Iron Deficiency Anemia

Diseases & Conditions Hepatitis
1
Hi everyone,
 
I need your input. As you recall, Gene had great lab results a week ago with one exception. His iron level was low. Normal is 22 to 300 and Gene's was 16.
 
Recently Gene has felt fatigued, short of breath, weak, extraneous movements, irritabile and lack of appetite. We assumed the symptoms were liver related. Yesterday Gene looked up iron deficiency anemia on the Internet and it described all the symptoms he has noticed recently.
 
We are puzzled as to what to do. Most likely the anemia results from his liver failing to metabolize properly but could also be from a bleed. His doctors weren't concerned but Gene feels terrible. We have an appointment to see his hemotologist/oncologist doctor tomorrow morning. When I called for an appointment with the hepatolagist in Walnut Creek we were told he was very busy and they won't schedule an appointment. They will have the doctor call us first.
 
I read about all the excellent medical care people on the forum are getting and cringe that we are locked into the Kaiser system. I'm tempted to seek outside medical help.
 
This is our problem. Treatment for iron deficiency anemia is iron. I know this is toxic to Gene's liver and causes problems with constipation and increased enephalopathy. Gene will add more red meat to his diet but this will probably not do it by itself and we know too much protein causes encephalopathy. We are darned if we do and darned if we don't but the problem can't be overlooked. Meanwhile his blood pressure is rising along with his pulse which increase his risk for bleeding varicies.
 
Your prayers are needed and we will listen to suggestions. Whatever way we go, there is risk and uncertainty. I'm scared. In some ways I'm happy it's not liver failure but there is no fast cure for anemia. Just a note, his hemoglobin, hematocryt and platelets are just slightly low. It's the iron that's the problem.
 
Love you all,
Barb

                     LIVE IN THE MOMENT!
 
                          Hugs and Prayers
                                     Barb
 
 
 
 

2

Hi Barb, I just saw your post. I'm not sure what to do about the anemia, because you are right about the iron. We are seeing a Hepatologist tomorrow. I will ask what he would do for the iron deficiency, as Mark is also anemic. Mal-nourished big time.

HUGS!!

Teresa

3

Hi Barbara,

I am sorry I can not help you out with this. But I can pray, which I will continue to do.

Love & Hugs to you BOTH!

Donajean

 

 

 

 

4
Hi Teresa, I'll be anxious to know what your hepatologist says as this is a biggie for all of us with advanced cirrhosis. the only answer they give me is unless it is bottom they don't intend to give me iron as iron is dangerous for cirrhotic patients.I have heard of people getting some short term at very late end stage but only a temporary fix. later......

Good luck tommorrow I will be praying for Mark.

"There is at least one good thing in each and every day we just have to find it and if we look hard enough we will.Somedays we just have to look a little harder than others,but its alway's there.
 
Valerie

5
Hi Barb, your right it is a catch 22But maybe Teresa can tell us more tommorrow. I hope. my thoughts & prayers are with you & gene.later....

"There is at least one good thing in each and every day we just have to find it and if we look hard enough we will.Somedays we just have to look a little harder than others,but its alway's there.
 
Valerie

6

Hi Theresa,

I'm interested in hearing what your hepatologist has to say tomorrow about the anemia and want to thank you for your much appreciated offer.

The soonest Gene can see his hepatologist is March 27 and I'm grateful that they even agreed to see us. Ironically, they only tested the iron level at Gene's insistence; the last test was a year ago.

Thanks for your hugs and prayers.

I hope Mark's visit goes well for him also.

Hugs,

Barb

                     LIVE IN THE MOMENT!
 
                          Hugs and Prayers
                                     Barb
 
 
 
 

7
Hi all -

I'll be interested also because my Dad is still taking the iron for his Anemia - even with that iron levels are low but I know this is not good for his liver - he has been taking iron for 3 months now. In the beginning of the Anemia I was making greens and spinach for our veggie - although the Dr. had said not too much of anything - to keep his diet balanced (I only make him one dinner a week now so he is in control of his diet). My Dad also uses kaiser and I was happy with the treatment he recieved in the hospital and I like his Dr. I am getting the feeling he still considers my dad a "hospice" type patient and is in a "do whatever makes you comfortable" mode - my Dad has a VERY addictive personality and he has been perscribed Vicodin for pain - the hospice nurse months ago said to stick with the motrin and the dr. told him not to take the motrin but to take the Tylenol or the Vicodin???? I was thinking the Dr. is more worried about his kidneys - hmmm....

I need to talk to the Dr. and see where he is comming from.


