Encephalitis

[jody]

Three months ago my husband was bleeding internally (throwing up massive amounts of blood)and I took him to the ER, at this time he was admitted into ICU. He has an ulcer on his small intestine which was bleeding. He has had a drinking problem for many years, he is 45. He is disabled from a spinal injury and takes Vicodan(been taking large amounts for 11 years) and Oxycontin regurarly for pain. While in ICU they used a scope to indentify where the bleeding was coming from and it was also discovered that his "varicese" veins were close to bursting, they were "banded". Naturally he was put under for this and he became comatose as he was unable to come out of the anethesia. I was told at this time that his protein levels were dangerously high and he may or may not recover from the coma. Thank God he did, he was put on "Lactulose" in order to bring the amonia levels down and it appeared that he was on his way to recovery. He has been alcohol free now for three months. He has good days and bad days as far as they way he feels. Unfortunately, it seems the bad days rule. My concern right now is he is not thinking clearly again, he sleeps all day and has virtually no appetite, no energy ( I should mention that he had one blood transfusion while in the hospital because he had lost so munch blood), and now he seems to be confused alot. He was like this immediately following the coma, which I understand to be normal,and he seemed to come out fine, but it seems that he is more disoriented again lately. He was seeing his Dr. every week for the first month and a half following his release from the hopsital, it's been a month and he's due to see him again in a few days, my problem is my husband doesn't believe that he's having the confusion and such. It will be difficult for me to explain this in the Dr.'s office as he will argue with me. I am 100% sure that he has NOT any alcohol since the day before I took him to the ER. What & why would this be coming on again? The Dr. has said that he's not sure how much of his liver is damaged by the alcohol, but is positive in believing that he has a good chance to live a longer life without the drinking, the Dr. has told me that he believes that only a small portion of his liver is chirrosed. His blood work shows stability each time. Can you tell me what I should expect in the near future? Is it possible that he has Encephalitis?(the Dr. had mentioned this while he was in the hospital) and if he does have this, is it going to get progressivley worse? I am quiet scared right now and I myself have been through alot of worry and pain watching him do this to himself over the years, I am very proud that he FINALLY quit the drinking, I just hope that it wasn't too late. I might mention that a little over a year ago he tried to quit and began going into gran mull seizures and was hospitalized for that, he unfortunately resumed drinking in just a shor time after he came home from the hospital.
If you can give me some type of information on all of this, I would sure appreciate it.
Thank you.

[HFHSm.D.-Gastro-rf]

Dear Jody,
Alcohol can damage the liver, as you know, by destroying the liver cells.  When the cells are damaged scar tissue results.  If there is extensive scarring, cirrhosis is the result.  The liver scarring increases the resistance to blood flow in the liver.  Nirmally, blood from the intestines returns to the heart via th eliver.  With cirrhosis,alternate routes are needed.  One of these alternate routes is via the veins in the esophagus.  When these esophageal veins enlarge (as a reult of carrying increased amounts of blood) they are called varices.  Bleeding from varices is a potentially fatal condition.

A second result of liver cell destruction is an inability to perform the normal work of the liver which includes removal of waste products that can interfere with nerve( brain) function.  Even though your husband has stopped alcohol, he may have damaged so much liver that even normal amounts of waste products can not be handled and he becomes confused.  In this situation of confusion it i snecessary to exclude possible contributing factors suchh as infection, electrolyte abnormalities, dehydration and medications that have sedative effects.

If your husband has a) been sober for several months and b) has extensive liver disease, he may be a candidate for a liver transplantation.  You should speak with his doctor about this option.

This information i spresented for educational purposes.  ASk specific questions to your personal physician.