1 hour ago, Neeranam said:

My wife and I share our money, so if she wants to help her brother, it's up to her. If I want to help my brother, it's up to me. 

Sounds fair enough.

 

 

9 hours ago, Sheryl said:

As he is now in hospital in the US he is not in any condition to go see another doctor.

 

And frankly the CT scan result is abundantly clear.

In the US? i must have missed that post

6 hours ago, scubascuba3 said:

In the US? i must have missed that post

Sorry, autocorrect mistake. Meant to say ICU.

 

So definitely not in a position to make the rounds of other doctors.

 

Given the clarity of the CT scan findings, and his described critical condition,   I really cannot see the point.

 

 

14 hours ago, Neeranam said:

Liver disease is often caused the food Thais eat, esp. in the NE. Khon Kaen has the highest rate of liver disease in the world, I believe.

Live fluke infection due to eating raw or undercooked fish (as is common in NE, including in som tam) can cause cancer of the bile ducts.  Chronic Hepatitis B infection, which is common in Thailand and often acquired at birth, can often lead to liver cancer.

 

Liver cancer can also be caused by metasatsis from cancer elsewhere in the body.

 

Doesn't really matter which it was. A very large tumor in the liver (>7 x 7 x 8 cm) like this, coupled with extensive cirrhosis and clear signs of liver failure equals a very bad prognosis.

 

The rate of liver cancer in Issan is indeed among the highest in the world.

Just an update .

 

The wife's relative passed away in hospital at 4 am this morning , he was 48 years old

 

3 hours ago, Bill Poster said:

Just an update .

 

The wife's relative passed away in hospital at 4 am this morning , he was 48 years old

 

 

Sorry to hear this, but to be expected given the test findings.

 

I hope his passing was peaceful.

On 1/24/2022 at 11:42 AM, Sheryl said:

 

Sorry to hear this, but to be expected given the test findings.

 

I hope his passing was peaceful.

Thanks Sheryl 

 

I have just been given a copy of some type of hospital medical report on the wife's relative who passed away . I'm trying to use google to understand a bit more about the report . The part where it says ( Child C ) seems a bit strange . The relative leaves behind a wife and daughter .

 

 

I think they mean acquired from childhood, chronic

 

His immediate cause of death was sepsis and fulminant cirrhosis secondary to chronic Hep B infection.

 

I am glad to note that the family & doctor agreed not to intubate or do CPR but rather give palliative care, and that he received morphine.

 

Hepatitis B is very common in Asia and most cases these days are acquired at birth from a mother with chronic HBV.

 

Thailand now tests all pregnant women for chronic HBV and puts them on antiviral medication if they have a high viral load, so mother-to-child transmission of HBV will become a thing of the past, b ut there are plenty of people already born who have it.

 

 

31 minutes ago, Sheryl said:

I think they mean acquired from childhood, chronic

 

His immediate cause of death was sepsis and fulminant cirrhosis secondary to chronic Hep B infection.

 

I am glad to note that the family & doctor agreed not to intubate or do CPR but rather give palliative care, and that he received morphine.

 

Hepatitis B is very common in Asia and most cases these days are acquired at birth from a mother with chronic HBV.

 

Thailand now tests all pregnant women for chronic HBV and puts them on antiviral medication if they have a high viral load, so mother-to-child transmission of HBV will become a thing of the past, b ut there are plenty of people already born who have it.

 

 

Thanks again Sheryl

 

As far as I understand the hospital doctor treating the now deceased wife's relative ,  did not ask the wife or his daughter to take any form of test at all  , so I was wondering if it was now wise for the daughter and wife to undergo some sort of testing relating to HBV , which I would gladly pay for. 

 

Is there a standard HBV test that the both of them could now take. 

 

Thanks .

37 minutes ago, Bill Poster said:

Thanks again Sheryl

 

As far as I understand the hospital doctor treating the now deceased wife's relative ,  did not ask the wife or his daughter to take any form of test at all  , so I was wondering if it was now wise for the daughter and wife to undergo some sort of testing relating to HBV , which I would gladly pay for. 

 

Is there a standard HBV test that the both of them could now take. 

 

Thanks .

Yes, it would be wise for them both to be tested for the Hep B surface antigen (HBsAg).

 

Any lab should be able to do this

 @Sheryl

 

20 hours ago, Bill Poster said:

Thanks Sheryl 

 

I have just been given a copy of some type of hospital medical report on the wife's relative who passed away . I'm trying to use google to understand a bit more about the report . The part where it says ( Child C ) seems a bit strange . The relative leaves behind a wife and daughter .

 

 

 

18 hours ago, Sheryl said:

I think they mean acquired from childhood, chronic

 

His immediate cause of death was sepsis and fulminant cirrhosis secondary to chronic Hep B infection.

 

I am glad to note that the family & doctor agreed not to intubate or do CPR but rather give palliative care, and that he received morphine.

 

Hepatitis B is very common in Asia and most cases these days are acquired at birth from a mother with chronic HBV.

 

Thailand now tests all pregnant women for chronic HBV and puts them on antiviral medication if they have a high viral load, so mother-to-child transmission of HBV will become a thing of the past, b ut there are plenty of people already born who have it.

 

 

Child C here isn't about childhood, it's the grading system for liver disease - suggesting it was very severe cirrohsis secondary to Hep B

 

https://en.wikipedia.org/wiki/Child–Pugh_score

 

When you look at his Child score, it's suggested he only had around a 50% chance of surviving the year in the best case scenario.  

 

The clinical reads more likely that he suffered from sepsis (from a source of infection - unclear origin from notes), which lead to rapid decompensatory liver failure and subsequent multiorgan failure in my opinon

 

@Sheryl I have refrained from commenting previously due to lack of information and I didn't want to spread more misinformation, but my suggestion is for many people to be careful what they post (not directed at you Sheyl), especially since I've seen quite a few anecdotal comments both in this thread and quite a few others recently, so I think we have to be very careful about what we allow on the sub, as well as remind people to sign post what are their opinions and what are actual facts and the way they phrase them

 

Bill - sorry to hear about your brother in law and best wishes to your family

 

Your friendly neighbourhood surgeon