A cirrhosis case
Posted: Sun Jan 02, 2005 9:07 am
I bring this forum the case of a 63 year old man who is approximately 5ft. 10in. tall and weighs about 165lb. He is slightly built Caucasian having lost a great deal of weight in the last three years purposefully. He has gray hair and brown eyes. He has a history of congestive heart failure and a least one instance suffered from complete cardiac arrest for a time and had some unusual near death experiences. As result of a heart attack and the actual drowning in his own fluids (pulmonary edema), he has a fear of water though he maintains a swimming pool and hot tub at his residence.
He was in high stress business most of his life and retired about six years ago. His wife and family continue to run his business. He's a very wealthy man and is what my dad would say was a man who was tight with a nickel but loose with a dollar. He is a car collector and from time to time I've bought cars from him and he keeps all of his equipment in meticulous shape.
He was recently diagnosed with cirrhosis of the liver and the attendant estimated that he would die within two to three years. At that point, about six weeks ago, he came to me for consultation. I had treated him a variety of aches and illnesses over the years. I found no evidence of the severe cirrhosis that the allopathic clinician found. There was no jaundice, but there was a great deal of edema around his waist (ascites), and his liver was swollen and somewhat indurated.
His most severe symptom is that though he lost a great deal of weight through exercise and diet is that he will have moments of extreme witness from very little activity such as walking up the set of stairs or leaning over to pick up a gift or toy for one of his grandchildren. The weakness occurs so quickly that is hard to imagine what brings in on. I expect that it is hyperinsulinism and is related to his disorder liver. He has a history of borderline diabetes, as well.
Part of the time in the three years or so that he lost probably 65 or 70lb. of body weight, he spent several weeks in a vegetarian resort in northern California where the daily regimen was eating vegetables and walking. Even though he was an expensive resort he liked it immensely and even though he's usually rather tight with his money, he did not begrudge the money that he spent for himself and his wife. He has a strong sense of family and is very proud of his grandchildren and great grandchildren. He tends to stay at home and seems to enjoy barbecuing for his family and friends.
He is one of my best friends, as well as my patient. He frequently hosts events for his company and hundreds of people are usually there to participate. He is from Arkansas and for years sang and picked in a country western band as a sideline. He is known to have a remarkable singing voice but I have never heard him sing in the nine years that I've known him.
I've never seen him cry though I have seen him lose numerous family members. He has been under a lot of stress during his life by the nature of his business which included a large collection agency. At one time in his life he was attacked by thugs who broke into his house and used a modified electrical control device such as the police use (a zapper) and effectively electrocuted him. By sure chance his jerking around while they were shocking him caused him to hit the alarm system that was at the headboard of his bed which turned on the lights and summoned the police. He was quadriplegic for several months following the event. He had the faithful assistant who would set him in very hot water which was very uncomfortable and served as the only motivation he could find that made him start moving again and regain his bodily controls.
At one time he confronted a major criminal figure who owned a casino in Las Vegas. He succeeded in collecting approximately a half million dollar debt owed by this figure only to have his office building blown up at 4:00 the following morning. He has been threatened and assaulted numerous times throughout his life.
He tends to brag about his accomplishments his money and his holdings in a faux humble sort of way. . "Not bad for a country boy" this man. This would be a typical statement by this man. He is very accommodating to his friends. An example of his generosity is represented when he recently bought and paid for a late model Mercedes convertible that he gave to an out of luck friend. At other times he seems rather tight with this money and begrudges anybody ordering extra at a lunch where he's the host. He's very wise in common sense and a very good businessman.
He has strong feelings of loyalty to his deceased parents and feels great empathy for their last days. His mother for example, had both eyes repaired in a procedure typically used today that left her blind.
He constantly calls attention to his humble roots. He has helped many people and some of them by the types of people they are have betrayed his trust and take advantage of his generosity. I know that hurts him a lot, though he doesn't expose that emotion publicly.
The accumulation of edema around his waist is very uncomfortable to him and interferes with his breathing. He can't take a deep breath at those times. His allopathic doctor gave him some strong diuretics and it helps sometimes. Lately they have been drawing off the edema with a needle.
Due to his lack of overt symptoms, I have tried to prescribe for him on the basis of his clinical findings. I've had some success with Lycopodium and at other times success with Carduus marianas with him. However, I have no lasting success and the ascites has recurred. He takes frequent naps in the afternoon and is more comfortable at his home on the coast of California some three hours distance from this San Joaquin valley where we live. Most likely due to the clean air there as opposed to the very dirty air here.
