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  #1  
Old 09-21-2008, 01:58 PM
Mr Buttons Mr Buttons is offline
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How long from cirrhosis diagnosis until death?

Assuming the person still drinks heavily.

My SO's father has been drinking about 4 30-packs of beer per week for going on 4 decades now. He's finally been diagnosed by his doctor as having cirrhosis of the liver.
Doesn't matter to him it seems, because he's still drinking around 4 cases a week. He drinks from about 10am until bedtime.
How much longer will he be around at this rate?
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  #2  
Old 09-21-2008, 02:32 PM
Stranger On A Train Stranger On A Train is offline
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It depends on the stage of the disease, the otherwise health of the patient, any comorbid factors (steatosis, hepatitis, autoimmune failures, et cetera) along with excess alcohol consumption. The actual damage done to the liver is essentially irreversible but it is possible to live decades with only a small faction of liver function provided that one maintains a healthy lifestyle and doesn't suffer any aggravating conditions. I doubt even an internist can give a definitive answer to your question--sometimes liver function continues long past any reasonable expectations, and other times it just collapses suddenly--but given the description you offer a wild-ass guess would be a few years or less.

I guess you could encourage him to drink less (or not at all) and maintain a healthy diet, but someone who has been drinking 120 beers a week for decades is probably a devoted alcoholic that doesn't live for much beyond drink. It hardly seems worth the bother.

Perhaps Qadgop the Mercotan will step in and give a qualified medical perspective on cirrhosis, since he is not only a physician but probably has extensive practical insight into the disease given his population of patients.

Stranger
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  #3  
Old 09-21-2008, 03:05 PM
st1d st1d is offline
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Yeah, too many factors. Was he diagnosed during a routine checkup, or did he feel ill and that's how he found out? A lot of it seems to be luck, the stage of deterioration, and genetics. Some people are more susceptible a couple genes are more sensitive, and the structure of his liver could allow a maximum of damage before it impairs him, or it could block up and he'd deteriorate quickly without a transplant or other option.

Either way, cutting back or stopping altogether is probably the best option, but a lot of folks with poor outlooks tend to give up, figuring they might as well continue if it looks bad anyway. I knew a guy in that situation, his explanation was it was better to enjoy himself and wreck his liver (transplant wasn't an option, he was too old for the surgery), so when it did go, he went quickly. He was already getting bad, if he quit he would still die, just slower.

It's not ideal logic, but I could kind of understand.
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  #4  
Old 09-21-2008, 03:28 PM
Qadgop the Mercotan Qadgop the Mercotan is online now
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What stranger said. Much depends on the severity of the cirrhosis, how fast it is progressing, and what the complications are already.

Once one develops ascites, low platelets, or bleeding esophageal varices, those are signs that the scarred liver is physically impairing blood flow thru it to an extent that the rest of the body is suffering.

If the blood doesn't clot properly, or the albumin level is low, or the ammonia level is above normal, then the liver isn't doing its physiologic job of producing proper proteins and detoxing the blood for normal physiologic functioning anymore either.

But people can live a long time, even with those complications, if the continuing liver damage is arrested and their diet/meds adjusted.

I've one guy right now who has ascites and high ammonia levels but has muddled along for about 5 years because he no longer drinks, takes his meds, and watches the protein level in his diet. He may survive long enough to get a new liver.

So stopping drinking is the single key thing that needs to happen to significantly improve survivability. Otherwise, continuing damage occurs, more scarring happens, and things get worse.

Granted, stopping brings no guarantees that things won't progress anyway; but it's unlikely the disease will stabilize without that step.

Last edited by Qadgop the Mercotan; 09-21-2008 at 03:29 PM..
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  #5  
Old 09-21-2008, 03:39 PM
Qadgop the Mercotan Qadgop the Mercotan is online now
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Hey, Chief Pedant is back!

I bet he's got lots to say on this topic!
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  #6  
Old 09-21-2008, 03:40 PM
Shagnasty Shagnasty is offline
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The liver is one of the more resilient organs when it comes to damage. He will kill himself early if he keeps up his drinking level. This comes from a person who drank much more for less time. He can live but don't do something stupid like throwing out his drinks. That could kill him literally. Alcohol withdrawal is among the most serious of all drugs and can be fatal if not done correctly. I would research finding the best one in your area and getting him to go.

The problem is that most people don't want to go and one detox/rehab isn't usually enough. This is a terrible statistic but many major alcoholics requires 10+ detoxes and 100+ is common as well. It just becomes a matter of how much effort family members want to expend.

