“The statistics on Cirrohosis by the CDC:
Number of adults age 18 and older with diagnosed liver disease: 4.5 million
Percent of adults age 18 and older with diagnosed liver disease: 1.8%
Number of deaths: 54,803
Deaths per 100,000 population: 16.4
Cause of death rank: 10”
Centers for Disease Control and Prevention – CDC (https://www.google.com/search?client=firefox-b-1-d&q=statistics+of+cirrhosis)
HEALTHY LIVER LIVER DISEASED
The liver is an organ about the size of a football that sits just under your rib cage on the right side of your abdomen. The liver is essential for digesting food and ridding your body of toxic substances.
Liver disease can be inherited (genetic) or caused by a variety of factors that damage the liver, such as viruses and alcohol use. Obesity is also associated with liver damage.
Over time, damage to the liver results in scarring (cirrhosis), which can lead to liver failure, a life-threatening condition.
Cirrhosis is a complication of many liver diseases characterized by abnormal structure and function of the liver. The diseases that lead to cirrhosis do so because they injure and kill liver cells, after which the inflammation and repair that is associated with the dying liver cells causes scar tissue to form. The liver cells that do not die multiply in an attempt to replace the cells that have died. This results in clusters of newly-formed liver cells (regenerative nodules) within the scar tissue.
There are many causes of cirrhosis including chemicals (such as alcohol, fat, and certain medications), viruses, toxic metals (such as iron and copper that accumulate in the liver as a result of genetic diseases), and autoimmune liver disease in which the body’s immune system attacks the liver.
The liver is an important organ in the body. It performs many critical functions, two of which are producing substances required by the body, for example, clotting proteins that are necessary in order for blood to clot, and removing toxic substances that can be harmful to the body, for example, drugs. The liver also has an important role in regulating the supply of glucose (sugar) and lipids (fat) that the body uses as fuel. In order to perform these critical functions, the liver cells must be working normally, and they must have a close proximity to the blood because the substances that are added or removed by the liver are transported to and from the liver by the blood.
The relationship of the liver to the blood is unique. Unlike most organs in the body, only a small amount of blood is supplied to the liver by arteries. Most of the liver’s supply of blood comes from the intestinal veins as the blood returns to the heart. The main vein that returns blood from the intestines is called the portal vein. As the portal vein passes through the liver, it breaks up into increasingly smaller and smaller veins. The tiniest veins (called sinusoids because of their unique structure) are in close contact with the liver cells. In fact, the liver cells line up along the length of the sinusoids. This close relationship between the liver cells and blood from the portal vein allows the liver cells to remove and add substances to the blood. Once the blood has passed through the sinusoids, it is collected in increasingly larger and larger veins that ultimately form a single vein, the hepatic vein, which returns the blood to the heart.
In cirrhosis, the relationship between blood and liver cells is destroyed. Even though the liver cells that survive or are newly-formed may be able to produce and remove substances from the blood, they do not have the normal, intimate relationship with the blood, and this interferes with the liver cells’ ability to add or remove substances from the blood. In addition, the scarring within the cirrhotic liver obstructs the flow of blood through the liver and to the liver cells. As a result of the obstruction to the flow of blood through the liver, blood “backs-up” in the portal vein, and the pressure in the portal vein increases, a condition called portal hypertension. Because of the obstruction to flow and high pressures in the portal vein, blood in the portal vein seeks other veins in which to return to the heart, veins with lower pressures that bypass the liver. Unfortunately, the liver is unable to add or remove substances from blood that bypasses it. It is a combination of reduced numbers of liver cells, loss of the normal contact between blood passing through the liver and the liver cells, and blood bypassing the liver that leads to many of the manifestations of cirrhosis.
