I have cirrhosis - seeking support or general advice

Miscellaneous and Personal Stuff I Must Share
1

(Insert standard “you are not my doctor” disclaimer)

Some of you who’ve been around for awhile probably know I’ve been a heavy drinker for much of my adult life. In my champion drinking days, I was consuming more than a fifth of hard alcohol every night, sleeping it off, and then working through the hangover the next day. After a medical incident in 2016 I sobered up for about six months, and tried AA and group therapy (which if anything only worsened my depression) before I fell off the wagon again - I cut my alcohol intake by about half of what it was before, but I was still drinking every day.

Flash forward to last year, when I caught rotavirus courtesy of Amtrak and spent a week in a hospital in Chicago. With the high turnover in GPs post-covid, it was a few months before I got a chance to follow up on the visit with my doctor, and when I did she noticed that a CT I’d been given during that stay indicated abnormal liver morphology. She started me on naltrexone to get me sober, which has made a huge difference as I was able to cut back to drinking only on my days off. Still, it took awhile before I was able to get in for an ultrasound, and once we had that she referred me to a gastroenterologist who booked me for a liver biopsy. That was earlier this week, and though I haven’t gotten to talk to the GEist yet, I was able to read the results online and it’s a clear diagnosis of cirrhosis.

As far as I can tell, it’s still “compensated” at this point - there’s no evidence of portal hypertension or ascites or edema, and I’m not experiencing any external symptoms. I feel completely fine. Still, this is scary - I’ve never had to contemplate my mortality before, and I know there’s still a lot I can do to prevent further damage, but there’s a decent chance that this could be what eventually kills me.

I’m not looking for pity or to be lectured to - I’m fully aware that I did this to myself and it’s nobody else’s fault. I know the biggest things I can do to help keep myself healthy right now are to avoid alcohol and to eat healthy and lose weight. The first part honestly seems like the easiest - I’m already only drinking on days off, so all I have to do is not buy it and then I can’t drink it. The diet part feels more challenging - I live alone and don’t always have the energy to cook after working all day, so I eat what’s easy and/or cheap, which isn’t necessarily the best for me.

Anyone else out there living with liver damage who has some sage advice for someone in my predicament, or know where I might look to find it?

2

I drink everyday when I take the dogs out for their Jeep ride. I often wonder, every time I open another beer, “Is this the one that kills me?”

I got nothin’

3

My advice would be to use some of the money saved/not spent from not drinking, and look into some meal delivery service. Hopefully, there’s one out there that will deliver some frozen meals that you can stand and even enjoy.

i totally feel you about being too tired to cook when you get home from work. This would be what i would have done at home, except my late husband did have the asciites, the edema. And eventually the jaundice and organ failure.

Not drinking on your days off is a good idea, too. My understanding is if the liver doesn’t have to work to filter extra toxins, it has a better chance of healing itself. Not telling you what to do, it’s just a suggestion. Take care.

4

I have no clue about how to convince yourself not to consume alcohol, but I feel you on the lack of energy after work to cook healthy food for yourself. What works in my household: when we do cook, we make extra so we have leftovers. I think in this case, your solution is going to be incremental. Can you meal prep or cook a few things on the weekends and freeze in serving-sized portions? Get yourself an Instant Pot or slow cooker and cook in batches? Find a few very simple recipes that require little to no cooking and have the ingredients handy for days when you are tired? (The Instant Pot has been a lifesaver for us - we pretty much always have lentil soup ingredients in the house, and the Instant Pot lets you brown in the pot and cuts cooking time by 2/3, which means lentil soup is 15 minutes or so once it reaches high pressure and is easy to cook in big batches, and something like arroz con pollo or beef stew is a feasible weeknight meal.) In my single days, I used to cook batches of things in the slow cooker overnight and then just plunk it in the fridge in Tupperware before I left for work.

