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Hello all,

I have read most of the messages since joining last week, and have to

admit learned more than I could have ever gleaned out of the many

doctors I have seen.

I went to see a Hep doc in San Francisco back in January. I was

actually feeling better; the nausea was minimal, the pain was down,

and the fatigue was better. When I returned home to New Mexico, all

my symptoms came back and then some. Lately I've been getting

extreme hot flashes followed by intense chills lasting sometimes for

hours. I increased my compounded estrogen cream but it didn't help.

I am up to four times the dose and still no help. I'm getting severe

pain on the right side of my abdomen when I eat and then intense

nausea.

All the doctors I have seen just tell me that I will get sicker and

then need a transplant. They didn't bother to say that the PSC would

be causing any of my symptoms. Have any of you experienced the hot

flashes followed by the chills? Could really use some help here.

Thanks,

Enid in NM

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As someone already mentioned, fever, nausea, chills and URQ pain etc.

can be symptoms of bacterial cholangitis. Hot flashes usually aren't

mentioned, but these can accompany a fever also, so I wouldn't rule it

out based on them.

You definitely do need to find out what's going on, and if you do have a

significant fever (it's hard to say exactly what's significant, but I've

seen 101.5 mentioned a number of times) it may be time for a trip to the

ER. Bacterial Cholangitis can be very serious. Also in my own

experience, when I started having mild bacterial cholangitis attacks

they kept reoccurring until I had a course of antibiotics, so if you

don't have fevers or if they're low grade, you may be able to just get a

prescription for antibiotics (Cipro is what I always got) to take.

Hope you get it figured out!

athan

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As someone already mentioned, fever, nausea, chills and URQ pain etc.

can be symptoms of bacterial cholangitis. Hot flashes usually aren't

mentioned, but these can accompany a fever also, so I wouldn't rule it

out based on them.

You definitely do need to find out what's going on, and if you do have a

significant fever (it's hard to say exactly what's significant, but I've

seen 101.5 mentioned a number of times) it may be time for a trip to the

ER. Bacterial Cholangitis can be very serious. Also in my own

experience, when I started having mild bacterial cholangitis attacks

they kept reoccurring until I had a course of antibiotics, so if you

don't have fevers or if they're low grade, you may be able to just get a

prescription for antibiotics (Cipro is what I always got) to take.

Hope you get it figured out!

athan

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As someone already mentioned, fever, nausea, chills and URQ pain etc.

can be symptoms of bacterial cholangitis. Hot flashes usually aren't

mentioned, but these can accompany a fever also, so I wouldn't rule it

out based on them.

You definitely do need to find out what's going on, and if you do have a

significant fever (it's hard to say exactly what's significant, but I've

seen 101.5 mentioned a number of times) it may be time for a trip to the

ER. Bacterial Cholangitis can be very serious. Also in my own

experience, when I started having mild bacterial cholangitis attacks

they kept reoccurring until I had a course of antibiotics, so if you

don't have fevers or if they're low grade, you may be able to just get a

prescription for antibiotics (Cipro is what I always got) to take.

Hope you get it figured out!

athan

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Enid,

Why are you on Estrogen? Does your liver specialist know this? Mine absolutely

forbids any

HRT, says it's very dangerous for people with compromised livers. Maybe the

reason you are

having pain right now ????

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Enid,

Why are you on Estrogen? Does your liver specialist know this? Mine absolutely

forbids any

HRT, says it's very dangerous for people with compromised livers. Maybe the

reason you are

having pain right now ????

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What you are experiencing is part of the

disease; however, when you have a cholangitis flare up you will know.  At least

in my case, my fever spiked, I had chills, I ached all over, my upper abdomen

hurt much more than usual, I couldn’t eat due to nausea and I was

fatigued.  Your symptoms may be different, but unfortunately I think they will

be worse than they are now. 

I had one when they diagnosed me and was

lucky enough after my ERCP, to have virtually no symptoms for fifteen years. 

Then the cholangitis attacks returned.  My key for knowing when I had one

coming was the fatigue.  It is beyond tired, it was closer to exhaustion.

From:

[mailto: ] On

Behalf Of serbrinamv@...

Sent: Wednesday, February 25, 2009

6:13 PM

To:

Subject: Re: Not

doing too well

Hi I was

diagnosed with PSC in 2004 and have had an ERCP to balloon my bile ducts and

have had elevated liver enzymes for years. I've been reading on the posts about

" bouts of cholangitis " but feel very naïve because I'm not sure what

that really consists of and how I will know if I am experiencing that. I often

experience discomfort in my upper right side quadrant and have as cites but do

those symptoms constitute as cholangitis or are they just part of the disease.

Thanks for the help.

