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Cirrohosis and hep C diagnosis

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Posted 3/25/2008 7:58 PM (GMT 0)
Hello,

My brother,45, went to the hospital because his arm was not healing.  Doctors immediatley knew something was wrong because he was almost orange in color.  They told him he had cirrohosis and had to stop drinking immediatley, and that was why his arm wasn't healing. 

He went home and stopped drinking cold turkey.  He has been an alcoholic for over 20 years.  Over the next three days, he began hallucienating, apparently took 12 oxycontin in a twenty four hour period, and had to be taken to the emergency room.

He has been in the hospital now for two weeks.  He was also diagnosed with hep C.  He cannot communicate.  Sometimes he tries to talk but has trouble speaking.  Everything he does is in slow motion.  We gave him a pen and paper because he is trying to tell us something so badly, but he could barely grasp a pen and he couldn't write anything.

Is his brain foggy because of ammonia in his system.  I asked the nurse if he couldn't speak because of medication they are giving him, and she said she feels that it is because of the alcohol withdrawal. 

Has anyone experienced such a long detox process.  Is this the end stages of cirrohosis?  Has anyone known of a person having brain damage after detoxing?

Thanks for your help.

Posted 3/25/2008 9:49 PM (GMT 0)
Hello Tracy and welcome to HealingWell, I am so sorry about your brother. It must be very tough on you and your family.
I have heard of people actually dying detoxing too rapidly ( It doesn't happen often though). It depends on how long and how much he has been drinking along with how bad of shape his liver is in as to how the detoxing is affecting him. My husband quit cold turkey also after about 26 years of alcoholism. Thank God that he didn't need to be hospitalized. If he hallucinated, he didn't tell me and I didn't notice any strange behavior either. He was one very sick puppy and grouchy though. It lasted a good week for him. Dan'sbrother is right......they do need have blood work done to see where his ammonia levels are and also a CT scan of the brain. As the liver deteriorates it can cause a lot of of other problems ....seizures and strokes are just the tip of the iceberg.
As far as ESLD did he have any of the usually symptoms before he went to the hospital for his arm? Usually the symptoms start gradually and get increasingly worse as the months/years go by. You don't go from being healthy one day to ESLD the next.
Read up on some of our older posts. There's a lot of good information to be had.

Hope this helps.......Hang in there. Thoughts and prayers
Posted 3/25/2008 10:01 PM (GMT 0)
Thanks for your replies. I'm sure my brother had lots of symptoms before this, but unfortunately, before this week, I hadn't seen him in over a year. We were not estranged, but he lives in another city and we have different life styles. It was always very apparent that he had been drinking when we would get together at family gatherings. It was the only way he could function. Whenever a family member confronted him about his drinking, he became very defensive so it was just easier to not be around him.

My parents had spoken with him the week before he went into the hospital, and they felt that he wasn't noticably intoxicated on the telephone and seemed as well as could be expected. It just seems so strange for him to be able to speak then, and then stop drinking and not be able to speak.

I am glad I found this forum. I will tell my family about it too. I will also ask about his ammonia levels and if he has had a CT scan.

Thanks again
Posted 3/25/2008 10:54 PM (GMT 0)
tracy39, hi and welcome to the forum. I am so sorry that your brother is so ill. This disease is a nightmare for everyone involved. When I read your post I was a little curious about your brothers inability to speak. Can I ask if he is comprehending your questions? Does he seem to recognize you? Also, is he able to follow simple commands? I will be anxious to see what the CT scan shows as it is possible that he has had a CVA (stroke). I am not saying he has had a CVA but it is a possibility. It would depend on whether there were any other signs or symptoms. If he has been in the hospital for awhile then certainly they have evaluated his amonia levels already and he should be receiving treatment for elevated levels if they are actually elevated. It is also possible that the overdose of oxycontin has increased his liver damage and has not cleared yet. Although I have to admit that 2 weeks going by should have cleared the oxy by now. Keep us posted OK? I'm glad you found us. We are here for you.
Posted 3/26/2008 2:59 AM (GMT 0)
1Shelly1, hello and thanks for the response. At times he seems to recognize us and has said mom and dad. We were showing him a photo album with a pic of my father when he was a boy. When my brother saw it he said 1939, which is the year my father was born. On one occasion, the physical therapist and family were trying to move him from a chair to the bed and he clearly said, "I'll do it by myself." Then he went back to mumbling. Tears run down his face at times when my parents speak to him.

I am not sure what his ammonia levels are but I believe they have improved. My mom said she thought some xrays were done and she is double checking if a CT scan was done.

A few days ago, he asked if anyone was hurt, so I believe he thinks he may have been in an accident. My dad asked him if he knew why he was there, and he just stared. Yesterday, my brother did ask his wife why he was there. When she told him, he just stared away for about a half an hour. Thankfully, his wife is by his side almost 24/7 and seems to understand what he is saying more than the others in the family do.
Posted 3/26/2008 7:40 PM (GMT 0)
Thanks for the info dansbrother. I just spoke to my mom and found out that they are planning on sending him home tomorrow. Apparently his ammonia levels are still high and they never did a CT scan because the doctor didn't think it was necessary.

