref. Range
Result Comment
Bilirubin
30
umol/L
2-21
ALT
32
iu/L
<40
Albumin
30
g/L
35-50
Alk Phos
209
iu/L
30-130
Set Comment:
Urea & Electrolytes
Result
Value
Units
Ref. Range
Result Comment
Sodium
126
mmol/L
133-146
Potassium
3.6
mmol/L
3.5-5.3
Urea
18.3
mmol/L
2.5-7.8
Creatinine
108
umol/L
49-90
eGFR
42
mL/min/1.73m2
Hepatitis B surface antigen : Not detected
Hepatitis B core antibody : Indeterminate
Hepatitis C antibody : Not detected
Meaning she may have been exposed to Hepatitis B in the past, but she doesn’t have it.
Kind regards
Description: Description: Description: Leeds Liver Unit v small
Anna Crosswaite
CLINICAL NURSE SPECIALIST
Level 3 Bexley Wing | St James’s Hospital [email protected]
