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Old 06-19-2011, 04:15 PM  
mohel
 
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The growing culprit behind liver disease

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http://www.cnn.com/2011/HEALTH/06/16/liver.disease.ep/
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(CNN) -- The first time Wilson Alvarado got lost on the way to a neighborhood park, he told his wife, Patricia, not to worry about it -- he was 62, he told her, and just getting a little forgetful.
Patricia thought it was strange, considering the park was only a half-mile away, and he'd driven there every week for more than 30 years. Then Wilson got lost again on the way to the park. A few months later, he called Patricia from the supermarket, asking why he was there.
"I thought, well, maybe he really is just getting old," Patricia recalls. "My mother has Alzheimer's, and I thought maybe that was it."
It was easy to overlook the little memory lapses until several years later when the situation reached a head. While her husband was visiting relatives in Puerto Rico, Patricia received a phone call from his cousin saying they'd taken Wilson to the hospital because he "wasn't making any sense" and was acting so aggressive the hospital put him in restraints.
"It was really horrifying," she says.
Patricia had him put back on a plane to Buffalo, near their home in Cheektowaga, New York. His doctors explained that liver disease was behind Wilson's memory lapses and erratic behavior.

"When you think about this kind of thing, you think about dementia or Alzheimer's," she says. "You don't think about the liver."
Wilson had cirrhosis, just like alcoholics get, but in his case, fat, not alcohol, was the culprit. At 5 feet 8 inches and 185 pounds, Wilson is overweight, and too much fat in his liver eventually caused it to malfunction.
According to the Centers for Disease Control and Prevention, two-thirds of Americans are either overweight or obese, and doctors say they're seeing more and more patients like Wilson Alvarado.
"It's overwhelming how many patients we're seeing with this problem," says Dr. Naim Alkhouri, a hepatologist at the Cleveland Clinic.
Dr. William Carey, also a hepatologist at the Cleveland Clinic, adds, "This is huge. We didn't even know this disease existed 30 years ago. Now it's the most common liver disease in America."
'We won't have the ability to treat all these patients'
About a third of the U.S. population has nonalcoholic fatty liver disease, according to Dr. Michael Curry, a hepatologist at the Beth Israel Deaconess Medical Center in Boston.
Curry said most of those people -- about 80% -- will not develop significant liver disease. The other 20% will develop a disease called nonalcoholic steatohepatitis, or NASH. Of those, about 20-30% will go on to develop cirrhosis and end-stage liver disease, where the only real treatment is a liver transplant.
"That's about 6 million people. We won't have the ability to treat all those patients," Curry says. "If we even have a fraction of that number of patients, it will overwhelm liver transplant programs."
Laundry in the refrigerator
NASH is often silent, according to the National Institutes of Health. While some people have pain in the right side of their abdomen, most do not. Liver enzyme tests are sometimes normal, and even ultrasounds and CT scans don't always pick up on the disease.
"Symptoms are few and far between," the Cleveland Clinic's Carey says.
"It can sneak up on you," says Dr. Kevin Mullen, a hepatologist at the Case Western Reserve University School of Medicine. "Even your doctor might miss it."
Often symptoms don't show up until the disease has progressed. Sometimes, the first sign is a swollen stomach or ankles, or vomiting blood.
Some patients, such as Wilson Alvarado, develop brain changes called hepatic encephalopathy. As the disease progresses, the liver has a hard time filtering out toxins, which can go to the brain and cause problems such as memory lapses, trouble sleeping at night and lack of coordination.
"It might start out with minimal changes, like a few more dents in the car," Curry says.
Later, the changes can become more disturbing.
"I had a patient who put his laundry in the refrigerator," Carey says. "Another one couldn't remember the family party that had just happened that very day."
Curry adds, "One of my patients got into the shower and turned on boiling hot water and couldn't figure out how to switch it off."
Mullen says, "It really can be bizarre. They might try to sell their house for $100 or walking around the neighborhood unclothed."
Preventing nonalcoholic fatty liver disease
If a patient loses weight, eats better and exercises, he or she can often reverse the disease in its earlier stages.
"That's why we like to find these people early," says Alkhouri of the Cleveland Clinic.
However, by the time the disease has advanced to the point of cirrhosis, it's usually irreversible, he adds.
Alvarado had to have a liver transplant last month at the Cleveland Clinic, and his wife says his thinking has become more clear.
The growing culprit behind liver disease-dementia.jpg 

The growing culprit behind liver disease-shr0934l.jpg 

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Old 06-19-2011, 04:57 PM  
ɹoʇɐɹǝpoɯ ɯnɹoɟ
 
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Ive seen this coming for some time. In fact, it was one of the reasons I quit drinking alcohol. (Lo and behold that wasnt my issue)

It is a real threat, and its good to see that information like this is coming more into the mainstream.
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Old 06-19-2011, 05:07 PM  
mohel
 
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Just stumbled on it on a news page. Mom had Alzheimers so I've been watchful for years.

I'd noticed in recent years exhaustion can lead to memory lapses. I haven't had a drink in 16 years but I did have cirrhosis so I'm in the group that should be concerned.
Fortunately I'm not fat, watch my diet and avoid toxins. I no longer do the NY Times crossword in ink but on the other hand I can no longer afford to buy it either.
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Old 06-20-2011, 06:36 PM  
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another besides fat that causes chirosis is the farely recent discovery (late 1990's) of hereditary hemachrometosis.
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Old 06-21-2011, 02:27 PM  
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It's like we're making patte with our own livers. Gross.
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Old 06-21-2011, 03:10 PM  
mohel
 
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Originally Posted by Austin View Post
It's like we're making patte with our own livers. Gross.
just mentioning pate is gross once you know about force fed geese.

At one point I was sent to Temple University in Philly to be evaluated for a liver transplant. I'd been warned by my doctors that few applicants received livers. You needed to be sick enough to need the liver (First interview with the head of the program was a yes for "need") but appear healthy enough to survive 11 to 13 hours on an operating table.

I'd gone in dressed in a nice tan suit & silk tie. Few of the other applicants looked like they would even survive the week.
My last interview of the day was with an Israeli surgeon who took a long look at me and said, "you look okay to me". I wasn't concerned his one opinion would trump the program head so I went home to wait for a liver.

When the people I'd seen that day voted the head of program was out of town and the Israeli surgeon's no won out. That man saved my life.

In coming months I was calling the hospital frequently. Messages never seemed to get through. I ran a small test and left a message with an operator and she promised to get it to the person I was trying to reach after the lunch hour ended. Five minutes later I reached her again and asked her to read it back to me. She had no copy, had never written down the message and this turned out to be far from uncommon. I would not survive this mind set but I have survived 16 more years using original equipment.

With cirrhosis the scarring from the fat constricts an artery that passes through the liver. That causes dysfunction and pressure. Unchecked the pressure causes a blowout and the person usually dies.

I eat non fatty meats and I'm far from vegan but there are limits to what I will put in my mouth.
The growing culprit behind liver disease-pate2.jpg 

The growing culprit behind liver disease-geiersporkliverpate6.5oz.jpg 

The growing culprit behind liver disease-goose-liver-pate.jpg 

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Old 06-22-2011, 09:52 AM  
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I've seen the force feedings, I don't know I still want to try it. I like liver.
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Old 06-23-2011, 06:44 PM  
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Pork Liver Pate......made with goose meat.
I laughed.

First pic in the thread cracked me up too.
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