Thursday, February 6, 2014

To TIPS, or not to TIPS?

Ok, so last Monday we set a record with 11.3 liters of fluid removed during the paracentesis. I thought we'd get 6 or 7 today. Nope! Record territory again--11.4 liters! Fat Albie now weight a whopping 453 pounds. That's 55 pounds of fluid weight up and down in two weeks--this can't continue.

Fortunately, my creatnine was back to 1.3, so I get some but not all of the diuretics back. That will help. Tomorrow during the weekly call with the transplant center in Milwaukee, they are going to talk about whether or not I'm a viable candidates for the TIPS placement. With a history of hepatic encephalopathy, it's risky. But it can be controlled and reversed. Dr. E said it makes his mind race thinking about doing that to me, but the more frequent and high volume removals of fluid carry their own risks. Under no circumstances am I a candidate for a port and tube for home fluid removal due to infection risk. With the recent bout of sepsis, I whole-heartedly concur! If we do the TIPS, I am insisting on general anesthesia, not local. Here is why:

http://www.nlm.nih.gov/medlineplus/ency/article/007210.htm