🎯Three Content Types · One Force Field
Every square belongs to one of three content types — not three levels you climb. Track progress in your Course and Skills Lab.
📘 Learn It Content type
Concepts to absorb.
🛠 Live It Content type
Daily skills and habits.
📣 Share It Content type
Teach, advocate, carry forward.
🛡️Your Force Field — 16 Squares
Deeper detail lives in the Prepared Patient Cirrhosis course.
What Cirrhosis Is
Severe liver scarring from chronic injury (alcohol, hep B/C, NASH, autoimmune).
Learn ItDaily Med Discipline
Diuretics, lactulose, beta-blockers if varices. No NSAIDs ever.
Learn ItSpot Decompensation
Variceal bleed · SBP · encephalopathy · severe ascites — all 911.
Learn ItAvoid Hepatotoxins
Alcohol absolute. NSAIDs, certain herbs, acetaminophen >2g/day.
Learn ItMELD + Child-Pugh
Severity scores. Drives transplant decisions.
Learn ItVaccines
Hep A and B if not immune. Flu, pneumococcal, COVID — all important.
Live ItHCC Surveillance
Liver cancer screen every 6 months. Ultrasound ± AFP.
Live ItDiet + Sodium
Low salt for ascites. Adequate protein (don't restrict).
Live ItLab Monitoring
INR, bilirubin, albumin, creatinine, platelets. Trends matter.
Live ItMake Every Visit Count
Bring weight log, meds, ascites symptoms, mental clarity notes.
Live ItYour Care Team
Hepatologist, PCP, sometimes transplant team, dietitian.
Live ItTelehealth
Most med management works telehealth. Imaging in person.
Live ItInsurance + Cost
Most coverage available. Transplant care is centralized.
Live ItTeach & Mentor
Stigma around liver disease real. Sharing helps others get treated.
Share ItAdvocate
Push for hep screening, alcohol policy, NASH research.
Share ItResearch & Trials
NASH drugs, regenerative medicine, machine perfusion.
Share ItThree things to learn before you actually need them.
Workflow lives in the Prepared Visit Tool. Trackers in your Course.
Which door do I use?
Cirrhosis lives quietly until it doesn’t. The ladder catches decompensation early.
Handle at home
- Stable labs and imaging
- No new symptoms
- Following med list and avoiding hepatotoxins
Log it. Strict alcohol avoidance + careful med review.
Call the office / message the portal
- Mild ankle swelling or weight gain
- Mild fatigue trend
- Running low on meds (diuretics, lactulose, etc.)
- New medication from another doctor
Same day. Decompensation can sneak up.
Urgent / Acute care
- Worsening ascites (belly swelling)
- Increased weight 3+ lb in a week
- Mild confusion or sleep disruption
- Bruising more than usual
- New fatigue or appetite loss
Urgent care or hepatology urgent slot.
ER NOW / call 911
- Vomiting blood or black stools (variceal bleeding)
- Severe abdominal pain with fever (spontaneous bacterial peritonitis)
- Severe confusion or unresponsiveness (hepatic encephalopathy)
- Severe jaundice with rapid worsening
- Sudden severe belly swelling
Call 911. Cirrhosis complications kill fast without treatment.
How to describe a new symptom in 30 seconds
What is it?
Plain words.
How bad?
0-10.
When did it start?
Time + what you were doing.
What made it worse?
Movement · food · meds.
What helped?
Even a little.
What else was new?
Fever · med · supplement · stress. The forgotten detail often shifts the diagnosis.
“Belly swelling and fatigue worsened over 2 weeks, a 6, started after I missed a few diuretic doses while traveling, lying flat is hard, low-salt diet helped a little, and I had a cold last week.”
Questions worth asking
Four for every patient, every condition, every visit:
- “Could this be a side effect of one of my medications, a supplement, or something else I’m doing — and should we change that?”
- “Would any non-drug therapy help — physical therapy, meditation, rest, ice or heat?”
- “If I can’t afford this medication or this test, can we talk about samples, alternatives, or a social worker who can help?”
- “What should I be watching for between now and my next visit — and when do I handle it myself, when do I call your office, when do I go to urgent care, and when do I go to the ER?”
Questions specifically for Cirrhosis:
- “What’s my MELD score and trend — what does that mean for me?”
- “Am I being screened for liver cancer (HCC) every 6 months?”
- “Do I have varices — have they been banded?”
- “Am I a candidate for transplant evaluation now or later?”
- “What medications absolutely must I avoid — can we make a list?”