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317787 tn?1473358451

The Liver, time table and nourishment

I have a question that I think relates to the liver.  I have cirrhosis.  I am suddenly waking at 3 am every night.
As I tend to do I search for answers to find out what I can do so that I can be awake at dinner time or at least noon.
I have read, someplace, that the liver does its cleansing from 1-3 am and for sensitive people it can awaken.  I have also read the Hepatic Encephalopathy can cause a persons days and nights to get mixed up, I am hoping that is not my answer.

I have also had numerous tendon problems, a snapped one while just stepping down, golfers elbow, tennis elbow,
planter fascias, knee problems, now frozen shoulder.  I thought I should try to find out what I can do to help myself.
I read on an acupuncturist site that tendon problems can be cause by the liver not nourishing the tendons. I am going to continue my search however wanted to ask here.  I fought the HCV virus for many many years, it is now dead. I would like to get my life back or at least function.  I hope it is ok to ask this question here.

I would appreciate any response, thank you
Dee
Best Answer
Avatar universal
Here with ESLD Stage 4, decompensated liver, Meld 12, holding moderate liver level, am on a tp list, have HE and HCV (viral load 1 Million)

With cirrhosis I do not maintain a normal sleep schedule.  This is common at my stage and you just learn to deal with it.  I normally will sleep 4-6 hours, get up around  do things and walk the dog, and can easily be asleep within two hours of waking up in the morning.  I will sleep another hour or two, then be up for about 6-8 hours, fall asleep for another couple of hours...then be back up for 4 -6 hours and start over again.  

There is no rhyme or normal pattern.  The sleeping pattern can change daily or weekly.  I do tend to find if I am out and about I can tend to stay up all day and if I can get over that 4 pm - 6 pm draw to sleep I will stay up.  However, sometime this also means I can not sleep at all and will do a good 16-24 hours straight up and then crash.

Also a whole day of out and about activity, maybe even two days, will lead me to be down the next day for most of the day in a series of many cat naps.  

I'll bring up a couple of things that haven't been mentioned.:

I eat very small meals.  Try to also keep something like fruit, greek yogurt or a few other things and eat a handful or couple spoonfulls.  Drinking plenty of water is essential at this point of my disease.  

I try to walk my dog several times a day and I am still able to drive and usually will go somewhere with him to a local dog park or just go get a coffee.  Activity is also essential.  

Sometimes I don't really sleep, I just close my eyes.  Swear I couldn't open them if I had to...so it is kind of like sleep but I hear everything going on.  Other times I descend into a coma like sleep....

As someone said above, my liver controls my sleep patterns at this time.  Everyone who is around me, even my 6 yr old granddaughter, can tell by the look on my face, my body movement and my eyes that I need to lay down.  My family is the most freaked out by my sleep patterns because I was always the person who went to bed at 1 a.m. and was up by 5 or 6 a.m.  Always said I could sleep when I was dead.  No time to waste on sleep.  LOL.

But now the reverse is true too. The other day I fell in to one of those coma sleeps, must have had disruptive breathing because my little dog was on top of my head licking my forehead, eyes and ears until I woke up.  He will do that....hate it...and that's why he does it...he has a intuitive ability to tell when I am in trouble.  He got his lease, plunked it on my chest.  I clipped it to his collar and he pulled and jumped around so much he was funny that I got up but I was so dizzy but I went out the front door, and he led me straight over to the apartment office across the street.  In retrospect I probably looked like a drunk walking over the lawn but I got to the door, opened it and went in and sat down and started talking to my friends who work there and within about 10 minutes I was fine.

Feel sorry for him because he usually only sleeps when I am awake and up.  I'll open my eyes when I am sleeping and he is sitting in his chair, with his jaw on his paws, just watching me.  

So staying active, drinking water, eating many small meals.and napping when my body tells me to or just plain resting is what I do. And yes it is aggravating to be watching a TV show or reading a book or being on the computer and the next second you wake up and it's 3 hours later.  When I cook I never sit down....just on a kitchen stool if necessary.  

And yes, it is also aggravating not to be able to do all social commitments you want to.  If I go to the store today, that is it for the day.  If I go to one of my grandkids soccer games today, I will not do anything tomorrow. I once was the person who could do a dozen things at the same time. Not now.

The activity helps the blood flow, the water flushes the liver and kidneys and keeps you hydrated which is important also for your skin, blood pressure and muscles.  Eating smaller meals does not put the stress on the liver all at one time as a large meal would since your liver works to filter everything you intake into your body at this point and at my point will sap my energy. Not as much if I eat smaller meals.

