Shelly, need your advice

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Mischa
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Date Joined Mar 2008
Total Posts : 47
   Posted 4/18/2008 6:53 AM (GMT -7)   
My husband has the inguinial hernia that has descended to his scrotum. Before it started its descent, it would be uncomfortable and hurt if he moved around to much but he would relax and it would stop. Here lately it has been interferring with his bowel movements ( see "Update")
Lastnight it we extremely distended and had dropped further. The dr had told him as long as he could push it back up he was ok. Well he pushed it back in because he hasnt had a bowel movement and it seems like it was clogged there at the hernia. This morning he cannot have a bowel movement it is very firm in that section of intestines whereas before it was always soft and malleable. I have a call into the transplant nurse ( not sure if we have to go thru them for everything or not) but they are in a meeting until 9:30 and my husband is getting scared. He is wondering if pushing the hernia back up in place while he is laying down could have twisted that section of intestine causing him to be unable to have a bowel movement?
Therese

1Shelly1
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Date Joined Oct 2007
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   Posted 4/18/2008 11:53 AM (GMT -7)   
Mischa, I hope that the transplant nurse has called you back by now. This could be a serious problem as the hernia may be blocking any movement in th eintestine. If the nurse has not called you back please call again and tell them that this is an emergency and you need to speak to her STAT. If she still doesn't call back within a few minutes call the transplant Dr STAT.

 Shelly
 

“Life is not the way it's supposed to be. It's the way it is. The way you cope with it is what makes the difference."

 


exhaused
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Date Joined Nov 2007
Total Posts : 445
   Posted 4/18/2008 9:47 PM (GMT -7)   

Micha  I hope your husband has seen a Dr. by now.  My husband had a similar problem with his hernia.  The first few times it came out I had to take him to the ER.  They really had trouble getting it back in.  Also it was very painful.  Now if it pops out we can usually get it back in.  But they did tell us if we couldn't get it back in to go to the ER ASAP.  I hope all is well.  Please let us know.

 

JoAnn


lavendar
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Date Joined Nov 2007
Total Posts : 450
   Posted 4/19/2008 1:12 AM (GMT -7)   
Just wondering why they can't have surgery? Is it because of the extent of the disease.

exhaused
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Date Joined Nov 2007
Total Posts : 445
   Posted 4/19/2008 8:29 PM (GMT -7)   

June17  We were told early on by Jerry's gastro Dr. that his liver could not handle anathesia(to lazy to look up spelling).  I guess when they put you under they use a lot and its very dangerous.  I'm sure Shelly can explain it better.  I don't seem to have much of a brain these days.  I wish there was pill to charge up my brain!!

 

JoAnn


Mischa
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Date Joined Mar 2008
Total Posts : 47
   Posted 4/19/2008 9:29 PM (GMT -7)   
Sorry to leave ya'll hanging, lastnight was a rough one.
Bk finally had a bowel movement ( cowpatty) at about 11 lastnight, good thing too, that portion of his intestines that is protruding thru the hernia has become very very firm. I was advised by the transplant nurse to have him drink a bottle of Magnesium Citrate to see if that moves him. Well, 8 hours later he finally moves a little, cowpatty. He hasnt gone since then, I plan on having him drink another botlle of the stuff tomorrow if he hasnt moved well.That portion of the intestines has dropped into his scrotum and really has the skin stretched taunt with the contents very firm. I know it sounds disgusting and I am trying not to be to graphic while still getting the thought across. I just dont know what else to do. Unless it becomes discolored, extremely painful or unable to push it back in they will not do anything about it until after the liver transplant ( if he gets one). Another issue with all of this, he isnt eliminating waste so the ammonias are building also.
When the nurse called me I asked her about him getting listed, she said that it had been to committee that morning and that besides a few labs that were not issue, the only thing holding him up from getting listed is the heart cath results on tuesday and they want him to see a transplant psychiatrist. lol I feel sorry for the poor psyc, he is good at reversing things, but I told him he will have to behave this time .
Therese

lavendar
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Date Joined Nov 2007
Total Posts : 450
   Posted 4/20/2008 3:23 AM (GMT -7)   
Well I'm still alive after getting anesthesia for surgery on my foot. The podiotrist read all my info and talked with the anithiseologist. They both told me minimal anestisia is given and it would not affect the liver in any way. Surgery took about two hours. But I am healing well. What would I do if I get a liver transplant and can't walk. It will be a real waste. Best to give it to someone else. Anyway I am going in for surgery on my other foot in about a week. Then I will go to an otho. for my knees and back. ((I'm a mess)). When I was eveluated for transplant they told me NO SURGERY THAT IS NOT LIFE THREATENING. When I went in March they said I was stable and could go ahead an get a few of my other problems taken care of. ( GUESS YOU COULD SAY I GETTING AN OVERHAUL) . I have a question for anyone, may sound stupid but I'd like to know if there is any pain involved in the liver. So far I guess my prayers are being answered. At present time with lactulose and diet I am not as bad as others. Only brain fog , slurred speach. fear of sleeping at night because I sleep walk and I'm afraid I may go out or do something insaine when no one is awake to keep an eye on me.