There’s also no shame in the occasional bit of reasonably healthy prepared food, takeout from a local independent hole-in-the-wall ethnic restaurant, or simple meal like a big salad with some protein in the form of rotisserie chicken, quickly sautéed fish, chickpeas, or some canned tuna thrown in for protein. Marinating meat or tofu ahead of time is a magical way to end up with food that tastes like you slaved over a hot stove without actually slaving over a hot stove. We also find things like lentil pasta (which is made from 100% red lentils) and a quick jarred sauce to be handy with bits of random sautéed veggies on top. A crispy fried egg on top of a rice bowl, along with some kind of quick sauce or dressing, can really tie together a meal made of random bits of leftover meat and veggies. Or keep ingredients handy like a big batch of cooked brown rice or beans cooked from dried in the Instant Pot to be handy as bases for healthy meals like brown rice bowls. Polenta, etc. work too. There are plenty of days when I have thrown some dried beans or chickpeas in the slow cooker with water in the morning and then figured out what kind of quick meal I can make with them after work - for this purpose, spice mixes (especially salt-free ones) are definitely your friend. It may not be gourmet cooking, but it’s reasonably tasty and much healthier than fully prepared foods.

For the cooking side of things, you ight get a good response with a Cafe Society thread. Good luck!

5

Oh, I’m quite the home cook when I set myself to it. The thing is, the things I cook tend to be loaded with fat and salt and other not-good-for-you stuff, and from what I understand I need to eat a high-protein high-fiber diet without excess fats or salt.

Part of the challenge is gonna be finding healthy recipes that are easy to make and actually taste good. I foresee a lot of grilled chicken breasts in my near future.

6

Since I’m not a doctor, not have any personal or second hand experience with liver issues, I’ll just give my sympathy and hopes that you can finish weaning yourself away from the alcohol entirely.

As for cooking, a big advantage of days gone by is that there are tons of mostly ready made stuff that’s tasty and easy to prepare. Sadly, little of it is cheap, and most of it STILL has waaaaay to much salt.

What I’d advise (other than reviewing a lot of the CS threads) is batch cooking. Make a big batch of something (rice and beans, slow cooker roasts, etc) that you like, has a decent nutritional balance and reasonably priced ingredients. Depending on freezer and fridge space, you can make one batch on Saturday of Dish A and a batch on Sunday of Dish B, and alternate between the two all week with only reheating needed during the work week.

Beans and rice being a staple of reasonably priced but high nutrition options, but I’ve made slow cooker Jerked chicken, and other highly spiced foods that pack in flavor but are low in fat. Serve over greens, wild rice, or whole wheat couscous and you can do pretty well while keeping the fat down and fiber up!

7

I am sorry to hear this.
My son had cirhosis.
Any alcohol will be detrimental.
Everyones system is different. There are vitamins (A) and minerals which can be helpful, I suggest googling that.

8

Maybe try playing around with different sauces?

I’ve done a chick’n boobie with (jarred minced, cuz lazy) garlic, plus orange marmalade, all slathered on it while - okay, before - it was baking. You can add a sprinkle of pepper flakes if you like it a bit spicy.

Pork chops (see also garlic + marmalade) or lean red meat like sirloin (Worcesterwhateverthefuckshire sauce for marinade) are easy to sear.

If you like fish, almond tilapia is dead simple.

Frozen tilapia (inexpensive compared to a lot of protein) and you really only hafta barely get it half thawed, it’s so thin.
Season with Old Bay (or whatever salty seasonings you like) then lightly coat with mayo.
Yes.
You won’t taste it in the final dish, I promise.
Press slivered or sliced almonds, then bake at 350 for maybe 10 min. When the nuts are lightly browned, it’s good to go.

Can be done in a toaster oven, in fact, I recommend that.
The mayo melts and keeps the fish ultra moist, and the almonds give this decadent, crunchy contrast.

… there’s always scrambled eggs?

9

sorry to hear (now there are 2 internet-pals here who came out with serious health issues in the past few days) … I really hope you get any further plan working for you.

my “bestest” advice (not that its much) is … try to get intermittent fasting working for you. You mention a busy and hard day … if you can drop the breakfast, you are already 80% there in terms of IF. There have been a few threads here in the past that will make for a great reading…

you know that weight control and alc-ingest are now no longer a “nice to have” for you, but a “need to have” …

hopefully that gets you the energy and motivation needed to get back on track and you die being hit by a bus, age 97. (didn’t check, but I sure hope you are not 96 :wink: )

make a plan, (depending on personal structure) write it down and stick to it … you know have very clear scenarios of what will happen if you don’t

not preaching, not “better-knowing” or finger-pointing on you - just my best shoot-from-the-hip-advice that I can come up.

