We left for the hepatologist at 2:30 pm Tuesday and didn't get home until 8 pm. The liver specialist is over an hour away and we weren't seen for our 4 pm appointment until 5:30 pm. Turns out there was a mystery diagnosis that wasn't given enough time in the schedule and that patient will likely be blind in a few days and for the rest of his life. Reminders of common blessings (like sight) make waiting easier.
The hepatologist said the blood tests indicate that Mom has a lot of salt in her system that isn't leaving. This means that her diet is too salty; she's breaking the strict low-salt 2000mg Na max per day, and this is the source of her ascites fluid as of late. She's looking six months pregnant again, and on her small frame, it's more obvious. He increased the dosage of her water pills and is considering a liver biopsy. They tried a trans-jugular biopsy when she was in the hospital in October of last year, but it failed due to a bizarre curvature in the artery. The guide wires kept curling on themselves, and they couldn't get past one of the organs down to the liver. They won't go through her abdomen with this much fluid or it could cause an infection. If the fluid goes down, they can go through the belly much easier than the neck, but it'll take time.
The doctor said that if it wasn't for Mom's high-salt diet, she wouldn't have ascites, and it's essentially the biggest complication she's experiencing from the liver failure. We are currently looking at her diet and trying to figure out what is so high in salt that it's tipping her over this much. The english muffins she's been downing and the tuna with mayo sandwiches she makes from them aren't that high in salt. The only thing we can guess is the egg drop soup and cream cheese wontons she's been getting from a chinese restaurant lately. She's been downing this soup like crazy lately and the doc says that restaurant soup is worse than canned soup, and canned soup is too high in salt for her to eat (except the low-sodium versions). They actually wrote it in the doctor's notes: "patient advised to stop eating restaurant soup". I guess the stuff is that bad. Who knew? Mom has agreed to stop buying the soup, but she is insisting on finishing the soup she already bought and froze (5 containers at once, froze 3 at the time, and I think she only has one left...). She is having problems coming up with low-salt or salt-free foods that sound appetizing to her.
The primary doctor previously said they would try to get her the Aciphex for her acid controller medication and push it through the insurance for approval. They haven't done that yet, and the samples they gave ran out. They told her Tuesday that they would set aside more samples for me to pick up, and then told her today that they gave them away instead. She will be on Prilosec until we can afford to put her on Aciphex. Seeing as how I'm still unemployed, and we're not sure what the insurance is changing to next year (her retirement group plan is being dropped by the current company and it's unclear what will really happen with the new company and plan), I'm not sure that she will be on Aciphex any time soon.
She will be 54 years old tomorrow. My boyfriend and I plan on taking her out to wherever she wants to go, if she feels up to it. It may well be a lovely dinner from Red Lobster enjoyed from the comfort of her own bed.
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