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Post by Girlrocker on Jun 26, 2014 19:39:10 GMT -5
Hi everyone, Lisa asked if I would let you know how she's doing, as she's just not up to posting and updating herself at this time. She knows how many of you have asked about her and she wants you to know how grateful and appreciative she is, it means a lot to her. She had surgery a month ago to fix what turned out to be an obstruction in her bilio-pancreatic limb and Dr. Keshishian did some additional exploratory surgery. In addition to the obstruction and other tests she had, she is diagnosed with Nonalcoholic Steatohepatitis (NASH), which is a non-alcoholic fatty liver disease. Here is a definition from WebMd, www.webmd.com/digestive-disorders/tc/nonalcoholic-steatohepatitis-nash-overviewNonalcoholic Steatohepatitis (NASH) - OverviewWhat is nonalcoholic steatohepatitis (NASH)? Nonalcoholic steatohepatitis (NASH) is liver inflammation caused by a buildup of fat in the liver. Many people have a buildup of fat in the liver, and for most people it causes no symptoms and no problems. But in some people, the fat causes inflammation of the liver. Because of the inflammation, the liver doesn’t work as well as it should. NASH can get worse and cause scarring of the liver, which leads to cirrhosis. But the disease doesn't always get worse. NASH is similar to the kind of liver disease that is caused by long-term, heavy drinking. But NASH occurs in people who don't abuse alcohol. What causes NASH? Experts don't know why some people with a buildup of fat in the liver get NASH and some don't. It could be that something in the environment triggers the inflammation in those people. Or maybe it runs in their families. Things that put people at risk for NASH and for liver damage include: Obesity. Type 2 diabetes. High cholesterol and high triglycerides. Metabolic syndrome. Most people who have NASH are 40 to 50 years old and have one or more of the problems listed above. But NASH can happen in people who have none of these risk factors. Her recovery from the obstruction surgery has been excruciatingly painful for her, she wasn't able to eat and her weight has plummeted; she has been able to maintain her fluids and very slowly her appetite is coming back. She is seeing a hepatology specialist next week and following up with Dr. Keshishian, which happens to be tomorrow. She's getting various infusions including iron and other nutrients she needs. After both these appointments she'll know more about a course of action. She's much more optimistic than she had been, and really wants you to know it means a lot to her that you've asked. Her parents will drive her to her up here from San Diego we're going to have lunch first and then I'll drive her to the appointment, her parents will take her home. She will know more after her appointments and I'll update after I've seen her.
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Post by west4thavenue on Jun 26, 2014 19:46:12 GMT -5
I am so sorry to hear she has had all this trouble, but I'm glad to know she is on the recovery end. Please send my best.
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Post by newyorkbitch on Jun 26, 2014 20:04:30 GMT -5
I want to add some info about NASH.
Rapid weight loss is also a risk factor. There is no known cure for NASH. It is often progressive. Unfortunately the best way to "treat" NASH is to lose weight but of course in Lisa's case, that is not an option. Exercise, total elimination of alcohol forever, increase dietary fiber....
Lisa has NASH with severe steatosis. It's going to be a difficult road for her, she will need all the support she can get.
Also for everybody: make sure you include a hepatic panel every time you do labs.
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Post by meq815 on Jun 26, 2014 21:15:08 GMT -5
Thx, Sharyl. As usual, you rock! Give her my love ❤️️
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Post by maggiesara on Jun 26, 2014 21:40:36 GMT -5
Oh Sharyl, thank you for the update. I'm so sorry she's having to deal with all this SHITE. Please make sure she knows how strongly we are all pulling for her. I like her so much.
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Post by bboop on Jun 26, 2014 21:49:47 GMT -5
I hope she progresses nicely...poor baby this does not sound like fun at all. I wish her the best.
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Post by PrettyGirlBounce on Jun 26, 2014 22:33:47 GMT -5
And THIS is why we have surgery angels. Thank you for posting this information my sweet, amazing angel - but more importantly, TRUE friend. It is something I've wanted to do for a few weeks now but could not come to terms with my diagnosis and everything else mentally, especially while I am still managing physical symptoms during my recovery from surgical hell (has not been an easy one)!!!.