If you really want to save him, it will take a lot of effort on your family's part. A trick to get into such a hospital is for him to get as drunk as possible and then get taken to the emergency room. That becomes a potentially clinical fatal case and has to be addressed right away. That is highly recommended if you just want to address the situation right away. It bypasses waiting lists which are usually quite lengthy.
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  #7  
Old 09-21-2008, 03:46 PM
Stranger On A Train Stranger On A Train is offline
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Quote:
Originally Posted by Qadgop the Mercotan View Post
I've one guy right now who has ascites and high ammonia levels but has muddled along for about 5 years because he no longer drinks, takes his meds, and watches the protein level in his diet. He may survive long enough to get a new liver.
What are the preconditions to be considered for a transplant? It was my understanding that people suffering from alcoholic liver disease are way down on the list for consideration, and I'd think being a felon probably doesn't improve one's chances. I remember when Mickey Mantle got a transplant (after years of drinking and suffering from untreated Hep. C) and there was a big stink about how he shouldn't have been eligible or at least as high up on the list as he was.

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  #8  
Old 09-21-2008, 03:47 PM
Qadgop the Mercotan Qadgop the Mercotan is online now
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Quote:
Originally Posted by Shagnasty View Post
The liver is one of the more resilient organs when it comes to damage.
Unless you get cirrhosis. Which happens in only about 20% of alcoholics, but is a devastating consequence. And cirrhosis does not reverse itself.
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  #9  
Old 09-21-2008, 03:52 PM
Qadgop the Mercotan Qadgop the Mercotan is online now
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Quote:
Originally Posted by Stranger On A Train View Post
What are the preconditions to be considered for a transplant? It was my understanding that people suffering from alcoholic liver disease are way down on the list for consideration, and I'd think being a felon probably doesn't improve one's chances. I remember when Mickey Mantle got a transplant (after years of drinking and suffering from untreated Hep. C) and there was a big stink about how he shouldn't have been eligible or at least as high up on the list as he was.

Stranger
Active drinking is a contra-indication. Most transplant programs require at least a year of sobriety. But a sober alcoholic can be a good transplant candidate.

Courts have ruled that inmate status cannot be taken into account when deciding rank on transplant lists.

Mickey Mantle met the abstinence criteria. But he should have been screened more rigorously for liver cancer before the transplant.
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  #10  
Old 09-21-2008, 05:30 PM
smiling bandit smiling bandit is offline
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He's drinking 120 beers a week?! That's (on average_ more than one beer per waking hour!
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  #11  
Old 09-21-2008, 08:50 PM
Shagnasty Shagnasty is offline
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Originally Posted by smiling bandit View Post
He's drinking 120 beers a week?! That's (on average_ more than one beer per waking hour!
And yet the body can process just about that much. If you time it perfectly, you won't even get drunk. I was up past 30 a drinks day at my peak and I still held down a good job, a beautiful family, and a nice house. I have never had any formal law infractions either. I just got back from an AA meeting with 300 people in a town of 13,000.

Alcohol addiction is a horrible thing. It strikes all groups including doctors, lawyers, and homeless people. You can't stereotype alcoholics no more than you can other groups. No one could ever tell that I was drunk because my drunk was their normal. It is hell on earth for someone that suffers from it but your drunk is not the same as their drunk. They just need drinks to function.
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  #12  
Old 09-21-2008, 09:15 PM
Mr Buttons Mr Buttons is offline
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Thanks for all the answers everyone.

I know he's not going to stop drinking, no matter what happens, so rehab is basically out the door.

I don't really know any of his med stats are, but his health is in pretty bad shape (350+ lbs, need a breathing aparatus to sleep, requires oxygen for a couple hours a day [i think that's more from smoking, which he also hasn't stopped.])

I was just curious. I don't really like the guy, but it's obviously going to impact my SO when he does finally pass. I was imagining it would only be a couple months, surprised to here it could keep going on for years.
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  #13  
Old 09-21-2008, 09:23 PM
R. P. McMurphy R. P. McMurphy is offline
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Quote:
Originally Posted by Shagnasty View Post

The problem is that most people don't want to go and one detox/rehab isn't usually enough. This is a terrible statistic but many major alcoholics requires 10+ detoxes and 100+ is common as well. It just becomes a matter of how much effort family members want to expend.
Can you elaborate on this? What is involved for an event to be classified a detox? 100+ detoxes sounds like a lot of intervention.