frustrated_n_wv
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Date Joined Aug 2006
Total Posts : 469
   Posted 4/20/2008 3:45 AM (GMT -7)   
June

I am so glad that your foot surgery went well. We all need an overhaul everyonce in a while I think at least. I sometimes have pain on my right side under my ribs in that area where my liver is located. At times it is a dull ache or soreness and at times depending on how I am sitting or laying it can become more intense. I have also noticed that when the fluid retention is accumulating this becomes worse. I see my hepatologist in 2 weeks so that was one of my many questions I have written down for me. Will let you know if he says anything specific to help with that problem.

Hope you have a wonderful day.

Lucy

1Shelly1
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Date Joined Oct 2007
Total Posts : 502
   Posted 4/20/2008 5:42 AM (GMT -7)   
Mischa, I am curious why they can't give him some Versed and then manipulate the hernia back up. He has to be able to move his bowels or he will encounter more serious problems. I know that you gave mag citrate but he may need to eat prunes on a daily basis too to keep the stool soft. I would definately persue manipulation of the hernia at least. The poor guy must be severly uncomfortable.
As for the use of anesthesia-although it's a little complicated to explain I'll say that it is very difficult for liver disease patients to rid the body of anesthesia. There are possible complications for anyone (healthy people) to have surgery and anesthesia. Add to that risk that the individual has liver disease and as you know darn near every medication is processed thru the liver the potential for additional complications rises. However; surgery is still done on many liver patients and has to be decided by the primary Dr if the patient can tolerate it or not. They also evaluate the condition of the patient overall in determining if it can be tolerated so there are many factors involved.

JoAnn- yes..........the liver is an organ and you can most certainly have pain in the liver and surrounding tissues. Some complain of right sided pain that radiates to their back, others have specific liver pain only on the right side. It depends on the degree of damage, pain thresholds, edema (swelling), and many other factors. But bottom line is yes the liver can be in pain.
 Shelly
 

“Life is not the way it's supposed to be. It's the way it is. The way you cope with it is what makes the difference."

 


Mischa
Regular Member


Date Joined Mar 2008
Total Posts : 47
   Posted 4/20/2008 6:17 AM (GMT -7)   
Shelly, We can push the hernia back in, but as soon as we take our hands off of it it is right back out. He cant strain while having a bm, it pushs the hernia out and he can actually feel the matter moving thru, or trying to. They are going to have to do something, pain or not, this is becoming very seriously. He has elimination waste building up in that section and it is turning bad, you can tell by the gas that he passes, he usually is pretty odorless but since this started whew it would make a dog proud.
Therese

exhaused
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Date Joined Nov 2007
Total Posts : 445
   Posted 4/20/2008 8:17 AM (GMT -7)   

Mischa  I just wanted to let you know that Jerry has had constipation problems also at times.  Even while taking his lactalose.  We started squeezing grapefruits and mixing the lactalose with the fresh squeezed grapefruit juice.  Made a big deferance.  I don't know that it would work for your husband but its worth a try.  We got the grapefruits at Sams and you can get a lot of juice out of one grapefruit.  Hope this helps.

JoAnn


exhaused
Regular Member


Date Joined Nov 2007
Total Posts : 445
   Posted 4/20/2008 8:18 AM (GMT -7)   

Shelly  Can you believe that Dr. told me that. I knew that didn't sound right.  Thanks

JoAnn


1Shelly1
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Date Joined Oct 2007
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   Posted 4/20/2008 1:21 PM (GMT -7)   
JoAnn, I must hawve missed something...the Dr told you what?
 Shelly
 

“Life is not the way it's supposed to be. It's the way it is. The way you cope with it is what makes the difference."

 


1Shelly1
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Date Joined Oct 2007
Total Posts : 502
   Posted 4/20/2008 1:35 PM (GMT -7)   
Mischa, I have a suggestion and it is only a suggestion. Why not schedule an appointment for him to see his Dr and request that surgery be done. Ask them to consult an anesthesiologist with you and your husband present to evaluate him for surgery. If they decide not to do it then it is probably because he is too high a risk. Then ask about a Truss. I can't think of any other alternative right now.
 Shelly
 

“Life is not the way it's supposed to be. It's the way it is. The way you cope with it is what makes the difference."

 


exhaused
Regular Member


Date Joined Nov 2007
Total Posts : 445
   Posted 4/20/2008 2:09 PM (GMT -7)   

Shelly  I pretty sure I have lost my mind.  What I meant is the Dr told me there is NO pain with cirrhosis!  That is the honest truth.  I remember thinking that can't be possible.  Isn't that crazy.