Sharyl and NYB - thanks for taking the time to research and report what info you've found regarding my diagnosis and providing links, etc. I am terrified about it but need to be proactive hereinafter to do what I can to at least control it's progression. Fear has definitely gotten the best of me...but I know i cant ignore this issue OR I WILL DIE. Today I weighed in at another dr appointment with my pcp and almost passed out when I saw the number...103 lbs. Unbelievable and VERY scary. Looking forward to seeing Dr K and then my other appt is next week with a local Gastrointerologist who specializes in Hepatology (at NYB's suggestion - thanks girl!!!). I read really good things about him so I'm crossing my fingers.
It really is a lot to process (y'all have NO idea) but I'm doing my best. Sharyl, my dear sister...I can't wait to squeeze the guts out of you tomorrow! Lol
Lastly, thank you to ALL of my PB family for your care and concern. It means so much!!! I will be sure to update this thread (along with Sharyl) and keep you all in the loop. It's just hard to be my happy Lisa self right now that all of you have grown to know and I am all about keeping it real...so I have just withdrawn until things calm down so you won't have to deal with my crabby pessimistic ass right now. Lol true story!!!
Bye for now...hope to report better news tomorrow.
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ttfulmer
Full Member
Posts: 177
Surgery Type: DS
Surgery Date: December 2013
Surgeon: Dr. K
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Post by ttfulmer on Jun 26, 2014 22:40:00 GMT -5
My appointment with Dr. K is at 1:30 tomorrow. I will pray that my visit is quick so that you do not have to wait. I am praying that Dr. K will give you great news. I hope to see you both tomorrow, just to give you a smile of encouragment.
Sharyl, you are a true Angel to us all.
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Post by PrettyGirlBounce on Jun 26, 2014 23:21:17 GMT -5
Oh really? That's awesome! I love to put a face/live body with a screen name/profile. And take all the time you need during your appt honey. I'm in no hurry.
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Post by nursemelanie on Jun 26, 2014 23:38:06 GMT -5
Lisa- I have thought of you often and I pray for healing and comfort as you deal with this diagnosis. You have made such a big impression on so many and although your wit is enjoyed immensely ....your good health is obviously on all of our minds. I will gladly read any pissy, aggravated, scared thing you want to post!! VSG to DS 7-01-14/ Dr Boyce, Knoxville, TN /Age 40/5'8"/HW 287/CW 273.2
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Post by mlleelise on Jun 27, 2014 1:40:36 GMT -5
Lisa, I don't know you personally - but I have ALWAYS appreciated your insight here on the board. I admire the courage with which you're facing this ordeal! You have a great 'team' beside you, especially with Sharyl - and, of course, Dr. Keshishian. I'll be thinking about you and hoping for a positive outcome. <3
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Post by Leonie on Jun 27, 2014 3:00:58 GMT -5
Oh Dearest Girl It is the most precious thing seeing your lovely face here. I know it's tough right now, but we really are your friends and it is an honor being here for you in the tough times too.
Hugging you
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Post by jpcello on Jun 27, 2014 5:00:52 GMT -5
Lisa - so glad to hear from your. So very sorry about these current hurdles you're facing but we are all here for you.
