RE: Re: Can I drink........

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Copper wrote:

> Would this cause you more or less concern (or could an individual's

> " hope " or " personal preference " for study results influence their

> interpretation)? Or would this cause you to have more questions about

> the validity of the study itself?

It's true that the " true " value *could* be anywhere in the range, but

it's also true that the number given (2.95 in the study under

discussion) is the most likely to be correct. For instance you could

lower the confidence interval to say 80% and exclude the numbers at the

outside ends of the 95% confidence interval. So instead of say " odds

ratio: 2.95; 95% CI: 1.04-8.3 " you might have " odds ratio: 2.95, 80%

CI: 1.7-6.2 " (numbers I made up btw). Meaning that you can be 80%

certain that, not only is the " real " number in the range 1.7-6.2, but

also that the " real " number isn't outside that range.

So while a wide confidence interval does make it harder to draw a

definite conclusion, in the case of this study it would actually be

pretty hard to interpret it as saying anything other than that alcohol

increased the risk of CCA. One might add that further research was

warranted, but the interpretation that (for instance) alcohol didn't

increase the risk of CCA (due to the fact that 1.04 was inside the 95%

confidence interval) would be an obviously biased opinion.

I hope that's not too confusing. can probably clarify and correct

anything that I've got wrong! It's been a long time since statistics class!

athan

[Guest guest]

My hepatologist said that alcohol can tip the scale and cause sudden liver toxicity. I doubt this is very common, but still something that would be horrible to have happen.

Marie

To: From: tom@...Date: Sat, 5 Jan 2008 20:35:38 +0000Subject: Re: Can I drink........

I also had to sign a statement that I would abstain from alcohol andany illicit drugs in order to stay listed. Like you, I was also toldthat even "alcohol free" beverages can contain trace amounts ofalcohol that will show up on the random tests that we receive.While I'm told that there is no proven PSC-Alcohol linkage, I thinkthe concern is that given the dearth of transplantable livers, anyonewho might potentially abuse alcohol should not qualify for transplant.This doesn't imply that anyone who drinks the occasional glass ofwine is an alcoholic. Any alcohol is going to stress the liver,causing undue strain on an organ that has already been traumatized bygoing through the transplant process.I've been on the wagon ever since I got listed, and it isn't bad atall. I was never much of a drinker anyway, but abstaining was easierthan I thought it would be. It's a small sacrifice to have a chanceat a life-saving transplant.Tom>> Unfortunately all cases are different. I have not heard of a study > that proves that PSC was caused by alcohol or that PSC has worsened > because of alcohol use. > > An example is my wife. She has PSC that causes severe itching > (pruritis)on a daily basis and very poor quality of life because of > this. Prescription drugs give no relief and she is now on the > transplant list at UCSF because of this. Her MELD score, however, is > only 6 (the lowest) and the MELD gives no "credit" for pruritis > because the MELD authors determined that "Quality of Life" is not > an "Exception" for a transplant. She has been told that it can be 20 > years before she qualifies for an actual transplant.> > Before being listed she enjoyed an occasional glass of wine, that > helped cope with the horrible itching. However in order to be accepted > on the transplant list (for what it's worth) she was required to sign > an agreement to not use alcohol (even the "alcohol free" kind), and a > number of prescription drugs. They do random testing for this.> Get the power of Windows + Web with the new Windows Live. Get it now!

[Guest guest]

athan -

Thanks - your explanation was not too confusing!

Joanne H

-----Original Message-----

[Guest guest]

Suzanna, for every one of us, this " can I drink? " question will depend in

large part on our chosen transplant center's protocol(s). My husband (by

definition, a teetotaler) was txd @ USC in Los Angeles, & their protocol

happens to be zero tolerance of not only alcohol in any way, shape or form,

but grapefruit consumption, too (as grapefruit can negatively interact

w/post-tx chemical immunosuppression... especially stuff like Rapamune).

Re wine sauces, the belief that alcohol " cooks off " in cooking is actually

skewed thinking... it actually does NOT, at least, not nearly to the levels

once believed (depending on cooking method, time & temperature, all kinds of

variables). When our daughter attended culinary school, she learned from

her professors that President Bush (I think the first Bush, not the second?)

ordered a " definitive " study on that, & the results of that study (which I

wish I had!) absolutely " rocked the culinary world. " Uh, so we were told.

All that being said, it's quite possible that, post-tx, SOME tx doctors/tx

centers out there WILL " approve " alcohol on some scant-to-moderate level

(sure, youbetcha, go ahead & celebrate your birthday with a lil glass of

wine, I've heard some posters post they'd supposedly been told by their

docs) ...regardless, Jim chooses 100% compliancy w/his tx center's protocol.

This topic of discussion has become (oh-so-slightly) heated in the past...

not only in this group, but even moreso in a different liver transplant

group (in which I lurk 'n' learn), but all in all... we listen to our

trusted doctors, who hopefully abide by their transplant center protocol.

N'est-ce pas? ;-)

Maureen, of the too-long tag line. Here's an example:

(wife of Jim: UC & elevated LFTs '84; PSC '96; LRLTx # 36 on 12/7/01 at USC

in CA; donor son doing well; post-tx incisional hernia surgical repair

1/03; multiple post-tx skin cancer issues presenting 18 months out &

continue, to this day; sporadic post-tx UC issues -- which means Jim has

dermatology appts every 90 days & undergoes colonoscopy every 24 weeks; in

new learning curve for possible future colectomy?); one-time ecstatic empty

nesters & delighted doters to grandsons Stryder & Indiana... who've now made

room in their home for daughter Jillian, her boys, ages 2+ & 1+, & newborn

daughter Leia. Except we must wait for an injunction or some such legal

thing, as AZ has jurisdiction over the children. Son-in-law abandoned our

daughter 2 weeks before Leia was born, after he quit his church job & lost

their medical insurance benefit. & he has subsequently impregnated his

mistress who lives back east - uh, said impregnation actually occurred while

Jillian was convalescing w/us in CA, & SIL brought the " other woman " into

their AZ home. This guy insisted he wouldn't pay Leia's hospital bills,

wanted Jillian to apply for welfare, instead... then proceeded to run up

$11K credit card debt on his mistress over the next 2 months. Mistress is

supposedly being divorced by her Navy husband, who's suing for custody of

their 3 girls aged 6, 4, 2. Latest update on this soap opera -- which

defies all country western music lyrics, if you ask me! -- is that the

Psychopath SIL flew off to FL just this morning, after returning to AZ to

supposedly work on his marriage... but the pastor caught him in more lies,

hence the hasty getaway? We're all heartbroken, & we sure could use your

prayers. especially for our daughter's & her 3 kids' protection. And yes,

after wrestling with the decision, & giving counseling a chance -- which is

more than he afforded her -- this young woman of grace has finally decided

to divorce him.) See, I TOLD you it was a too-long tag line! :-(

Re: Can I drink........

Seriously? No alcohol whatsoever? My doc didn't mention anything

about this. I rarely drink anyway, but I LOVE wine sauces and cooking

with cooking wine. Does this only apply to people on transplant lists

and post-transplant patients?

Suzanna

[Guest guest]

When my son has talked to his Dr's they told him he could have a drink at his sister's wedding. When he went the last time they asked if he drinks. He is honest and say yes but does not like the taste so it it 1 drink about twice a year and they said that was fine. Martizus888 wrote: Seriously? No alcohol whatsoever? My doc didn't mention anything about this. I rarely drink anyway, but I LOVE wine sauces and cooking with cooking wine. Does this only apply to people on transplant lists and

post-transplant patients? Suzanna

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