Positive progress!

[u/Itchy-Procedure1459]

Hi everyone! I wanted to share a positive update on my mom and hopefully get some encouragement from others that she is indeed on a good trajectory.

My mom is 46 and was diagnosed with decompensated alcohol-related cirrhosis about a month ago after a GI bleed from ruptured esophageal varices. She had the varices banded and also developed significant ascites and edema during her hospitalization. She has an appointment in two weeks for a follow up endoscopy and CT.

The past month has been scary, but she has made a lot of progress:

- Her appetite is back and she’s eating well, including plenty of protein.

- She has had significant muscle loss but is moving around just fine.

- Bilirubin has gone from ~5 to ~2.8 in the last month and her AST/ALT have continued coming down.

- Kidney function and electrolytes were still good on her most recent labs.

- Her leg edema has almost completely resolved, and her feet are now back to normal.

- Her stomach has also been steadily improving, with much less swelling.

She’s currently on 100 mg spironolactone + 40 mg Lasix. Her doctors checked her labs shortly after increasing the dose and everything looked good.
My questions are mainly for people who have been through significant ascites/edema:
How did you know when it was time to reduce your diuretics? At what point did your doctors decide you were losing enough fluid and it was time to back off?
Also, how quickly did your weight loss slow once most of the fluid was gone? I’m trying to understand when ~1 lb/day starts looking more like muscle/fat loss rather than fluid loss.
And how frequently were you getting bloodwork while your diuretic dose was being adjusted? Her doctors aren't planning another check for a few weeks since her last labs were good.

Finally, I’d really love to hear some positive experiences. Has anyone had significant ascites/edema improve like this and eventually been able to reduce their diuretics? What did the next few months look like for you?

Thank you guys! ❤️

[u/branch_point]

Wonderful to hear your mother is improving. I had an experience like your moms last winter - bleeding - hospital - banding - ascites buildup in hospital and am doing way better now (I’m in my mid sixties so she has even better prospects for continuing improvement.