I would appreciate any clinical or symptomatology comments or lines of investigation or suggestions in managing this case.
Best wishes,
Tom
[Non-text portions of this message have been removed]
He was in high stress business most of his life and retired about six years ago. His wife and family continue to run his business. He's a very wealthy man and is what my dad would say was a man who was tight with a nickel but loose with a dollar. He is a car collector and from time to time I've bought cars from him and he keeps all of his equipment in meticulous shape.
He was recently diagnosed with cirrhosis of the liver and the attendant estimated that he would die within two to three years. At that point, about six weeks ago, he came to me for consultation. I had treated him a variety of aches and illnesses over the years. I found no evidence of the severe cirrhosis that the allopathic clinician found. There was no jaundice, but there was a great deal of edema around his waist (ascites), and his liver was swollen and somewhat indurated.
His most severe symptom is that though he lost a great deal of weight through exercise and diet is that he will have moments of extreme witness from very little activity such as walking up the set of stairs or leaning over to pick up a gift or toy for one of his grandchildren. The weakness occurs so quickly that is hard to imagine what brings in on. I expect that it is hyperinsulinism and is related to his disorder liver. He has a history of borderline diabetes, as well.
Part of the time in the three years or so that he lost probably 65 or 70lb. of body weight, he spent several weeks in a vegetarian resort in northern California where the daily regimen was eating vegetables and walking. Even though he was an expensive resort he liked it immensely and even though he's usually rather tight with his money, he did not begrudge the money that he spent for himself and his wife. He has a strong sense of family and is very proud of his grandchildren and great grandchildren. He tends to stay at home and seems to enjoy barbecuing for his family and friends.
He is one of my best friends, as well as my patient. He frequently hosts events for his company and hundreds of people are usually there to participate. He is from Arkansas and for years sang and picked in a country western band as a sideline. He is known to have a remarkable singing voice but I have never heard him sing in the nine years that I've known him.
I've never seen him cry though I have seen him lose numerous family members. He has been under a lot of stress during his life by the nature of his business which included a large collection agency. At one time in his life he was attacked by thugs who broke into his house and used a modified electrical control device such as the police use (a zapper) and effectively electrocuted him. By sure chance his jerking around while they were shocking him caused him to hit the alarm system that was at the headboard of his bed which turned on the lights and summoned the police. He was quadriplegic for several months following the event. He had the faithful assistant who would set him in very hot water which was very uncomfortable and served as the only motivation he could find that made him start moving again and regain his bodily controls.
At one time he confronted a major criminal figure who owned a casino in Las Vegas. He succeeded in collecting approximately a half million dollar debt owed by this figure only to have his office building blown up at 4:00 the following morning. He has been threatened and assaulted numerous times throughout his life.
He tends to brag about his accomplishments his money and his holdings in a faux humble sort of way. . "Not bad for a country boy" this man. This would be a typical statement by this man. He is very accommodating to his friends. An example of his generosity is represented when he recently bought and paid for a late model Mercedes convertible that he gave to an out of luck friend. At other times he seems rather tight with this money and begrudges anybody ordering extra at a lunch where he's the host. He's very wise in common sense and a very good businessman.
He has strong feelings of loyalty to his deceased parents and feels great empathy for their last days. His mother for example, had both eyes repaired in a procedure typically used today that left her blind.
He constantly calls attention to his humble roots. He has helped many people and some of them by the types of people they are have betrayed his trust and take advantage of his generosity. I know that hurts him a lot, though he doesn't expose that emotion publicly.
The accumulation of edema around his waist is very uncomfortable to him and interferes with his breathing. He can't take a deep breath at those times. His allopathic doctor gave him some strong diuretics and it helps sometimes. Lately they have been drawing off the edema with a needle.
Due to his lack of overt symptoms, I have tried to prescribe for him on the basis of his clinical findings. I've had some success with Lycopodium and at other times success with Carduus marianas with him. However, I have no lasting success and the ascites has recurred. He takes frequent naps in the afternoon and is more comfortable at his home on the coast of California some three hours distance from this San Joaquin valley where we live. Most likely due to the clean air there as opposed to the very dirty air here.
I would appreciate any clinical or symptomatology comments or lines of investigation or suggestions in managing this case.
Best wishes,
Tom
[Non-text portions of this message have been removed]