My dad

Digestive health
1

Hi, I was wondering if anyone could give me any advice on what to expect in terms of life expectancy for my dad.

He has been a drinker for pretty much all of his life, cans of strongbow cider being his choice of drink. He use to drink I would say 16 cans a day. My mum used to try and keep his drinking under control and make sure he ate properly but she sadly passed away from cancer 5 years ago and since then he has been drinking more and eating less. He has since remarried but his health has been rapidly declining.,

He has been unwell for a few years now, extreme weight loss, hardly eating, easily bruising, purple skin, excessive nose bleeds where he would have to go to the hospital to get them stopped. over the past 6 months or so he developed more serious symptoms - ascites, swelling of the lower legs and feet, bleeding varisces and blood in stools. He was also slightly jaundice. The more serious symptoms all seemed to happen quite quickly and I know he was putting off going to hospital as he didnt want to stop drinking. Around 6 weeks ago he was finally admitted to hospital. He was in there for a week, medicated and had the fluid drained from his stomach.

I spoke to a doctor whilst he was in the hospital but he had no time for me and just told me his liver is decompensated and he MUST stop drinking. Since leaving hospital, he has stopped drinking completely, the fluid built up again in his stomach but he got some medication from his gp which has helped to reduce it dramatically again. He seems to have got even thinner, he is depressed and complaining of pain in his kidneys and stomach. He does, however, look less jaundice as his eyes are noticeably whiter, whereas a few weeks ago they were quite yellow.

I know I have written quite a long post so thank you to anyone who has taken the time to read this. I just wanted to know if anyone could give me any indication of how long he has left. I know no one can ever know for sure but I just want to know what to expect. I have done some reading online and I know a decompensated liver can never return to normal but there seems to be a lot of conflicting info. My dad doesn't really like to talk about whats going on and like I said, his doctor didn't seem to want to speak to me. I just want to know if the end is imminent really or if he could still have years left.

 

2

hgb25,

I am so sorry for the loss of your mom and for what you are now facing with your dad.

None of us really know how long we have, but it does sound like your dad is very sick.  I'm glad he stopped drinking.  Is his current wife being supportive at all?

As for the doctor, I had a similar experience, so I searched and found a new doctor. 

He needs to have a hepatologist!  How old is he?

Sorry to have so many questions.  Did they give you his blood work?  Always get copies of any test results in case you go to the hospital again, and if you see another doctor.  Copy all his doctors on test results too.  GP, gastroenterologist, etc.

I had ascites too and it's painful.  I had my fluid drained 3 times before the diuretics started working.

I will send prayers your way!  I know it's hard...but if he continues to stay sober...there may be some hope!!!

I am sending prayers your way!

Sabrina

3

Thank you so much. I really appreciate your reply.

His current wife is very supportive, he is lucky to have her. She really looks after him and tries to make sure he eats. He is so thin he looks anorexic. He's 52.

I didn't get to see any of his blood results because he is quite private and doesn't like us too involved. I only saw notes that said liver was decompensated. And then had the doctor confirm that to me. Obviously I have done my own research aswell which showed he had all the symptoms of defompensation.

I am hoping he will stay sober. I think he will. It time will tell. Even if he doesn't stay sober though I don't see him ever getting better. I know that a decompensated liver can't recover just don't know if he will have maybe months left or years.

4

Hi there,

I could probably answer some of your questions, fill in some of the blanks, but before I take the time out to do so, can you just confirm you are still following the thread?

5

Hello, I am still following yes. Thank you!

6

Okay, well, I'm not medically qualified, but I did drink for a very long time, ended up in hospital, have cirrhosis and have spent the last couple of years seeing docotrs as an outpatient, so I have some experience. Obviously, without knowing your father's complete medical history or having access to his medical records, I am to a certain extent limited in what I can say.

I'll come on to your main question at the end, and go through your post in order.

16 cans is a lot, I usually did 8 cans or a mixture of pints and cans and I'm a big person, I don't mean fat, tall and stocky. Your mum did the right thing to make sure he ate properly. The worst thing a drinker can do, is not eat, it makes it twice as worse. Unfortunately, drinkers get most of their carbs from alcohol and don't feel the urge to eat, plus it gets in the way of drinking.