No argument, just looking for information and insight.
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  #14  
Old 09-21-2008, 11:00 PM
MissGypsy MissGypsy is offline
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Originally Posted by Shagnasty View Post
He can live but don't do something stupid like throwing out his drinks. That could kill him literally. Alcohol withdrawal is among the most serious of all drugs and can be fatal if not done correctly.
I'm curious about this, because I know that one of my sisters had to be in the hospital for a few weeks to get her off alcohol (because she needed a major surgery), but I didn't really understand why.
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  #15  
Old 09-21-2008, 11:20 PM
Chief Pedant Chief Pedant is offline
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Quote:
Originally Posted by Qadgop the Mercotan View Post
Hey, Chief Pedant is back!

I bet he's got lots to say on this topic!
He's got 42 months, 11 days.

C'mon Q; I appreciate the welcome back but if I could prognosticate via the web I wouldn't be still holding my Tesoro shares. Can't add anything worth adding to what you and Stranger said except that, like you, patients like to stick it to me when I throw a termination date out there for 'em. As long as they surprise me to the good side I am OK with that.

Mr Buttons:

If the wife's Pop has turned bright yellow that's a whole different "finally has cirrhosis" than if he had a biopsy showing some minor cirrhotic changes. With the liver and cirrhosis it is sort of all about function more anything else. When things the liver does (keep you from bleeding; clear toxins, e.g) stop happening, it's a very bad sign b/c you don't see clinical effects til it's mostly crapped out. Or if you get so much cirrhosis your blood backs up and you get big veins that bleed, that's a bad thing. OTOH doctors will often try some sort of warning ("Sir, you've finally got Official Cirrhosis") as a last ditch effort to keep Pa and Sam Adams in separate rooms. Sometimes we'll even hang a little crepe to save our own sorry arses in case things unravel rapidly. If they do unravel, the patient's clan is not aggreived; if the patient outlives the prognostication the worst that happens is that they gloat a bit.
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  #16  
Old 09-22-2008, 05:15 AM
irishgirl irishgirl is offline
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Shagnasty- seriously I wouldn't recommend the old drunk and dump route. When Pop sobers up and discharges himself against medical advice or absconds to get drunk, it wastes everyone's time. If people don't want to stop drinking trying to force them into it is not the way to go.

Here, drunks sober up and usually discharge themselves, we don't detox people who actually have drink in their system bcause you can't assess capacity to consent, intention to maintain sobriety, suicide risk, any of that in a drunk person. Once sober, if you tell me you want to go home, I'll let you. Hospital is not prison.

Less than 24 hours off alcohol and you get sent home with vitamin tablets and some Librium, more than 24 hours off drink, you'll get taken seriously and probably admitted for inpatient detox.

Different if dad is confused, encephalopathic, bright yellow or vomiting blood, of course, but otherwise I wouldn't go down the route of taking him to an ER in the hope of getting him detoxed.
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  #17  
Old 12-31-2011, 12:01 PM
drtj drtj is offline
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I have the same question

Hi all,
I'm new to this forum. I found it searching for information on death by cirrhosis because my 69-year-old father-in-law has been dying a very slow death and we just got back from a visit. About 15 years ago he was diagnosed with cirrhosis but it only just started seriously impacting his health the last five years or so since he retired.

3.5 years ago we moved very far away and my husband is his only family so it's difficult to help him. He drinks beer constantly and smokes cigarets. We are not going to get him to stop. He's a stubborn curmudgeon who values his privacy and independence. It's amazing he's still alive. Must have a very strong constitution! I'm not new to alcoholism. I know you can't change an alcoholic; you can only help them if they want to change and he doesn't. My mother was an alcoholic and killed herself with a drug overdose.

This recent visit was especially tough. He's been having some bouts of confusion and a couple of dangerous driving situations and finally he lost his driver's license. We got him to consider making some end of life arrangements and he signed power of attorney for health and fiances. I had an opportunity to speak with his doctor and she said his ammonia blood levels were high but he did well on cognitive memory tests. The only thing more she would say was that he should stop drinking (NOT going to happen!).

I think he has bouts of hepatic encephalopathy and spends a lot of time in a stupor or asleep. When my husband arrived at his house this visit, he was asleep in the afternoon and he didn't know the time or day. He was surprised that we were there. He has two little dogs and there was no dog food. His house was a mess. There was a 3-week-old turkey out on the counter. (Yuck!).

