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MedHelp Member's Question

cirrhosis- liver failure- need help

by Kush, Aug 03, 2002 12:00AM
I tried this post on two other forums without any success. I hope sommebody out there can help me. I am married to a 56 year old alcoholic. He was diagnosed with cirrhosis in l995 and has had two medical indents in the last two years (bleeding varises)

The doctor said he woud need a transplant within 3 years in 2000.

Myy husband went to rehab, but walked out within 4 days and has coninued to drink. He is showing signs of liver failure (white nails, yellow eyes, bronze skin, bruising, foul breath, and his doctor said his platlets are down from l50,000 to 36. Now he is refusing to go to the doctors, and says all his symptoms are from a bad hip. Xrays showed nothing. I realize this is denial, but need to know what are the symptoms of liver failure and when to call an ambulance. A counselor said I can't force him into treatment, so I am swimming in a sea of blindness.

Can anyone help me?

Member Comments (10)

by mrmichael67, Aug 03, 2002 12:00AM
Listed below are the major symptoms of liver failure.  Do a search on your favorite search engine and you will find a ton of info.  Here they are:



GENERAL

Weakness

Anorexia

Weight loss

Abdominal discomfort  Hematologic

Bruising

Epistaxis

Petechiae

Thrombocytopenia

Anemia

Decreased fibrinogen

    activity

**********************************

CARDIOVASCULAR

Flushed skin

Hypo- or hypertension

Dysrhythmias

Bounding pulses

Spider angiomata

**********************************

RESPIRATORY

Pleural effusion

Hypoxia

Decreased lung  

    expansion Fluids & Electrolytes

Ascites

Hypokalemia

Hypocalcemia

Hypomagnesemia

Dilutional hyponatremia

Hyperammonemia

**********************************

GASTROINTESTINAL

Rectal varices

Esophageal varices

Fetor hepaticus

Clay-colored stools

**********************************

DERMATOLOGIC

Jaundice

Palmar erythema

Pruritus

Vascular spiders

**********************************

RENAL

Decreased renal perfusion

Brown urine

Decreased renal output

Increased urine bilirubin

   and urobilinogen

**********************************

ENDOCRINE

Gynecomastia

Female escutcheon

Testicular atrophy

**********************************

NEUROLOGIC

Personality changes

Disorientation

Sensory alterations

Asterixis

Peripheral nerve

   degeneration

Coma

Kernicterus (in neonates)

**********************************

LABORATORY VALUES

Elevated AST, ALT,

   alkaline phosphatase,

   bilirubin, PT, PTT

Increased or decreased

    BUN

Decreased platelets,

   serum albumin & protein Immunologic

Increased susceptibility

    to infections

  Decreased WBC

    phagocytic activity

by Kush, Aug 03, 2002 12:00AM
To: Michael
OMG! He has a lot of them- what do all the systems begin to because the liver is shuting down? His symptoms began about 6 weeks ao. Every week he seems to manifast a few more. This is really scarey. I belong to Al Anon and everyone says get him into a hospital NOW. He refuses to go.

I have done a google search. Perhaps there is no real answer about whe to cal an ambulance, besides hemmoraghing and the last time he almst died. nce he is refusing help at this point, I feel terribly helpless.

Thanks for the list. Gosh- he is in trouble.

by mrmichael67, Aug 03, 2002 12:00AM
To: Kush
You need to get him to the hospital right away!  I don't understand how he can be so flip about his life like that.  He does understand this all is terminal, doesn't he?  He only has one liver, and needs it.

by fishman59, Aug 03, 2002 12:00AM
To: kush
I don't want to scare you but perhaps you should let your husband read this thread..My father in law died 1 year almost to the day that my first son was born,he was only 47 years old and had so much to live for.It was truly a shame that he was too unhappy to care about his own life.If he won't go to the hospital for himself--will he go for your sake?And if not and the law won't allow you to commit him may I be so bold as to tell you to give the paramedics another reason to take him to the hospital (conk).I'm not trying to be humorous here my own foster  father was nowhere near as ill as your husband sounds and also refused so I gave them another reason to take him in it only helped temporarily but did give him time to dry out and semi-realise what he was doing to himself.