I have muscle problems in my knees and hips and right now have a pulled tendon in my upper right arm.  I am doing exercises for knees, hips and arm.  As a nutritional person I think a lot of that comes from apathy because we aren't eating sufficient  amounts of protein, might not have adequate vitamin and mineral levels, and have to watch iron, sodium and sugars.  We aren't exercising or as mobile as we should be or were.  Plus there are some medicines that can affect these issues after prolonged use.  But we also could just be at a age after a active life that lack of the same activity leads to problems.  My knew could be from being taking 18 yrs of dance, being a softball catcher for about 10 yrs, and bartending and working in 6 in. heel highs for too many years to count.  

I am a yogi and have stopped doing all but minor stretches at this stage. Have a palates machine, a yoga chair, mats, etc.;  a bike, and a total gym plus a library of yoga tapes.  But I do walk about 3 - 4 miles a day, even with several rest breaks along the way and do stairs multiple times a day.

I never sleep at night anymore...haven't for a couple of years......a.m. appointments are the worst because this is when I sleep!  I can feel the loss of strength and energy slowly ebbing away and know that eventually I will be sleeping more than being awake but until that time comes,  I will put one foot in front of the other and keep on trying.

Oh one more thing...I had fatigue with the HCV....mine is still active.  But my doc said that even if my HCV was gone, being in cirrhosis you now have cirrhosis issues.  As in my case, if they cured my HCV today I'd still have to have a transplant.  So while one may or may not lead to another, I look at all of this diseases or problems as separate and as a unit but mainly as separate issues.  

Good luck to you finding your answers.  
31 Responses
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5901196 tn?1395543909
I'm VERY glad to have been of some help! And even happier that it worked.
SWEET DREAMS  :)
Dee
Helpful - 0
317787 tn?1473358451
Thanks so much for posting. I tried 3 mg of melatonin, it did not work. I ended up taking 6 and that worked great.
Thanks again
D
Helpful - 0
Avatar universal
Hi,
I am following the postings on this forum and they provide me
With big help.
I have, had, the same problem with sleep pattern.
My solution was to stop drink and food about 3-4 hours before going to sleep.
I used to wake up 4-8 times each night; not anymore.
Melatonin is also a good option, if it works for you.
Helpful - 0
317787 tn?1473358451
Hey there, so happy the melatonin is working for you.
Thank you for adding that, it does help. I know how important keeping days and nights straight can be.  Like you I was determined not to let my days and nights get mixed up.
Dee
Helpful - 0
5901196 tn?1395543909
Hi Dee,
  I've been following this conversation. I was having trouble with my days and nights too. I found a natural sleep aid named, MELATONIN 3 mg. tablets. (There's a stronger dose, I don't know what it is, I never looked.)
  I haven't checked with my Dr. yet. I plan on it when I see him next. I pray he doesn't tell me I can't take them anymore for some reason.
  Just thought I'd share this info. in the hopes that it may help!  It's definitely helped me. My days and nights are back to "normal".
Take Care,
Dee
Helpful - 0
317787 tn?1473358451
Thank you my dear friend for your excellent response. I really appreciate you helping Val.
Love
D
Helpful - 0
1840891 tn?1431547793
Hi Val, and welcome to the forum. I am really sorry to hear about this.  Hector knows vastly more about this level of cirrhosis than I do, but he is sometimes unavailable for a few days at a time, due to his own illness, so I wanted to reach out in the meantime. Based on what you've said, your husband has pretty severe cirrhosis, with varices, ascites and hepatic encephalopathy. He should be under the care of highly skilled hepatologists and he should be on the liver transplant list. Unfortunately, this is not going to happen if he is continuing to drink. He is by definition an alcoholic if he is continuing to drink with such a sick liver, and no alcoholics are ever added to the waiting list for a new liver until they have been off the alcohol for at least six months. Livers are in short supply, so they are carefully apportioned to those individuals where they are both most needed AND most likely to provide a long life. Alcoholics are considered a poor placement, as they are likely to destroy the new liver quickly, when it might provide much longer benefit to someone who isn't drinking. That rule in itself can tell you a lot about how bad continuing alcohol use is for your husband's liver. If his doctors aren't saying this clearly it might be for one of the following reasons: 1) they are not adequately knowledgeable about liver disease, or 2) he may have made it clear in previous visits that he had no intention of giving up alcohol. If its the former, you should step in and help him transfer his care to hepatologists at a facility that does perform liver transplants, as even if he is not a candidate these are still the best doctors for treating him at this point. If it is the latter, then there isn't much you can do other than get yourself some support while encouraging him to give up the drinking. I'm sending lots of good wishes and hopes your way.
Helpful - 0
317787 tn?1473358451
Hi there, yes others will answer as well.
Helpful - 0
Avatar universal
Thanks for your help, I'm new this forum and could not figure out how to address a certain person on this site, but I guess anyone's input would be great!
Helpful - 0
317787 tn?1473358451
Hi I have taken  your question and posted it so that Hector will see it, I hope that is ok.  I was worried he would not see it here
Dee
Helpful - 0
Avatar universal
Dear Hector,
I have been researching about cirrhosis for hours a day since my husband was diagnosed with it exactly one year ago. The symptoms started way before that with extreme tiredness, depression.... After that , in last October he was throwing up blood and had bloody stools for   a month or two. He went to the hospital and got some plasma and the bleeding got fixed. reading your post made me realize that you have a lot of insights and good advice for people with this condition. Up to this date my husband is declining fast. He had a couple of episodes when he did not know where he was or who his family members were. His legs are swollen all the time in spite of water pills, he sleeps all the time, his stomach is huge and full of water, he has muscle aches, tiredness, he is always irritated and angry, he started to have a yellow colored skin. I have been trying to convince him to stop drinking and of course the doctors warned him also, but he is still consumes alcohol. He is in denial and does not think he is close to death at all. Do you have any idea how his progression will be in the next few months if he keeps this up? The doctors don't act  too anxious, he has a check up in every three months and they never say anything alarming front of me. The last two times my husband did not want me to go so I have no idea what they told him. I'm really worried and don't know what to do or what to expect. Any input will be extremely appreciated. Thanks!
Helpful - 0
317787 tn?1473358451
Hi after reading again I decided to test it. I went to the Mayo site, entered
1.0 INR
.6 Bil
.77 Creat

