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How fast does Alcoholic Liver Disease Progress?

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Posted 5/7/2009 7:10 PM (GMT 0)
Hi All,

I am new here to this forum.  My husband is 54 and was diagnosed 3 years ago by biopsy of having alcoholic liver disease, which the hepatologst said is a "spectrum" so he didn't say any stage or grade of anything.  According to the biopsy, he has diffuse microvesicular and macrovesicular steatosis, mild increase in reticulin (?) and some fibrosis.  Dr. didn't say how much, kinda didn't care since my husband wanted to continue drinking alcoholically. 

My husband drinks at least an 18 pack of beer per day, most days much more, is drunk from morning till he passes out, his whole face is covered w/spider angiomas/telectasias, he's lost alot of hair on his arms and legs, he has parotid gland enlargement, and every day gets bloody nose which lasts from 15 mins to 1/2 hour.  He doesn't smoke, but he gets this bad choking cough all the time when he's on his binges. His labs last year were all over the place, all his lft's out of range, even bilirubin (direct, indirect and total) were all slightly elevated.  Last year he was hospitalized cause he had severe muscle wasting which caused rhabdomyolysis, then went to rehab, where he was sober for almost 4 months before relapsing again (even worse than before he stopped), went to rehab again, was sober almost 4 months and is now on another binge for the past three weeks, drinking 24/7, over 18 beers per day, not eating at all.   Before this binge, his lft's were almost down to normal range (first time in over 20 years).  God knows what they are now.  He does not have hepatomegaly, dr. can't even feel his liver upon palpation.  I want him to get a CT scan to see if his liver disease has progressed, but ins. is giving us a hard time paying for it, so don't really know what's going on. 

Does anyone know where we might be at right now.  I need to know what's in store more me, and if anyone knows if there may be a progression, I would appreciate it.  He also was recently diagnosed with type 2 diabetes (after his last relapse) and left ventricular hypertrophy.  Today he is supposedly going thru "withdrawals" cause he wants to stop drinking.  That may last a day or two before he goes back, but I don't like him doing that either, I don't think it's safe.  Any help you can give me is appreciated.

 

Posted 5/7/2009 10:18 PM (GMT 0)
Hi, Queenie, and welcome to our forum!  I am sorry that your husband continues to drink.  It's the very worst thing he can do for his liver.  If he continues to do so, his liver disease will progress to End Stage Liver Disease and failure...not a pleasant thing for either the patient or the caregiver.  How long that will take nobody can say, as every case is different.  But I can tell you that he is on that path.  I suggest you read some of our educational threads to get a better understanding of what is in store for both of you.  A CT scan will only be diagnostically valuable to detect tumors.  If he has progressed to cirrhosis, then the possibility of liver cancer is always there. 
Posted 5/7/2009 11:06 PM (GMT 0)
Hello and welcome Queenie,

I understand what you are going thru. For the past 5 years, I have watched my Mother in law, do the same thing, except her drink of choice was vodka. We recently found her unresponsive in the bathroom and then found out that she has cirrhosis of the liver. She's End Stage and is now being evaluated for a liver transplant. That is her only hope now.

I know this may seem a bit harsh and I am sorry but.... Have you thought about having him sign papers, so that you decide his medical needs? If so you can make him stay in treatment, until he is well enough to evaluated for a transplant. That was what we planned on doing with my mother in law, but luck for us she has agreed to outpatient therapy/rehab. My next question is how is he getting the alcohol at home, does he go to the store to buy it? If so, put an end to it, hide his keys, wallet ect. He will get upset, but in the end what is more important? Him yelling that he wants a beer, or him starting to feel better. With my mother in law, I noticed that she would fill small water bottles, with the vodka, and hide them everywherer in her room. I guess she thought that we wouldn't check to see if it was water or not. But we did check. We also made her pour it out, so she would have the power to actually let it go. To my surprise it worked. What is the underlying reason for his drinking? That is something that he will need to face.

As for the how fast or slow this disease is... well it's kind of like it has it's own idea, and does things at it's pace, not ours. Some days will be good, others not so good.
Has anyone ever checked his ammonia levels? It sounds like there may be a need to check them.

I really wish you the best, and I will pray that he gets better, and that you are able to have the strenght for this very unfair battle.
Posted 5/8/2009 3:44 PM (GMT 0)
Hi, I am new here today. My husband just got out of the hospital last week.. liver failing, bloated bloated stomach.. can't breath. He drank a good case of beer a day and went to the bar...(don't know how much there) as I didn't go. This is the 4th time since he was 33 in the hospital..He's 40 now. Face swollen..went to er..drained his stomach but back already (in 4 days). He takes alot of the drugs you all have mentioned spina? furosemide, a powder for conspiration (lacutose)? makes not sense and cost $300. And a few others.. He would HATE me looking this up so trying not to bother him,, as he has gotten really mean if I try to help him The one girl was right about his hair..he's going think and hardly any hair on legs..His legs are also BLACk from ankles (swollen) to knees.

Any help? These doctors in Floida don't say much and I have no idea if he's going to live. How long they keep taking the fluid out or does is ever stop? How do they get it under control if ever?

