alcoholic cirrhosis with diabetes

My mum (55) was admitted to hospital yesterday, to the ER. I thought it went fast, but after some search on internet during today I realised she had symptoms before too - shaking hands, not healing wounds, change of behavior. I thought some of that could be blamed to diabetes (trevted without insulin). One week ago my mum started to be very tired (she got moved her spine - 13mm, so i thought it was getting worse), pains, cramps, last monday she started to act as if she was drunk. But she wasnt. She took a few days off, went home and just slept and still with the "funny" behaving. On friday last week she got her eyes yelowish. On Monday (yesterday) she finally agreed to go to the doctor, then shen was sent to hospital, after initial tests she went to the ER. She acts confused, has trouble talking, seems and acts puzzled, cant sit properly, trembling, falls asleep while talking, extremely cold feet, hands (due to diabetes she cant feel her legs right). I dont know anything abt cirrhosis, just what google found me. The doctor said today she is having alcoholic cirrhosis (i know she was a drinker, but still - she used plenty of meds for heart, blood pressure, diabetes, diuretics etc.), he didnt mention any hepatitis, and said the blood tests showed sugar in blood 50 mmol/l (its not an error, really 50). To be honest I dont know what to do. I dont know how to know how much the liver is damaged, what to expect, how to help, will be the confusion / strange behaviour be like this forever? I want my mum back :( I would like to take her home after she is released from the hospital (I hope my landlady will not object) but I dont know what to expect from the confused behaviour - will it get worse? better? I ask because I live with just my little daughter (4.5), and when we (me and my daughter) were living with her one year ago for six months (she did drink every single evening, maybe 5 days out of 7) her mood swings were horrible, she was constantly going at me shouting at me and locking herself in her room (with wine etc.) shouting at me wishing I was never born etc. etc. these were just evenings/nights, sometimes daytime (drinking just after evening). Im worried it gets worse. How is this behaviour with cirrhosis? Is it similar? Or is it "jusst" this confusion and behaving disoriented? I love my mum coz I know this behavin was affected by drinking, I know she was be better before drinking (manymanymany years ago) and I dont know how to help her. Im sorry, I wanted to ask so many questions, but somehow I cant remember any other questions :(

Simona, hello, and welcome to the forum. First of all, your mom's confusion and "acting drunk" are probably due to high levels of ammonia in her brain. This happens when the liver is so damaged that it cannot filter out toxins. The ammonia builds up in the brain. There is a medication for this: Lactulose. A doctor should prescribe it for her. You may have to mix it with juice or soda for her to take it. It works through bowel movements which remove the ammonia from her system.

The trembling, etc., are from low blood sugar. Are they putting her on medication for her diabetes? Alcohol has a lot of sugar in it, which can raise her blood sugar.

Cirrhosis means scarring. Her liver is scarred and not working properly. Cirrhosis is not reversible, but its progression can be slowed and even stopped by abstaining entirely from alcohol and eating a proper diet rich in fresh fruits and veggies. NO red meat, but she can have skinless chicken, turkey, fish, lean pork. None of this will do a bit of good as long as she continues to drink.

Also, the doctors really can't do much for her if she continues drinking. In fact, they are not going to want to even try and treat someone with alcoholic cirrhosis who is still drinking. She MUST stop.

I agree with Arneeb that having her move in with you might be a huge mistake and very disruptive to your family. It would be better if she were to go to an alcohol treatment program or even an assisted living facility or NH. Just not with you and your daughter. She needs structure and help getting off alcohol. Do not try to swoop in thinking you will "save" her or "fix" her. Not your job, and she has to be willing to make the changes necessary to live a relatively healthy life.

Hugs,
Connie

Dear Simona,
Being a caretaker for someone with cirrhosis is very difficult, and if they are still drinking I can't imagine how difficult it would be, with a young child...FORGET IT. Although it would be nice if you could take care of your Mom, here's how I see it.

Your main responsiblity is your young child. I would do whatever I could to protect a youngster from living with someone with who is still drinking and is so so sick with cirrhoisis. The confusion and disagreeability will make it so so hard with a young child. I say DON"T MOVE HER IN WITH YOU. Find another option, a nursing home, etc. You are over your head, here. She will get worse, especially if she won't quit drinking. It will drive you crazy that she won't do what Dr. says to do, etc.

If you can get her into a NH, they can be responsible for her care and you can be her friend and provide emotional support, because you won't be so drained yourself. Give it some thought.
Angie1953

Hi Simona: I'm a bit late here, however, my husband had exactly the same symptoms as your mother last December. He stopped drinking alcohol completely 5 years ago ( he was NOT a heavy drinker ), and in Dec 2012 he more or less went into a coma on the sofa! He had all the signs like your mother...Confusion, acted drunk, yellow eyes, swollen ankles, cold etc etc...I honestly thought he was just being obnoxious when he did not want to answer me, or just ignored me when I spoke to him!! However, the next day, I realized something was terribly wrong and called for an ambulance! Went straight to ER, and within 2 hrs, he was diagnosed w/ "end stage liver disease" (Cirrhosis) and immediately given Lactulose! The Lactulose helps w/the confusion, which is basically Encephalopathy.