Came up with Meld Score of 2
I hope I did this right.
Thank you again
Helpful - 0
317787 tn?1473358451
Hi thanks so much, I appreciate your response,
I tried to do that meld score before treating this last time and I came up with little to nothing as far as my blood work.  Everything is now, since finishing tx, within the normal range, It has been almost two years since I started tx and within 4 weeks I was UND. My INR is within normal range.
In fact my hepatologist does not think I have cirrhosis.  He said the diagnosis was iffy.
Helpful - 0
Avatar universal
If you do have cirrhosis you have probably had blood work.

You can go to Mayo Clinic...type in MELD in the search box and it will give you a configuration that you can figure your MELD score on.

You will need your levels from your lab report of:
INR
Bilirubin
Creatinine
Helpful - 0
Avatar universal
You know Dee I have just come to the place that I can't be concerned with how others look at me.  People will say "everyone gets tired"...they do not know this tiredness.

My 12 year old grandson has Type 1 Diabetes since he was about 1....he explains it well.  It's like I am a helium balloon just zooming along and all of a sudden the helium is gone.  He understood almost before anyone else did.  

The others are finally catching on as I fall asleep for a hour or two on their couch.  It seems the youngest get it best.  My granddaughter who is 7 will say say...oh-oh...I better get a pillow and blanket for grandma. She tells everyone she is on my support team....her mother, my daughter, has finally got it and understands it.

My little dog will herd me to where I can sit down or lay down.  My God...if a dog can understand why can't people?

As people realize the serious of the disease more they understand.  If they don't, they don't.  I tell my kids I would love to come and do this or that with them...give me the date, the time...I will call if I can make it.  I can wake up just fine or yesterday was wonderful and then today I crash. It's been that way for years....especially around holidays when stress is so high.

When I was going through all those trials I worked for Anthem who was wonderful....they were amazed that I could work like I did.  They arranged that I could come in for 8 hours anytime between 6 a.m. - 8 p.m. M to Sat to get my 40 hours in.  Some other employers are not that helpful....

So people, employers, and so called friends who don't make an attempt to understand or educate themselves or believe you.... I really just do not have time for.  I am more than willing to try to help anyone understand but the consideration is...do they really care enough.

I am still trying to help my sons understand all of this. It is hard to see some of their struggles with this information.  My oldest son has a PHD from Wharton and he is struggling the most....my other son is working on creating a line of hot sauces and spice rubs and he is calling them  "Summer's...this or that...what ever it is"...he has buried his head in doing what he does best...both boys have always believed that I was strong and they are going to have a really rough time with all of this.  

My kids I will try to help...those in the family who I am close to know from watching me all these years that it is weird to see me in a lawn chair and not on the high dive or out kicking a soccer ball, going to a tailgate at IU or at the Colts or just go-go-going.