Sending you hugs. Janet
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Post by illinids2 on Jun 27, 2014 7:13:47 GMT -5
I want to add some info about NASH. Rapid weight loss is also a risk factor. There is no known cure for NASH. It is often progressive. Unfortunately the best way to "treat" NASH is to lose weight but of course in Lisa's case, that is not an option. Exercise, total elimination of alcohol forever, increase dietary fiber.... Lisa has NASH with severe steatosis. It's going to be a difficult road for her, she will need all the support she can get. Also for everybody: make sure you include a hepatic panel every time you do labs. What all is in hepatic panel besides AST, ALT, Billirubin and Lipase? BTW thanks for the update Sharyl. Lisa and I have been chatting sporadically (try not to bother her as I know she is hurting and coping) so i am glad she feels well enough that she gave you the okay to update the board. Lisa has been in my thoughts for a few months now. She is a feisty fighter and Mom who doesn't quit so I know she will hit this head on and they will figure out a plan
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Post by newyorkbitch on Jun 27, 2014 7:17:25 GMT -5
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Post by goodkel on Jun 27, 2014 9:26:40 GMT -5
Lisa, it is reassuring that you will be seeing both Dr. K and a noted gastroenterologist who specializes in hepatology. It sounds like you are in good hands. I've had two medical issues since my DS that landed me in the hospital. I lost an alarming amount of weight both times. Once my condition was stabilized, the weight gradually came back on its own as I am sure it will for you, too. My concern for you was protein because it can be stressful on the liver and you require it. But, a little research found the following study that shows that whey protein isolate is actually helpful in improving your condition. I've highlighted the happy information in bold, if your're not up for reading all of it. Journal of Gastroenterology and Hepatology Open-labeled Pilot Study of Cysteine-rich Whey Protein Isolate Supplementation for Nonalcoholic Steatohepatitis Patients Taned Chitapanarux, Prasong Tienboon, Suwalee Pojchamarnwiputh, Donrawee Leelarungrayub Disclosures J Gastroenterol Hepatol. 2009;24(6):1045-1050. Discussion In this pilot study, we demonstrated that oral undenatured cysteine-rich whey protein isolate supplementation for 12 weeks was associated with significant biochemical and metabolic improvement in patients with NASH. The improvement in steatosis was documented by hepatic imaging as unenhanced computed tomography of liver showed marked decrease in liver fat. A statistically significant improvement in antioxidant status, as measured by serum glutathione level and total antioxidant capacity was also observed. All patients tolerated whey protein isolate well, with no serious adverse effects. NASH is now considered to be a common manifestation or even predictor of metabolic syndrome.[16,17] Our patients had a high frequency of metabolic risk factors for NAFLD and the majority of patients were diagnosed with metabolic syndrome. NASH could progress to cirrhosis in up to 20–30% of these patients.[1] No effective therapy for preventing disease progression or amelioration of this disease currently exists. After 12 weeks of whey protein isolate supplementation, sixty-six percent of the patients had liver enzyme improvement. Sixty-three percent of the patients had improvement in hepatic steatosis. The improvement in liver enzymes in the study was associated with the degree of hepatic steatosis resolution of NASH. Short-term oral supplementation with cysteine-rich whey protein isolate thus could prove a useful supplement for the management of NASH in addition to improving hepatic steatosis. Undenatured cysteine-rich whey protein isolate produces a sustained delivery of cysteine to the cells via normal metabolic pathways. By providing abundant cysteine, this whey protein allows the cells to synthesize and replenish glutathione (L-g-glutamyl-L-cysteinyl-glycine; GSH) levels without adverse or toxic effects. This protein might well find applications in diseases where oxidative stress and pathology of GSH metabolism are largely implicated. Decreased GSH and/or increased GSSG contributed to liver injury susceptibility and toxic risk by altering fundamental cell functions such as protein synthesis, enzyme activities, transport processes, microtubular and other structural support, and secretion mechanisms. Oxidative stress characterized by an imbalance between pro-oxidant and antioxidant mechanisms in favor of the former, has long been recognized as a key mechanism responsible for liver damage and disease progression in NAFLD.[18] Enhanced oxidative stress occurs in the liver of patients with NASH, as well as in animal models of NASH. Because of the importance of oxidative stress in the pathogenesis of NASH, we used plasma glutathione and total antioxidant capacity as markers of systemic oxidative stress to reflect the level of oxidative stress in the liver. Cysteine-rich whey protein isolate supplementation significantly increased plasma glutathione levels and total antioxidant capacity in all patients. It, thus, seems reasonable to conclude that the results of this study support the postulate that oxidative stress is a key mechanism responsible for liver damage and disease progression in NAFLD. Modest, but statistically significant, reduction in body weight, body mass index, and waist circumference were observed after supplementation of oral whey protein isolate for 12 weeks. Improvement in metabolic outcomes correlated with improvement in hepatic steatosis. However, reduction in body mass index did not correlate with improvement in aminotransferase. The improvement of hepatic steatosis was not associated with weight reduction. Because patients included in the study were not prescribed any specific diet or enrolled in a weight-reducing program, we believed that the reduction in weight, body mass index and waist circumference may be a secondary effect of whey protein isolate supplementation. An association with insulin resistance and NASH has been shown in various studies.