How people with aspergillosis can help look after their liver

What does our liver do?

Our livers are really important for us to live a healthy life. Tucked right underneath our ribcage it is a large soft organ that has a rich blood supply. It can recognise and break down or filter any toxic substances that it may find – consequently our blood is quickly cleaned of anything that is not meant to be in our bloodstream.

Toxic substances can get into our body when we eat them, drink them, inhale then or when our doctors inject substances directly into our bloodstream. They can even be part of the daily process that continually renews the tissues that make up our bodies, breaking down proteins and ridding us of any toxic by-products of this process. This is a hugely complex process that we are as yet unable to reproduce artificially – the only way we can replace a badly damaged liver is to replace it with a transplanted donated liver.

What happens if our liver stops working?

Not surprisingly if our livers become dysfunctional our bodies soon start to suffer and there is a long list of illnesses caused by a sick liver. One of the most well-known ways we can damage our livers is to take alcoholic drinks to excess regularly, but we should also be aware that obesity is also a risk to our livers.

Why is this important to aspergillosis patients?

In addition aspergillosis patients should be aware that the medications that they have to take can risk damaging their livers. Doctors closely monitor their patients especially when they first prescribe a mediation that may cause toxicity. They need to watch closely for signs of the liver starting to be distressed by monitoring the signs using blood tests referred to as liver function tests. The purpose of these tests is to detect the very early signs of liver distress so that the doctor can take action to prevent any long term damage.
We know that antifungal medication can cause liver damage in some people, sometimes because the dose of an antifungal is too high and a quick adjustment can prevent further problems, or sometimes the patient is switched to a different drug if dose reduction doesn’t have the desired impact on the liver.

What can I do?

What can you, the patient do to help yourselves when taking an antifungal medication? Firstly, of course, it is very important to have a good working relationship with your medication team and report any new symptoms quickly to your doctor can assess if any action is needed.

You can also help by keeping your liver in the best condition it can be so that it can detoxify your blood quickly and keep you in the best health possible. You may be surprised by some of the things you should and shouldn’t do!

  • Smoking is bad. There are hundreds of toxins in cigarette smoke that your liver has to work on to keep you well while it should be working on other toxins
  • Coffee is good! Take a few cups a day but ensure you are still taking plenty of water as well
  • Alcoholic drinks – stick to medical advice. If you are taking antifungal drugs I am afraid the advice is no alcohol consumption (your liver will love you for it)
  • Eat the rainbow – select fruit and veg of every colour to be part of your diet.
  • Take care when using acetaminophen – often found in colds & flu remedies. No more than 4000 milligrams per day.
  • Weight – keep your Body Mass Index between 18 and 25
  • Infection control – wash your hands well after using the toilet and before preparing food
  • Exercise as much as you can – see your specialist physio for advice
  • Get vaccinated against hepatitis
  • Practice safe sex – diseases transmitted by sex can hurt your liver
  • Avoid ‘liver detox’ products eg milk thistle, turmeric. Tell your doctor what you are taking.

NOTE: Herbs and supplements cause 25% of the liver damage treated by doctors – especially borage, comfrey, groomwell, coltsfoot but also Atractylis gummifera, celandine, chaparral, germander and pennyroyal oil.

Good foods for your liver (all in moderation)

  • Coffee
  • Oatmeal
  • Green tea
  • Water
  • Almonds
  • Spinach
  • Blueberries
  • Herbs & spices

Foods you should limit

  • Sugar
  • Fatty foods
  • Salt
  • snack foods (usually rich in the above)
  • Alcohol

Stoptober

Stoptober is an initiative which aims to help people quit smoking. The dangers of smoking are well understood, but for those with chronic lung conditions the risks can be even greater – for example smokers are 5 times more likely to catch the flu, a major complication for aspergillosis patients.

We have had 2 talks at the National Aspergillosis Centre patient and carer support meeting that mentioned smoking and aspergillosis. At one meeting, Dr Khaled Al-shair (National Aspergillosis Centre Researcher) spoke of several guidelines to help patients suffering from Chronic Pulmonary Aspergillosis (CPA) feel their best while being treated at the NAC. Exercise and good diet played their part but one of the major improvements many patients can make to their lifestyle was to stop smoking cigarettes.

We have also had a talk from our local ‘Stop Smoking’ nurse – this talk focused what can be done locally using UHSM (University Hospital of South Manchester) services; so if you are a NAC patient or live withing striking distance of UHSM (Manchester, UK) you can take advantage of this help directly. There was also extensive information for anyone about the advantages of giving up cigarettes and different strategies to employ when trying to find a way to stop smoking.

The NHS also provides a wealth of information and advice on quitting smoking which can be found here.

Advice for people with respiratory conditions in winter

Many patients with respiratory conditions like aspergillosis report increased frequency of chest infections during the winter months, and this is mentioned repeatedly in our Facebook support groups (Public, Private). The cold weather brings problems of many kinds, but respiratory infection is one of the most serious. Infections by bacteria or virus have a major impact on their quality of life as their breathing becomes restricted and often they quickly become too exhausted to carry on with tasks of daily living.

Why does the winter cause increased vulnerability to respiratory infections? Is it because of the cold weather making us weaker and unable to fight off infection? In part – yes it is! Cold air cannot hold moisture as well as warmer air and thus cold air, is drier air. Inhaling dry air tends to dry out our airways and this can make us vulnerable to infection. This has two impacts – it irritates the lining of our airways and makes us cough, which itself increases our risk of infection, but it also dries out the mucous lining our airways and makes it more difficult to move – so we end up coughing much more than normal as we try to cough up this thickened substance.

People with chronic respiratory disease such as COPD, asthma, aspergillosis are particularly vulnerable to dry air as their airways are very sensitive to irritation.

Winter holds all kinds of pressures for the NHS and one of the biggest is a huge increase in people with respiratory conditions whose condition has become worse as a result of the cold weather. This video includes some advice on how to make sure the cold doesn’t affect your condition to prevent you from needing hospital treatment.

Reproduced with thanks, produced by NHS Blackpool CCG 2019

We Are Undefeatable

We Are Undefeatable is a campaign which aims to help those with chronic health conditions exercise. Both the conditions and forms of exercise vary widely – the goal is to find out what works best for you!

Visit the website to discover how exercise has helped other people with chronic conditions, and what the campaign can do for you : We Are Undefeatable

For more information on exercises specific to aspergillosis and chronic lung conditions:

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