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Avatar universal

cirrhosis- liver failure- need help

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?
12 Responses
Avatar universal
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
Avatar universal
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.
Avatar universal
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.
Avatar universal
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
Avatar universal
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
Avatar universal
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.
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