The liver helps to produce the proteins for platelets, which is what clots our blood. With a damaged liver, they are not produced in high enough quantities, which leads to brusing, easy bleeding and the failure of it to clot like a normal person.

Ascities, peripheral odema (swelling of the ankles & feet), oesophageal varices (caused by portal hypertension), and jaundice, are all signs of a failing liver.

As for the doctor, most medical professionals view people who become addicted to alcohol as people lacking in moral fibre and treat them if they are brought into hospital, but don't have much compassion for them. It is prevalent throught the industry, sadly you have to get used to it and be more demanding when you speak to them. They don't like to get in a row with people, so if you really stand your ground, they will be more forthcoming.

As for the medication given to him, to help with the swelling on the stomach, feet and ankles, that will be diuretic (also known as a water tablet) and is most likely spironolactone. The pain in the kidneys (the stomach good be so many things, because there are so many organs) might be down to dehydration and lack of water. People who drink are notoriously bad for drinking non alcoholic fluids.

As for getting thinner. People think of the brain being very important and also the heart. But the liver is right up there with them, if it fails or is in a bad way, then the consequences are the same. It controls so many of the body's functions. One thing it does is metabolise food. When the liver is damaged, it cannot process food properly. It cannot hold energy for more than two hours, therefore he needs to eat, little and often. Small breakfast, morning snack, small lunch, afternoon snack, reasonable evening meal, small snack shortly before bed. The last one is to give his liver something to function on overnight. Failure to supply food at regular intervals means that the liver will start cannabilising the body for energy.

Yes, you have decompensated liver and compensated liver. The latter means there is some part of the liver left, functioning that can handle the liver functions. The former means that the liver cannot perform all its normal functions. He should be taking lactulose stop stop hepatic encephalopathy. He should also be taking thiamine for brain function and vitamin B compound strong and folic acid to help his body - note, not ordinary vitamin B.

As for life expectancy, well, there's three reasons for not being given an answer. One, if you wnet and saw your GP tomorrow and said, how long have I got. He'd say, well it dependes on so many things, I can't really make assumptions like that. Secondly, if someone is going to die, doctors are human and they feel about as comfortable as you or I would, telling someone they were about to die soon. Lastly, it is so difficult with people who drink themselves to death. They know most never stop until they're too ill to carry on drinking, but if people do stop completely, start eating well, it is amazing how well some people caan carry on for a long time.

If you really must persue an end date, then liver cirrhosis is split into three classifications, and then each one by a score. The classifications are called Child-Pugh and you need to find this out and the score they have given him. It is like getting hen's teeth.

Midway down this page, is a rough guide to Child-Pugh with life expectancy.

https://patient.info/doctor/cirrhosis-pro

Apologies for typos and spelling, I haven't checked it. If you have more questions, then please do reply to the post.

7

Hi, thank you so much for such a detailed response. It is much appreciated.

I spoke to my Dads GP today for the first time and she was actually really nice and helpful. She told me that he could have up to 2 years best case scenario but it is likely he will get an infection or have a bleed before. Wasnt nice to hear but kind of what I expected anyway.

Thanks again.

8

UPDATE:

My Dad is still not drinking but I saw him last week and he is looking thinner than ever, he literally looks like a walking skeleton. He isnt really eating but does have some build up drinks. He also wasnt sleeping but has been given sleeping tablets. He also has purple spots all over his body. He is less yellow though. He doesnt let anyone go to his GP or consultant appointments with him so its hard to know exactly whats going on as he doesnt give much away.

Anyway, he has told me that he was taking 2 types of duiretics but it was found in a blood test last week that his kidneys were getting damaged by the medication so he has been told to stop taking one of them. Im not sure how serious this is, an anyone shed any light? Is this common and does it mean kidneys are failing?

 

9

It is normal to stop diuretics (spironolactone) if it it is giving the kidneys a problem, because it maakes them work harder. It may or may not point to weak kidneys, only the GP could tell you that.

The build up drinks, has he been prescribed Fortisip, that is the usual preferred supplement drink. See if you can get him to have soups, wwhen people can't eat, they can usually take soup and chicken is the one.

Not sure about the purple spots, could be spider anginoma, Google it and look at the images and you will know. He won't let you come, because A) He doesn't want you to hear bad news or B) He is ashamed to have someone close to him be told what is going on.

You'll just have to keep working at him, you really need to be there, to be able to hear and to be able to ask questions.