To My Friends Who Still Have Their Mothers


This will be my first Mother’s Day as a motherless mother.

For what it’s worth, my personal insight is this: as affectionate, imperfect, difficult – even dysfunctional – as your mother-daughter relationship may be, it still has a value you will only fully recognize when you are motherless.

I found this article by Jessica Wolstenhom on the Huffington Post recently, and felt like, in many ways, it could have been written by me. My story is a little different from Jessica’s in that my mother was terminally ill for two years after her diagnosis of cirrhosis of the liver (caused by non-alcoholic fatty liver).

Whether sudden or a long goodbye, whether a wonderful relationship or a difficult one; the eventual loss of your mother will change your perspective on life, and inevitably leave you with at least a few regrets.

I hope those of you who still have your mothers will take this advice to heart.



Dear friends who still have their mothers,

It came like a thief — 10 months almost exactly from the day she was diagnosed until the day she left us. Cancer has a way of doing that, robbing its victims and their families of health and freedom. One day we’re doing life together, making plans for the future — and the next we’re fighting this battle and eventually saying goodbye.

I never imagined I’d lose my mom this way or so soon. I couldn’t have planned or prepared for it. Her fate swooped in like a thief and took her away before I ever had the chance to fully realize what was happening.

And because of my faith I stand with peace and continue to hope but still…

This Mother’s Day, I am — for the first time — a mom without a mother. I will receive cards and gifts and lots of love, but I cannot give them. I cannot express my gratitude, despite her imperfections, with lavish love. I cannot thank her for all she taught me about being a mom, both good and bad. I cannot share how much she’s impacted my life, as a mom and a wife and a woman.

So dear friends who still have their mothers,

Whether you walk extremely close or there’s a valley of difference between you, reach out to your mother this week.

Whether you see eye to eye or you can’t agree on much of anything, look your mother in the eyes if you can and tell her how special she is.

Whether she’s loved you well or lacked in affection, tell her how much you appreciate her and linger in love through words or embrace.

Whether she’s been your role model or she’s shown you what not to do, tell her how much you’ve learned from her.

Whether she’s been a near perfect mother or a much less than perfect one, she’s still here and that fact alone leaves so much potential for you both.

Call her, embrace her, surround her with your love whether it comes easy or along with tons of baggage.

Reach out for reconciliation if you are estranged.

Reach out in compromise if you are indifferent.

Reach out with time and attention if you are busy.

Reach out with affection if you are reserved.

Reach out with generous love even if you already do it regularly.

This time last year, I never dreamed I’d spend Mother’s Day without my mom. Please, don’t let another day slip by without connecting with yours.

Happy Mother’s Day, friends. May you find grace to give and receive so much love.


Jessica Wolstenholm Jessica Wolstenholm is an author and freelance writer who blogs about motherhood and life at


Coping With Grief

Alarming New Canadian Liver Statistics

Obesity Linked to Dramatic Rise in Liver Disease



From the Canadian Liver Foundation


Alarming new statistics show that 1 in 4 Canadians may be affected by liver disease

The obesity crisis is taking its toll on the liver with potentially deadly consequences.


Research shows that 1 in 4 Canadians may be affected by liver disease due primarily to the rapidly rising prevalence of non-alcoholic fatty liver disease linked to obesity, lack of physical activity and poor eating habits.


This progressive disease is predicted to overtake hepatitis C as the leading cause of liver transplants. 


 “Many people still believe that all liver disease is alcohol related,” says Dr. Eric Yoshida, Chairman of the Canadian Liver Foundation’s Medical Advisory Committee.


“With the prevalence of non-alcoholic liver disease however, the odds of anyone, including  adults and children, being affected by liver disease are in the same realm as health conditions like heart disease or diabetes that Canadians  are far more familiar with.”


