Welcome! I too went through a smilar situation...wanting more info in order to make an informed decision. In August 2010 my liver specialist wanted me to have the TIPS procedure for my ascities & portal hypertension. I did not have the procedure then for various reasons, but I will be having it soon...(I now really have no choice). I have read and heard pros and cons...but you have to look at quality of life and the reason why they are doing the procedure. I have to have the TIPS due to lung collasping, portal hypertension,hernias,ascities,quality of life. I will let you know how it goes. They perform 60 TIPS per year at Loma Linda and their success ratio is 75%-90% based on blood pressure,heart rate and pluse during the procedure. I hope this helps, please let me know.
God Bless you
Smili

I think you will find a combination of both. You can search all previous discussion on TIPS-there is a search bar at the top of the page.

It is a difficult decision and there are pros and cons.

We had TIPS in July and not knowing a thing about HE. Then we had several TOUGH spells with HE untill we learned what caused it and how to control/prevent it. Our MELD score went from 15 to 3. Everything actually looks good. For someone who needs a liver, we almost dont need a liver. We've increased muscle mass, activity levels, clarity of mind and optimism. We really are not a candidate for liver transplant due to cancer problems, so we are not sure we will really ever get on the list. We are delighted with the TIPS. We've read that it is normal for the shunt to be readjusted within the first 3 or 4 months of placement, but we haven't had any issues. No more ascites or hypertension portal issues. Just MILITANT about our diet and salt intake. No more HE.

To Smili: I hear ya, partner. My husband makes the same valid quality-of-life argument. He's had 21 tappings. 1 esophageal bleed. Hernia operation. And, as I said, 3 HE hospital stays. He wants SOME sense of normalcy. We are low sodium, lots of bedrest, good diet, etc. We are doing our part. Maybe TIPS is the ticket. I'll keep you posted. AND keep me posted on your fight. Thank you so much for responding.

To kacc: You are right. Every case is different. I'm just looking for anything that can help me better understand. I'll check out the "search" bar. Thanks.

To Rfalqout: Thanks for the information. My husband is pretty set on getting the procedure and your post really made me feel better. (AND I love the use of the plural pronoun. WE are all certainly in this battle together.) I was most unclear about the HE post-procedure. Had it in my head that we take the permanent train to Confusionland. That could be the case, I guess. But it's apparently not an absolute. Thanks, again.

To all: I have read my husband all of your responses. HE (Ha! guess I should lower case) He is very appreciative. Back to the hepatologist April 27 for more evaluation. I'll take your helpful words with me. I can't express how thankful I am for your time.

Getting ready for procedure - I am being transfused with platelets as they are down to 10 and my WBC is down to 1.39. This could be a problem, but I have no choice. I should return after 4pm God wiling. I am now receiving an antibotic while they are waiting for more platelets. Getting a headache and really tired so until I write again. See you in the funny papers. (My grandmother used to say this - don't ask me what it means I just like it).

My husband was diagnosed in Oct 2009. He had refractory acites and varies (banded but no bleeds). The past 6 months he's been tapped every 10 days. (He has other health issues such as congestive heart failure). Never had HE prior to getting TIPS on Mar 7 but has been in and out of the hospital since getting it. We're hoping it's a matter of his body adjusting.

Smili: I hope that all is going well with you. I'm thinking of you. And smiling about thinking of "seeing you in the funny papers." I, too, don't know what that means....but it sure has a fun ring to it.

Letsdance: I'm really curious about your issues. HE a new monster? (bless your heart)....I hope that you are getting it under control. Keep that lactulose going. Flush out the ugly! Go to the mattresses! Wondering about the "in and out of the hospital" comment. HE returns quickly? HE returns with no warning? I'll will be watching for your posts. I can't tell you how much your time means to me. Thanks.

Had my procedure and my old friend is back - itching. Wow I had forgotten what that was like. I have started taking Lactulose again for the itching and HE. I am dizzy and my head feels like it is swimming. I have lose 20 lbs of fluid, what a relief, but my right lung is still collapsed. Tomorrow is my Dr.s appointment and I need an xray and blood work prior to the appointment. Dr.s looking for a good result with my lung after putting me back on diuretics (I stopped taking them in November of last year due to kidney problems). I am on a very low dose and they appear to be working. We shall see tomorrow. I have not been interested in reading, watching tv, the computer, etc. I just sit and rest. Not like me at all as I love all of the above. Not sure what is going on.