And you know Dee...you need to do what is right for you.  I eliminate all people who will cause me stress as at this point of where I am at, stress is bad.  Start going to sleep on their couches...maybe they will get it. LOL

But seriously I do try to explain to them...and you are right...that is what makes this disease so insidious is that you can't see it.
Helpful - 0
317787 tn?1473358451
Thank you again, every thing you wrote was wonderfully helpful to me. I really appreciate you taking the time to answer
I am trying very hard to improve.
I went through 2 tx's and had hope that I would improve.  I am still trying.  As you said, putting one foot in front of the other.
I do things similar to you. I can get up early raring to go, do well for about 6 hours then need a couple hour nap.
How do you explain that to people?
I have tried to tell them that my body has limitations, they just laugh at me or make fun of me for going to bed early or for taking a nap.
I am really trying as hard as I know how.
I would love your advice on how to tell others in a way they could understand.
I think if I had a broken arm it would be easier, they could see, they can't see the broken liver.
Thanks again, you are a love
Dee
Helpful - 0
317787 tn?1473358451
Oh sweetie, don't knock yourself out that way, argh!  Sometimes I take 10 mg melatonin
I try reading a book before falling asleep but then I fall asleep with the lights on TV blaring, I know that can't be good but if I move to turn it all off, then I am awake :)
Thanks for sharing
D
Helpful - 0
4043517 tn?1374006573
That sums it up great, my life as I know it. Last night passing out, stumbled to bed, awoken it seems like 10 hours later, but it was only an hour. I was then up for the next 6 before I was tired enough to doze off, the best is when I knock myself out with my Kindle. Just when I was getting some good sleep the Kindle falls forward into my head getting my attention.
Helpful - 0
317787 tn?1473358451
He there, thank you so much for your post, this is great, to share with each other.
I just found something about the liver and how stress affects us.  I thought it was interesting and wanted to share with you guys

http://www.liversupport.com/wordpress/2011/04/five-signs-you-and-your-liver-need-stress-relief/?eml=lshn104&utm_source=iContact&utm_medium=email&utm_campaign=LiverSupport.com&utm_content=LSHN104+A
Helpful - 0
317787 tn?1473358451
mixing again, it is interesting, I hope, this is about the liver

The liver holds the final position, number twelve, in the body clock. The clock starts each day at 3 AM with the lungs, and passes the baton every two hours to a different organ throughout the 24 hour clock. This month our focus will be on the liver which begins its daily routine at 1 AM and continues until 3 AM.

The liver has a number of functions including:
• Managing blood volume and menstruation
• Determines tone of muscles
• Produces healthy nails
• Regulates eye health and vision
• Synthesizes life and coordinates the body’s work for each day

Often the following symptoms may accompany a liver that is not balanced:
• Depression or moodiness
• Spots in visual field
• Uterine fibroids, abdominal masses or lumps
• Red eyes or face
• Irritable bowel; flatulence
• Bitter taste
• Fever
• Spasms of neck and shoulders

There are a number of ways to address an imbalance in the liver such as exercises like Qi Gong, Yoga, or Tai Chi.
The liver ends our body clock journey. If you wake up multiple times a nig
Helpful - 0
317787 tn?1473358451
http://www.theholykale.com/2011/11/livin-with-a-liver/
Just anecdotal but I will find more.
I just type liver waking me in the am and find all kinds of stuff, some silly some informative

I am hoping the serrapeptase, like the probiotics will help
Helpful - 0
317787 tn?1473358451
Hi I did find that our liver does its most imortant work between 1 and 3 am and in sensitive people it can wake them.

I will look for the report or article
Helpful - 0
317787 tn?1473358451
Thank you so much for posting, you are so right! I was looking for connections between the liver and joint tendon problems and came across this one site, I only copy and pasted one part of it which I did not need the entire site, it would have been even more confusing :)

I am learning that the frozen shoulder I have is where the body lays down collagen over the shoulder joint and the arm and slowly grows until the arm and shoulder are one unit.  Not a good thing if you want to wash your hair or put on a shirt or a coat.

I am working on it with PT and I am also taking something called Serrapeptase to try to help me get rid of the extra collagen that is in the wrong place.  I wonder if I could convince it to move to my face? ha ha

Thanks so much for your response.  I can also see where bad habits picked up over the past two years, since starting tx, are contributing to my problem.

I am taking glucosamine and chondroitan to try to help with the joints, tendons, ligaments.

Something is helping, not sure which one :)
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