Serbrina L.A./UC '01, PSC '04

Sent via

BlackBerry by AT & T

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What you are experiencing is part of the

disease; however, when you have a cholangitis flare up you will know.  At least

in my case, my fever spiked, I had chills, I ached all over, my upper abdomen

hurt much more than usual, I couldn’t eat due to nausea and I was

fatigued.  Your symptoms may be different, but unfortunately I think they will

be worse than they are now. 

I had one when they diagnosed me and was

lucky enough after my ERCP, to have virtually no symptoms for fifteen years. 

Then the cholangitis attacks returned.  My key for knowing when I had one

coming was the fatigue.  It is beyond tired, it was closer to exhaustion.

From:

[mailto: ] On

Behalf Of serbrinamv@...

Sent: Wednesday, February 25, 2009

6:13 PM

To:

Subject: Re: Not

doing too well

Hi I was

diagnosed with PSC in 2004 and have had an ERCP to balloon my bile ducts and

have had elevated liver enzymes for years. I've been reading on the posts about

" bouts of cholangitis " but feel very naïve because I'm not sure what

that really consists of and how I will know if I am experiencing that. I often

experience discomfort in my upper right side quadrant and have as cites but do

those symptoms constitute as cholangitis or are they just part of the disease.

Thanks for the help.

Serbrina L.A./UC '01, PSC '04

Sent via

BlackBerry by AT & T

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Enid-

My husband (62/PSC 2006) has severe boughts with hot flashes and

chills. His hot flashes and chills will sometimes last up to several

hours. This is sometimes accompanied by mid to severe nausea. Often

this happens when he is not taking in enough liquids.

He is now home with a central line and I give him IV fluids every

several days and it seems to help.

Early on when he would get these " attacks " , the chills ( the severe

ones where your whole body shakes uncontollably are called " rigors " )

he would not be able to warm up (put blankets in the dryer..it helps)

for about an hour or so. Our Gastro doc told us that it was a

cholangitis attack. Your urine could turn darker after this also.

Now, I do not know what stage you are in, however, my husband has had

his bile ducts removed to his liver and artificial stents put in and

had his gallbladder removed. They have attached those stents to his

small intestines. Sometimes for one reason or another the bile will

thicken and this will cause chill/hot flashes/ fever, etc. He takes

900mg of Urso/day...Lactulose 2T/ day /protonix to help with bile

acids/ carafate to coat his stomach and fenigrin for nausea / He also

has several pain meds that do not metastisize through his liver. They

have a calming effect when he is going through this.

As far as getting help....there are docs who know this disease and

should be making you as comfortable as possible. We are fortunate

enough to have one (Dr. Briggs,Tulsa, Ok). He makes our

nightmare easier.

Blessings.

Bobbie

>

>

> Enid,

>

> I have not had any of the symptoms you mentioned, except hot

flashes, and those were

> definitely caused by menopause.

>

> I am on a very low-dose estrogen patch (which has completely

eliminated the hot flashes),

> and that was approved by my Hep, as long as my LFTs are monitored

every 3 months. If

> there is any sign of the LFTs steadily increasing, I will have to

go off the patch.

>

> There is a big difference between orally taken estrogen, which must

be processed by the

> liver, and topically applied estrogen, like you (and I) are taking,

which largely bi-passes

> the liver. However, you still need to be monitored very closely

while you are taking it. It

> wasn't clear to me from your post whether you increased your

estrogen under the advice

> and care of a doctor, or on your own. But it could be very

dangerous to increase it 4x

> without a doctor's supervision.

>

> Are the docs that are telling you that you will just get sicker and

sicker liver specialists? It

> sounds like you might need to look for a specialist who will listen

to you and be more

> understanding. You definitely should not just accept the symptoms

you are having.

>

> I hope you can find some help and are feeling better soon.

>

> Debbie

>

>

>

> >

> > Hello all,

> > I have read most of the messages since joining last week, and

have to

> > admit learned more than I could have ever gleaned out of the many

> > doctors I have seen.

> >

> > I went to see a Hep doc in San Francisco back in January. I was

> > actually feeling better; the nausea was minimal, the pain was

down,

> > and the fatigue was better. When I returned home to New Mexico,

all

> > my symptoms came back and then some. Lately I've been getting

> > extreme hot flashes followed by intense chills lasting sometimes

for

> > hours. I increased my compounded estrogen cream but it didn't

help.

> > I am up to four times the dose and still no help. I'm getting

severe

> > pain on the right side of my abdomen when I eat and then intense

> > nausea.

> >

> > All the doctors I have seen just tell me that I will get sicker

and

> > then need a transplant. They didn't bother to say that the PSC

would

> > be causing any of my symptoms. Have any of you experienced the

hot

> > flashes followed by the chills? Could really use some help here.

> >

> > Thanks,

> > Enid in NM

> >

>

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