My hsb is 58 years old and has cirrhosis secondary to ETOH abuse. The first 3 months of this year he would have parencentitis with up to 12L removed Q2 weeks with transfusions of 2 units of blood approximately Q2weeks for anemia Hgb/Hct 5/15. He spent the entire month of April in hospitals after a near death experience of septic shock from bacterial peritonitis complicated with hepatic renal syndrome/acute renal failure/hypotension/anemia and profound encephalopathy. A TIPS procedure was preformed in late April which has essentially relieved the ascites and bleeding from the esophageal varices. He continued to require blood products/iron infusions and platelets Q10 days. In June during another admission we were thrown a curve with the dx of Type 2 diabetes. He requires 4 insulin injections daily with target BS 100-180.(MD's are afraid of low readings). He continued to loose blood and began recieving 2 units of blood/albumin weekly to maintain Hgb/Hct of 7/21. Since June he has had 8 EGD treatments with laser and cautery treatments with promising results. We still have to receive blood products every 2 weeks but the blood counts seem to be stabilizing. He has experienced numerous episodes of encephalopathy that require Lactulose 30ml at least TID and Xifaxin 200mg BID which works but needs to be monitored. The TIPS procedure has been grand with decreasing the ascities but the poor man has 4+ pitting edema up to his groin/takes 3 diuretics(have to be careful with elevated renal functions)and on a 2gram sodium diet with 1000ml fluid restrictions daily. After the TIPS procedure his MELD score dropped to 10 so it will be a while before transplant available. I work full time and have no family to oversee him on those "bad"days. Luckily, I can leave work and come home and check on him at lunch if indicated. I need some suggestions on low sodium, diabetic diets and ideas on how to monitor fluid consumption while I am at work. On his good days-and he has more now than he did earlier- he will drive to the grocery store and begin(not finish-HA) little tasks around the house. I live in a constant fear of what I am going to find when I come home. I am good about preparing his meals daily and he is usually pretty good about eating what I leave for him. Anyway, I am sorry to keep going on and on but what a relief to find I can talk to others that might be going through what we are. Thanks for listening.
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