#cholestasis

This morning we welcomed the final piece to our family. After 17 1/2 hours of labor, Alexander James was born weighing 7lbs 6 ounces and 20 inches long. By far, our tiniest baby. Hes passed all his blood sugars and if we pass our billirubin tonight, well be heading home tomorrow morning.

I reached 9cm naturally before I could no longer handle the pain. We had one dose of IV medication while we waited for the epidural and within 20mins of the epidural, we were 10cms and baby was getting low. We labored down breifly and pushed a total of 6 times (2 contractions). I got to stop and feel his head as he was crowning and watch him come out with a mirror. D cut the cord and we got a full golden hour of snuggles. I didnt even tear this time! It was so low stress and just a beautiful ending of this chapter of birthing our babies. I feel so complete. Hes so beautiful. He looks so much like Rhyan did but so much smaller. D told me he felt his name was Alexander James and I told him if thats his name, then thats it ❤

the rule is that a hepatobiliary dysfunction leads to a hepatobiliary clinical sign.

Combined all in WaBBBeNN

1- Water (Wa):

Polyuria PU/ Polydipsia which are multi-factorial:

psychogenic

hypercortisolism

renal concentrating defects.

2- Bilirubin (1st B): A cholestatic disease causes bilirubinuria and icterus that may appear also by a hemolytic disease. Then by severe cholestasis leads to acholic grey feces.

3- Blood (2nd B): Coagulopathy occurs due to the inability to synthesize clotting factors following severe hepatic failure or common obstruction. Subclinical clotting disorders may convert into clinical apparent ones just after hepatic biopsy, surgery or gastroduodenal ulcer.

4- Belly (Be): Ascites

Severe chronic hepatic disease causes hypoalbuminemia, portal hypertension, sodium and water retention.

Also rupture of bile duct leads to bile peritonitis as well as fluid accumulation.

5- Nervous (N): Hepatic encephalopathy occurs as a result of bacterial action on some substrate in colon that forms some potential encephalopatic toxins like ammonia, GABA and mercaptans ..etc, then by low detoxification of diseased liver or portosystemic shunt, metabolic encephalopathy rises leading to wax and wane nervous signs that may ended by coma.

6- Non-specific signs (the last N):

Vomiting and small bowel diarrhea which is less frequent than vomiting.

Hematmesis as a result of ulceration.

Heart health often involves treating multiple, related risk factors. Elevated cholesterol levels and a tendency to develop blood clots are among the major factors associated with heart attack, strokes, and other vascular problems: they can increase risks independently, and also together, since they each have effects on the cardiovascular system.

Reasons for Combination Support

When LDL cholesterol is elevated, it can cause plaque to build up within the walls of arteries, causing the arteries to narrow and harden (this is called atherosclerosis).

Plaque can rupture easily, creating new surface area and a shape that is more likely to cause blood clots. Once you have blood that can clot on these ruptured areas of plaque, it is likely that it will block that already narrowed artery, increasing the possibility of sudden events like heart attacks and strokes.

When you lower cholesterol in the bloodstream and potentially block the formation or slow the progression of plaques, and while providing blood-thinning support, it would lessen the risks of stroke and heart attack.

Benefits to a Combined Approach

Addressing cholesterol and clot formation provides a greater opportunity to protect against cardiovascular events than focusing on only one component.

Lowering your cholesterol will decrease your chances of forming new plaque, and the thinning of your blood will diminish the chances of blocking that artery with a clot. Together, they provide added protection against sudden blockages.

Combination meds such as ecosprin Av 75 capsule, can provide cholesterol and blood thinning support in a single tablet. It will likely improve your compliance.

Combining therapy

Combining therapy or combination therapy is often prescribed for individuals with a prior heart attack, or angina, or stroke; any of those risk factors exposes you to both risks, i.e., cholesterol and clot behaviour.

Individuals with multiple cardiovascular risk factors or an established atherosclerotic disease can benefit from lowering their cholesterol and their blood clot risk at the same time.

Important Considerations

A combination plan typically involves a combination of medications, as well as lifestyle changes, diet, exercise, and quitting smoking, to maximise the protective effects on the heart and vascular supply.

Ongoing monitoring and support from a medical professional will help ensure you are supported in making informed decisions regarding safety and treatment options.

Cholestasis of pregnancy (also referred to as Obstetric Cholestasis) is an illness of the liver which most frequently impacts expecting mothers in their third trimester, most often in relation to an inability of bile to flow freely and result in increased levels of bile acid within bloodstream resulting from inability of bile production; understanding its signs and ramifications are critical in protecting both mother and fetus’ well-being.

We will delve into all complexities related to Cholestasis pregnancy while providing pregnant women with information that will enable them to navigate their health journey confidently!