We spent the next two weeks making a lot of arrangements, cleaning up after him and making his house more livable. He's pretty much confined to a scooter chair because he has hip and back problems. He is also suffering from diabetes and has heart problems (pacemaker). This time we also noticed that he has developed hand tremors which are related to his encephalopathy. His abdomen and feet are swollen and he complains of being cold all the time. The only cirrhosis symptom he doesn't seem to have is jaundice.

We've suggested various agencies that can help him with food, transportation, etc, but he's extremely resistant to any help from anyone but us. He does not want to go into assisted living. He doesn't want anyone coming to check on him or providing any services. He's a very cheap SOB and doesn't want to spend any money on anything but beer and cigarets. We did work out an arrangement where we'll call him once a week to check on him (but he didn't like this idea at all and he rarely answers the phone.)

It would really help to have a better sense his prognosis and the timing of his death. He hasn't seen his doctor that much so she really couldn't tell us. From reading stuff on the internet and observing his symptoms, I guess is that he won't live 6 months. It would be a blessing if he would slip into a hepatic coma and die peacefully. Anyone been through something similar? What can we expect? How can we help make his end of life as peaceful as possible? How can we best handling traveling back and forth to help him?

Thanks!
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  #18  
Old 12-31-2011, 12:13 PM
Qadgop the Mercotan Qadgop the Mercotan is online now
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drtj, I'd advocate that you raise the topic of Home Hospice. Look for a qualified one in his area.

The goal of hospice is to make the patient with a terminal diagnosis more comfortable, and help them to enjoy what's left of their lives. Hospice care will not try to cure the underlying problems, as the chance of doing so is rather miniscule. They will try to provide the hospice care in the person's home environment if possible.

Last edited by Qadgop the Mercotan; 12-31-2011 at 12:15 PM..
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  #19  
Old 12-31-2011, 12:34 PM
guizot guizot is offline
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Quote:
Originally Posted by R. P. McMurphy View Post
Can you elaborate on this? What is involved for an event to be classified a detox? 100+ detoxes sounds like a lot of intervention.

No argument, just looking for information and insight.
I can't answer for Shagnasty, but detox is not the same as rehab. Medical "detox" is usually considered to be about at week, but that's just from the immediate physical dependence. The physio-biological effect on one's mental condition is more long-term. "Rehabs" are usually one month (and that's mainly because they're so expensive). It may include medical detox (if necessary), but otherwise it involves being holed up someplace where it's difficult to sneak off and go back to drinking. They have classes, and counseling, etc. From what I've seen, though, one month just isn't long enough. After 30 days people feel physically better, so they think they no longer have a problem--but they haven't changed psychologically. They leave the rehab, get back out into the reality of the real world, and eventually just fall back into the same routines they had before, and end up drinking again. In quick time they're as bad off--if not worse--than before, and so some circumstance (work or family) sends them back. That's how it's possible for someone to go to so many detoxes or rehabs, and still be drinking.
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Old 12-31-2011, 12:35 PM
drtj drtj is offline
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Hi Qadgop,
That's a good idea. I think we need to get a better handle on his prognosis first. Doesn't the doctor officially need to give him 12 months to live first?
DrTJ (not the medical kind)
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  #21  
Old 12-31-2011, 01:52 PM
Qadgop the Mercotan Qadgop the Mercotan is online now
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Quote:
Originally Posted by drtj View Post
Hi Qadgop,
That's a good idea. I think we need to get a better handle on his prognosis first. Doesn't the doctor officially need to give him 12 months to live first?
DrTJ (not the medical kind)
Depends on the local practices, the hospice policy, and possibly local applicable law.

But in my jurisdiction all I generally need to do is state that I feel the patient has a 50-50 chance (or worse) of expiring from their disease within the next 12 months.

And for my cirrhotic patients who are in and out of encephalopathy with worsening edema, horrible albumin levels etc. that's a pretty safe statement.

I had one guy who lasted 3 years instead of 1, but I also had a guy last 2 weeks when I thought he had more than that in him. It evens out.

Last edited by Qadgop the Mercotan; 12-31-2011 at 01:54 PM..
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  #22  
Old 12-31-2011, 02:04 PM
drtj drtj is offline
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Qadgop,
Sounds like you have a lot of experience with this. He is in CA and has Kaiser HMO which may limit his home care options but I'll check and see what they offer. I'll also reconnect with his doctor and see what she thinks. She's very young and I don't get a sense that she has had much experience with alcoholics and long-term cirrhosis. She just keeps encouraging us to stop his drinking.
Thanks!!
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  #23  
Old 12-31-2011, 02:45 PM
johnpost johnpost is offline
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start looking for institutional hospice also if that is coverage available.

it takes time to get care and payment methods and medical prognosis all together. the more prepared ahead of time you can be the better. knowing what places will take his insurance allows you to watch for openings when the medical situation warrants.
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Old 12-31-2011, 05:51 PM
KarlGauss KarlGauss is offline
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There actually is a fairly accurate way to estimate survival in people with cirrhosis (although the predicted ranges the method yields are broad).