All you do from today on, depends on only one person.

10

Here is a favorite vegetable dish I absolutely love and it’s fairly healthy and easy. I get some zucchini and yellow squash, wash it and chop it in chunks. Sauté it in a little olive oil and/or butter. Season with salt and pepper as it’s sautéing. I like to get the veggies a little browned on each side. Sprinkle with a good parmesan cheese. That’s it.

You could probably use a good blue cheese too. Anyway, I could eat this several times a week. You can add onions or carrots too.

I too have an addictive personality. It’s a curse. Good Luck to you Smapti.

11

I am retired, so plenty of time to cook, but I still meal prep on weekends. I make 5 servings and stick them in the fridge. This works if you don’t mind eating the same thing every day. I almost always use chicken, usually in the slow cooker with random vegetables. Sometimes I add broth and make a soup.

Tips: caramelize the onions first, adds much flavor. Vary the spices. Use canned diced tomatoes for convenience. Throw in some beans for variety. Add some (pre-packaged, if you like) bacon. I use the pre-packaged rotisserie chicken from Costco.

Best of luck to you, @Smapti.

mmm

12

This is what I strive for (as I think it’s the healthiest way to eat).

Consider upping your fresh fruit intake. Be sure to eat whole pieces (not just juice); fruit is usually a good source of fiber. My son knows that a piece of fresh fruit, along with a grilled steak, is a “daddy special” - it makes for a good dinner.

As for that steak - I eat a lot of red meat, but it’s lean (so, low fat; not a lot of marbling). That means buying “top round”, which is cut into thin strips (since it’s not tender). If you get sick of chicken, beef is tasty and pretty easy to cook (I throw it on a grill pan on the stove).

Another way to get in a “high protein, high fiber” meal is to use supplements. For breakfast, in addition to having yogurt and a banana, I make a smoothie by mixing Metamucil with whey protein powder. The Metamucil is orange flavored (and the protein I get is “fruity pebbles” flavored), so it’s very palatable. And one drink gives me a good dose of fiber and protein, easy peasy.

(I’m less help with the alcoholism; my own cannabis use mirrors your drinking. But if you are committed do one of those AA “90 in 90” things (I.e. 90 meetings in 90 days), and get a sponsor you can call daily to keep up the motivation).

All the best! You got this!

13

Your first order of business is to not drink alcohol. Without that piece, other medical/dietary/lifestyle interventions are pretty much futile. So I’d focus on that first and foremost.

Good luck, I know giving up alcohol is tough; it’s been decades since my last drink but I have had to work hard to stay sober, and still attend AA to hedge my bets and stay alive. It can be done.

14

I have maybe third-hand experience. My father was a liver doctor, and he treated a lot of people with alcoholic cirrhosis. He used to have a little plaque in his office (the private one, not the one where he saw patients) with a picture of a drunk saying, “I’d rather be a good liver than have one”.

The liver has unusual powers of regeneration. The myth of Prometheus being tied to a rock and having an eagle eat his liver every day and having his liver grow back every night is founded in fact. (My dad had my brother draw an illustration of the myth that he used when he taught medical students.) Some of the scarring from cirrhosis is permanent, but the liver can partially grow back. If you don’t have a lot of symptoms, that’s a great sign, you still have enough healthy liver tissue to do the job, and if you stop damaging it, you can maintain that.

I think the key is to stop drinking. I don’t recall my father ever talking about his patients’ diet, but he talked a lot about their alcohol consumption. (This was before HIPAA. He never used names, but he did talk a lot about his patients at the dinner table.) I mean, a healthy diet never hurts, and other good habits like getting enough sleep and enough exercise are good for pretty much everyone, too. But alcohol is tough on the liver, and you need to stop damaging it.

Also, not having a working liver really sucks. I mean, it can kill you, of course, but it makes you miserable, first. I remember my father’s joy the first time one of his patients had a liver transplant, and my dad walked into the hospital room and found that the patient, who had been bedridden and looked mostly dead had gotten up and shaved his face. You don’t want to go there.