A second reason for the problems caused by cirrhosis is the disturbed relationship between the liver cells and the channels through which bile flows. Bile is a fluid produced by liver cells that has two important functions: to aid in digestion and to remove and eliminate toxic substances from the body. The bile that is produced by liver cells is secreted into very tiny channels that run between the liver cells that line the sinusoids, called canaliculi. The canaliculi empty into small ducts which then join together to form larger and larger ducts. Ultimately, all of the ducts combine into one duct that enters the small intestine. In this way, bile gets to the intestine where it can help with the digestion of food. At the same time, toxic substances contained in the bile enter the intestine and then are eliminated in the stool. In cirrhosis, the canaliculi are abnormal and the relationship between liver cells and canaliculi is destroyed, just like the relationship between the liver cells and blood in the sinusoids. As a result, the liver is not able to eliminate toxic substances normally, and they can accumulate in the body. To a minor extent, digestion in the intestine also is reduced.
“Liver cancer is cancer that begins in the cells of your liver. Your liver is a football-sized organ that sits in the upper right portion of your abdomen, beneath your diaphragm and above your stomach.
Several types of cancer can form in the liver. The most common type of liver cancer is hepato-cellular carcinoma, which begins in the main type of liver cell (hepatocyte).
Cancer that spreads to the liver is more common than cancer that begins in the liver cells. Cancer that begins in another area of the body — such as the colon, lung or breast — and then spreads to the liver is called metastatic cancer rather than liver cancer. This type of cancer is named after the organ in which it began — such as metastatic colon cancer to describe cancer that begins in the colon and spreads to the liver.”
MAYO Clinic (https://www.mayoclinic.org/diseases-conditions/liver-cancer/symptoms-causes/syc-20353659#:~:text=Several%20types%20of%20cancer%20can,hepatoblastoma%2C%20are%20much%20less%20common.)
The liver is a large, meaty organ that sits on the right side of the belly. Weighing about 3 pounds, the liver is reddish-brown in color and feels rubbery to the touch. Normally you can’t feel the liver, because it’s protected by the rib cage.
The liver has two large sections, called the right and the left lobes. The gallbladder sits under the liver, along with parts of the pancreas and intestines. The liver and these organs work together to digest, absorb, and process food.
The liver’s main job is to filter the blood coming from the digestive tract, before passing it to the rest of the body. The liver also detoxifies chemicals and metabolizes drugs. As it does so, the liver secretes bile that ends up back in the intestines. The liver also makes proteins important for blood clotting and other functions.
The liver is a vital organ of vertebrates and some other animals. In the human it is located in the upper right quadrant of the abdomen, below the diaphragm. The liver has a wide range of functions, including detoxification of various metabolites, protein synthesis, and the production of biochemicals necessary for digestion.
The liver is a gland and plays a major role in metabolism with numerous functions in the human body, including regulation of glycogen storage, decomposition of red blood cells, plasma protein synthesis, hormone production, and detoxification.[3] It is an accessory digestive gland and produces bile, an alkaline compound which aids in digestion via the emulsification of lipids. The gallbladder, a small pouch that sits just under the liver, stores bile produced by the liver. The liver’s highly specialized tissue consisting of mostly hepatocytes regulates a wide variety of high-volume biochemical reactions, including the synthesis and breakdown of small and complex molecules, many of which are necessary for normal vital functions Estimates regarding the organ’s total number of functions vary, but textbooks generally cite it being around 500.
Several types of cancer can form in the liver. The most common type of liver cancer is hepatocellular carcinoma, which begins in the main type of liver cell (hepatocyte). Other types of liver cancer, such as intrahepatic cholangiocarcinoma and hepatoblastoma, are much less common.
Not all cancers that affect the liver are considered liver cancer. Cancer that begins in another area of the body — such as the colon, lung or breast — and then spreads to the liver is called metastatic cancer rather than liver cancer.
Most people don’t have signs and symptoms in the early stages of primary liver cancer. When signs and symptoms do appear, they may include:
It’s not clear what causes most cases of liver cancer. But in some cases, the cause is known. For instance, chronic infection with certain hepatitis viruses can cause liver cancer.
Liver cancer occurs when liver cells develop changes (mutations) in their DNA — the material that provides instructions for every chemical process in your body. DNA mutations cause changes in these instructions. One result is that cells may begin to grow out of control and eventually form a tumor — a mass of cancerous cells.
