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Posted 9/11/2012 8:35 PM (GMT 0)
My brother is back in the hospital for the 3rd time in a year from issues from his alcoholic cirrohosis.  I stopped talking to him almost a month ago because I told him I would no longer watch him kill himself with alcohol.  He dedided to stop drinking 3-4 days ago COLD TURKEY.  Not smart given the amount of alcohol he drinks daily.  He was having bad detox symptoms (was afraid to sleep, tremors, hallucinations etc) and asked to be taken to the hospital.  He seemed ok yesterday morning before he went in but after he was admitted and I went up there to be with him, he seemed ok at first but then started hallucinating almost contstantly. Talking to people who aren't there, seeing and hearing lots of different things.  Talking to me about ME, like "you should meet my sister, you'd like her".  Every time I left the room he took the IV out and tried to get out of bed.  One time he told the nurse he was a surgeon and had to go to surgery that's why he was getting up.  They had to strap his arms down.  They moved him to the bigger hospital of their health group as I had to go get my kids from school.  They put him on Adivan and gave him magnesium and potassium via IV. 

I went back up last night and stayed for an hour. He couldn't even answer his admission questions, I had to.  The whole time I was there all he did was try to get his hands out of the restraints and still totally confused and making no sense.  They had a sitter come in and stay in his room all night.  His ammonia level is 71.  They started giving him lactulose last night, 4 times a day.  His bilirubin was 9 yesterday (lower than his last hospital stay).  They gave him haldol to try to get him to calm down more.

Today I'm at work and I've called the nurses several times and all they're telling me is that he's sleeping almost all day, he woke up for lunch but went back to sleep.  I just talked to his Dr on the phone.  She said he's more aware today, knows where he is etc.  His amonia dropped down to 61 today.  His bilirubin is 8, he's eating and drinking, they lowered the lactulose to 2 times a day.  He is anemic his heoglobin was at 7.7 yesterday today it's at 9.6 but they are finding no obvious bleeding.  I requested that the liver dr's come see him because she said she couldn't really tell me how much of his liver is damaged. He's sleeping a lot but she said she didn't think he'd improve this fast and that he'd still be in for a few more days.

At first the ER doctors thought the hallucinations were from detox now they're saying it's more encephalopathy.  He's never had this before.  I'm getting frustrated because I can't get a straight answer.  I want to know HOW much of his liver is damaged, is he at risk to go into a coma are they gonna test his liver, the ER dr said they doubted they'd do a biopsy because of risk of bleeding.  I honestly just don't know what to think or expect with all of this.

Posted 9/11/2012 8:47 PM (GMT 0)
Catgirl, You've been through this before. He has liver disease and he is an alcoholic. Bad combination. If he were to stop drinking, remind me, does he have Hep C also?

Without Hep C, it is possible a clean and sober brother could have a chance at a fairly normal life. I think Ziff has posted on your topics before.

BUT, if he is not going to be clean and sober, it really doesn't make a lot of sense to do all kinds of testing...as there is no treatment bar transplantation for a decompensated liver. Once it is gone, it's gone. And they won't do a transplant on a person who is non compliant about sobriety. They require 6 months sober with documentation from a treatment program.

Your brother needs to make a life or death decision. And he seems to be in a bad way.

I'm really sorry. This is not the news you hoped to hear. Not all alcoholics get cirrhosis, but those who do have a long sad slippery slope to the end.

Best,
Mama Lama
Posted 9/11/2012 8:58 PM (GMT 0)
No he doesn't have Hep C.

I guess it's the "planner" in me that always needs all sorts of answers and I guess with this disease there are no clear cut answers. I "guess" it's good that he decided to quit on his own this time, but then again we've seen this before. Maybe I'm holding out hope for no reason?? I don't know...... I'm so confused.
Posted 9/11/2012 9:06 PM (GMT 0)
One thing you could do would be to encourage him or make an appointment with a Hepatologist yourself ( as opposed to a community GI doc).

It was the Hep that put his hand on Mike's knee in the fall of 2010 and said, "son, if you don't quit drinking you won't last 3 months." And that did the trick. Other docs (and ME a zillion times)suggested, cajoled, recommended. But putting it like this: IF YOU DRINK YOU WILL DIE...well, that did the trick. Mike went to AA and got his transplant May 1, 2011.

Now that you have taken some time away from the situation because you couldn't stand it any more, you might want to stay tough. He is safe in hospital and is detoxing (again). You might want your next contact with him be the first day and 30th day of his alcohol treatment program. You can ask him to show you his CHIPS and be really really proud of him! (Even go to the AA meeting to support his commitment.)

