Any information about end stage liver failure/end stage liver cirrhosis?
My father, who has been an alcoholic since before I was born, has been in the hospital for the past week. He has been in the hospital countless times over the years for his alcoholism, especially since I was 15 (I'm now 22) and has developed cirrhosis. This time around, my brothers and I were informed that he is in end stage liver failure. He seems to be more alert and chatty than when he first got into the hospital, but he is still shaking, jaundice, EXTREMELY bruised (up & down his arms and legs are massive bruises). I noticed yesterday that his eyes are yellowing, which I did not see in the previous days, but his face looks less yellow.
Last week he was expected not to make it through the night, but the doctors and nurses lowered the dosage of his withdrawal medicine (ativan) and he was able to recover. However, he is still on 100% oxygen assistance & has to have a procedure done has he has internal bleeding which they need to find the source of, yet it's not in his stool (he'd been getting blood transfusions and sodium drips since his blood and sodium levels were very low). He is also very fatigued still and is either sleeping, just waking up, or about to fall asleep each time we've visited.
Over the years, he's had many issues with this, including a month and a half long stay in the hospital after he almost died from vomitting up too much blood; had to have surgery on his hands as his body got so deteriorated that his nerves in his left hand had died and it wouldn't function; and many times before this during his hospital stays he'd be extremely jaundice.
Every time my dad goes into the hospital, he always thinks he'll be out in a few days once he's feeling just a little bit better. But each time it's about 2-3 weeks on average, and this time it'll be at least a week. After he's out, he'll need a personal nurse to help him with all his medicines and liver care at home.
All of this has caused my family so much stress over the years and I just wonder how much more his body can take? What will the outcome be? Of course I don't wish death upon him, I'm always worried it's going to happen. Any tips/information is helpful & welcomed.
- Baa BaaLv 76 years agoFavorite Answer
I'm sorry that your family is going through this, but this is the sad end to long term alcoholism for many alcoholics. Your father is very near the end from what you have said, so it's just a matter of time before it's over. He will just continue to get weaker and sicker and probably become unresponsive when it's very near the end. Once they stop drinking, it's just a matter of a few days at most. All the symptoms you describe is quite common for anyone with end stage cirrhosis.
He will probably need full time care with all his daily function needs in the not to long future. I don't know how your family situation is, but unless he has round the clock care, you may want to place him in a nursing home to receive the care he will need there. Don't ever feel guilty about that since it will proably be best for him and his family too. Never try to take on the task of caring for him alone with no help since it will just wear you out and then you become sick. It's best to put them in a place that will meet all their medical needs and the family can go and visit and sit with him all they like and not have to worry about anything other than visiting him when you want to. If your family wants him to stay at home, then I suggest you get in touch with Hospice who are really good with the patient and families going through this.
It is very hard on familes to go through this. It takes a toll on them physically, mentally, and emotionally. My heart goes out to all of you. I lost both my brother and father to cancer plus I'm a nurse who as worked with a countless number of terminally ill patients. I know what you are going through.Source(s): I'm a nurse who had cirrhosis from a biliary disease and received a liver transplant.
- mildred fLv 76 years ago
I had most of these same issues with my brother, the identified alcoholic in my family. The DT's he had and then denied since he never remembered them, the problems with his vision(blind), the problems with his memory and judgment(dementia). The way you solve these gaps is to take photos in the hospital every day while on the many machines to help him, preferably with a calendar nearby and in the photo. That stops all the denial. I had a 4 enlarged to 5 X 7 and about 10 were the larger regualr sized prints. These days computer photos are the norm. But I made sure to have these printed.
Then, of course, you have the ready admission of alcoholism, not doing anything about it, but he admits it readily. You just have to know that this happens in every family and reconcile yourself to the fact that you can't 'say 'told you so.'
My brother had his lower stomach and upper colon removed, a Bilroth II. He aspirated once and was in the ICU near death. When he got to the nursing home, I got to see him two times. He aspirated and died a month later.