[19,20] However, the results of the study were inconclusive with the measurements of insulin sensitivity indices, except β-cell secretion determined by HOMA-β percentage. These indirect measurements may be too insensitive to reflect changes in insulin resistance. Alternatively, the main therapeutic mechanisms of whey protein may be by preventing of the second hit such as glutathione generation by oxidative stress pathway. In conclusion, undenatured cysteine-rich whey protein isolate supplementation of NASH patients lead to a significant reduction of hepatic steatosis as determined by liver attenuation index from computed tomography, a significant reduction of AST and ALT levels, a significant increase of plasma glutathione level and total antioxidant capacity as well as improvement in metabolic outcomes. Supplementation with whey protein might well find other applications for patients where oxidative stress and pathology of glutathione deficiency are implicated. Randomized, long-term controlled trials including histologic assessment with cysteine-rich whey protein isolate are warranted. www.medscape.com/viewarticle/707601_4Adding some soy protein to your diet seems beneficial, too: Nutrition. 2011 Sep;27(9):943-8. doi: 10.1016/j.nut.2010.09.004. Epub 2011 Feb 18. Soy protein retards the progression of non-alcoholic steatohepatitis via improvement of insulin resistance and steatosis. Yang HY1, Tzeng YH, Chai CY, Hsieh AT, Chen JR, Chang LS, Yang SS. Author information Abstract OBJECTIVE: Non-alcoholic steatohepatitis (NASH) is a common cause of liver disease, and it may progress to fibrosis or cirrhosis. The aim of this study was to investigate the effects of soy protein on hepatic steatosis and insulin resistance in NASH. METHODS: Forty male Sprague-Dawley rats were fed a high-fat diet for 4 wk to induce NASH and then were allocated to one of four diets: a NASH-inducing diet, a standard diet, a NASH-inducing diet plus soy protein, and a standard diet plus soy protein. RESULTS: After the 10-wk experimental period, the results showed that soy protein significantly lowered plasma cholesterol concentrations and body fat accumulation. Soy protein intake also decreased the hepatic lipid depots of triacylglycerols and cholesterol and decreased the concentrations of lipid peroxides. In an analysis of antioxidative status, rats fed the soy protein diet showed improved antioxidative potential due to increases in superoxide dismutase and catalase activities and a decrease in the protein expression of cytochrome P450 2E1. CONCLUSION: Soy protein may improve the liver function in patients with NASH by lowering lipid levels in the blood and liver, increasing the antioxidative capacity, and improving insulin resistance.
Copyright © 2011 Elsevier Inc. All rights reserved. www.ncbi.nlm.nih.gov/pubmed/21333494Please be sure to address this issue with your hepatologist, but I must say that these studies seem reassuring that you will be able to not only get in the protein nourishment that you need, but that it will be beneficial to your condition as well. Hang in there and know that we are all pulling for you. Your presence is a shining light on the forum and it has been missed.
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Post by Girlrocker on Jun 27, 2014 10:00:32 GMT -5
This is really great info and I'll make sure she sees it when I see her today. Lisa, it is reassuring that you will be seeing both Dr. K and a noted gastroenterologist who specializes in hepatology. It sounds like you are in good hands. I've had two medical issues since my DS that landed me in the hospital. I lost an alarming amount of weight both times. Once my condition was stabilized, the weight gradually came back on its own as I am sure it will for you, too. My concern for you was protein because it can be stressful on the liver and you require it. But, a little research found the following study that shows that whey protein isolate is actually helpful in improving your condition. I've highlighted the happy information in bold, if your're not up for reading all of it. Journal of Gastroenterology and Hepatology Open-labeled Pilot Study of Cysteine-rich Whey Protein Isolate Supplementation for Nonalcoholic Steatohepatitis Patients Taned Chitapanarux, Prasong Tienboon, Suwalee Pojchamarnwiputh, Donrawee Leelarungrayub Disclosures J Gastroenterol Hepatol. 2009;24(6):1045-1050. Discussion In this pilot study, we demonstrated that oral undenatured cysteine-rich whey protein isolate supplementation for 12 weeks was associated with significant biochemical and metabolic improvement in patients with NASH. The improvement in steatosis was documented by hepatic imaging as unenhanced computed tomography of liver showed marked decrease in liver fat. A statistically significant improvement in antioxidant status, as measured by serum glutathione level and total antioxidant capacity was also observed. All patients tolerated whey protein isolate well, with no serious adverse effects. NASH is now considered to be a common manifestation or even predictor of metabolic syndrome.[16,17] Our patients had a high frequency of metabolic risk factors for NAFLD and the majority of patients were diagnosed with metabolic syndrome. NASH could progress to cirrhosis in up to 20–30% of these patients.