Stage4 liver end stage re:medications

[tink215]

I am posting because I have a friend age 57 who has Stage4 end stage liver disease. He got it from intravenous drug use & sure there was needle share. This happened during a number of years that we had not seen them. So, I don't know a lot about it all. So, I'm looking for some answers or suggestions as this is tough but confusing for me.
He is on Oxycontin, Percocet, Morphine, Soma Compound, aspirin (he says for a pulmonary embolism) he took it while we were there & looked in extreme pain. His wife said his Dr.s are going to try to wean him directly to morphine if they can. His wife told me he has Fibromyalgia too.
It just seems like he is on a death sentence anyway with all these different pain medications along with the aspirin. I worked in a pharmacy for some years and this was always such a deadly combination of drugs. I would just like to hear some opinions regarding this as when we were there at their home, he threatened his wife, he shoved my husband for standing up out of his chair and seems extremely combative to be anywhere near him. He won't consider hospice when needed ( I understand) but feels like if he just takes enough medication he will pass without assistance. Of course I am not his POA and I am only hearing what I'm being told by him and his wife. She is not a drug user.
We sat down with them both, I know he is very ill, his skin is mildly yellow but nothing in his eyes or like I've seen in when someone is in shut down. Of course we are extremely concerned about his physical condition, but since he has always been an all about him type of personality, his mental condition is a big concern.
Are there any type of drug protocals for end stage 4 liver disease combined with very depressed combative behavior? I would like to help his wife as I'm worried about her well being. But if there is a protocal that will help him, I am searching for answers or suggestions?
My ex-husband passed away from liver and kidney failure due to drug use and alcohol and was abusive to me. I had 2 small children so I divorced and left to survive. We did go to the hospital for the girls to see him a last time and could hear him screaming at ppl as soon as we hit the door. I just wondered if this is part of the personality or personality and the end stages of this disease?  Thank you ahead of time, even a small amount of opinions might help.  Sincerely, Tink

[HectorSF]

If he is really has End-Stage Liver disease it is too late to treat his hepatitis C. He only chance of survival is a liver transplant but...

The drugs he is talking are not allowed for patients needing a transplant. If he is uncooperative he won't be listed for a transplant either. So he has to stop all of his drug use and get a new attitude if he wants to live. Only he can make the choice not his wife or anyone else. He needs to clean up his act once and for all.

"he threatened his wife, he shoved my husband for standing up out of his chair and seems extremely combative to be anywhere near him.
He doesn't sound like he wants to live. He will never be listed for transplant either. So he has run out of options.

He won't consider hospice when needed ( I understand) but feels like if he just takes enough medication he will pass without assistance."
Of course he is naive idea about death. As though he will be able to take those drugs on his own. Don't he realize he will become as helpless as a little baby in the end? He won't be be to feed himself or control his body's basic functions, yet somehow he will be even able to open a pill container and count pills and remember what he took. I'm afraid he is in for a rude awakening. There is nothing heroic or pretty about death from liver disease.

His wife should prepare for herself for him to die. His liver disease didn't happen over night. His drug abuse has probably been going on for decades.

Unfortunately as you know from your own experience, only the patient can save themselves. If they want to continue their addictive lifestyle there is nothing anyone can do but provide support if he can accept it.

This is a very sad position for your friend to be in.  
So sorry.

hector

[Idyllic]

Wow I wonder why your post has gone unanswered for so long. There are lots of knowledgeable people on here.

The array of medications you outline is rather alarming but it would help to know more specifics about your friend's medical condition since there are many variables

I was wondering what  genotype your friend is, whether he has treated before (and the result); if he drinks alcohol; if your friend is compensated or not; if he seems focused or sharp, whether he has been tested for cancer and whether he is being followed by a hepatologist.

Most of all I wonder what he was told his prognosis is and why he is in so much pain. I understand fibromyaligia can be quite incapacitating but  his doctor's are weaning him off the morphine might mean something.

Depressed combative behavior though scary is understandable.  If he has been misdiagnosed or given inadequate information about his treatment options he might feel hopeless.  Of the drugs you mentioned none are intended to manage any mental condition (if he has one) and it seems possible what is happening with him could going untreated or flat out misunderstood. I am not sure if a psychiatric assessment is in order or if the couple as a whole could use counseling and support to get through this.

I can more than empathize with your concern and I am sorry for your own loss. Still, this is a second-hand account of a hear say situation and I regret not being able to offer more meaningful insight. I wish I could offer more insight. Be sure to check back as others may have more to contribute.

Best of luck to you.