It's called the Child-Pugh score and gives points according to whether or not certain complications of cirrhosis are present. The prognosis depends on the number of points a person scores.

As you can see in the link, three of the prognostic factors are based on blood tests (bilirubin, albumin, INR - the blood level of each being a reflection of the degree of (loss of) liver function) and two clinical features (ascites, which refers to the distended abdomen people with liver disease can develop; and hepatic encephalopathy which is a form of brain malfunction that occurs in advanced liver damage).

I admit it's not terribly helpful, especially when things are quite advanced or when you're trying to determine a narrow time frame for prognosis.

Last edited by KarlGauss; 12-31-2011 at 05:54 PM..
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Old 12-31-2011, 06:44 PM
drtj drtj is offline
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Everyone, thanks for the information.
John, residential hospice is going to be a last resort choice. He values privacy and control above all. He would rather suffer and die alone with no help at all than be institutionalized. He has a very traumatic history. He was institutionalized as a child under awful conditions. He also has two little dogs that are his only companions and I'm sure he couldn't have them with him. One idea we have brought to his attention is to move him across the country to where we are. Caring for him here would be much less expensive and we would be able to help more. However, that would be a huge move for him and I don't know how much time he realistically has. It would be a bummer to start the process to have him go in the midst of it all.

Karl, I'm familiar with the prognostic factors but his doctor didn't tell me anything except that he has high ammonia levels and that she put him on Lactulose. I was concerned that he was eating a lot of sweets including ice cream and he's diabetic but she surprised me by saying that his blood sugar was doing ok and that he could eat sugar. This seemed really strange to me.

We have to be careful about how we approach this issue. He doesn't like people meddling in his life and if we piss him off he may stop communicating with us which won't be of any help to him. So we usually bring up one thing at a time, let him mull it over and then take action when he's ready. It's just so hard to do this when we live more than 2,000 miles away.
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Old 12-31-2011, 07:28 PM
KarlGauss KarlGauss is offline
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Quote:
Originally Posted by drtj View Post
I was concerned that he was eating a lot of sweets including ice cream and he's diabetic but she surprised me by saying that his blood sugar was doing ok and that he could eat sugar. This seemed really strange to me.
Since the complications of diabetes take years, decades, to develop, and since people with cirrhosis unfortunately don't have decades to live, there's really no justification for them to aim for anything close to normal sugar levels. In fact, cirrhosis can sometimes lead to an inadequate response to low blood sugar levels (since the liver is where sugar is made and thus is the source of sugar to counteract any low blood sugar levels). What this means is that not only is there is no benefit in aiming for tight sugar control in cirrhosis, there's a real risk of profound, life-threatening hypoglycemia if you do. So, let him eat all the sugar he wants (well, be liberal, at least).

I should also point out that if his ammonia level is high and he is using lactulose, it's almost certainly the case that his diet is restricted in protein. If you restrict sugar as well, there ain't a lot left. Certainly nothing palatable. And, especially if the goal is a good quality of life for what's left, why make the diet unbearable?

Last edited by KarlGauss; 12-31-2011 at 07:29 PM..
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Old 12-31-2011, 11:55 PM
drtj drtj is offline
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Karl, he's not on a restricted diet. He eats whatever he wants, including lots of protein. He doesn't listen to anyone's advice and particularly doctors'. I guess you're right. At his stage, nothing is going to make much of a difference. It's all down hill from here. We're just trying to make it as comfortable and painless as possible. Thanks for the advice.
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Old 01-01-2012, 06:10 AM
Cicero Cicero is offline
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For a purely anecdotal (non medical) aspect.

A relative of mine was an alcoholic. I think you mention that your SO's father starts drinking at 10 am every day. My relative was just never sober. He drank two bottles of rum a day. He would have a bottle beside his bed and if he woke at whatever time he would start having a rum and coke.

Eventually of course it caught up with him and he was rushed to hospital several times after collapsing. This was after he had started bleeding from the back passage (his clothes were stained). He never gave up drinking although I think he slowed down. He was about 57 when he died which was about 6 months after the diagnosis. However, I would suggest he would have been diagnosed with it years earlier if he had ever seen a doctor about it.