He is now on the waiting list for a Liver Transplant; but ONLY because he's no longer drinking alcohol! A person will ONLY ( in the USA at least ) be put on the transplant list, IF there is NO TRACE of alcohol or other drug abuse, for AT LEAST the previous 6 months! It is extremely important for your mother, if she is still with us (which I sincerely hope), to STOP..STOP....STOP the alcohol! Perhaps a rehab facility could help her? Do not know where you live; but I live in The USA (East Coast), and help is everywhere, IF ONLY YOU TAKE ACTION ASAP. Good luck, and God Bless !!

The Cucus

Post Edited By Moderator (hep93) : 4/20/2013 1:48:08 PM (GMT-6)

Hi Cucus,

I hope you start a new thread, as the road to transplant can be tough.

Where are you...what center.

What is his MELD score today?

How are YOU doing...there is a caregivers thread...as your journey isn't that easy either.

How is he feeling?  Behaving? 

Let us help.

Hugs,

Mama Lama aks Carol

Thanks Mama Lama and Dvid! Do I have questions??? U bet I do! David, I would be curious as to how long it took you to recuperate fully, if that is possible. Have you had any trouble since your transplant? How's your life now? Are you able to do "normal" things, such as sports, travel, work etc etc? How long ago did you have your transplant and where? Hope you are doing GREAT! ...Also if you would care to give me your age, I would appreciate it..My husband just turned 59.

Mama Lama: we are w/ Weill Cornell - Presbyterian / Columbia Medical Center. However, we are looking in to The Mayo Clinic in Jacksonville. Any thoughts?

His MELD score at the moment is 23, and we are being told, that he probably needs to get "more sick" before anything happens!!!

Back to hubby, and enough about me... He was diagnosed w/ Diabetes 2 last week, and now I understand why he's so tired. Sometimes, not often, he appears a bit forgetful, and he's got very little energy. Next week we are going in for a "ABG on room air" and a "AFBG 100% Fi02" test, as he sometimes become very short of breath...

I'm extremely happy that I hae found this Forum, and I thank you all for sharing your experiences....

The Cucus ( Heidi )

I was doing fine until yesterday!!! Not sure what happend; but all over sudden this whole situation, and the fact that I am alone with no help to take care of him, just came crashing down! We are both from Europe, and have zero family in the States. I have always worked; but stopped when this happend. Now I'm wondering if I can be appointed "caregiver" for him, and perhaps get compensated for my time? I know this sounds callous; but the fact is, I need the money! We are not legally married, although I refer to him as my husband, but we have been living together for 25 years.....

Hi Heidi,

There is a lot here.

Click POST NEW TOPIC and call it HUBBY WAITING FOR TRANSPLANT or something like that.

And it would be great if you cut and pasted this last post in there...as more folks will reply.

And I will cut and post this also.

If you don't know how to do that, I could try....let me know...my email is in my profile.

Okay, trying to answer some questions.

In NY the MELD score for transplant is HIGHER than in some other centers. At Jacksonville MAYO the average is 22. So he is sick enough for FLORIDA. If you have the means to get down here and stay down here for a while, I'd call the center MONDAY!

There is a gal here who has just been through this with a brother from Massachusetts...they came, he got his surgery, they stayed a while longer in on campus housing I think...MAE is her name...look up her old posts. Put MAE BE HERE in the SEARCH and her old posts will pop up.

Mike had his transplant 2 years ago. He was 62. He is "better" but not a well man. We are also not married (for over 30 years) and it has actually worked out BETTER that way for insurance purposes. He has qualified for Medicaid. But if he had to report that I own a home and a car, he would likely lose it. He has had no income for many years as he has been too ill. He sold his home, sold his car, used all the money for med expenses and ran out of $$ for private insurance.

Mike is up, dressed, drives, shops, goes to the movies, enjoys his friends, reads a lot, visits with the grandchildren. But he can not work. He has not paid golf (his one true love). Or gone fishsing (his second true love). He is too tired. But he also still has Hep C though he has a new liver...so he still has a lot of liver disease stuff. Those with other kinds of cirrhosis actually do better post transplant. Our intimate life is behind us...many say that. We enjoy a snuggle, but that is about it.

Before transplant being his Caregiver was AWFUL. I would do anything for the guy, but with his changes in mood and grumpy affect it was terrible. He made me cry almost every day. I am a changed woman since transplant as I had to learn to "give it to god (as I know her)" as much as he did for AA. I mean that I realized I don't control things...I have to let things go and live day to day. It has been hard. Really hard. there is a caregivers thread and if you read back in that there are some pretty interesting stories....I love the one about the hubby who took the horse for a walk on the highway because the grass was too bumpy and he had to be rescued from the traffic. He has since passed (he refused transplant route), but I love that story.

Many with liver disease deal with diabetes also. Even those without a previous diagnosis. The meds can mess them up. Mike was on insulin for months and then...his sugar began to regulate itself and he gave up the shots!

On the caregiver allotments, they don't do that here to my knowledge...though they may if someone is a Vet...and if the patient dies. You could ask the social worker at the Transplant Hospital. I didn't hear about anything like that when I was looking after Mike. They may do that in the UK and other countries, but I don' t know about it here.

Good luck, come back often.

Hugs
Carol