A review of current liver disease data reveals that as much as 20 per cent of the Canadian population has fat build-up in their livers. ‘Non-alcoholic fatty liver disease’ or NAFLD is a term used for the condition that varies in severity from simple fat accumulation with no inflammation to its most advanced stage that involves inflammation and fibrosis. From this advanced stage, a person can progress to cirrhosis and liver failure. 


“A diet full of sugar, high calorie and high fat foods can lead to excess fat being stored in the liver,” explains Dr. Yoshida. “This fat build-up might never impact the functioning of the liver but it is the first step toward what could be a life-threatening condition.” 


If left unchecked, NAFLD has the potential to develop into cirrhosis, liver cancer and liver failure. 


“NAFLD is already having an impact on the demand for liver transplants but what few realize is that it is also affecting the supply,” explains Dr. Yoshida. “Too much fat in a donor liver can mean that that organ cannot be used for a transplant. This means it is making the organ shortage even worse and we are losing out on the opportunity to save more lives.”

The good news is that NAFLD can often be prevented, or even reversed if it is detected before permanent liver damage has occurred.


The Canadian Liver Foundation is alarmed by the dramatic change in liver disease statistics and wants to alert the public about their increasing level of risk.


“When you bring up the topic of liver disease, it doesn’t take long for someone to say how it has personally affected them or someone they know,” says Gary Fagan, Canadian Liver Foundation president.


“Ten years ago we said that 1 in 10 Canadians were at risk but when you factor in the rise of non-alcoholic fatty liver disease along with prevalence rates for hepatitis B and C, alcoholic liver disease, autoimmune liver diseases, children’s liver diseases,  liver cancer and more, we are now looking at 1 in 4. The numbers show liver disease is relevant to everyone. People can’t ignore it any longer.”


The Canadian Liver Foundation is using this opportunity to encourage Canadians to consider how close liver disease might be to them and those they love and to find out how to get involved in helping themselves and others.

About the Canadian Liver Foundation
Founded in 1969 by a group of doctors and business leaders concerned about the increasing incidence of liver disease, the Canadian Liver Foundation (CLF) was the first organization in the world devoted to providing support for research and education into the causes, diagnoses, prevention and treatment of all liver disease. Today, we are bringing liver research to life by promoting liver health, improving public awareness and understanding of liver disease, raising funds for research and providing support to individuals affected by liver disease.



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Symptoms of Cirrhosis of the Liver

Symptoms of Cirrhosis of the Liver





Cirrhosis of the Liver, or Chronic Liver Disease, is often asymptomatic until the liver is extensively damaged, and therefore symptoms are not common during the early stages of cirrhosis.  However, as scar tissue accumulates the liver’s ability to function properly is undermined.



How We Discovered That My Mother Had Cirrhosis


My mom’s very first sign of liver cirrhosis was edema – fluid buildup in the ankles, feet and legs.


She mentioned this numerous times to her physician, who prescribed diuretics (water pills) to help flush out the extra water. 


My mother was not a drinker, but she was overweight, sedentary and pre-diabetic with high lipids (sometimes called Metabolic Syndrome or Syndrome ‘X’).


Mom had been diagnosed with fatty liver some years before, but that is quite common, and had not set off any alarms.


At this point though, her doctor should have done a simple liver enzymes blood test, as chronic edema is considered one of the early signs of liver decompensation. 


But he didn’t.


I imagine he assumed the swollen feet and ankles were caused by other, more common, benign factors.


Mom suffered with uncomfortable and unsightly swollen legs for around five years before a much more serious symptom emerged…


ascities – fluid buildup in the stomach.  In her case, the fluid was pushed by her diaphragm up into the lining around her lungs, and she began having a hard time getting a full breath of air.


When she saw the doctor for this, he sent her for a chest x-ray that day.  The x-ray indicated a problem, and mom was told to go to emergency immediately for more testing.  She was admitted briefly to the hospital for a battery of tests, which ultimately confirmed she had cirrhosis of the liver.  At that point, the cirrhosis was considered advanced.


That was only the beginning of a two year nightmare, involving nearly all of the symptoms listed below at some point or another. 