(Just as a disclaimer, he smoked pretty heavily as well. He told me he would have to vomit every morning due to too many cigarettes and grog. To this day I wonder if he may have had eosophigal cancer as well).
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Old 01-01-2012, 12:03 PM
moejoe moejoe is offline
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My dad drank himself to death, and while I can appreciate your desire to make the end as painless as possible for him, your energy would be better spent trying to help your SO through it instead.

It's an ugly way to go, and there really isn't any way to pretty it up. He might turn orange and lose his mind and bleed from the wrong places, even if you don't like him at all it's an awful thing to watch, and it can take a long time to finish.

I hate to be such a downer, but from my experience the best part of your story is that you live so far away. My best advice is to say your goodbyes and never go back. That might sound horrible, but in retrospect it's what I wish I had done myself.

I wish you all the best.
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Old 10-12-2013, 08:44 AM
JustASis JustASis is offline
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Sorry for bumping a new thread as my first ever post here, but this is the thread that brought me to Straight Dope via google and I don't want to get lost in the forums trying to make a new thread. Hope nobody minds!

My brother who is about 50 has been an alcoholic for probably 30 years now. We are not close in age nor geographically and so my information is somewhat limited, as it is trickling down to me now through the family. I expect to know more soon, hopefully. Here is what I know about his situation:

He went to rehab earlier this year for 30 days to detox from alcohol. When he went in, he was quite overweight as compared to usual despite not eating hardly at all for weeks, and having no appetite. When he got out of rehab he went back home.

A couple of months later he went to the ER - I do not know what prompted this yet, he is not married and lives alone so it was not a loved one who brought him there, I do know that. They kept him for about ten days and drained 5 liters of fluid from his abdomen (which lost him 15 pounds right off the bat apparently), got him hooked up with a kidney specialist, and informed him that if they can't figure out why the fluid keeps coming back then its going to be a real big problem. They eventually discharged him and he filled a half dozen or so medications. One comes in ampules that he injects into his abdomen twice daily. I cannot find any information online as to what this might be (I've only heard of medicines for MS that are injected in this manner until now).

This is all I know. I presume he is in end stage cirrhosis and that his kidneys are also kaput, based on what little I know. I hope he will reply to my repeated attempts to communicate with him but I fear he is in denial and also feeling bad about his life choices, though nobody in our family has ever made him feel that way. We do have a GREAT DEAL of very bad cancer in our family that tends to always metastatize all over the insides, but I presume his situation was caused by drinking.

I realize this is a post missing much information but I would like to be able to prepare myself for worst case. Right now based on the liver and kidney involvement I fear he may well have weeks to months, and not years, to live. I am not looking to feel better, I am looking for realistic information... which is why I came here. Many thanks to any information anyone can share with me regarding whether my presumptions on his diagnosis and mortality are correct (or is it morbidity? I always mess that up.)

Thanks!

Last edited by JustASis; 10-12-2013 at 08:46 AM..
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  #31  
Old 10-12-2013, 09:20 AM
Manda JO Manda JO is online now
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I will tell you it is amazing how long end-stage liver failure can take, and how people can come back. I've known two people off the top of my head who were in the ICU for weeks and weeks-- somewhere between incoherent and comatose--and who ended up going home somewhat recovered. One quit drinking after that and is still alive seven years later. One hasn't quit drinking and it hasn't been that long, so who knows?

I guess what I am saying is that this can be an extremely long, disgusting, and erratic process and you should probably have your brain in the "long haul" mode, not the "bracing for the bad news soon" mode. In my experience.
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  #32  
Old 10-13-2013, 05:03 AM
handsomeharry handsomeharry is offline
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I think that this hijack is minor, and semi-related, so here it goes:
Just for the sake of argument, say that one had cirrhosis similar to that noted by Manda JO, above. So, one of these people totally quit drinking, with proper weaning, and started working out, pumping iron and cardio, proper nutrition, etc... Can any of our med types give us a hint as to increased longevity/quality of life (how much physical change, i.e., lack of pain, etc...) one may experience?
Thanks.

