End stage liver disease

[Ta63]

Someone very dear to me was diagnosed with decompensated liver disease back in May, during the last two months ascites keeps building up and has been drained twice. Now vomiting brown stuff and sleeping constantly.  Are we nearing the end?

[miss_torr]

Hi my father is sick from the liver also. I was wondering if your husband tends to shake when he doesn't have alcohol,?

[Advocate1955]

No one knows how long someone with End Stage Liver Disease will live.  Your husband sounds like he is in the last stage of ESLD, which includes vomiting blood (bleeding esophageal varices), ascites (fluid build up on the abdomen), and possibly hepatic encephalopathy (the build up of ammonia and other toxins causing cognitive and behavioral changes).  If you have nurses at home 3 nights a week, then you must have home hospice care, which is usually provided when someone is very ill and not expected to live much longer.  Really, only your husband's hepatologist can give you some idea as to what to expect next.  Each person's symptoms can vary.  He may continue to vomit blood, eat nothing or little, become weaker and less able to move, he may sleep more and more, he may have cognitive or behavioral changes, he may have edema in his limbs or generally throughout his body again making movement difficult, he may begin to have trouble breathing comfortably due to the ascites and/or edema.  He may slip into a coma.  His liver will eventually fail completely and other organs may shut down shortly after that.  Again, not being a doctor, I have no way to predict which of these symptoms will occur specifically for your husband.  I'm glad that you have hospice care 3 nights per week.  Hopefully they will be able to support you and your family with information along with caring for your husband and making him as comfortable as possible.  Call or meet with his hepatologist and ask him/her specifically what to expect.
Prayers to you, your husband and your family.
Advocate1955

[Ta63]

My husband is still with us at the moment, but hardly eats, ascites is building up every two weeks. He is very unsteady on his feet and still continues to drink both white wine and whiskey. I do now have help from the nurses 3nights per week and my son has come home from abroad to support me. My husband is slightly yellow, but eyes not too bad. He does not sleep well, very restless and depressed. Can anyone who has been through this advise on what will happen next and how long this will go on for.  I don't want to lose him, but he is so miserable. I can't expect my son to stay indefinitely.  I do appreciate you taking the time to write to me. Kind wishes to you all. TA63

[Advocate1955]

I'm so sorry to hear about your loved one's situation.  I'm glad that you have the support of hospice care.  It sounds as though the end may be near, although I am not a doctor, and I don't have first hand experience with liver failure.  It sounds as though he has the three major symptoms of decompensated liver (ascites, bleeding varices, and hepatic encephalopathy).  No one knows how long a patient may last with end stage liver disease, but based on what you have written, perhaps a week or two?  If I were you, I would ask his hepatologist what to expect both in terms of length of time and in terms of symptoms toward the end, so that you can prepare yourself.  Rely on the hospice team to help with everything and guide everything.  I would assume that your husband already has a will, has given you DPOA, and has discussed his final wishes with you?
My prayers to you and your husband.
Advocate1955

[Ta63]

Thank you so much for answering my post, I know he has very little time left and cannot help himself.  I am just trying to be as supportive and loving as I can. have been with him for 46 years, and he has been a dear sweet husband and father, but afraid the alcohol has got to him and there is nothing I can do.  Have now got the support of the hospice, so feel a little better. Thank you so much for caring enough to write to me. Much love Ta63

[nan535]

   Your loved on is lucky to have you. You obviously care about him very much.  Unfortunately, based only on your posts, it appears he is an alcoholic which  is also a disease. ('He is still drinking and in denial").  In his current condition, every drink he takes  is like pouring kerosene on a fire. With decompensated cirrhosis, I am so sorry to tell you he is shortening whatever time he has left. An alcoholic who is unable or unwilling to stop drinking will not be a candidate for transplant.
    Creatinine is a chemical waste product in the blood that passes through the kidneys to be filtered and eliminated in urine.  Serum creatinine is a blood test that is commonly performed as part of a physical examination if have blood work done. Blood is  analyzed to find out how much creatinine is in the bloodstream. It helps evaluate kidney function. Normal range for men is 0.6-1.2 mg/dl.  When there is kidney damage or kidney disease, and the kidneys are not able to filter waste efficiently, there will likely be a rise in creatinine levels in the blood. For adults with chronic kidney disease, dialysis is recommended when creatinine levels reach 10.0 mg/dL. You need to find out what is creatanine level is in order to know if his kidneys are also failing.
     You wrote:  "I feel very alone at the moment and very scared of the future."   I am so sorry. It is very difficult to want to help someone you love and not be able to.  You need some emotional support yourself to help you prepare for what may be coming. Only you know where you can find that support - perhaps other family or friends, church, etc.
     In the meantime, keep coming back here to this forum. There are many caring and knowledgeable people here who will continue to answer your questions. I find it does help to know what you are dealing with and what you can expect.
     A big hug,
      Nan

[Ta63]

My loved one has now had 3  drains in 3 months, the doctor said if he keeps on drinking he has just 2 months and he is still drinking and in denial. Blood tests were taken at the time of the last drain, and they want to repeat the kidney function in a week and stop all duiretics, can they tell that kidneys are failing with a blood test? Can anyone tell me what will happen at the end.  Thank you so much for caring enough to give your time to me, I feel very alone at the moment and very scared of the future.
My best wishes to you all TA63

[Ta63]

Thank you so much for your prompt reply and good wishes.

Kind regards
Ta63

[HectorSF]

Only the patients treating doctor can assess the patient's health status and prognosis. Please contact the doctor who is managing your loved ones illness. Tell them you want to know what the patients current health status is and what is their future prognosis. They should give you an honest answer. Please be prepared when you ask this question to hear something that may be bad news. I truly hope that is not the case.

Many patients with decompensated cirrhosis need to have the ascites fluid buildup drained periodically.

Best wishes to you and the person who is dear to you. I hope this is only a temporary situation and your loved one can recover from this and get a transplant.

Hector