While there were some periods of time when her health would rally somewhat (my sister and I called these ‘reprieves’), the disease was unrelenting in its progression. 


Mom was in an out of the hospital, and eventually had a TIPS procedure to bypass the liver’s portal vein and help with the fluid buildup.  It only helped for a few months.


In the end, mom was admitted to hospice, where she suffered a fatal variceal bleed (internal bleeding caused by increased blood pressure in the portal vein system).


The presence of enlarged veins (varices) usually causes no symptoms.


Until they bleed.


And then it becomes an emergency.


Sometimes a surgeon can tie off or cauterize the bleed.


In my mom’s situation, she was already so weak and ill that her body would not have survived any kind of invasive medical intervention.


So with that said, these are the signs and symptoms may occur in the earlier stages of cirrhosis:


  • Blood capillaries become visible on the skin on the upper abdomen
  • Fatigue
  • Insomnia
  • Itchy skin
  • Loss of appetite
  • Loss of body weight
  • Nausea
  • Pain or tenderness in the area where the liver is located
  • Red or blotchy palms
  • Weakness.


The following signs and symptoms may appear as liver cirrhosis progresses:


  • Abdomen fills up with fluid, giving the patient a large tummy (ascites)
  • Accelerated heartbeat
  • Altered personality (as blood toxins build up and affect the brain)
  • Bleeding gums
  • Body and upper arms lose mass
  • Body finds it harder to process alcohol
  • Body finds it harder to process drugs
  • Confusion
  • Dizziness
  • Fluid buildup on ankles, feet and legs (edema)
  • Hair loss
  • Higher susceptibility to bruising
  • Jaundice (yellowing of the skin, whites of the eyes, and tongue)
  • Loss of libido (sex drive)
  • Memory problems
  • More frequent fevers (susceptibility to infections)
  • Muscle cramps
  • Nosebleeds
  • Pain on the right shoulder
  • Panting (breathlessness)
  • Stools become black and tarry, or very pale
  • Urine becomes darker
  • Vomiting blood
  • Walking problems (staggering).




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Causes of Cirrhosis of the Liver



 If you’re like me, you probably associate Cirrhosis of the Liver with alcoholism.

It was an terrible surprise to learn that my mom, a non drinker, had developed this deadly disease.  In her case, the cirrhosis developed as a result of NASH (nonalcoholic steatohepatitis, or Fatty Liver disease).


In fact, cirrhosis has a variety of causes, and many people with cirrhosis have more than one cause of liver damage.


The list below shows common causes of cirrhosis in the United States. While chronic hepatitis C and alcohol-related liver disease are the most common causes of cirrhosis, the incidence of cirrhosis caused by nonalcoholic fatty liver disease is rising due to increasing rates of obesity.


Chronic hepatitis C. Hepatitis C is due to a viral infection that causes inflammation, or swelling, and damage to the liver. The hepatitis C virus spreads through contact with infected blood, such as from a needlestick accident, injection drug use, or receiving a blood transfusion before 1992. Less commonly, hepatitis C can be spread by sexual contact with an infected person or at the time of childbirth from an infected mother to her newborn.


Hepatitis C often becomes chronic, with long-term persistence of the viral infection. Chronic hepatitis C causes damage to the liver that, over years or decades, can lead to cirrhosis.


Advanced therapies for chronic hepatitis C now exist, and health care providers should treat people with chronic hepatitis C before they develop severe fibrosis or cirrhosis. Unfortunately, many people first realize they have chronic hepatitis C when they develop symptoms of cirrhosis.


Alcohol-related liver disease. Alcoholism is the second most common cause of cirrhosis in the United States. Most people who consume alcohol do not suffer damage to the liver. However, heavy alcohol use over several years makes a person more likely to develop alcohol-related liver disease. The amount of alcohol it takes to damage the liver varies from person to person.,fl_progressive,q_80,w_800/gbigr28lwjypbyz1mmgk.jpg


Research suggests that drinking two or fewer drinks a day for women and three or fewer drinks a day for men may not injure the liver. Drinking more than these amounts leads to fat and inflammation in the liver, which over 10 to 12 years can lead to alcoholic cirrhosis.