His wife is very excited that he is going home, but it seems so soon. He did walk a little with assistance today and he really wants to go home. I am wondering if not having a CT scan and going home early has something to do with not having insurance.
Posted 3/26/2008 8:00 PM (GMT 0)
Tracy, You are probably right-since he doesn't have insurance they aren't doing some of the testing that they would do if he had it. It's also possible that the Dr thinks this is all related to encephalopathy. I would definately ask the Dr before he is discharged. Also have your sister-in-law ask for a copy of his labs. That way you can check the results yourself when he's home. I am glad that he has such a supportive family. Let us know what you find out OK?
Posted 3/27/2008 6:58 PM (GMT 0)
I just found out that my brother is home now. He is in and out of reality and his ammonia levels are still high. He has a walker (he only walked for the first time yesterday in the hospital). Do you think this is what his life is going to be like without improvement. I think my family is scared to ask the doctor these questions.

I appreciate all of your insight and support.
Posted 3/27/2008 9:39 PM (GMT 0)

Tracy39, welcome to the forum!  I am a sober alcoholic (sober 21 1/2 years.)  I can tell you that your brother should NOT have detoxed cold turkey.  That can be dangerous.  If he had gone to a detox facility, they would have given him a mild tranquilizer the first few days.  But that's a moot point now.  The possibility that he suffered a mild stroke is very real, especially considering that he took a massive quantity of pain meds within a short time.  His liver was not able to metabolize that.  Back in 1969, I took an intentional overdose of 6 bags of heroin and 40 Doriden (a sedative.)  I stopped breathing and was rushed to the ER and placed on a ventilator.  I recall the doctor telling me that the Doriden did more brain damage than the heroin, as it takes longer for the system to metabolize pills.  I had short-term memory loss for at least a month.  Between your brother's sudden detox and the pain meds, along with his liver disease, it was a shock to his system.  The symptoms he is now exhibiting could be a result of the overdose, or he could have had a mild stroke.  I agree he should have had a CT scan, and that it wasn't done because of no insurance.  Which is all kinds of wrong!

Did he received discharge meds or Rxs?  He should be taking Lactulose if his ammonia levels are high.  He could also benefit from physical therapy.  He would have a chance of functioning better if he had both of these.

Is there a clinic he could go to for medical help?  Do you have a teaching hospital nearby?  If he is not working, he may be able to qualify for temporary or partial Medicaid.  I also suggest that he apply for Social Security Disability, although he would need someone to help him fill out the paperwork.

Please come back and let us know how he is doing.

Hugs,

Connie


Post Edited (hep93) : 3/27/2008 3:49:13 PM (GMT-6)

Posted 3/27/2008 10:11 PM (GMT 0)
Tracy, I hope you don't let fear rule you. It is better to know what is happening then go thru the nightmare of guessing what's going on. The not knowing is usually worse then knowing. I would ask lots of questions but it is of course up to you and your family. If you decide to ask then make a list of questions so you won't forget when the time comes. For example, what was is admitting and discaherge diagnosis? What tests were run and what were the results and what do they mean? What medications is is on and why? What is the prognosis? What can be done to further his recovery? Will rehab help? Did they contact a social worker for him while he was hospitalized to get assistance for applying for medicaid? These are just a few of the questions that need to be asked if you do decide to do it. Connie is right, there are agencies and federal ones at that where he can get help. Keep posting and let us know OK? Also, please follow up with a clinic so he can be evaluated for a stroke.
Posted 3/27/2008 11:40 PM (GMT 0)
cool   Hi Tracy,

I am Carol and am going through some of the same things you are. I am caregiver for my husband. He did not quit cold turkey though.He knew that wouldn't happen. He traveled with his job. He built conveory systems in major factors. With the last job his company sent him on, they put him up in a motel that had a" free happy hour". Can you imagine what I went through. I WAS SO-O-O MAD. He finally came home in August and by the time I got him into a rehab facility ( 6 months required here at MUSC, for a transplant ) and the DOCS kept telling me his HCC was stable, it was to late for a transplant. We only made it to the first meeting and then found out after a liver scan that  his cancer had grown to 11mm.  I think he new before he left that he might have cancer. I was so busy taking care of my Dad, and couldn't always go to the  Dr. with him. Either he didn't remember what the Dr. told him or he just didn't want to tell me. I think he just wanted to build up our bank account. In some ways he knew what we were in for. He is now unable to work and is on SSDI. I haven't worked since Nov. '06.

I used to work for Wal-Mart and they will welcome me back anytime I want to return. I am just too scared to leave my husband now. I might go back part time though. WM would be happy for that, as that is all they want to pay for now. 

Just talk to your brother about "things", and learn to give him hand massages when you are with him! That is very relaxing for anyone. Even if you are not that close, no one can resist a good hand massage!

Take a deep breath and relax yourself,

Carol

 

Posted 3/29/2008 2:17 AM (GMT 0)
Tracy, Welcome to the forum. It is really good that you have come here. You and your family need to get educated as much as you can on this disease. There are a lot of ups and downs with it. It can be very scary and confusing, as I am sure you are finding out. My husband has cirrhosis. He suffers frequently with encephalopathy. He is know longer the person I used to know. He has been taking Lactulose for awhile now. It helps quite a bit. But I doubt that I will ever have the same person back. I hope that your brother is able to sustain from alcohol. I will be keeping you both in my prayers.
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