Factors that increase the risk of primary liver cancer include:
MOST IMPORTANT is PREVENTION:
Cirrhosis is scarring of the liver, and it increases the risk of liver cancer. You can reduce your risk of cirrhosis if you:
You can reduce your risk of hepatitis B by receiving the hepatitis B vaccine, which provides more than 90 percent protection for both adults and children. The vaccine can be given to almost anyone, including infants, older adults and those with compromised immune systems.
No vaccine for hepatitis C exists, but you can reduce your risk of infection.
For the general population, screening for liver cancer hasn’t been proved to reduce the risk of dying of liver cancer, so it isn’t generally recommended. The American Association for the Study of Liver Diseases recommends liver cancer screening for those thought to have a high risk, including people who have:
Discuss the pros and cons of screening with your doctor. Together you can decide whether screening is right for you based on your risk. Screening typically involves an ultrasound exam every six months.
Tests and procedures used to diagnose liver cancer include:
During a liver biopsy, your doctor inserts a thin needle through your skin and into your liver to obtain a tissue sample. In the lab, doctors examine the tissue under a microscope to look for cancer cells. Liver biopsy carries a risk of bleeding, bruising and infection.
Once liver cancer is diagnosed, your doctor will work to determine the extent (stage) of the cancer. Staging tests help determine the size and location of cancer and whether it has spread. Imaging tests used to stage liver cancer include CTs, MRIs and bone scans.
There are different methods of staging liver cancer. One method uses Roman numerals I through IV, and another uses letters A through D. Your doctor uses your cancer’s stage to determine your treatment options and your prognosis. Stage IV and stage D indicate the most advanced liver cancer with the worst prognosis.
Treatments for primary liver cancer depend on the extent (stage) of the disease as well as your age, overall health and personal preferences.
Operations used to treat liver cancer include:
Localized treatments for liver cancer are those that are administered directly to the cancer cells or the area surrounding the cancer cells. Localized treatment options for liver cancer include:
This treatment uses high-powered energy from sources such as X-rays and protons to destroy cancer cells and shrink tumors. Doctors carefully direct the energy to the liver, while sparing the surrounding healthy tissue.
During external beam radiation therapy treatment, you lie on a table and a machine directs the energy beams at a precise point on your body.
A specialized type of radiation therapy, called stereotactic radiosurgery, involves focusing many beams of radiation simultaneously at one point in your body.
Targeted drugs work by interfering with specific abnormalities within a tumor. They have been shown to slow or stop advanced hepatocellular carcinoma from progressing for a few months longer than with no treatment.
More studies are needed to understand how targeted therapies, such as the drug sorafenib (Nexavar), may be used to control advanced liver cancer.
Palliative care is specialized medical care that focuses on providing relief from pain and other symptoms of a serious illness. Palliative care specialists work with you, your family and your other doctors to provide an extra layer of support that complements your ongoing care. Palliative care can be used while undergoing other aggressive treatments, such as surgery, chemotherapy or radiation therapy.
When palliative care is used along with all of the other appropriate treatments, people with cancer may feel better and live longer.
Palliative care is provided by a team of doctors, nurses and other specially trained professionals. Palliative care teams aim to improve the quality of life for people with cancer and their families. This form of care is offered alongside curative or other treatments you may be receiving.
“Your liver is a powerhouse, performing over 500 life-sustaining functions. This 3-pound organ and is located in the upper-right part of your abdomen. Can you live without a liver? No. The liver is so crucial to existence that while you can live with only part of a liver, you can’t live without any liver at all. Without a liver:
Without a liver, death would occur in a matter of days.”
Healthline (https://www.healthline.com/health/can-you-live-without-liver)
The liver is like our transmission to the human body—it cleans out end products of what enters our body keeping the essentials we need inside. This is what this organ does for us:
Your liver is your very own chemical processing plant. It receives 30% of the blood circulating in your system every minute – performing chemical reactions to remove harmful toxins and distribute and store essential nutrients. This vital process is called ‘metabolism’ and cells in the liver, known as hepatocytes, are put to work to keep your body working at its best. Essentially, your liver loves and cares for you.