[1] No effective therapy for preventing disease progression or amelioration of this disease currently exists. After 12 weeks of whey protein isolate supplementation, sixty-six percent of the patients had liver enzyme improvement. Sixty-three percent of the patients had improvement in hepatic steatosis. The improvement in liver enzymes in the study was associated with the degree of hepatic steatosis resolution of NASH. Short-term oral supplementation with cysteine-rich whey protein isolate thus could prove a useful supplement for the management of NASH in addition to improving hepatic steatosis. Undenatured cysteine-rich whey protein isolate produces a sustained delivery of cysteine to the cells via normal metabolic pathways. By providing abundant cysteine, this whey protein allows the cells to synthesize and replenish glutathione (L-g-glutamyl-L-cysteinyl-glycine; GSH) levels without adverse or toxic effects. This protein might well find applications in diseases where oxidative stress and pathology of GSH metabolism are largely implicated. Decreased GSH and/or increased GSSG contributed to liver injury susceptibility and toxic risk by altering fundamental cell functions such as protein synthesis, enzyme activities, transport processes, microtubular and other structural support, and secretion mechanisms. Oxidative stress characterized by an imbalance between pro-oxidant and antioxidant mechanisms in favor of the former, has long been recognized as a key mechanism responsible for liver damage and disease progression in NAFLD.[18] Enhanced oxidative stress occurs in the liver of patients with NASH, as well as in animal models of NASH. Because of the importance of oxidative stress in the pathogenesis of NASH, we used plasma glutathione and total antioxidant capacity as markers of systemic oxidative stress to reflect the level of oxidative stress in the liver. Cysteine-rich whey protein isolate supplementation significantly increased plasma glutathione levels and total antioxidant capacity in all patients. It, thus, seems reasonable to conclude that the results of this study support the postulate that oxidative stress is a key mechanism responsible for liver damage and disease progression in NAFLD. Modest, but statistically significant, reduction in body weight, body mass index, and waist circumference were observed after supplementation of oral whey protein isolate for 12 weeks. Improvement in metabolic outcomes correlated with improvement in hepatic steatosis. However, reduction in body mass index did not correlate with improvement in aminotransferase. The improvement of hepatic steatosis was not associated with weight reduction. Because patients included in the study were not prescribed any specific diet or enrolled in a weight-reducing program, we believed that the reduction in weight, body mass index and waist circumference may be a secondary effect of whey protein isolate supplementation. An association with insulin resistance and NASH has been shown in various studies.[19,20] However, the results of the study were inconclusive with the measurements of insulin sensitivity indices, except β-cell secretion determined by HOMA-β percentage. These indirect measurements may be too insensitive to reflect changes in insulin resistance. Alternatively, the main therapeutic mechanisms of whey protein may be by preventing of the second hit such as glutathione generation by oxidative stress pathway. In conclusion, undenatured cysteine-rich whey protein isolate supplementation of NASH patients lead to a significant reduction of hepatic steatosis as determined by liver attenuation index from computed tomography, a significant reduction of AST and ALT levels, a significant increase of plasma glutathione level and total antioxidant capacity as well as improvement in metabolic outcomes. Supplementation with whey protein might well find other applications for patients where oxidative stress and pathology of glutathione deficiency are implicated. Randomized, long-term controlled trials including histologic assessment with cysteine-rich whey protein isolate are warranted. www.medscape.com/viewarticle/707601_4Adding some soy protein to your diet seems beneficial, too: Nutrition. 2011 Sep;27(9):943-8. doi: 10.1016/j.nut.2010.09.004. Epub 2011 Feb 18. Soy protein retards the progression of non-alcoholic steatohepatitis via improvement of insulin resistance and steatosis. Yang HY1, Tzeng YH, Chai CY, Hsieh AT, Chen JR, Chang LS, Yang SS. Author information Abstract OBJECTIVE: Non-alcoholic steatohepatitis (NASH) is a common cause of liver disease, and it may progress to fibrosis or cirrhosis. The aim of this study was to investigate the effects of soy protein on hepatic steatosis and insulin resistance in NASH. METHODS: Forty male Sprague-Dawley rats were fed a high-fat diet for 4 wk to induce NASH and then were allocated to one of four diets: a NASH-inducing diet, a standard diet, a NASH-inducing diet plus soy protein, and a standard diet plus soy protein. RESULTS: After the 10-wk experimental period, the results showed that soy protein significantly lowered plasma cholesterol concentrations and body fat accumulation. Soy protein intake also decreased the hepatic lipid depots of triacylglycerols and cholesterol and decreased the concentrations of lipid peroxides. In an analysis of antioxidative status, rats fed the soy protein diet showed improved antioxidative potential due to increases in superoxide dismutase and catalase activities and a decrease in the protein expression of cytochrome P450 2E1. CONCLUSION: Soy protein may improve the liver function in patients with NASH by lowering lipid levels in the blood and liver, increasing the antioxidative capacity, and improving insulin resistance.