Recommended: The Alcohol Free Forever program.


Nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH). In NAFLD, fat builds up in the liver; however, the fat buildup is not due to alcohol use. When the fat accompanies inflammation and liver cell damage, the condition is called nonalcoholic steatohepatitis, or NASH, with “steato” meaning fat, and “hepatitis” meaning inflammation of the liver. The inflammation and damage can cause fibrosis, which eventually can lead to cirrhosis.



Extra fat in the liver is more common in people who:



  • are overweight or obese.
  • have diabetes—a condition characterized by high blood glucose, also called high blood sugar.
  • have high blood cholesterol and triglycerides, called hyperlipidemia.
  • have high blood pressure.
  • have metabolic syndrome—a group of traits and medical conditions linked to being overweight and obese that makes people more likely to develop both cardiovascular disease and type 2 diabetes. Metabolic syndrome is defined as the presence of any three of the following: large waist size, high triglycerides in the blood, abnormal levels of cholesterol in the blood, high blood pressure, and higher than normal blood glucose levels. NASH may represent the liver component of the metabolic syndrome.


See The Fat Loss Diet I Recommend.


NASH now ranks as the third most common cause of cirrhosis in the United States.


Chronic hepatitis B. Hepatitis B, like hepatitis C, is due to a viral infection that causes inflammation and damage to the liver. Chronic infection can lead to damage and inflammation, fibrosis, and cirrhosis.


The hepatitis B virus spreads through contact with infected blood, such as by needlestick accident, injection drug use, or receiving a blood transfusion before the mid-1980s. Hepatitis B also spreads through sexual contact with an infected person and from an infected mother to child during childbirth.


In the United States, hepatitis B is somewhat uncommon, affecting less than 1 percent of the population, or fewer than one in 100 people.


In many areas of the world, however, hepatitis B is common. In some parts of Africa and in most of Asia and the Pacific Islands, about 5 to 7 percent of the population has chronic hepatitis B. In some parts of Africa, more than 8 percent of the population has chronic hepatitis B. For these reasons, hepatitis B is likely the major cause of cirrhosis worldwide. However, in the United States, hepatitis B ranks well behind hepatitis C, alcohol-related liver disease, and NASH.


Therapies for chronic hepatitis B now exist and health care providers should treat people with chronic hepatitis B before they develop severe fibrosis or cirrhosis. Unfortunately, many people first realize they have chronic hepatitis B when they develop symptoms of cirrhosis.


Hepatitis B is also a preventable disease. Since the 1980s, a hepatitis B vaccine has been available and should be given to newborns and children in the United States. Adults at higher risk of getting hepatitis B should also get the vaccine.


Less Common Causes of Cirrhosis:


Autoimmune hepatitis. In this form of hepatitis, the body’s immune system attacks liver cells and causes inflammation, damage, and eventually cirrhosis. Normally, the immune system protects people from infection by identifying and destroying bacteria, viruses, and other potentially harmful foreign substances. In autoimmune diseases, the body’s immune system attacks the body’s own cells and organs.


Researchers believe genetics, or inherited genes, may make some people more likely to develop autoimmune diseases. At least 70 percent of those with autoimmune hepatitis are female.


Diseases that damage, destroy, or block the bile ducts. Several diseases can damage, destroy, or block the ducts that carry bile from the liver to the small intestine, causing bile to back up in the liver and leading to cirrhosis.


In adults, the most common of these diseases is primary biliary cirrhosis, a chronic disease that causes the small bile ducts in the liver to become inflamed and damaged and ultimately disappear. Primary sclerosing cholangitis is a disease that causes irritation, scarring, and narrowing of the larger bile ducts of the liver.


