end stage liver disease

[keyker]

I have a loved one with cirrhosis of the liver; he had ascites about 6 months ago and was in the hospital and had the fluid drained from his stomach; doctors told him then that if he drank he would not see Christmas; well he kept drinking and he saw Christmas; he takes lactalose and a diuretic and drinks right along with it....He has lost weight, bleeds easily, has trouble sleeping, eats OK, but KEEPS DRINKING. Vodka, beer, anything....I am amazed that the human body can take this kind of abuse for as long as his has, is he some kind of medical miracle? He usually drinks all night and sleeps all day,and in the moments when he is sober, he is all right...I don't know what to do for him anymore....this can't go on for years can it???

[hilly]

I'm really sorry that your loved one has decided to contine to drink ever though they have cirrhosis of the liver. I think if they continue the next step will be liver failure. When you have cirrhosis your not supposed to drink ANYTHING! Good luck to you!

[imkindly]

A doctor can guess at life expectancy, but they can't be exact.
Generally, (only GENERALLY), here's how it works:
Stage A cirrhosis has a life expectancy of 15 to 20 years
Stage C cirrhosis has a life expectancy of 1 to 3 years

[keyker]

Can you tell me what the Stages of Cirrhosis are? Thanks so much for your help

[imkindly]

There's 3 stages to Cirrhosis:
Stage A ("compensated"; not too sick)
Stage B (beginning to decompensate; complications beginning to appear)
Stage C ("decompensated"; end stage)

Doctors use something called a CTP Score, to see what Stage of cirrhosis that a person is in.

The CTP Score is based on FIVE QUESTIONS.
You receive a point value (score) for each of the answers.

Here's how it works:

1. Total Serum Bilirubin
.....if Bilirubin is <2 mg/dl: score 1 point
.....if Bilirubin is 2-3 mg/dl: score 2 points
.....if Bilirubin is >3 mg/dl: score 3 points

2. Serum Albumin
.....if Albumin is >3.5 g/dl: score 1 point
.....if Albumin is 2.8 to 3.5 g/dl: score 2 points
.....if Albumin is <2.8 g/dl: score 3 points

3. INR
.....if INR is <1.70: score 1 point
.....if INR is 1.71 to 2.20: score 2 points
.....if INR is >2.20: score 3 points

4. Ascites
.....No Ascites: score 1 point
.....Ascites controlled medically: score 2 points
.....Ascites poorly controlled: score 3 points

5. Encephalopathy
.....No Encephalopathy: score 1 point
.....Encephalopathy controlled medically: score 2 points
.....Encephalopathy poorly controlled: score 3 points

Total your score.

Sum total score gives grades of:
5 to 6 points = Stage A
7 to 9 points = Stage B
10 to 15 points = Stage C

[imkindly]

PS-

You'll need to see his bloodtest results in order to know his "Total Bilirubin".....his "Albumin"......and his "INR".

You mentioned that he's taking diuretics (that would be to control the ascites)........and that he's taking lactulose (that would be to control the encephalopathy).

[hilly]

how do you know which stage you are when all of these can change over time?

[imkindly]

Hi there

While my husband was waiting for his liver transplant, he had blood tests done every 6 weeks.
(A person needs to be at least a Stage B or Stage C, to get referred for a chance at a liver transplant.)
(Once a person is accepted onto the liver transplant waiting list....another scoring system ("MELD Score") is used.)

If a person is Stage B or C....it's important to have a good doctor. (A doctor who does blood tests on a regular basis.....and updates dosages of medications when needed.) For example----lactulose may need to be increased as cirrhosis gets worse.....diuretics need to be increased as cirrhosis gets worse.

Once a person hits Stage C, there's no turning back. (They just try to "control" it as well as they can, until transplant.)

[hilly]

Thank you for the information. I'm just confused about my biopsy because it says I have cirrhosis of the liver but it never had a score system on it and I have never had ANY symptoms nor do I take any medication for it. Also my test results are all normal now. Thanks again.

[imkindly]

Hi Hilly
If you've never had any symptoms (if you've never had ascites)----you are probably Stage A.
If you take care of yourself (avoid alcohol, etc.)----you have many many good years ahead of you. :)

[hilly]

Imkindly, Thank you for writing back.

[ribhurting]

i was diagnosed (vid abdominal ultrasound )with "fatty liver" after a horribly painful bout of pain just below my right ribs wrapping most of the way around,,,,i have been a VERY heavy drinker and have recently reduced my consumption to 4-6 vodka's per day.  My doc says my alcohol abuse is causing it however i am 6'0 and weigh 280.  Your thoughts anyone? Also, if i quit drinking completely, are there any recovering alcholic's out there that knows how long it takes the pain to go away.  I can't even sleep on my side,,,back only...and then sometimes only in a recliner,,,only 43 years old and I do work everyday...any feedback would be most helpful...thanks!!