Copyright © 2011 Elsevier Inc. All rights reserved. www.ncbi.nlm.nih.gov/pubmed/21333494Please be sure to address this issue with your hepatologist, but I must say that these studies seem reassuring that you will be able to not only get in the protein nourishment that you need, but that it will be beneficial to your condition as well. Hang in there and know that we are all pulling for you. Your presence is a shining light on the forum and it has been missed.
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Post by Girlrocker on Jun 27, 2014 22:22:07 GMT -5
Well, as luck would have it not Lisa had to kick into mom gear today, her son got hurt at a bonfire last night when an enthusiastic dancer gave him a playful shove than landed him IN the bonfire with burns on his hand and one arm up to his elbow. So she had to take him to the emergency room today and had to reschedule her appt with Dr. K. Her son is going to be ok, and Lisa definitely sounded in classic PGB form when she mentioned what she'd like to do to said 'dancer'. So no news from today, but she's ready to fight now as you can see!
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Post by nursemelanie on Jun 27, 2014 23:32:18 GMT -5
When it rains it pours!! Nothing takes your mind off of your own worries like your child sick or in need. I hope he heals quickly and she can get seen herself. VSG to DS 7-01-14/ Dr Boyce, Knoxville, TN /Age 40/5'8"/HW 287/CW 273.2
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Post by bagaof4 on Jun 28, 2014 4:11:16 GMT -5
I am so very sorry to hear of your recent troubles and diagnosis, Lisa. Sending you healing thoughts and positive energy. I know you are a fighter and am hoping the worst is over. (((HUGS))))
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Post by meq815 on Jun 28, 2014 5:54:08 GMT -5
Thinking of you, Darlin' , and praying things can only get better! MWAHHHHHHHH!!!!!!
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Post by PrettyGirlBounce on Jun 28, 2014 16:36:11 GMT -5
Lisa, it is reassuring that you will be seeing both Dr. K and a noted gastroenterologist who specializes in hepatology. It sounds like you are in good hands. I've had two medical issues since my DS that landed me in the hospital. I lost an alarming amount of weight both times. Once my condition was stabilized, the weight gradually came back on its own as I am sure it will for you, too. My concern for you was protein because it can be stressful on the liver and you require it. But, a little research found the following study that shows that whey protein isolate is actually helpful in improving your condition. I've highlighted the happy information in bold, if your're not up for reading all of it. Journal of Gastroenterology and Hepatology Open-labeled Pilot Study of Cysteine-rich Whey Protein Isolate Supplementation for Nonalcoholic Steatohepatitis Patients Taned Chitapanarux, Prasong Tienboon, Suwalee Pojchamarnwiputh, Donrawee Leelarungrayub Disclosures J Gastroenterol Hepatol. 2009;24(6):1045-1050. Discussion In this pilot study, we demonstrated that oral undenatured cysteine-rich whey protein isolate supplementation for 12 weeks was associated with significant biochemical and metabolic improvement in patients with NASH. The improvement in steatosis was documented by hepatic imaging as unenhanced computed tomography of liver showed marked decrease in liver fat. A statistically significant improvement in antioxidant status, as measured by serum glutathione level and total antioxidant capacity was also observed. All patients tolerated whey protein isolate well, with no serious adverse effects. NASH is now considered to be a common manifestation or even predictor of metabolic syndrome.[16,17] Our patients had a high frequency of metabolic risk factors for NAFLD and the majority of patients were diagnosed with metabolic syndrome. NASH could progress to cirrhosis in up to 20–30% of these patients.[1] No effective therapy for preventing disease progression or amelioration of this disease currently exists. After 12 weeks of whey protein isolate supplementation, sixty-six percent of the patients had liver enzyme improvement. Sixty-three percent of the patients had improvement in hepatic steatosis. The improvement in liver enzymes in the study was associated with the degree of hepatic steatosis resolution of NASH. Short-term oral supplementation with cysteine-rich whey protein isolate thus could prove a useful supplement for the management of NASH in addition to improving hepatic steatosis. Undenatured cysteine-rich whey protein isolate produces a sustained delivery of cysteine to the cells via normal metabolic pathways. By providing abundant cysteine, this whey protein allows the cells to synthesize and replenish glutathione (L-g-glutamyl-L-cysteinyl-glycine; GSH) levels without adverse or toxic effects. This protein might well find applications in diseases where oxidative stress and pathology of GSH metabolism are largely implicated. Decreased GSH and/or increased GSSG contributed to liver injury susceptibility and toxic risk by altering fundamental cell functions such as protein synthesis, enzyme activities, transport processes, microtubular and other structural support, and secretion mechanisms. Oxidative stress characterized by an imbalance between pro-oxidant and antioxidant mechanisms in favor of the former, has long been recognized as a key mechanism responsible for liver damage and disease progression in NAFLD.