I don’t have any advice for stopping drinking. My MIL swore by AA (she was a recovering alcoholic, and had been sober for a few years when i met her) but you’ve tried that. You might want to try a different meeting with different people, as I’m sure they vary. But she took me to a meeting once, and it felt awfully like a religion to me (an observation that she objected to, fwiw) and if that turns you off, you may need to find other social support for quitting and staying sober.

Best wishes.

15

One possible idea is to look at different cultures for cuisine. Not only can it be a source of variety, but various cuisines use different ways of providing flavor. Different spices and such, instead of butter and salt.

Good luck.

16

As an alternative to AA, look up SMART Recovery meetings in your area or online. I attended 3 meetings a week with 3 different groups of people, all done under science-based recovery methods. I pretty much quit attending at the outset of the pandemic, as I detest having to do any kind of meetings online, but after a while, the lessons absorbed through the meetings do tend to set in and become your “default thinking”.

I’m living with cirrhosis myself, after almost 30 years of hard drinking, up to a half-gallon of whiskey every 2 days at the end. The main thing that has motivated my (not complete) diet change has been my diabetes, high blood pressure, and high cholesterol. Fortunately my wife is amenable to eating the same thing several days in a row, so I do cook on the weekend, dishes we can eat on for the week - keeps either of us from having to cook after work. I take dishes I like, and figure out where I can make healthier substitutions, or cuts that don’t affect the recipe too horribly. After a while, your tastes get used to it, and you won’t notice the differences.

17

I’m sorry you’re dealing with this @Smapti. I read your post last night and was still thinking about it when I woke up.

I totally agree with what others have said. The most important thing is to stop drinking. Thank goodness you found out about this before things progressed to the point of serious symptoms. As my former wife was fond of saying: “Fear is a powerful motivator.” And fear of dying before your time can be particularly motivating.

Next, besides cooking for yourself in batches like others have suggested, I often buy family-size portions of ethnic food during the workweek (Indian and Chinese, usually). For Chinese food, I ask for the sauce on the side because they put far too much sweet sauce in their dishes. (I also get salads, soups, and sushi, but they are more expensive, come in smaller portions, and don’t last as long or stretch as far.) The frozen ethnic food from Trader Joes is also pretty good. It’s very fast and easy to make during the week. Plus, the sauce usually comes in a separate packet so it’s very easy to omit most of the sauce and also to cut up and add more vegetables.

Your post hit a nerve with me because I feel like I’ve been drinking too much since my divorce: usually 2-3 drinks per night most nights. I think I still fall into the category of moderate drinker, but I may be fooling myself. Your story may be what it takes to scare me into drinking less. And thank you for that very encouraging news about the liver being to regenerate and heal itself, @puzzlegal.

18

Sorry to hear about this. Hope you managed to stop drinking. I’ve known too many people who went through this, but it wasn’t always terrible. You might live a long time. Sounds awful to say this, but hopefully you’ll live long enough to die from something else.

19

It’s true that liver tissue can regenerate. However its powers of regeneration, especially to form normally functioning parenchyma, are hampered in cirrhosis.

Agree that timely lifestyle changes/therapy in pre-synptomatic cirrhosis may preserve adequate liver function for a long time.

Sending best wishes to Smapti.

20

Several years ago when I was having an MRI done as part of checking on a heart condition it was noted that my liver showed some minor signs of deterioration. I had never been much of a drinker, but it turned out I had “fatty liver disease” - all the extra weight I had been carrying around for all those years caught up with me. After a bunch of tests it was determined that while the damage was minor it was best if I stopped consuming alcohol to avoid putting any unnecessary stress on my liver.

As I said, I was never much of a drinker, but being told I could no longer crack open an Angry Orchard apple cider, or take part in a scotch or whiskey tasting, or spike my Christmas eggnog suddenly increased my desire to do so.

I was also told to work on my weight. By watching what I ate and cutting down on my snacking I’ve managed to drop about twenty pounds. I need to lose more. A lot of the advise previously given is good. I’ve also been trying some of the veggie burger and other options, and have found a few of them tolerable.