Lab help

ALP/209, AST/118 ALT/66 BILIRUBIN 1.7, PLT 43, What does this mean, it is for my father, he went to detox, he said the Dr. gave him a year to live, he is very confused, should I take him to a Dr. to get his levels checked, he has chronic liver disease, cirrhosis, has been drinking his  entire life, will his levels go back to normal after detox or is his liver shot, the wont do a biopsy in fear of bleeding. Help please!

[boogieman]

hi there. alp=alkaline phosphatase. normal levels range from 20 to 140. elevated level could indicate bile duct blockage. ast=aspartate aminotransferase. levels of this must be referenced to other enzymes to interpret. alt=alanine transaminase. level interpretation same as ast. bilirubin levels are referenced as a function of production vs. excretion. plt=platelet count. low levels of this can indicate a risk of spontaneous bleeding.

having said all that, combined with the doctor's comments it sounds like your father has probably done some serious damage to his liver. however, doctors usually base their statements about potential mortality on past experiences, and it's likely that most folks in your father's condition have passed relatively fast (within a year). but i would also like to point out that such individuals usually continue to drink until they die, so the possibility of some recovery would be based on your father's ability to remain sober. the liver is capable of healing itself to a degree, but it depends how badly it has been damaged. does he want to stay sober? please advise----gm

[sharky1002]

He says he does but I know my Dad he has been drinking his whole life, I do not think it will last,  I did some research, found these test  do you know what these mean.
MELD score was 11
GAHS was a 6
mDF was a 3.5
Do not understand what they mean can you help.  I know that he has had chirrosis (cirrhosis) for over 10 years, has hepatitis c, my question is even if he quits, is his liver shot and he will die anyway?  Or can he live a long life?

[boogieman]

hi. these numbers are predictive scores used in determining severity of chronic liver conditions. meld score (model for end stage liver disease) is a mathematical model used in ranking a patients eligibility for a liver transplant. the higher the score, the more urgent the need for a donor organ. there are 4 levels of which your father falls into the second best (score of 11 to 18). transplant patients on average usually have 20 or higher. the gahs (glasgow alcoholic hepatitis score) can be used to predict survival rates---a 6 is interpreted as a 90% 28 day survival rate and a 79% 84 day survival rate. the higher the number, the lower the survival probability over a given time span. mdf (modified discriminant function) is a score used to determine the potential benefit of using corticosteroid therapy. a threshold of 32 is considered to be the cutoff level, and the higher the number, the lower the survival probability.
your father has definitely done some damage. neither i nor anyone else can predict his life expectancy and these scores are diagnostic tools. but i can tell you if he continues to drink, he will likely prove the doctors correct. if he can stay sober long enough and survive, he may be able to become eligible for a transplant, but if he drinks all bets are off. these scores are not at the severe end of their respective scales, so i would say yes, he has a decent chance if he stays sober to outlive the current prognosis.

it is also important to remember that quality of life is often much more important than the quantity. make the best of right now and you can never go wrong. take care,  gm

[sharky1002]

Thank you so much for all your help, I hope he gets it, but 90% sure he will drink.  He is in a 30 day program which he gets out on the 23, and usually addicts dont want to leave such a safe place, but he wants to get the hell out of there, he does not like AA at all.  So I guess we will just make the best out of the time we do have., he's my dad and I just have to love him and spend as much time with him.  Thanks again, it is very hard to find people to talk to about all this.

[KjFlicka]

Geeesh, boogieman, Nerd alert!  ;-)

sharky1002-  Though am I fairly young for an alcholic cirrhosis patient (36), the prognosis for this type of cirrhosis with 100% alcohol abstinence is very, very good. My MELD score at its highest was a 17 and now I'm coasting happy and healthy at about a 8-9.  I wish I could shake people and really show them how much better they can get if they don't drink. When they continue to drink, just as boogieman says, that's where all the doctors get their pessimistic attitudes. I got that attitude, too, and I pretty much took it as a challenge. So, HA!  Doing fabulous and not even a desire for alcohol since 2007. Wish I could help more.

Take care,
Nicole

[boogieman]

howdy. i would highly recommend checking out al-anon----it's for people affected by another person's drinking and it can be an invaluable resource. it will help you deal with whatever happens and to better understand what your dad is going through. please ask if you have other concerns---there are folks here who can relate to your situation, and sometimes that alone makes all the difference. take care,  gm

kj---thanks for the comment  :)

[ibizan]

see what happens when ya stop drinking?boogiemans brain clear concise....a highly intelligent well read researched sober dude!we r indeed graced to have him in this forum!:)gracias boogie!:)