urgent help!!!!!

Question

my 47 year old cousin is in the hospital in and out of consciousness. He drank and has liver failure. The doctors don't seem to want to help him. Anything suggested lately they say "he would not survive that procedure" even non invasive procedures. He has not had a bowel movement for almost two weeks. There are bowel sounds. They refuse to put a J tube further into his digestive system (if that is the proper procedure)? They wanted the family to sign a dnr from the beginning even when he was fully functional and awake. He has laid there for several weeks and I am afraid that they are just not doing anything hoping that he will pass away. First they said there was fluid in the abdominal cavity putting pressure on the bowels. When we asked that they take the fluid off. They did once but then said that it wasn't fluid that he had an obstruction. He doesn't have adhesions or scar tissue. I am afraid that they are not giving him the proper nutrition or care to help him recover and time keeps going by and things could have been done. Is there anything that they can be doing to try to relieve the pressure in his bowels or try to get them going again? I'm not sure that they are giving him enough fluid or nutrients for a proper recovery either. Please help.

steph9671 · Answer

if he has a bowel obstruction he needs immediate surgery that is keeping him from having a bowel movement. a dnr order is the families choice...u should not be pressured by staff. they are the healthcare workers there to do what they can to take care of the pt, yes, he may be in liver failure but to me they do not seem to be doing their jobs. good for you for being your cousins advocate, don't stop doing that!! I would try to get him moved to a different hospital if his condition will allow it. if not, do your research...many hospitals, nurses dr's just don't care...not all but some. maybe they are, but not explaining it or approaching it in the best manner...see that too. prayers to your cousin and to you and your family as well!!

robinsmcneil · Answer

I'm not a Dr. but my father passed away from liver failure. I'm sorry to tell you but he maybe too far gone. If you can check liver failure early the liver can recover. It's one of the amazing things about the liver. It can regrow its self. However, in ALOT of cases liver failure isn't caught until it's too late. At this point, although he may seem fine, there is very little time and not much to do. It's almost like the symptoms do not reflex the seriousness of the condition. In my experience it's best to try to get him into another hospital. Sometimes different hospitals are willing to try more without giving up. The same thing happened to my dad. He ended up passing away, but the second hospital exhausted all efforts. They gave him a fighting chance. My dad seemed fine one day. He was working like everything was normal but was gone within the month. In my experience, you have very little time and there maybe very little that can be done. Make sure to tell him you love. My prayers are with your family!

BarefootinMN · Answer

uffdah (as we say in Minnesota)... I'm not a dr but lost an uncle to liver failure /cirrhosis, so I  can identify..  your cousin's liver need support & cleansing. If the dr's aren't willing to take aggressive steps, are they willing to allow you to try alternative means? maybe if you suggest them as "to help him be comfortable", rather than a cure, they'd allow it? It just seems odd that they'd keep him in the hospital but not be taking action to even make him comfortable ("palliative care").....
   I know it seems odd but sometimes a long-un-diagnosed dental infection can cause death; I actually know a fellow who was dying until they pulled all his teeth! he got better! The human body is amazing & very complex...
    Are they giving him an IV?   If so, try to find out what is in it. Sometimes medicines are given with a solution of something like glucose or  other, & if there is an allergy that can be a problem...
  If he has an obstruction in the bowels, surgery is usually what they recommend; if they aren't trying that, you can try to soften the stools yourself using stool softeners that are given in suppository form; but often some movement/exercise is needed to get the bowels moving, even something as simple as walking;...I know for one of my kids, it took a few minutes of bouncing on the trampoline & then "oh my gosh I need the bathroom!!"....so I imagine it'd be prudent to wear a "depends" while walking down the hall in the hospital!
      mint tea acts to relax the sphincter at the top of the stomach, thus releasing some pressure; but take care ti be at least at 30 degrees , not lying flat, as you may get some heartburn & sure don't want to aspirate. 
   lastly, I've known 2 friends who  got the flu &  later had a kind of stomach paralysis as a result. One had problems with passing her food - it would get partially digested & then not proceed any further along the digestive tract, so it sat there, rotting. She had to literally subsist on an IV for 12 hours every day, to stay alive, for a number of months.  Eventually she got well, but she still has to be careful what she eats.
     Your cousin is lucky to have you there to advocate for him; keep trying !