[18] Enhanced oxidative stress occurs in the liver of patients with NASH, as well as in animal models of NASH. Because of the importance of oxidative stress in the pathogenesis of NASH, we used plasma glutathione and total antioxidant capacity as markers of systemic oxidative stress to reflect the level of oxidative stress in the liver. Cysteine-rich whey protein isolate supplementation significantly increased plasma glutathione levels and total antioxidant capacity in all patients. It, thus, seems reasonable to conclude that the results of this study support the postulate that oxidative stress is a key mechanism responsible for liver damage and disease progression in NAFLD. Modest, but statistically significant, reduction in body weight, body mass index, and waist circumference were observed after supplementation of oral whey protein isolate for 12 weeks. Improvement in metabolic outcomes correlated with improvement in hepatic steatosis. However, reduction in body mass index did not correlate with improvement in aminotransferase. The improvement of hepatic steatosis was not associated with weight reduction. Because patients included in the study were not prescribed any specific diet or enrolled in a weight-reducing program, we believed that the reduction in weight, body mass index and waist circumference may be a secondary effect of whey protein isolate supplementation. An association with insulin resistance and NASH has been shown in various studies.[19,20] However, the results of the study were inconclusive with the measurements of insulin sensitivity indices, except β-cell secretion determined by HOMA-β percentage. These indirect measurements may be too insensitive to reflect changes in insulin resistance. Alternatively, the main therapeutic mechanisms of whey protein may be by preventing of the second hit such as glutathione generation by oxidative stress pathway. In conclusion, undenatured cysteine-rich whey protein isolate supplementation of NASH patients lead to a significant reduction of hepatic steatosis as determined by liver attenuation index from computed tomography, a significant reduction of AST and ALT levels, a significant increase of plasma glutathione level and total antioxidant capacity as well as improvement in metabolic outcomes. Supplementation with whey protein might well find other applications for patients where oxidative stress and pathology of glutathione deficiency are implicated. Randomized, long-term controlled trials including histologic assessment with cysteine-rich whey protein isolate are warranted. www.medscape.com/viewarticle/707601_4Adding some soy protein to your diet seems beneficial, too: Nutrition. 2011 Sep;27(9):943-8. doi: 10.1016/j.nut.2010.09.004. Epub 2011 Feb 18. Soy protein retards the progression of non-alcoholic steatohepatitis via improvement of insulin resistance and steatosis. Yang HY1, Tzeng YH, Chai CY, Hsieh AT, Chen JR, Chang LS, Yang SS. Author information Abstract OBJECTIVE: Non-alcoholic steatohepatitis (NASH) is a common cause of liver disease, and it may progress to fibrosis or cirrhosis. The aim of this study was to investigate the effects of soy protein on hepatic steatosis and insulin resistance in NASH. METHODS: Forty male Sprague-Dawley rats were fed a high-fat diet for 4 wk to induce NASH and then were allocated to one of four diets: a NASH-inducing diet, a standard diet, a NASH-inducing diet plus soy protein, and a standard diet plus soy protein. RESULTS: After the 10-wk experimental period, the results showed that soy protein significantly lowered plasma cholesterol concentrations and body fat accumulation. Soy protein intake also decreased the hepatic lipid depots of triacylglycerols and cholesterol and decreased the concentrations of lipid peroxides. In an analysis of antioxidative status, rats fed the soy protein diet showed improved antioxidative potential due to increases in superoxide dismutase and catalase activities and a decrease in the protein expression of cytochrome P450 2E1. CONCLUSION: Soy protein may improve the liver function in patients with NASH by lowering lipid levels in the blood and liver, increasing the antioxidative capacity, and improving insulin resistance.