Once carbs have been broken down into glucose in your gastrointestinal tract, the glucose enters the blood stream and is taken straight to your liver to regulate and maintain healthy levels. Your liver also stores excess glucose in the form of glycogen (inactive glucose) and the liver will fill up with this glycogenl (like a gas tank). When the tank of the liver gets full the excess of the sugar floating in your bloodstream is used by our tissues that need it right than. The sugar that couldn’t go in the liver is extra glucose that now needs a place to store (if the liver is full) than it gets dumped in our fat tissue next. This is how we get obese. This is the logic of eating small meals not 3 large meals a day. The small meals are utilized mostly where there is no extra floating glucose that needs to be stored anywhere like in our case the fatty tissue. The average American doesn’t realize this with knowing that glycogen (inactive glucose) when needed by our body is ready for converting back into glucose when levels drop between meals which usually occurs during exercise or when you’re fasting; which most of us in America don’t do by overall population. For our liver to do these processes of breakdown of our foods (including medications), to convert active glucose to inactive glucose (glycogen), store glycogen in the liver and to do much more the liver has to be working meaning healthy.
And here’s the really clever thing. Your liver can also convert non-sugars, such as amino acids, into glucose to keep levels healthy. It does some pretty impressive things with fats too.
Every time you eat either through food or protein fluid drinks in place of your food, your liver feeds you. Once food is digested, nutrients enters the blood from the stomach after digestion in that organ takes place including the small intestines, which are taken straight to your liver for processing. Depending on how low or plentiful these nutrients are in your body, the liver cells will either release the goodness of these processed broken down nutrient end products to where it’s needed (regarding our tissues of the body) or store they will be stored away for when your body tissues needs a boost later.
And here’s the really clever thing. Your liver can also convert non-sugars, such as amino acids, into glucose to keep levels healthy. It does some pretty impressive things with fats too.
Your liver is your fat processing factory – it breaks down fat and compounds such as lipoproteins, cholesterol and phospholipids. If fat is in excess, the liver combines fatty acids and glycerol to form a storage molecule and transports it to your body’s storage depots, such as the subcutaneous tissue (tissue just under the skin). Then, at times when energy levels are low, between meals and during exercise, this stored fat is converted back into glycerol and the liver turns the remaining fatty acids into an alternative energy supply. To aid absorption of fat and fat-soluble vitamins and flush out unwanted substances from your body, your liver produces bile. It stores the bile in your gall bladder, where it can be emptied into your intestines when needed.
Proteins are also vital for a healthy body, and your liver takes charge of these too. Once proteins are broken down into amino acids in your intestines, they enter the blood stream and flow direct to the liver. Here, the liver cells (hepatocytes) go to work on removing nitrogen from the proteins which rapidly changes into ammonia – a highly toxic substance. Your liver then acts fast to convert this into urea to be excreted into the urine and eliminated from your body. With excess amino acids, your liver converts them into fat for storage or, if your body needs an energy boost, it will use them to create glucose.
Ending line the liver breaks down our Calories & CHOs, Fats, and Proteins that enter our body.
Our liver watches out for us. When harmful toxins and substances enter your blood stream, your liver acts fast to detoxify and destroy them. Some may simply be a by-product of a normal metabolism, others may be ingested or inhaled substances such as drugs and alcohol. Filtering the blood, your liver removes dead cells and invading bacteria, processes nitrogen and cholesterol and neutralises harmful hormones.
The problem comes when the body liver can’t do this function anymore, meaning it can’t break down or do the processing of out nutrients we eat causing toxins to build up in our body. Soon this break down of the liver with no reversal or without treatment will go into liver failure. Liver failure can put a big hold up in your life but if you can reverse it your smart since you addressed the problem in getting cared for by a doctor. You can even be better than this in being healthy to your body which is you taking PREVENTION in allowing yourself never to deal with this headache.
Liver failure or hepatic insufficiency is the inability of the liver to perform its normal synthetic and metabolic function as part of normal physiology. Two forms are recognized, acute and chronic.
