Hello Arlene , Sorry I hadn't responded sooner but kinda hectic around here lately . Most doctors are and should be hesitant about
throwing TIPS on the table as a option for fluid issues . It's best to reserve the surgery for a last resort as most ascites can be controlled by combinations of diuretics and diet . When you consider a person with a compromised immune system has little defense against infections and surgery
opens that door widely , it pays to consider other options first .
I had chronic ascites and not only was diuretics not working I believe it caused bad reactions a few times . My G.I doctor who came highly recommended at the time firmly was against TIPS . So much so that after 8 months of agonizing with bi-weekly visits to outpatient for paracentesis procedures he still refused to consider TIPS . Mean time my Hepatologist stepped in and did the surgery at my request . The volume of paracentesis being done was exposing me to the same risk factors as the TIPS surgery .
Risk factors involved with TIPS are to be weighed heavily . It is a temporary solution to a long term problem , It's for relief and a chance for the body to recuperate hopefully so you can survive transplant . Should the TIPS not function correctly once done , There is a high risk of severe encephalopathy . Once done it can't be corrected or removed and transplant will be only option . The surgery in itself poses risk that include nicking internals while telescoping the shunt into place , It's precisely placed in a position to allow a maximum amount of fluid flow and a fraction off in any direction renders it useless . TIPs statistics suggest it has a good success rate and most patients don't see issues until roughly four years after , Then a loss of flow due to clogging may become a problem . This is corrected by cleaning the stint out surgically . It's not uncommon for some folks to exceed 12 years before problems .
I am on my fourth year and as of a few weeks ago there are no signs of failure reported by my Hepatologist . I don't regret the decision to have the surgery and given the situation I was in it was a " no brainer " . My doctors explained the risk and benefits and summed it up with a sentence that's stuck with me " It's about quality of life not quantity " . Sorry you all are going through this and my best to you and the family .
" Never try to teach a pig to sing , It wastes your time and annoys the pig . "