Any help Appreciated

[lahan]

I just found out that my mother in law has hepatitis C and cirrhosis.  After speaking to my sister in law, the doctor said her symptoms are progressing faster than anticipated. There is apparently 6 levels of liver disease and mom is at stage 4, which means that they can only control the symptoms for a time unless she receives a new liver. However, after doing some research I am not finding the 6 stages he is talking about.

Can someone please advise on what kinds of questions I should ask the doctor.  My husband and I live far away from our inlaws and are very concerned.

Any information or a starting point would be a big help as we are both new to this and very confused.

thank you

[HectorSF]

Grading and Staging a Liver Biopsy

Metavir

The scoring uses two numbers to assess the liver’s inflammation (the amount of
swelling and irritation “activity”) and fibrosis (scarring from prolonged inflammation).
Fibrosis is graded on a 4-point scale for fibrosis and inflammation. The fibrosis is
staged as follows:
• 0 = no fibrosis or scarring
• 1 = minimal scarring
• 2 = scarring has occurred and is outside the areas of the liver which include blood vessels
• 3 = bridging fibrosis (the fibrosis is spreading and connecting to other areas that contain fibrosis)
• 4 = cirrhosis or advanced severe scarring of the liver

Knodell
The Knodell score or HAI (histologic activity index) is also commonly used to assess or “stage” liver disease. It is a bit more complex a process than using the Metavir score; but some experts believe that it is better at finding how much
liver inflammation and damage are present. It has four different numbers that make
up a single score. The addition of these numbers reveals the amount of inflammation in the liver:

• 0 = no inflammation
• 1-4 = minimal inflammation
• 5-8 = mild inflammation
• 9-12 = moderate inflammation
• 13-18 = marked inflammation
The fourth part of the score assesses the amount of scarring in the liver and is scored from 0 (no scarring) to 4 (extensive scarring or cirrhosis). The report will be sent to the doctor to review and discuss with a patient.

The point is that she has cirrhosis. Since you indicate that her only option is a liver transplant, she needs to get listed at a transplant center.

Search the Internet if you want to learn more about cirrhosis, liver transplants and the progression of cirrhosis. The main thing is to support her throughout the process. Assist her in any way possible. Support from family and friends is at least half the battle. That is the most important thing you can do.

Best of luck.
Hectorsf

[copyman]

I would start by making sure she is seen by a Hepatologist (liver specialist).

Sounds like your mothers stage is for the scale they use in other countries to measure fibrosis stage. I believe it has 6 stages. (forget name of scale ?)

Here in USA they use a scale with 4 stages, 4 being chirrhosis.

[vik97]

Hi lahan,

Welcome to the forum.  There are 4 stages of liver disease.  The first 3 stages are mild to moderate fibrosis or scarring of the liver and the 4th stage is cirrhosis, which is usually irreversible.  The severity of cirrhosis is indicated by a MELD score.  I would ask the doctor what your mother-in-law's MELD score is now and what is was a few months ago.   Also, what are her symptoms and how severe are they?  If you have any lab results, biopsy results or bloodwork, it would help us to find out how severe her cirrhosis is.

Vik