First time post

My husband has liver disease but I don't know where we are in the dreadful journey I have been reading about here.

He has always been a  drinker but more of a 'functional' alcoholic, remaining sober for work by drinking very fast between 6.00 and 7.00ish & then going to bed to sleep it off resdy for the morning.  

He became very depressed when his brother died this time last year. He seemed to me to give in and wallow in the misery and he has always tended towards a melancholic outlook. He hasn't worked since Xmas 2009 and this has given him time to drink more and earlier - he now admits to two bottles of white wine a day and I think it's three. He also has had various stomach ulcers for all the time I've known him (25 years) and he has always had eating difficulties so his weight is always around 8.5 stones (120 lbs). He is also on medicatrion for high blood pressure - beta blockers etc. He doesn't have hepatitis as far as I know. He is just 59.

I finally got him to the GP who referred him for blood tests, they showed high sugar so he had to go back to be checked for diabetes, which he didn't have. When we were called back to see the GP in August it was to discuss an ultrasound (which he had once before some years ago but didn't take me to the results meeting).  He has very high ferritin that the GP wants checked out. Unfortunately by the time we got to our 6.15pm appointment he had very severe withdrawal symptoms - shaking and nausea and extreme difficulty walking so he couldn't be examined. The GP talked to me mainly and said  he would refer him to hospital for more tests but if he wished to continue to drink there was nothing he or I can do. He referred to my husband having liver disease as a long established and acknowledged fact, which it may be between them but it was the first time I'd heard it said.

Finally we got a letter for an appointment for mid-November to see a gastroenterologist, whereas I was hoping to see a liver specialist.

Meanwhile he is suffering terribly - awful pain when he goes to the loo and always veering between constipation & violent diorrhea.

He has a strange dry cough and a swelling on his neck. He hardly has a stomach but what there is may be slightly blubbery - not six months pregnant though as many describe. He is very weak and ccan hardly drag himself out though he tries to most days, taking over an hour to walk to the shops, a trip that used to take him half an hour - until about 8 months ago he used to walk miles a day. He sleeps for hours and hours and some days he is violently sick.

Our daughter and I don't  feel we've had any advice - do we just watch him die then?

Sorry to go on but thought I'd explain it all in one hit; I'll be very grateful for any advice..........

In answer to your question David, no he doesn't smoke - that is my poison! Of course every time I suggest he looks at giving up drink  he points out that I'm addicted to nicotine and equates the two, perhaps with some justification.

I went to Al-anon for a while and the teaching there is that there is no point trying to get an alcoholic to quit; it has to come from them.

18 months ago we had a big scare - I thought he'd had a stroke but at the hospital they said it was just drink and that he HAD to give up. We poured the drink down the sink but after three days he said I had infantalised him and he went back to it. I threatened, indeed intended, to leave him then but bottled it at the sight of his distress and my own feelings of isolation if I left. He said that things would change but as far as I can see all that changed was an increase in his drinking. I wish now I had left.

I haven't raised his giving up again; I'm afraid of becoming the focus of why he won't if that makes sense?

Scared, you are right that Al-Anon focuses on living with an active alcoholic and looking at what part you play in the addiction.  As a long-time sober alcoholic myself, I could never live with an active alkie.  You can have one conversation with him--when he is somewhat sober, not when he's drunk--and flat out tell him he is going to die a horrible death if he doesn't stop drinking now.  If he needs help, he can go to detox and/or AA.  I have a feeling he may not be able to stop by himself and probably needs detox.  Drinking alcoholically really is a slow form of suicide.  But he does have to want to stop and want to live.  By his saying that you smoke, he is looking for justification for his drinking.  You can tell him that you might develop lung cancer or COPD, but it will be nobody's fault but your own.

I also think he most likely has cirrhosis and is working towards end-stage liver disease, if not already there.  As you may have read, I have hep C and cirrhosis and had liver cancer.  However, because I've been sober 24+ years and eat the right diet...generally try to take care of myself to the best of my ability (make ALL doctor appointments, blood work and scans scheduled), I was successfully treated for cancer and the cirrhosis is stable.  Next year, I hope to tackle hep C when the new treatment becomes available.  It takes being very proactive and positive to halt the disease progression.  It may already be too late for him, I don't know--but if he doesn't stop drinking, he will definitely die sooner than later.

If you read the other threads and all the things people have posted, you will learn a lot.  Also take a look at the information in the Hepatitis Resources folder at the top of the page.  It is about liver disease, not just hepatitis--although hepatitis means inflammation of the liver and can apply to cirrhosis, AIH, etc., not just viral hepatitis.

You will also find a lot of support in the Caregivers thread.

Perhaps the Primary Care doc thought a GI doc would be best since your husband is still drinking and not a candidate for transplant.  However, it wouldn't hurt to ask for a hepatology consult, too.

Hugs,

Connie

Jane, beef is a no-no for anyone with liver disease.  Animal protein is the most difficult thing for the liver to digest, and for liver patients it's best not to eat beef at all or too much protein.  (And especially if he has high ferritin/iron!)  You are right about the salt--it's best to keep a low-sodium diet to prevent edema and ascites (swelling of extremities and fluid in the abdomen.)  You might try Ensure or Slim-Fast shakes for him, as they contain a lot of nutrients.  I drank the Slim-Fast when I had liver cancer and couldn't eat.  Soups might also be good--homemade vegetable would be good.  Canned ones have too much salt.  He should be taking a multivitamin without iron.  Is there a cereal he will eat?  (Not the sugary ones.)  Also consider puddings.  Just trying to think of things he might be able to keep down and like and that will get some nutrition into him.  When I was drinking I didn't eat much:  Marinated artichokes, cheese, things that would go with white wine.

The GI/rectal problem is probably related to his alcohol intake, but could be a separate issue.  Is he having pain upon urination?

Lactulose is used for high ammonia levels.  It excretes ammonia through bowel movements.  Probably not the best thing if he has spells of diarrhea anyhow.  If he starts acting really loopy and confused, or agitated--and he's not drunk or withdrawing--then it's hepatic encephalopathy and time for the Lactulose.  Ask the GI doc to test his ammonia level.

Hugs,

Connie

Jane, your husbands GI problems might also be why his doctor referred him to a GI doc.

His BP meds could possibly have some diuretic effect.

Roast a chicken next time.  Poultry is easily digested.  Use herbs and pepper instead of salt.

The lab and scan results go to the doctor here, too.  We have just learned to ask for copies.  I have a great hepatologist who always sends me my labs, scan results, and transcribed report of my visit without my asking.  If the doctors won't do this, we have to go through medical records and they charge per page, which can get expensive.

Hugs,

Connie