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re: liver cirrhosis and fatigue
Sep 14, 2004

hello dr,

i read your recent article on liver cirrhosis and fatigue, and wanted to tell you that i have had an experience that may be worth looking at on this...i'm st4, decompensated cirrhosis.. i'm also a scuba diver... after approx 3days of deep dives,65'+, i feel an enormous improvement in my fatige level, and in my level of "brain fog"...it's a temporary effect that i can feel for 4-5 days after my last dive... i had labs scheduled for the monday after my last dive trip...my alt/ast dropped approx 50-66%, and my ammonia was lower than i'm able to attain w/ diet and lactulose.... i feel the effect is from the hypersaturation of the body w/ 2 gases...oxygen and nitrogen... my body gets so saturated w/ oxygen that the plasma alone carries enough oxygen to support tissue... and, as ammonia is a form of nitrogen, it's possible that the saturation and pressure changes cause some of the ammonia to convert to nitrogen gas that i breath out on my surface intervals..

i'm not a scientist or dr, but i know what i've felt after all of my 75 dives.. i've done informal surveys on several hcv and scuba message bds, and well over half of those w/ hcv and cirrhosis report similar effects...

this effect should be able to be duplicated in a hyperbaric chamber breathing normal air mix...

if you'd like to examine my labs, or discuss this w/ my liver dr, pls let me know... if you decide to do a study, pls include me in it if possible

thx Robert

Response from Dr. Dieterich

That is very interesting. I am not sure I can explain it scientificlly either. However in people with ascites, placing them in a bathtub or tank up to their neck will help normalize blood flow in the portal system. It may be the pressure on your abdomen from the water that may be responsible. Whatever the cause, I am delighted that it makes you feel better! Keep it up! DTD



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