In infants and children, causes of damage to or disappearance of bile ducts that can lead to cirrhosis include:


  • Alagille syndrome, a collection of symptoms that indicates a genetic digestive disorder and leads to a loss of bile ducts in infancy.
  • biliary atresia, a life-threatening condition that affects newborns in which bile ducts are missing. The cause is unknown. Biliary atresia is the most common reason for liver transplantation in children.
  • cystic fibrosis, an inherited disease of the lungs, intestines, pancreas, and bile ducts in which the body does not produce enough fluid and mucus becomes thick and blocks off small bile ducts. This blockage of the bile ducts can lead to cirrhosis.


Long-term blockage of the bile ducts by gallstones can also cause cirrhosis. Cirrhosis may also develop if the bile ducts are mistakenly tied off or injured during surgery on the gallbladder or liver.


Inherited diseases that affect the liver. Inherited diseases that interfere with how the liver produces, processes, and stores enzymes, proteins, metals, and other substances can cause cirrhosis.


These diseases include alpha-1 antitrypsin deficiency, hemochromatosis, Wilson disease, galactosemia, and glycogen storage diseases.


Rare viral infections of the liver. Hepatitis D, or hepatitis delta, and hepatitis E are two rare viral infections of the liver. Hepatitis D infection occurs only in people who have hepatitis B. People infected with chronic hepatitis B and chronic hepatitis D are more likely to develop cirrhosis than people infected with chronic hepatitis B alone.


Hepatitis E is a virus found in domestic and wild animals, particularly pigs, and can cause hepatitis in humans. People with weakened immune systems, including people who are liver or kidney transplant recipients or who have acquired immune deficiency syndrome (AIDS), can develop chronic hepatitis E. Chronic hepatitis E can cause scarring of the liver and cirrhosis. Current treatments for chronic hepatitis D and E are experimental and only partially effective.


Other causes. Other causes of cirrhosis may include:


  • reactions to medications taken over a period of time
  • prolonged exposure to toxic chemicals.
  • parasitic infections.
  • chronic heart failure with liver congestion, a condition in which blood flow out of the liver is slowed. Liver congestion can also occur after surgery to correct a congenital heart problem—a heart problem that is present at birth.


Trauma to the liver or other acute, or short term, causes of damage do not cause cirrhosis. Usually, years of chronic injury are required to cause cirrhosis.


If you believe you may be at risk for liver disease from any of these causes, see your doctor as soon as possible.  A simple blood test of your liver enzymes can alert your physician to liver dysfunction which would warrant further investigation.


Do you have any of the risk factors for Cirrhosis of the Liver?  Or do you or someone you know have liver disease?  Please share your thoughts and experiences in the comment section below.


why you need to stop drinking


If you think you may have a problem with alcohol, please see your doctor as soon as possible to discuss it.  I also recommend that you download this free PDF Report: Why You Need to Stop Drinking … and how to get started TODAY!  I believe you will find it informative and helpful.

Do you have any of the risk factors for Cirrhosis of the Liver?  Or do you or someone you know have liver disease?  Please share your thoughts and experiences in the comment section below.






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Fatty Liver and Cirrhosis

Fatty Liver – This One’s Personal


Dear Reader,

This is a disease that upsets me deeply, as it is the one which took my Mom.  Until the time of her diagnosis, the only thing I “knew” about cirrhosis was that it was a disease which only affected alcoholics and drug abusers.  I was so wrong.


There are, in fact, several paths to liver disease, which I will cover in a separate post.  In my Mom’s case, her cirrhosis developed as a progression from NASH or Nonalcoholic steatohepatitis.  It is also called NAFL (non alcoholic fatty liver), or simply Fatty Liver.


NASH is a common, often “silent” liver disease. It resembles alcoholic liver disease, but occurs in people who drink little or no alcohol. The major feature in NASH is fat in the liver, along with inflammation and damage. Most people with NASH feel well and are not aware that they have a liver problem.


Nevertheless, NASH can be severe and can lead to cirrhosis, in which the liver is permanently damaged and scarred and no longer able to work properly.