Last edited by handsomeharry; 10-13-2013 at 05:04 AM..
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  #33  
Old 10-13-2013, 03:53 PM
JustASis JustASis is offline
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Thank you for your replies. I will keep checking in to see if anyone else responds. This all takes some time to process, sorry for being so quiet after posting. I didn't post and run though. Thanks again.
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  #34  
Old 10-14-2013, 12:21 PM
jtgain jtgain is offline
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Quote:
Originally Posted by handsomeharry View Post
I think that this hijack is minor, and semi-related, so here it goes:
Just for the sake of argument, say that one had cirrhosis similar to that noted by Manda JO, above. So, one of these people totally quit drinking, with proper weaning, and started working out, pumping iron and cardio, proper nutrition, etc... Can any of our med types give us a hint as to increased longevity/quality of life (how much physical change, i.e., lack of pain, etc...) one may experience?
Thanks.
I am not a doctor but as it was explained to me for a family member, recovery from this or any disease is dependent on the individual and how much damage has been done (which also varies based upon the individual). The doctor explained it as a "straw" analogy. You can bend it to a certain point, and if you let up, it will pop back up to its normal position. Once you've bent it too far, it creases and will not return.

So, not being a doctor, but just hearing from a doctor, the lifestyle changes for your hypothetical patients can be anything from a total arrest of the disease to absolutely worthless. I know that doesn't help, but if one of our resident doctors can confirm, I think that is the limit to our knowledge. We just don't know and can't quantity resiliency in the body of human beings.
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  #35  
Old 10-14-2013, 12:24 PM
nearwildheaven nearwildheaven is offline
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Originally Posted by Stranger On A Train View Post
What are the preconditions to be considered for a transplant? It was my understanding that people suffering from alcoholic liver disease are way down on the list for consideration, and I'd think being a felon probably doesn't improve one's chances. I remember when Mickey Mantle got a transplant (after years of drinking and suffering from untreated Hep. C) and there was a big stink about how he shouldn't have been eligible or at least as high up on the list as he was.

Stranger
Most transplant centers require that a person be clean prior to developing their terminal illness.
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  #36  
Old 10-15-2013, 01:26 AM
handsomeharry handsomeharry is offline
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Quote:
Originally Posted by jtgain View Post
I am not a doctor but as it was explained to me for a family member, recovery from this or any disease is dependent on the individual and how much damage has been done (which also varies based upon the individual). The doctor explained it as a "straw" analogy. You can bend it to a certain point, and if you let up, it will pop back up to its normal position. Once you've bent it too far, it creases and will not return.

So, not being a doctor, but just hearing from a doctor, the lifestyle changes for your hypothetical patients can be anything from a total arrest of the disease to absolutely worthless. I know that doesn't help, but if one of our resident doctors can confirm, I think that is the limit to our knowledge. We just don't know and can't quantity resiliency in the body of human beings.
Thanks, jtagain.
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  #37  
Old 02-08-2014, 06:06 PM
JustASis JustASis is offline
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I posted this back on October 15, 2013 (nearly 4 months ago):

Quote:
Originally Posted by JustASis View Post

My brother who is about 50 has been an alcoholic for probably 30 years now.

Here is what I know about his situation:

He went to rehab earlier this year for 30 days to detox from alcohol.

A couple of months later he went to the ER -

They kept him for about ten days and drained 5 liters of fluid from his abdomen, got him hooked up with a kidney specialist, and eventually discharged him and he filled a half dozen or so medications. One comes in ampules that he injects into his abdomen twice daily.
Hi there again. I'm at a loss for how to read this situation due to the fact that my brother is no longer taking his medicines nor seeing doctors due to having no health insurance and being in debt already, and I'm unsure whether he has stayed sober.

He has malnutrition and doesn't eat pretty much ever, but apparently does drinks nutritional drinks occasionally.

He hasn't got energy to pull himself up stairs or much anywhere else, and is confused at times lately.

Now apparently he's started occasionally having hallucinations and cold sweats with rapid heartbeat. As previously stated, he has had issues with ascites for some time, and when pressed for info he says his "liver and kidneys are messed up" and that he's been "sick for a year now".

Are these new developments with his health any kind of hallmark signs that help show the progress of his situation? I don't know if he's jaundiced at this time. I'm trying to help him out with his insurance situation now that I'm aware of it, but I'm not sure that he has much interest in medicine or doctors at this point regardless.

Thank you again for having such a fine and helpful community here, and for any commentary anyone can offer.