Hugs and prayers too all of you - here's to good test results!!
8

Hi, Barb!  Since the hem-onc must know of Gene's liver problems, he should be able to make a suggestion regarding the iron.  The only time I ran into this was about 2 1/2 years ago (prior to liver cancer, but positive for chronic active hep C) when I was post surgery for rt. hip replacement.  The surgeon said my iron was low and they were putting me on iron pills.   eyes    I was alarmed, as I knew this would be bad for my liver, but when I expressed my concern I was told that it would be short-term...for about 10 days.  I don't recall what my iron has been lately, but it must be okay or I would have noticed on the printouts.  I am not a red-meat eater and seldom eat leafy greens.  It could be that anemia is not the cause of Gene's symptoms, though maybe a contributing factor.

Do let us know what you find out, and our prayers are with you both.

Connie


Post Edited (hep93) : 3/9/2006 5:37:34 PM (GMT-7)

9
Hi Connie, thanyou for the info on the ironI have often wondered about you & iron. I guess iron has an effect on all liver diseases it seems. Is malnutrition as big of a problem for your condition as it is for advanced cirrhosis? Sounds like eating is a balancing act for you too, is it? I don't know much about liver cancer exceptwhat I have learned from you. I guess i should do some research on it too. How is your hip doing? You are absolutely right about Genes symptoms. They probably are cirrhotic symptoms & as always with cirrhosis malnutrition is a contributing facter. That seems to always be a biggie with cirrhosis. Hope all is going well for you Connie. My thoughts & prayers are with you all. later....

"There is at least one good thing in each and every day we just have to find it and if we look hard enough we will.Somedays we just have to look a little harder than others,but its alway's there.
 
Valerie

10
Lerie, I have no restrictions on my diet. I avoid extra iron as I know from hep C forums that iron can be toxic to hepatic livers. Out of common sense, I watch my sodium intake. I do have hypertension that is controlled well on 2 meds. I know I don't eat enough fresh fruits, although I eat canned or in the little cups that are out now. I could improve a lot when it comes to vegetable intake. I don't cook now, though, and frozen dinners tend to have either starches or broccoli. I was eating a lot of salads last summer, but with dental work I've had they are now difficult to chew. I try to have some sliced fresh tomatoes a couple of times a week. I haven't had anything said to me regarding nutrition as it relates to cancer, except for one oncologist stating that I looked to have good nutrition. I know that is stressed for those cancer patients who are going through chemo or are end-stage and have no appetite. For now, that's not a problem for me.

Lerie, are you having a bad day or just have nothing to say today? I know you usually have input in every thread. My thoughts are with you.

Connie
11
Hi Connie, just having a really off day. my liver hurts & I just feel a little unwell. Nothing serious. Aren't you enjoying the peace & quiet for a change? lol.I wish cirrhosis had no restrictions. we always have to be so carefull to protect liver function,keep progression slowed & prevent complications.In addition the to the cirrhosis preventing the liver from breaking much down anymoreor filtering toxins from everything we take in & that which are in the body. Oh Well can you do? I'm glad tho that you don't have those restrictions & are there for able to keep yourself better nourished. How's your cold? better I pray.My thoughts & prayers are with you.Love & Hugs. later...

"There is at least one good thing in each and every day we just have to find it and if we look hard enough we will.Somedays we just have to look a little harder than others,but its alway's there.
 
Valerie

12

Hi Everyone,

Here's an update on Gene's visit with the oncologist/hematologist.

The visit with Dr. Kleckner went okay; I just don't trust his judgment completely. He walked in the door and said, "See, Hospice was right, you weren't dying last January." Then he produced a printout of Gene's ammonia reading the past few years and said you've dropped from 185 last April to 78 and your liver is improving. Your lab results are great except for one thing, your iron levels are low and you need to take iron daily." Then he told Gene he would feel better if he lost weight. He doesn't have a clue that the weight gain is fluid and Gene needs all the nourishment he can get down. We worked hard to get him out of the malnourished range.

Dr. Kleckner went on to say our life was like living beside a volcano about to erupt again so he could understand my anxiety. He said I was like the birds who sense an earthquake before it happens and that Gene was alive today because of me.

But he really doesn't understand liver function well and couldn't answer any of our questions.

We were told that Gene probably has a slow bleed somewhere; either from his varicies, ulcer, cancer, etc., but that it wasn't worth the risks to try and find the cause as there was nothing we could do about it in Gene's condition.

He explained that when there is a blood loss or depletion of iron, it first comes out of the bone marrow and only later does hemoglobin drop. So hopefully we can replenish the iron and not have to take it for a long time.

Hopefully the hepatologist later this month will have more specific information on ramifications of treatment or alternate options.

Gene is not going on a diet. We've worked too long and hard to get his albumin levels back into the normal range. His liver does not metabolize food properly so we cannot decrease calories or cut out meals. His weight has stabilized with minimal diuretics. And we will settle for that.