Hey Smili! Glad to read that you are back. Sorry about the itching. Hopefully, that too shall pass. How long were you in the hospital? I was actually pretty surprised to read a post from you this soon. And to your getting on the computer and typing!? I think that that is amazing. You can focus well enough to compose and type? Your abilities already are definitely different from what I expected. But I'm glad you are doing well. Very glad. Keep me / us posted on your progress. Thanks!

It can be a challenge trying to type as I am laying down. My HE is worse and I was not taking enough Lactulose. I was only taking it once per day and after my husband called my coordinator when I slept for 29 hrs she told him that we needed to get the ammonia out. I am now taking kristalose (diabetic) 3 times per day. Hopefully this will help. I entered the hospital in Yuma on 4/6/11 was transported by plane to Loma Linda. My procedure was on 4/13 and I was released on 4/15 5 p.m. Swelling of the feet started immediately. Sleeping and tired started slowly, but by 4/19 late morning I was too tired to stay awake and having crazy dreams that I believe were real. I am trying to write things down because I am having difficulty keeping it straight. I have always had an excellent memory, so this is new for me. My portal hypertension appears to be completely gone and I do have chest pains every now and again, but that is really one huge relief, the other that comes with the procedure I'm still not sure if I could have been a better patient taking my diuretics and kristalose more often. Then I remember that my body did not tolerate the diuretics and that is why they wanted me to have the TIPS procedure. I was having renal issues with severe pain. I could control the swelling in the feet, pain in the kidneys with jamaica, but not the ascities which of course caused the lung problem. So where am I in the process,,, not sure as of yet. I still have a collapsed right lung that needs to be taken care of, HE and that appears to be on going. After I meet with the Dr. hopefully I will have a plan of action. I am trying to read this and certainly hope that I made sense. God Bless you.

Smili,
What is your itching caused from? The Portal Hypertension?? I'm having itching right now a day after I was given a Vit B12 injection, my chest is itchy and my kidneys hurt! My liver was burning terribly after I was given the injection. I just wonder what ingredients were in the Methylcobalamine that they gave me. I'm having allergic reactions to many things, like food especially! I'm so scared and don't want to go to the ER or have anyone give me Benadryl. From what I've read here that stuff is a no no for people with Liver Disease. What can I do? My doctor's won't do a liver biopsy on me and how convenient for them all! And unfortunate for me that my stupid doctor's botched things up, after the gall bladder was removed and the sphincter of oddi was cut, they just justified as those problems. The SOD wasn't the problem and I have gotten worse since the surgery. Gee you would think I would gotten better!

Smili, God love you for taking the time to respond to me / us when you are dealing with so much. But you seem like my kind of woman: Gotta keep going. Gotta keep going. Again, I am reassured by your capacity to type / record / share given the HE. You are one stonge-willed cookie. I know in my heart that you will conquer the beast. I am looking forward to hearing more and more good reports from you. You are in my thoughts.

have had one for about 6 yrs. works,change in diet is very helpful .

Thanks, Shannon. Good to know that TIPS does work because we are a "go." Just back from meeting with the hepatologist who says what all say here. No more ascites. No varices. More HE (but manageable). We're gearing up. We've dealt with HE before. Our eyes are open. If we have to work through that again in order to have husband have a more normal life, we are in. I will keep all posted. Won't happen until end of May or first of June. Thanks for all of the posts.

Went to the Dr. on Monday the TIPS worked as it should according to my Dr. he is very pleased and I have lost over 20 lbs, but I am so tired and still itching. On diuretics very low dose and still taking Kristalose. I started on Xifaxan again yesterday. No ascities, but the varices in my tummy is still there. I still have the hernia and the only problem with that is it may become incarcerated and then we will have a new problem to deal with. In the next couple of weeks I should get my strength back and my quality of life should be better once again.

Shannon I am a diabetic watch my sugar and salt intake. What else should I change? I do not eat red meat also on a low protein diet due to HE.