Mama Lama

Post Edited By Moderator (hep93) : 9/11/2012 7:00:22 PM (GMT-6)

Posted 9/12/2012 12:59 AM (GMT 0)
Catgirl, you really can't force things. Take it one day at a time. How much of his liver is damaged is not really important right now. He needs to be sent to an inpatient rehab when he leaves the hospital. If that's not possible, then AA. It is highly unlikely that he will stay sober on his own. I had a transplant and never was told how much of my liver was shot. I got it based on a liver tumor. Since sobriety wasn't an issue with me, I was listed after evaluation and got my new liver 3 mos. later.

You've seen what can happen. He could die the next time around if he continues drinking. It's not unusual for a person to seem worse when drinking is ceased. He is getting the care he needs right now and there is nothing you can personally do. Just wait and see.

Hugs,
Connie
Posted 9/12/2012 2:29 AM (GMT 0)
Hey Cat , Good to see you got your wits about you as far as the tough love thing . Keeping him at a distance emotionally will be hard but it very well may be what is needed to keep him alive , Set the ground rules and don't stray one smidgen . If things go bad and he takes a nose dive then the conditions can change , Otherwise he will have to prove himself worthy of your trust . Just be prepared that things like this don't usually happen like flipping on a light switch , Sobriety and saving whats left of a severely damaged liver takes awhile .

Nobody but the doctors can say for sure what percentage of damage has been done from the disease and the only reliable source is a Hepatologist . As mentioned before sobriety will become his first obstacle , They will treat him for whatever symptoms he may have at the moment but sobriety is the only way he will be considered for transplant . Six months consecutive meetings with AA or a therapist at however many times the doctors see fit for him a week . Miss one meeting and it's cause for you to start over completely ( Don't ask me how I know rolleyes .

I was by the sound of it in much worse shape than your brother and I managed to make it this far , Alot of folks don't and wont make it . It's a different experience for everyone . There is alot more you can learn about this disease and whats beyond the post medical evaluation ( Sobriety ) , But there's no need in sending you into overload . Focus on where you stand in this and what you can do to encourage him to meet the first set of goals , Come back often , Somebodies always around to help or just talk to .


A. Ziffle
Posted 9/12/2012 7:13 PM (GMT 0)
Thank you for your support everyone. He's getting released from the hospital today. He says he has to go back to his girlfriend's house because there is no where else to go. I've called a few in patient treatment centers but since he has no insurance or money he has to be on a waiting list to get in. Could be 2 weeks could be 7 weeks. I certainly don't have the over $4,000 it costs to self pay for a week of it to get him in right away. I can't/won't let him live at my house. I have two young sons and my own husband I need to care for. He can stay with us a day or so here and there but I can't take him in full time.

Basically he's going to get from me, the information I've got and phone numbers on the treatment centers to call along with the resources the hospital is giving him (more treatment centers, health department dr's etc) and I will tell him he can go to AA and a treatment center and GET SOBER and I will help him in all ways I can including attending family therapy with him OR he can go back to living with his girlfriend and drink again and i am DONE!! i will not answer his phone call and texts, I won't even answer the next time he needs to go to a hospital because I have a feeling he won't make it out next time. I could be wrong.....but it's how I feel. His Dr told him and me today that if he keeps drinking he will die soon. Of course she can't say how long.

I'm waiting for him to call me when he gets his discharge papers and I'm picking him up.
Posted 9/12/2012 7:47 PM (GMT 0)
It's good that you have limits. You and your family are your first priority. His #1 job is to stay sober. He needs to want that at least as much as you do, preferably more--enough to do whatever is necessary to hold onto his sobriety. He needs to be willing to go to any lengths to stay sober. Actually, he has just "put the plug in the jug." Real sobriety requires not only staying away from booze, but completely changing his lifestyle and staying away from those who are still drinking. It's a matter of seeing oneself and the world differently.

I very much doubt that he can abstain from drinking if his g.f. is still boozing it up. Also, she is not going to be happy if he abstains. She's losing her drinking buddy and the dynamic of the relationship will change.

I doubt that he has been working, but he needs to start looking soon...in another week or so, once his body starts healing itself and his nerves aren't so bad.

Hugs,
Connie
Posted 9/13/2012 2:42 AM (GMT 0)
Yep !!! To what Connie said .


A. Ziffle
Posted 9/13/2012 3:48 AM (GMT 0)
Cat it's not easy doing what you are doing but ... you have to take care of your family... he is making an active choice... keep your chin up!!

Sandia

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