JoAn

 

 


Mischa
Regular Member


Date Joined Mar 2008
Total Posts : 47
   Posted 4/20/2008 3:53 PM (GMT -7)   
We got him a truss a couple of weeks ago shelly, all the hernia did was drop down his scrotum instead of staying inside like it was supposed to. We did ask his dr here ( internal medicine) about surgery, darn near demanded it. He called over to the hospital and the surgeon refused saying they did not have a pulminary anesthesiologist specialist and his lungs were to bad. He has already had the pulminary study and his lungs are great, in fact the nurse was suprised his lungs were in such good shape since he had been smoking off and on most of his life. The dr's at the transplant hospital flat out said they will not operate until the transplant unless it is an absolute emergency. We go for his heart cath tuesday, maybe we will get out of day surgery early enough tot go upstairs to his transplant team and show them how much it has grown and how bad it has become.
Thanks for th eadvice tho :) I have him drinking lots of apple juice :)
Therese

1Shelly1
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Date Joined Oct 2007
Total Posts : 502
   Posted 4/20/2008 4:00 PM (GMT -7)   
JoAnn, the liver itself rarely causes pain BUT..................when the liver is acutely inflammed, irritated, and swollen the surface of the liver is painful to people. They often say that they have pain just slightly above where the liver is located. Medically it's described as "Right upper quadrant pain" which simply describes the location not the cause. Between the swelling and the irritation the pain increases as the symptoms become worse. In people with Hepatocellular Cancer the pain is often increased significantly as the cancer progresses. Normally, in stage 3 of liver disease patients really start complaining of pain and in some patients it is almost intolerable. It varies of course depending on several factors as I mentioned earlier. As the liver thickens from chirrosis it becomes more inflammed and swollen thus causing more pain. There are also other causes of the pain that may or maynot be related to liver disease such as gallstones. peptic ulcers and other things. I personnaly think alot of hep patients with chirrosis have infections and need antibiotics. Usually I've noticed that with antibiotic treatment many of them have decreased pain and more stamina.  Maybe I can use a little analogy, if I cut my finger then I will pain right? Is it the finger that hurts or the cut on the finger that hurts? It's the cut that caused the pain and not the finger itself. The finger is the location but the finger didn't hurt me the cut did. Does that make sense? Hope this helps a little to understand what is causing the pain.
 Shelly
 

“Life is not the way it's supposed to be. It's the way it is. The way you cope with it is what makes the difference."

 


exhaused
Regular Member


Date Joined Nov 2007
Total Posts : 445
   Posted 4/20/2008 5:52 PM (GMT -7)   

Shelly   Thanks for the explaination.  That is exactly where it hurts him.  Its been coming and going for some time.  Did I tell you the Dr. told Jerry that only about 15% of his liver is functioning.  He said maybe less.  So I'm just waiting for the day that his MELD score just jumps up.  I have mixed emotions about that.  The higher his MELD score the sicker he will become.  The sicker he becomes the sooner he will need a transplant.  That is if there is a liver available!  I'm sure you understant my fear.  Thanks again.

 

JoAnn


1Shelly1
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Date Joined Oct 2007
Total Posts : 502
   Posted 4/20/2008 9:44 PM (GMT -7)   
JoAnn, I do understand your fear and your frustration. I wish I had some magic words that would make you feel better but I don't. Just continue to pursue every avenue available to him and keep the Dr's honest. You are doing a great job with your caregiving and you know the rule..................NEVER GIVE UP!

 Shelly
 

“Life is not the way it's supposed to be. It's the way it is. The way you cope with it is what makes the difference."

 


lavendar
Regular Member


Date Joined Nov 2007
Total Posts : 450
   Posted 4/21/2008 12:48 AM (GMT -7)   
Joann ; How could the DR. tell how much of Jerry's liver was functioing. I've never been given a percentage. I was only told that according to the biopsy that I was at End Stage 4 of 4. Could that be the reason they told me I could make a turn for the worst in a matter of 48 hours. Fortunately (thank god) I have been relatively well. june

4boys4me
New Member


Date Joined Jan 2008
Total Posts : 10
   Posted 4/21/2008 2:09 PM (GMT -7)   

My dad has had a similar hernia for several months now and they won't fix it.  The specialist here said that they won't fix it for several reasons:

1.  Risk of infection
2.  Risk of serious bleeding complications during surgery
3.  When his ascites returns, like it always does, the repaired hernia is likely to come out again, or he will get another one.

The doctor explained that #3 is the most common occurance.  He said the only way they would fix the hernia is if he was in servere pain, or it was causing other complications.

 


4boys4me


1Shelly1
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Date Joined Oct 2007
Total Posts : 502
   Posted 4/21/2008 3:18 PM (GMT -7)   
Good post on the hernia. Sounds very logical but in Mischa's husbands case he is having some severe bowel problems. His Dr thinks he is at high risk for surgery. I really hope they can work something out for the poor guy. It sounds like he is miserable with the hernia.

 Shelly
 

“Life is not the way it's supposed to be. It's the way it is. The way you cope with it is what makes the difference."

 

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