I chose not to discuss the obvious errors in his thinking, or the errors in his health care, or the errors in his living arrangements, or the error when he stole money from me, or the time he stole money out of Mom's purse as she lay dying in the same room. He was gone, and I knew it. I just got to say goodbye.
Yes, I know what you're going through and you just have to do this. To watch while someone you love is killing themselves faster now.
I should mention that my brother just assumed he would just walk across town and catch the bus 175 miles home and resume his life. He had no clue at all. Weighed 80 pounds. The night before he died, he called me and asked to borrow money to keep his utilities on. I lied about keeping them on for him.
- abijannLv 76 years ago
I'm going to tell you the reasons for what is taking place with your
father and what can be done to try and make him more comfortable:
1. Ascites is the building up of fluid in the abdominal area.
This fluid accumulates there because the liver cells can no longer
produce a protein, efficiently, that normally holds fluid inside our
vessels. The fluid leaks out and collects in this area.
The doctor can try to do a procedure to remove some of this fluid.
However, they will not do it if his platelets counts are too low.
Removal would help the patient breathe and eat better because
the fluid pressure is not pressing against the stomach and the
2. Encephalopathy. The patient will get easily confused and
disoriented, have sleep pattern changes, and hand tremors.
The family will have to take over all financial and medical
affairs of your father. It is best to have an advanced directive
or power of attorney form giving someone in the family this
right to speak to his doctors directly (especially if he is in
surgery or under the influence of strong medications)
This condition is cause because toxins are now going into
the brain (especially the toxin, ammonia) that the liver can
no longer convert to a non toxic substance that the body
can easily dispose of. The doctor usually starts patient
on a drug known as Lactulose or Xifaxan, which helps
remove some of this ammonia from the body through
the intestines. If the patient doesn't take this med,
it can lead to him going into a coma.
Advanced directive free:
Caring Connections: http://www.caringinfo.org/stateaddownloa
3. Portal Hypertension with varices:
The blood is no longer flowing though the liver
because of the scar tissue inside of it. When cirrhosis
is diagnosed, the liver starts to shrink in size and takes
on a harder texture...it is dying. The blood is backing
up into the portal vein (that normally brings all blood
from the entire abdominal area to the liver) and other
smaller vessels, known as varices, that have weak
spots that can balloon outward and break open
causing internal bleeding. The doctor can go in
and band these vessels to try a stop it. Cirrhosis
patient bleed and bruise very easily do to the
fact that the liver can no longer make clotting
factors efficiently and the platelets get caught
up in the enlarged spleen on the other side of
the body. The varices are usually found
in the esophagus, belly button, or rectal area.
Any blood seen in the sputum, vomit, or rectal
area is a dire emergency.
Here are a couple links about Cirrhosis:
Each of these have more than one page
Medicine Net: http://www.medicinenet.com/cirrhosis/article.htm
It is very hard on the family to watch what he is going through.
But, the time you spend with him now...will be with you the rest
of your life.
Patients are placed on a the transplant list according to how
much time the doctors feels the patient has left to live without
having a transplant. When a patient reaches the very top of the list;
they may go into a coma.
If your Dad decides he doesn't want to be in the hospital and
the doctor feel he may not live another 6 months, the doctor
may sign for him to have hospice at home. A nurse would
come in and keep him comfortable until he would pass away;
they usually do this once a day.
You could contact the Area of the Aging...they sometimes
will help those who are disabled as much as they help the
HOSPICE SERVICES: http://www.hospicenet.org/html/services.html
AREA OF THE AGING: http://www.n4a.org/
Only the doctor knows how far advanced your father is in
the disease...usually the best test done to determine this
is a liver biopsy. If your father hasn't taken any alcohol now
and been under doctors care to be detoxed(for a six month
period)..they might refer him to a transplant center to go
through the evaluation process of being placed on the transplant list.
Some areas of the country have help for people
BenefitsCheck up: http://www.benefitscheckup.org
Angel Flight for entire US: http://www.angelflight.com/
I hope this has been of some help to you.
Caregiver to a liver transplant patient