Thank you
Posted 5/8/2009 3:48 PM (GMT 0)
To queenie,, I got wrapped up in writing this. My husband has the same nose bleeds.. hairloss.. gets means..passes out (he calls is napping at 10 am). Sounds familar. Hope we can find the answers. We have 3 children and my youngest is scared to death. So am I. They don't give "real answers"...my husband knows more than he is letting on to me.
Posted 5/8/2009 4:58 PM (GMT 0)

Patthom, welcome to the forum.  If you would start a new topic and introduce yourself and your situation, you would get more replies.  The Lactulose is for high ammonia which causes encephalopathy (forgetfulness, irritability, being "out of it.")  The excess ammonia is excreted through bowel movements.  That is the purpose of the Lactulose.  Do you go to his doctor appts. with him?  I suggest you do so.  Also, if you will read our educational threads, such as Signs and Symptoms of ESLD, you will learn a lot that way.

Unfortunately, nothing the doctors will do will help if he continues to drink.  They are not inclined to do much when they know a liver patient is still drinking, and he would not be a candidate for liver transplant.  If he were not drinking, I would tell you to get him to Mayo Clinic in Jacksonville, FL, as they saved my life.  However, as I said, there's nothing they can do for him while he continues to drink.  It doesn't sound like he would be interested in a detox or treatment program, or even AA.

Posted 5/8/2009 8:29 PM (GMT 0)
hi queenie, i am amy and i know what you are going through. my mom is a alcoholic and has a drug addiction. she claims she is clean but i dont know what to believe. my mom's disease is progressing fast and she just has one problem after the next. i do know if he continues to drink it will continue to progress really fast. if you need someone to talk to i am here to listen
Posted 5/10/2009 3:58 AM (GMT 0)
Aug. 2008, my husband was admitted to Hospital with Liver failure. He was an alcoholic, and now a recovering alcoholic. My husband was given 30 - 90 days at the max to live. He was not allowed to leave the hospital without my signing him into Hospice. Even though Hospice came five days a week to bathe and help with medications, I thought I would lose my mind. My husband was extremely jaundiced, could not walk, could not feed himself and lay in diapers for four months. Arriving home, I put him on a salt free diet, gave him fish three times a week, chicken twice and anything he wanted, within reason, on Saturdays. The Hospice Doctor came to our house, in January of 2009, as one of the aides told him that my husband was trying to feed himself and not as jaundiced. He took one look at my husband, examined him and discharged him from Hospice. I was very confused, as I had already made funeral arrangements for him. The Doctor said it was a Miracle, and that my husband is only the second person he has discharged that had severe Liver Failure. He does not drink at all, but I have noticed subtle changes in his health, that I HOPE someone out there can help me with. He is on Bp medication and 5mg of Thorazine. For the past three months, he has had severe Restless Leg Syndrome. That symptom disappeared, and a new one appeared. Now when he is not speaking, his mouth is opening and closing, continually. I asked him if he was thirsty and he said no. I asked him if he was aware of the mouth, and he said no. He is forgetful at times, which is to be expected, I'm sure, and has trouble with his trought processes. Is this the norm, is it a form of Dementia? I have mentioned it to his Doctors and they do not seem overly concerned.
Posted 5/10/2009 7:00 AM (GMT 0)

Hello, January Rabbi, and welcome to the forum.  I am sorry you are having to see your husband so ill, but it seems like he's doing a little better.  The type of behavior you are describing could be hepatic encephalopathy, caused by increased ammonia levels.  When the liver is damaged, it has difficulty filtering out toxins and ammonia levels can build up in the blood and brain.  This is usually treated with Lactulose or some form of it.  The ammonia is then excreted through bowel movements.  Ask that his blood ammonia be tested, if it hasn't been.

The diet you are describing is good.  Try to get him to eat fresh fruits and veggies, also.

As I suggested in a previous post, it's best for new members to start a new topic instead of adding on to someone else's old one.  That way, people get to know you and you don't get "lost."  Please consider doing this.

Posted 5/13/2009 2:48 AM (GMT 0)
Liver Failure - Husband

Forum Moderator, JanuaryRabbi - here.


Hello, and thanks so much for your suggestions and thoughts. I know his blood ammonia levels have not been checked since December, 2008. They said if he did not appear confused, that I was not to worry. So, I haven't worried. I thought the months he was on 50mg of thorazine was the culprit. The Doctors really did not know. They said he was fine. Now, I feel ignorant that I have not thought of the blood ammonia levels. He does appear confused at times, just not all the time. I have been reading all the posts and will talk to his Doctor as soon as I can get him in the office. He does eat fruit, but hates vegetables. I make him sometimes. I know that sounds bossy on my part, but you do what you have to do! I feel better knowing I can talk openly about this. I am so glad you folks are out there! Many thanks!
Posted 5/13/2009 3:09 AM (GMT 0)
Welcome to HealingWell Queeny,Patthom and January. I am glad all of you found us. But sorry that you had the need to. We have so many knowledgeable members in almost every aspect of liver disease. We have some educational threads that by now are on page 2 of this forum, they have a lot of good information in them. So when you get a chance please read them.

Again welcome. Thoughts and prayers............
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