An engineer in our group has been feeling ill the last couple of weeks. He showed up today, and his skin was yellow. He said the hospital drained some fluid out of his belly a few days ago.
It looked like he had lost a lot of weight, though he still had a protruding belly. It also looked like he aged 20 years over the course of a couple weeks.
He’s 46 years old. I really don’t know him that well. Another guy in our group told me he’s a *really *big drinker. He said he loves vodka. Every evening he goes to three bars: American Legion, the VFW, and another I can’t remember. He drinks vodka at each. The other engineer estimated he has drank about one bottle (fifth) of vodka each day for the last 20 years.
Wow, that sucks that you have to watch that guy go through that.
The exact same thing just happened to my BFF’s dad, who is a heavy drinker. Turned yellow, had his belly drained. He’s more like 66 than 46, but it doesn’t look like the old man is going to see 70.
It sucks when you have to see someone you have respect for in that kind of condition. I have a sister whose partner of 27 years, and older sister, ran a sort of “intervention” on. Turns out my sister had been knocking back I-don’t-know-how-much hard stuff daily, and she had been having walking blackouts. Her partner finally got really scared for her.
My sister has been sober for about two months now.
It really does suck that your co-worker is going through this, but if he gets sober, medical science being what it is, maybe he has a shot.
Sounds a lot like my uncle (well, my uncle’s BF–they can’t get married around here, but consider themselves so.) He hadn’t been sober for at least 20 years. He always said he was in pain, and I told him I was worried about him. He swells up really big and finally goes to the hospital, and barely has any liver left. He’s been told that he can’t drink ever again, or he will die. Then again, he’s not going to last much longer, anyways.
I just wish he wouldn’t have shut me out of his life. I was just getting to know him. (Turns out he’s an uber trekkie and actually had a part in hosting the convention when the actress who played Yeoman Rand wasn’t allowed on stage with the rest of the Star Trek cast.)
I worked with a woman that happened to. She’d been a recovering alcoholic and relapsed. After her trip to the hospital, she stopped drinking again and was fine.
My sister had to go through that and has been sober for two years. She’ll never have complete liver function, but it healed enough that she isn’t going to die anytime soon if she doesn’t drink.
I have a friend who drank about a fifth every two days for about 15 years, from 1970 to 1985. Then he dried out–his doctor told him his liver was turning to sawdust–and stayed dry for five years. Then he started drinking in a very controlled way and is still doing it twenty years later. I know it is controlled because every year for the past several we have spent two weeks under the same roof in Barbados for two weeks. He sometimes will have a beer or glass of wine during dinner and he makes a pitcher of frozen daiquiris every evening. four of us go through a fifth each week and the bottle does not go down during the day.
Now I have a question. I know that livers are one of the very few organs in the body that can regenerate. Can a diseased liver repair itself over the years? My friend is now 74 and does not seem ill.
He is dying. Sounds like end stage liver disease of some sort.
Where he drinks that is known as Cirrhosis of the Liver. Once they start draining off the fluid it is only for comfort measures. It is not reversible at this point. I’m sorry.
I knew a lady that was that bad and she ended up getting the fluid drained. She went inpatient and died within a month. She was only in her late 40’s but looked like 60.
If he is your friend now is the time to say your goodbyes.
I’ve read that a liver can regenerate up to two-thirds or three-quarters of itself. Like Qadgop says, though, if you keep damaging it, it will eventually give up, too.
Just as aside, the liver is one of my favourite organs - the more you learn about it, the more amazing it is. Here’s hoping your co-worker can do what he needs to do to get healthy.
Several years ago, my brother-in-law damned near drank himself to death via vodka at age 39. He went to the ICU when he started spitting up blood; he’d had the protruding belly for a while before that. He was diagnosed with alcoholic cirrhosis when he came in, and the doctors said to call his family, as they didn’t know how long he’d live. He did hang on, then his kidneys shut down, he had a mild stroke while in the ICU, and had to have a tracheotomy done at some point. IIRC, he also contracted pneumonia.
His liver managed to start recovering, his kidneys started working again as well. After he got out of the hospital, he was transferred to a physical rehabilitation center and had a whole lot of physical therapy after such a long period of being bedridden. His voice isn’t what it used to be because of the trach, and he’s still considered disabled to some extent, but he’s definitely alive and not doing too badly all things considered. He comes to family gatherings, he eats a healthy diet. He says that was his “rock bottom” and from what I’ve seen of him, I believe it.
Livers can regenerate wonderfully, if they don’t have too much cirrhosis.
But one must be rid of the agent that’s irritating the liver so, whether it’s alcohol, a hepatitis virus, an autoimmune disorder, iron overload, excess vitamin A, or other toxins.
And if cirrhosis is present, regenerative capacity will be reduced. Sometimes to zero.
It’s actually possible to predict with some accuracy which patients with cirrhosis will survive.
The Child-Pugh score, to predict survival in cirrhosis, is pretty simple and is based on only five things:
Bilirubin level: what makes you look yellow jaundiced
Albumin level: the liver makes this key blood protein which acts like a sponge to hold water in the blood vessels. So, when not enough is being made, you get swollen, i.e. edema
INR: a measure of blood clotting which is often abnormal in liver disease since the clotting factors are made in the liver
Ascites: accumulation of fluid in the belly; makes you look pregnant
Encephalopathy: a particular form of brain malfunctioning occurring when the liver fails to purify the blood of certain substances toxic to the brain
In the person you describe, we know his bilirubin level is over 50 (since obvious yellowing of the skin doesn’t happen at lower levels). That gives him 3 points according to the table in the link. Further, your description of his protruding belly and his report that fluid was drained from it prove he has at least mild, and probably severe, ascites. That gives him at least another 2, and maybe 3, points. I will guess he has at least some edema (you NEVER have ascites in cirrhosis without edema), and since edema in cirrhosis almost always means that the albumin level was depressed, that gives him at least another 2 points. Let’s give him the minimum 1 point for each of the remaining two criteria. Add everything up and you get 9 or 10 points.
Consulting the table for 9 or 10 points, he would have around a 50 percent chance of living two years. But, if he also had a high INR level and/or problems with encephalopathy and thus scored a few more points, his two-year survival would be around 35 percent. Surprised?
It is ESLD. He drinks a fifth a night, his kidneys are shutting down and he is getting fluid drained off. He has yellow Jaundice and his eyes are yellow. He has a big gut full of fluid and they can only drain the fluid so many times. I was wondering if he might also have a secondary condition like Hep C? Drug users get it and add that to ESLD and his mortality rate is worse. He is to sick to treat the Hep C if he also has that.
I wasn’t being mean but time is of the essence if he wants to say good bye to his friend. Once the kidneys shut down he may get to confused and delirious to know anyone.
My dad was about 2 weeks away from dying. Jaundiced, protruding belly, cirrhosis, the works. For about 2 years after the worst time of it he had relapses, but never long enough to kill him. Not living at home anymore, I don’t really know the details, but looking at his condition now I believe he’s hitting a year of sobriety.
But yeah, when you see them that bad, it changes things forever. I’ll never have a very good relationship with him again.
He’s 68 now, I’m hoping he’ll hit 75, especially since my brother has the first grandchild on the way this year.
Yeah, but the OP says nothing about hepato-renal syndrome going on. And per KarlGauss’s excellent post, his two year survival may be at 35% or lower, but that’s still not automatic imminent death.
I’ve taken care of a lot of ESLD patients, from both Hep C and alcoholic cirrhosis (often both diseases at the same time) and have been surprised how some of them don’t die that quick, even with ammonia levels in the 100’s, and albumin under 2.0 and INRs over 6.