Now I'll get off my soap box.

Love you all,

Barb

                     LIVE IN THE MOMENT!
 
                          Hugs and Prayers
                                     Barb
 
 
 
 

13
hi Barb, Quite frankly I dont trust this jokers judjement either! have you considered obtaining a new hepatologist? A good hepatologist is critical.Did the idiot say how much iron or for how long? Cirrhotic patients are very complicated cases & everything varies in amounts & stages with each stage being differant as the liver deteriates. Gene may be very stable at the moment but cirrhosis does not get better.Look for a new hepatologist hon & use extreme caution what you give him.My thoughts & prayers are with you both. later....

"There is at least one good thing in each and every day we just have to find it and if we look hard enough we will.Somedays we just have to look a little harder than others,but its alway's there.
 
Valerie

14

Hi Barb,

Today started at 6:30 this morning and has been busy since. The hepatologist says, there are 2 options to iron deficiency. The first is iron supplements and close monitoring on a short term bases for END STAGE CIRRHOSIS. The other is transfusion. I can understand you being upset with the oncologist/hematologist. I am glad you have an appointment with the hepatologist as he is the one who will be able, to answer your questions. I really feel it is always best to consult your hepatologist before adding any supplements, as they are the specialist in liver disease. Everyone is different in their needs with liver disease. The weight gain in cirrhotic patients is most often fluid, I would not put him on any type of diet unless it is advise by a hepatologist, Mal-Nutrition happens to be a serious complication of cirrhosis. It can not be taken lightly!!! I don't blame you at all for not putting Gene on a diet!!! about the only given in end-stage cirrhosis is sodium restricted diets. The amount should be determined by your doctor. I do hope you and Gene have a better day tomorrow! My Prayers are with You and Gene!!!

HUGS

Teresa

15
Hi teresa well put,good luck again tommorrow when you go back.Once again everybody PLEASE always check with your HEPATOLOGIST before doing anything with diet, vitamins,herbs,or medications . Your Life could depend on it or the life of your loved one! Cirrhosis is serious buisness & you can not live without your liver .Only your hepatologist can tell you what's best for YOU & help you slow progression down. My thoughts & prayers are with you all & your families. Love & hugs. later...
 
 
teresa sodium intake is generally started on restriction when edema starts to set in. I was sodium restricted (tho not as severely as now) 7 years before I went into liver failure. nobody knew about my liver at least the quack I was seeing at that time never told me I had liver disease toll after my first comma. The onset of acetis did not appear for several years after the edema. So in some cases a physician or hepatologist may advise sodium restriction to a point before end stage. But again only YOUR HEPATOLOGIST
 
 
 can say for sure.At least the quack knew what to do for edema.later....

"There is at least one good thing in each and every day we just have to find it and if we look hard enough we will.Somedays we just have to look a little harder than others,but its alway's there.
 
Valerie

Post Edited (lerie) : 3/9/2006 9:12:19 PM (GMT-7)

16
Barb, I agree that you shouldn't put Gene on a diet. Did you tell the heme-onc that it was edema? Geez, wouldn't you think he would know? My oncologist palpated my liver and went to my legs, saying I have edema in my thighs, as well as my feet and calves. I don't see it or feel it, but I do trust him. I have to say that since getting the laptop computer, I am not feeling a need for the TEDS. There is some edema, but nothing like what I was having sitting at this desktop p.c. for too many hours.

Reading your posts, I started thinking that I should have a hepatologist at Mayo...then remembered that I did meet with one once, to discuss the TheraSphere and get her input about it, as well as her evaluation of me as a recipient of the treatment. It was she eho asked about my nutritional status. I've been meaning to give her a call about the treatment to see if she knows something the others may not, as to when it might begin.

Lerie, I missed you today. Glad you were only feeling a little "off." I expect to start feeling better now that I'm taking Levaquin.

Connie
17
Thanks Connie, I always miss you too when i don't hear from you too. I also worry about you a great deal.Maybe it would be a good idea to give her a call.I'm glad your laptop is helping you to keep your feet up. That thing was heaven sent for you.I hope you get feeling better really soon sweetie. Take good care of yourself . Love & Hugs. My thoughts & prayers are with you always. later....

"There is at least one good thing in each and every day we just have to find it and if we look hard enough we will.Somedays we just have to look a little harder than others,but its alway's there.
 
Valerie

18

Valerie,

I was talking about sodium restricted diets being a given in end-stage cirrhosis. I am aware of sodium restricted diets with the presentation of edema also. I was addressing the end-stage. You are so right about checking with your Dr. as he is the expert.

Hugs
Teresa