Last edited by JustASis; 02-08-2014 at 06:06 PM..
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  #38  
Old 02-08-2014, 09:19 PM
slowlearner slowlearner is offline
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My brother and brother-in-law both died in their early 50's from drug and alcohol related liver problems. You intervene with them, you try to take care of 'em, nothing helps and finally one day you realize all they ever really wanted was to die anyway. Alcoholism is a slow way of killing yourself you don't have to take responsibility for. As time goes by you realize you didn't lose them when they died but years before when they decided to drop back and punt on 1st down. How do we keep on loving these perfectly self centered people who offer absolutely nothing in return?
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  #39  
Old 02-09-2014, 06:47 AM
Napier Napier is offline
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Love is anything but strategic.
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  #40  
Old 02-09-2014, 01:24 PM
Qadgop the Mercotan Qadgop the Mercotan is online now
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Quote:
Originally Posted by JustASis View Post
Are these new developments with his health any kind of hallmark signs that help show the progress of his situation?
IAAMD who treats end-stage liver disease patients. And it's hard to say anything definitive without knowing more, but altered mental status is a strong indicator that his liver is losing the ability to do its most core function: Clear the blood of toxins.

With proper evaluation and treatment, this might be stabilized and even possibly reversed a bit. Without it, the outcome does not look good, and people in this situation often decompensate and die quickly.
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  #41  
Old 02-09-2014, 01:37 PM
Charlie Wayne Charlie Wayne is offline
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Quote:
Originally Posted by Mr Buttons View Post
Assuming the person still drinks heavily.

My SO's father has been drinking about 4 30-packs of beer per week for going on 4 decades now. He's finally been diagnosed by his doctor as having cirrhosis of the liver.
Doesn't matter to him it seems, because he's still drinking around 4 cases a week. He drinks from about 10am until bedtime.
How much longer will he be around at this rate?
I once knew a man who drank so much that he had to have a liver transplant. The day he got home from the hospital, he paid some kid to go to the liquor store and buy a pint of bourbon.

It was a long time ago and so I don't recall exactly how long after that he died. But it wasn't too long.

I would guess that each person has some degree of variability. I don't know. But I think so.

Bottom line? I doubt they have very long. I won't guess because I wouldn't want to cause you any distress.

But, you should be able to Google that. No?

(Barney Google wit da Goo Goo Googley Booze ... No?)

I'm just J/K although it prob is not something to joke about.

Last edited by Charlie Wayne; 02-09-2014 at 01:41 PM..
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  #42  
Old 02-09-2014, 02:45 PM
JustASis JustASis is offline
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Quote:
Originally Posted by Qadgop the Mercotan View Post
IAAMD who treats end-stage liver disease patients. And it's hard to say anything definitive without knowing more, but altered mental status is a strong indicator that his liver is losing the ability to do its most core function: Clear the blood of toxins.

With proper evaluation and treatment, this might be stabilized and even possibly reversed a bit. Without it, the outcome does not look good, and people in this situation often decompensate and die quickly.
Thank you for this most helpful comment. I wish I knew more but my questions are met with answers that are apathetic or subject-changing or which indicate he doesn't know/remember/I need to ask someone else.
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  #43  
Old 07-09-2014, 03:35 PM
JustASis JustASis is offline
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Quote:
Originally Posted by Qadgop the Mercotan View Post
IAAMD who treats end-stage liver disease patients. And it's hard to say anything definitive without knowing more, but altered mental status is a strong indicator that his liver is losing the ability to do its most core function: Clear the blood of toxins.

With proper evaluation and treatment, this might be stabilized and even possibly reversed a bit. Without it, the outcome does not look good, and people in this situation often decompensate and die quickly.
Thanks again for your post. My brother died May 20, 2014. He drank til the end.
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  #44  
Old 07-09-2014, 05:13 PM
LibrarySpy LibrarySpy is offline
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I'm sorry for your loss. He was pretty young. Thank you for keeping this thread updated.
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  #45  
Old 07-09-2014, 08:30 PM
Qadgop the Mercotan Qadgop the Mercotan is online now
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Quote:
Originally Posted by JustASis View Post
Thanks again for your post. My brother died May 20, 2014. He drank til the end.
A pity. The fate of alcoholics, if they fail to find sustained sobriety, is generally one of jails, institutions, and eventual premature death. My condolences.
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  #46  
Old 07-09-2014, 08:42 PM
Lacunae Matata Lacunae Matata is offline
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I'm sorry for your loss. I hope you find peace.
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  #47  
Old 07-09-2014, 10:25 PM
Tom Tildrum Tom Tildrum is offline
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I'm sorry to hear this news.
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  #48  
Old 07-09-2014, 10:55 PM
chiroptera chiroptera is offline
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Quote:
Originally Posted by JustASis View Post
Thanks again for your post. My brother died May 20, 2014. He drank til the end.
I am very sorry. My father also died prematurely due to his alcoholism, he drank right up until he couldn't any more. It sucks.
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