Acute liver failure defined as “the rapid development of hepatocellular dysfunction, specifically coagulopathy and mental status changes (encephalopathy) in a patient without known prior liver disease.”.
Chronic liver failure usually occurs in the context of cirrhosis, itself potentially the result of many possible causes, such as excessive alcohol intake, hepatitis B or C, autoimmune, hereditary and metabolic causes (such as iron or copper overload, Steatohepatitis or non-alcoholic fatty liver disease).
CHRONIC can be prevented. How important is your health?
“October is Healthy Lung Awareness. Tips to keeping a healthy lung are the following:
1-Cigarette smoking is the major cause of lung cancer and chronic obstructive pulmonary disease (COPD), which includes chronic bronchitis and emphysema. Cigarette smoke can narrow the air passages and make breathing more difficult. It causes chronic inflammation, or swelling in the lung, which can lead to chronic bronchitis. Over time cigarette smoke destroys lung tissue and may trigger changes that grow into cancer.
2-Whether you are young or old, slender or large, able-bodied or living with a chronic illness or disability, being physically active can help keep your lungs healthy.
3-Secondhand smoke, chemicals in the home and workplace, mold and radon all can cause or worsen lung disease.”
American Lung Association (https://www.lung.org/lung-health-diseases/wellness/protecting-your-lungs)
October is a month set aside for lung awareness. It’s National Healthy Lung Month, and Lung Health Day is October 28. National Respiratory Care Week is October 25-30. It may seem arbitrary to set aside a particular month for health awareness, but it’s useful to remind ourselves of the things in our environment that can harm us and to act with compassion toward those who have already been harmed.
Lung disease affects a staggering number of Americans. About 10 million adults are diagnosed with chronic bronchitis each year, and about 4.7 million others have ever been diagnosed with emphysema. Chronic bronchitis and emphysema constitute the diseases that make up Chronic Obstructive Pulmonary Disease (COPD). About 25 million people live with asthma as well.
Occupational lung diseases, which include asbestosis and mesothelioma, also affect many Americans. Occupational illnesses are estimated to cost $150 billion annually. Chronic Obstructive Pulmonary Disease (COPD), typically caused by long-term exposure to lung irritants that damage the lungs and airways, is attributed to occupational exposure 19.2% of the time.
In support of Healthy Lung Month, let’s raise awareness about the rapid escalation of lung disease in the United States.
The notion that harmful air pollutants exist only outdoors is false. Some pollutants occurring in the home can be more harmful than those commonly encountered outdoors. Modern homes harbor many sources of respiratory irritation, but it’s not terribly difficult to lung-proof your home. Some common lung irritants found indoors are lead, formaldehyde, radon, cleaning agent vapors, and fire-retardants. Natural pollutants also make their way into the home, including pet dander, dust mites, and mold. Here are a few simple ways the people, especially those with lung disease, can avoid these lung damaging agents.
Your entire body depends on your lungs to keep breathing and distributing oxygen-rich blood throughout your body and to get rid of the body’s gaseous waste, carbon dioxide. Our bodies do have a natural defense system designed to protect the lungs, keeping dirt, germs and other irritants at bay. But there are some important things you can do on a regular basis to keep your lungs healthy and reduce the risk of disease.
Sometimes we take our health for granted. Lungs keep us alive and well and for the most part, we don’t need to think about them. Remember without lungs we couldn’t survive. Love your lungs this October and work to make any necessary changes to keep yours healthy!
“Spina bifida is a type of birth defect affecting the development of the baby’s spine. It occurs when a developing baby’s spine does not develop or close properly, leaving a section of the spinal cord and nerves exposed.
In the first month of pregnancy, a special set of cells form the neural tube. The top of the neural tube forms the baby’s brain and skull, while the rest of the neural tube becomes the baby’s spinal cord and other structures surrounding the spinal cord. Normally, the neural tube completely closes 28 days after conception. In people with spina bifida, though, parts of the neural tube stay open. An open neural tube leaves the brain or spinal cord exposed and at risk for damage, potentially causing physical and intellectual disabilities.”