Although having fat in the liver is not normal, by itself it probably causes little harm or permanent damage. If fat is suspected based on blood test results or scans of the liver, this problem is called nonalcoholic fatty liver disease (NAFLD). If a liver biopsy is performed in this case, it will show that some people have NASH while others have simple fatty liver.


NASH is usually a silent disease with few or no symptoms. Patients generally feel well in the early stages and only begin to have symptoms—such as fatigue, weight loss, and weakness—once the disease is more advanced or cirrhosis develops.


The progression of NASH can take years, even decades. The process can stop and, in some cases, reverse on its own without specific therapy. Or NASH can slowly worsen, causing scarring or “fibrosis” to appear and accumulate in the liver.


As fibrosis worsens, cirrhosis develops; the liver becomes seriously scarred, hardened, and unable to function normally.


Not every person with NASH develops cirrhosis, but once serious scarring or cirrhosis is present, few treatments can halt the progression. A person with cirrhosis experiences fluid retention, muscle wasting, bleeding from the intestines, and liver failure.


Liver transplantation is the only treatment for advanced cirrhosis with liver failure, and transplantation is increasingly performed in people with NASH.


Although NASH has become more common, its underlying cause is still not clear. It most often occurs in persons who are middle-aged and overweight or obese.


See Alarming New Liver Statistics


Many patients with NASH have elevated blood lipids, such as cholesterol and triglycerides, and many have diabetes or pre-diabetes, but not every obese person or every patient with diabetes has NASH.


Furthermore, some patients with NASH are not obese, do not have diabetes, and have normal blood cholesterol and lipids. NASH can occur without any apparent risk factor and can even occur in children. Thus, NASH is not simply obesity that affects the liver.

My Mom was 73, and had most of the risk factors for NASH, including age, obesity, sedentary lifestyle, insulin resistance and high triglycerides.  Doctors see NASH often, and usually call it “Fatty Liver.” 

Perhaps because it is fairly commonplace, it seems that most physicians don’t adequately impress on the patient the need to make the necessary lifestyle changes to reverse the condition before it potentially progresses to non-reversible cirrhosis of the liver.


Fatty Liver can be potentially reversed by weight reduction (if overweight), activity and healthy diet, and avoiding alcohol and unnecessary medications.  Most importantly, a major attempt should be made to lower body weight into the healthy range. Weight loss can improve liver tests in patients with NASH and may reverse the disease.


These are standard recommendations, but they can absolutely make a difference. They are also helpful for other conditions, such as heart disease, diabetes, and high cholesterol.


People with NASH often have other medical conditions, such as diabetes, high blood pressure, or elevated cholesterol. These conditions should be treated with medication and adequately controlled; having NASH or elevated liver enzymes should not lead people to avoid treating these other conditions.


Experimental approaches under evaluation in patients with NASH include antioxidants, such as vitamin E, selenium, and betaine. These medications act by reducing the oxidative stress that appears to increase inside the liver in patients with NASH. Whether these substances actually help treat the disease is not known, but the results of clinical trials should become available in the next few years.


Over time, more research will help physicians to better understand the liver injury found in this disease. When the pathways that lead to the injury are fully known, safe and effective means can be developed and used along with lifestyle changes to reverse these pathways and help patients with NASH. Recent breakthroughs in mapping the human genome and uncovering the individual steps by which insulin and other hormones regulate blood glucose and fat could provide the necessary clues.


My Mom was told that she had fatty liver by her doctor many years ago, but that information was accompanied by only the advice to lose some weight.  It haunts me to think that the disease could have been reversed if she had been warned of the potentially fatal consequences of ignoring it.  I wish somebody had frightened her into changing her lifestyle when it could have made a difference in her future outcome.

It is a sad thought, indeed, that I lost my Mom to a lifestyle disease which could have been prevented or reversed.



Please share your thoughts or experience with liver issues in the comment section below.



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