                     Best of luck

                     may you BOTH live long and prosper

by Kush, Aug 04, 2002 12:00AM
Thank you for the input. I tried to talk to him yesterday and he just walked out to the patio in the middle of our discussion. I think much of it is denial. I was very direct about the possibility that he is dying. I even suggested that if this is his choise, then I will make arrangements for hospice to come and help him with his pain, which I said will be worse than he is experiencing now.This morning he said he thinks everyone "hates" him. I believe depression is some of the problem and is attempting to divert the reality of the situation- the best defense is a good offense. Still denies alcohol is the root of the problem or that his symptoms are related to his liver. Still thinks his right side pain is related to his hip replacement and  that the severe bruise that runs from his waist to his knee cap is hip related. (xrays showed no damage) Now he has severe shooting pain on rt. side (near the hip) I think it is possible this is liver pain radiating down his right side.

I wonder if encephlaopathy is playing a role in this? I have put a call into the outreach program I am working with because now he wants to drive to our camp in Maine - 11 hours away for a vacation! I am terrified

by 1fortheroad, Aug 04, 2002 12:00AM
To: kush
i'm so sorry about what you are going thru.  i was at a family reunion yesterday, where i watched my husband's uncle literally sit like a statue all day long...he is dying because of liver failure as well.  he continues to drink.  we thought he would die last year, but he somehow continues to live - not a life any of us would want.  his wife cannot go anywhere - she has to be by his side every minute - he cannot function without help.  i was VERY surprised to see him there, but i think his wife really wanted to come and dragged him along.  everyone went into the back yard to have a family picture taken....everyone except him.  he couldn't make it down the stairs.  he would rather sit back and have his cocktail...it is so incredibly sad.  drink or life...pills or life?  all of us here have some kind of choice to make.  i'm sorry you have to watch your husband do this to himself.  i have no advice to give...i'm very sorry.

by sissy101, Aug 04, 2002 12:00AM
As a critical care nurse I could tell you that the biggest "warning" sign is a change in mental status.  That would mean his ammonia level was starting to rise- if not addressed he will go into a coma.  Do you notice a "fruity" smell on his breath?  Is his belly much larger than normal?  If your husband is refusing to go to the doctor or hospital its not good.  The only thing you can watch for is if/when his mental status changes, then you can call an ambulance or bring him yourself because he would then be considered disoriented and therefore not competent.



Good luck- I wish you well.

by Kush, Aug 04, 2002 12:00AM
Oh Gosh! Yes his breadth is awful. He uses mouthwash all the time. I would say more of a musty smell. It wakes me up at night and I have to move to another bed. I know about encephalopathy and watch for signs. I noticed a couple of weeks ago he tried to put on a new shower head I got him for his birthday. He worked for over an hour and couldn't manage to do it. Took me about a minute. He has a masters degree in engineering so he is not incapable.

He sleeps a lot, pretends to read and then falls asleep. He gets irritable and frustrated over little things. So far he still makes sense, except for his denial and pretending this is a hip problem (not to mention still drinking).

So far it's little things I notice, but not major yet. More agitation and irritibility and lack of concentration.

Thanks for all your support and input. It has helped me immeasurably- much more than you know.

by Yo_Tony, Aug 08, 2002 12:00AM
Sometimes people who refuse help have to keel over before paramedics are allowed to work on them. By the time your husband can no longer refuse medical treatment, chances are it won't do him a great deal of good.



It's very difficult to sit still and watch someone commit suicide, but when someone can legally refuse treatment, there's not a whole lot you can do.



There are some liver herbal remedies, but they're not intended to fight alcoholic binges. Your husband is at the crossroads, as you yourself have realized. Do all that you can, but the decision is his. Forced detox is your only other bet, but it's risky and illegal.













by Kush