Copyright © 2011 Elsevier Inc. All rights reserved. www.ncbi.nlm.nih.gov/pubmed/21333494Please be sure to address this issue with your hepatologist, but I must say that these studies seem reassuring that you will be able to not only get in the protein nourishment that you need, but that it will be beneficial to your condition as well. Hang in there and know that we are all pulling for you. Your presence is a shining light on the forum and it has been missed. Wow...just wow. This is AMAZING information. Thank you so much!
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Post by PrettyGirlBounce on Jun 28, 2014 16:44:23 GMT -5
Yeah it is beyond frustrating to have to reschedule with Dr K due to the planning that goes into getting me there in the dang first place since I can't drive.
Shane's doing much better today...enjoying the pain meds a *bit* too much lol so keeping him closely under my wing though.
I am so grateful to my group here...spending your own time to research someone else's problem is such a special gift. This information is so helpful!! Thanks to all.
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Post by goodkel on Jun 29, 2014 8:12:02 GMT -5
Wow...just wow. This is AMAZING information. Thank you so much! I am delighted to help you in any way that I can.
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Post by fallds on Jul 8, 2014 15:10:33 GMT -5
Hey girl! Glad to hear you are recovering and have answers as to what your issues are. You and the others who are struggling on this board are in my thoughts and prayers even when I am absent from here for long periods of time. Take care of you and try not to worry so much. I know that if anyone can follow the rules and do what they need to do for their health... it's you. Muah! =)
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Post by teachermomolp on Jul 8, 2014 20:02:03 GMT -5
PGB- I'm thinking about you. I have NASH too and I'm so glad to read about the soy protein study. Are we so lucky to have these brilliant people here willing to help us?? Thanks Goodkel!!!
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Post by goodkel on Jul 8, 2014 20:57:18 GMT -5
PGB- I'm thinking about you. I have NASH too and I'm so glad to read about the soy protein study. Are we so lucky to have these brilliant people here willing to help us?? Thanks Goodkel!!! Thank you. That's very sweet of you. I'm not brilliant, I just like to research the questions I have.
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Post by maggiesara on Jul 13, 2014 9:53:52 GMT -5
Any new info here, Sharyl?
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Post by Girlrocker on Jul 13, 2014 10:12:25 GMT -5
Any new info here, Sharyl? Maggie! xo As a matter of fact, yes! I was able to visit Lisa here, Dr. Keshishian had her admitted for a couple of days starting Thursday so he could take a look at her, since her weight is continuing to drop. She had to cancel her appointment with Dr. Keshishian because her son got burned in the bonfire party incident, and she was too ill to make her specialist appointment. She's struggling with a few things - various abdominal pains from the obstruction surgery which have made it hard for her to eat, and, the diagnosis of NASH. She was admitted for a couple of days into the hospital, and she is now hooked up with a PICC line, TPN, got loaded up with fluids and other supplements, and was feeling like a different person, much better. She needs to put on about 15-20 lbs. She and her beloved doggies are staying with her parents, and now she'll have home health care to help with the PICC line. Next rescheduling with the liver specialist. Lisa feels more encouraged, like she has a real game plan now, and has started to make tweaks in her DS eating to better work with the NASH. We had a nice long visit, the hospital let me stay until 10p, and I know it means a LOT to her that everyone here is in her corner. You're a doll to ask considering your own ordeal too!
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Post by teachermomolp on Jul 13, 2014 15:41:09 GMT -5
Lots of us are thinking about you PGB! Get well!
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