Radiology Affiliates Imaging-RAI (https://4rai.com/2022/09/15/october-is-spina-bifida-awareness-month/)
In most cases, spina bifida is diagnosed before birth (prenatal). However, some mild cases may go unnoticed until after birth (postnatal). Very mild forms of spinal bifida are found when doing tests for other conditions or may never be detected.
PRENATAL DIAGNOSED:
The most common screening methods used to look for spina bifida during pregnancy are maternal serum alpha fetoprotein (MSAFP) screening and fetal ultrasound. A doctor can also perform an amniocentesis test.
The second trimester MSAFP screen may be performed alone or as part of a larger, multiple-marker screen. Multiple-marker screens can look for neural tube defects and other birth defects, including Down syndrome and other chromosomal abnormalities. First trimester screens for chromosomal abnormalities also exist but signs of spina bifida are not evident until the second trimester when the MSAFP screening is performed.
POSTNATAL DIAGNOSED:
Closed neural tube defects are often recognized at birth due to an abnormal fatty mass, tuft or clump of hair, or a small dimple or birthmark on the skin at the site of the spinal malformation. Spina bifida occulta is usually found when x-rays are done for another reason.
In rare cases, myelomeningocele and meningocele are not diagnosed during routine prenatal tests. The baby will be diagnosed when they are born with a bubble on their back. Babies with myelomeningocele and closed neural tube defects may have muscle weakness in their feet, hips, and legs that result in joint deformities first noticed at birth. Mild cases of spina bifida (occulta, closed neural tube defects) not diagnosed during prenatal testing may be detected postnatally using ultrasound or X-ray imaging to look at the spine.
Doctors may use magnetic resonance imaging (MRI) or a computed tomography (CT) scan to get a clearer view of the spinal cord and vertebrae. To evaluate for hydrocephalus, the doctor will request a head ultrasound, CT or MRI to look for extra cerebrospinal fluid inside the brain.
Women of childbearing age can reduce their risk of having a child with spina bifida by taking 400 micrograms (mcg) of folic acid every day pre-conception. Because it is water soluble, folic acid does not stay in the body for very long and needs to be taken every day to be effective against neural defects. Since half of all pregnancies in the United States are unplanned, folic acid must be taken whether a woman is planning a pregnancy or not. Research has shown that if all women of childbearing age took a multivitamin with the B-vitamin folic acid, the risk of neural tube defects could be reduced by up to 70%. If you can prevent this the quality life is sure to be the best!
Some children with myelomeningocele and closed neural tube defects will need surgery to improve the alignment of their feet, legs, or spine. Children with myelomeningocele usually have hydrocephalus and may require surgery to help drain fluid in the brain, such as the placement of a shunt or ETV. Multiple surgeries may be required to replace the shunt, which may become clogged, infected, or disconnected.
Some individuals with myelomeningocele or closed neural tube defects require assistive devices for mobility such as braces, walkers, crutches, or wheelchairs. The location of the defect on the spine often determines the type of assistive devices needed. Children with a defect high on the spine will have little movement of the legs and will use a wheelchair for mobility. Children with a defect lower on the spine usually have more strength in the legs. They may be able to walk independently, or they may use crutches, leg braces, walkers, and wheelchairs depending on the activity. Children with myelomeningocele usually have some degree of delayed mobility, so they are referred to physical therapists early on to maximize their strength and function.
Treatment for bladder and bowel dysfunction typically begins soon after birth. Children with myelomeningocele and some closed neural tube defects have damage to the lowest spinal nerves which control typical bowel and bladder function. Some children may be able to urinate typically, but most will need to drain their bladders with a catheter or thin tube 4-6 times a day to remain dry in between and to prevent kidney damage. Kidneys are monitored closely so that medications or surgeries can be performed to prevent renal failure. To prevent bowel accidents many people with myelomeningocele and closed neural type defects will use rectal medications or large volume enemas to have planned bowel movements. Close follow-up with a spina bifida specialty clinic is recommended to develop a safe bowel and bladder program.
Treatment for progressive tethering of the spinal cord (called tethered cord syndrome) can be treated with surgery to help prevent further neurological deterioration.