[imkindly]

Alcohol can cause Steatosis (fatty liver).

Steatosis (fatty liver) causes the liver to become inflamed.
The more inflammation that goes on, your liver may swell up. (Hepatomegaly = enlarged liver)

Sounds like that's what you have going on.

Alcohol (any amount) will just cause more inflammation. (More swelling, more pain).

[ribhurting]

Thank you for your response, Will hepatomegaly eventually lead to cirrhosis? Is there any danger of the liver exploding?  I am neg. for HEP A,B and C.   Thanks again!

[ribhurting]

And I have absolutely set my goal for total alcohol cessation for Sunday, Feb. 9 ( this sunday ) going to hit A.A.,,,already have a book and a meeting schedule,,,just so damn hard,,,i have cut back from 18-25 ounces per day to 6-8,,,just wanted to "wean down" and have set my date for this Sunday.

[itsfm]

heya ribhurting. I dont know how long it takes for the pain to go away (I'm still waiting for mine to go away) but I do know about quitting drinking. I drank 12 to 15 beers a day for about 12 years. I've been sober for 6 months now. A couple of things to think about that helped me that might help you are.

1. drinking isnt a good medication and I'm just causing myself trouble and pain by doing it.. even though the pain goes away for a while when I'm drunk.

2. alot of people drink themselves to death and I dont want to be one of them. I thought cirrhosis was one of those things that you got, then you quit drinking and everything was fine. I spent some time reading up what happens to people like us and a short life isnt what I want, I was really playing with fire and I'm hoping I didnt burn myself too bad.

on a side note after a month or so I think you'll find alot of pluses to not drinking. hangovers suck and I spent alot of days waiting to get home to drink to get rid of them. now I dont have them and I dont have to drink to get rid of them. I dont have to rely on people to take me to parties because I'm too hammered to drive home etc. things like that..

Anyway.. hope you feel better and good luck. AA's a good place with lots of cool people just like us.

[hilly]

I'm really glad to hear that you stopped drinking and I hope everything goes well for the guy that's going to stop on Sunday. I'm a female who went through liver failure and almost didn't make it and now I have cirrhosis. Thank God I don't have any symptoms from it but the biopsy says I do. Good luck to all of you.

[ribhurting]

itsfm & hilly,,,thanks for your kind words,,,yep, those hangovers are REALLY nasty,,,,Sunday is the big day, say a prayer for me, i'll need it but im GOING to do it.  Ya'll have a great weekend.!!!!!!!!

[Verden]

You will never be able to make up for the time you have lost--make your goal to make the most of your life!  You are young and will be able to live many, many more years.  Just leave the bad stuff behind.  I have a family member who has suffered 15 years with a very bad liver, kidney insufficiency, vericose veins in the throat, bleeding problems, malabsorbsion problems, is on major meds to stay alive, now on lactulose therapy to handle the ammonia levels that will one day take their toll...from vodka!  What this person wouldn't give to feel better, enjoy family and friends, live without five specialits to manage the decline that will one day take it's toll.  Make the decision now to not take another drink and begin to live the rest of your life without the regrets that is the broken record of every alcoholic that chooses to admit that alcohol controls them, not the other way around.  Best of luck to you and to those your love and love you.

[ribhurting]

Thanks for your kind words Verden,,,,woke up this morning feeling much better,,,(no booze yesterday) today is day 2 and i had actually forgotten what it's like to wake up and not feel like a Mack truck hit me.  Will keep you updated.  Again, THANKS!

[hilly]

hey ribhurting, Congratulations on 2 days. Keep up the good work and I promise it will only get better for you. Good luck!! I'll say a prayer for you each night.

[gogeta925]

My mother has "end stage" Cirrhosis and is currently in the Hospital (she has been for three weeks). She also has Hepatits C and Diabetes. She also has a fatty liver, and is trying to get on the liver transplant list. She is overweight, however in a week she lost around 56 lbs. of fluid from her stomach. She doesnt drink, and actually picked up HEP C (the cause of the Cirrhosis) when she was a visiting nurse and one of her patients needles poked her. In the past 3 weeks she has had 8 plasma transplants and 7 or 8 blood transplants. Shes been predicted to live for "weeks, maybe days" for the past three years. She is trying to get transferred from the Hospital to the MAYO Clinic in Jacksonville so she can get a transplant. I was wondering if anyone knew anything about the MAYO Clinic, because I heard that it is a good place to get a transplant. Any help would be appreciated.