I'm sorry to hear that your brother is in such shape. I'm not a doctor, but I had a very similar experience with my husband when he was hospitalized (over 75 days total). He just received a liver transplant January 21st.
In November, his ascites (fluid) was so bad it entered his chest cavity and crushed his right lung (pleural effusion). They tapped 4 1/2 liters of fluid off the chest (Thoracentesis). Then they installed a chest tube and restricted his fluids. They also had him on heavy doses of diuretics. Over the course of the next 6 days, he became more confused until finally he and slipped into hepatic coma. He was way too dried out. His urine output nearly stopped. I grew very concerned about his kidney function. He lost at least 25 lbs that week.
I had a temper tantrum and chewed out a total of 7 doctors demanding the chest tube be removed. It was during my tyrant that I met the director of transplantation. He ordered the chest tube removed and immediately started him on saline drip. The diuretics were stopped. Within 3 hours, my husband regained consciousness. It was a very close call. We spent the next couple of months in the hospital trying to determine a middle ground and keep him stable. The diuretic doses were constantly being adjusted. Too much fluid and his blood pressure would drop to a point where they couldn't give him diuretics. Too dry and the encephalopathy (confusion) would increase.
He ammonia levels were monitored regularly. When they were high, the hepatologist would order Lactulose enemas every 8 hours. The quickest way to bring down the ammonia level is through bowel movements.
Your brothers condition may be far worse than my husband's was. But your story sounds frighteningly familiar. Don't be afraid to ask questions or have them explain his condition to you.
Hope this helps. God bless you. You and your brother will be in my prayers.
I am back to work these days. My Sister-In-Law is staying with us to help take care of my husband Harvey. I don’t get a chance to check in on the forum except in the evenings.
I’m glad you are encouraged and getting involved. It’s important for the family to get behind the patient. Let the doctors know how important he is to you. This goes a very long way in their willingness to make him well again. Your brother must also demonstrate his will to live and give up alcohol.
A transplant candidate/recipient needs a great deal of support to ensure all doctors appointments are met, medications are taken appropriately, vitals are reported, etc. It’s a very involved process and one that has no end. Anti-rejection medication must be taken for the rest of the patient’s life. Rejection can happen years after transplant, so a patient must be vigilant for any signs of rejection and report them immediately to the transplant team. So the more family supporting your brother, the more confidence the team will have for a positive outcome.
Depending on the extent of his cirrhosis, they may be able to stabilize him enough to be released. He would then need to join an organization such as AA to get his sobriety documented. Of course he would also have to meet with the transplant team regularly to be evaluated and have his condition monitored. But let’s not get too far ahead of ourselves. Bottom line, he is going to need a great deal of support.
First and foremost, they must get his infection under control and address his kidney function. I don’t know that much about dialysis, but I do know that the kidneys can “wake up” again and start functioning depending on the extent of the damage. Get to know his nurses. Ask them for their opinions. They can help guide you in what questions to ask the doctors. There are some very intelligent nurses out there and they tend to be more direct that the doctors. And unlike the doctors, they are on board 12 hours a day. The nurses can be your greatest ally.
I have to get ready for work. I wish you the best of luck and will continue to pray for your and your family.
I'd never turn my back on my friends. The people of this forum are wonderful and have been such a great source of support to me in my darkest hours. The least I can do it pass it along. Yeah, I'm busy, but I'll do what I can.
I'm so sorry. I know you will miss your brother. Please don't second guess yourself. You were there for him when he needed you. Don’t dwell on the circumstances of his passing. God has a plan for each of us. It’s one that cannot be changed and is beyond our comprehension. We are left to grieve those we loved and lost. Each passing reminds us how fragile life is.
Take comfort in knowing that your brother has gone home and is free of his suffering. Be grateful for the time you had with him on Earth and cherish the positive memories. Your love for your brother will keep him alive in your heart until you meet again as promised by our Lord.
You’ll miss your brother terribly. Please know that we will be here for you if you need us. We all share the pain of your loss.
You’re in my prayers. My God bless you.
“Life is not the way it's supposed to be. It's the way it is. The way you cope with it is what makes the difference."
Sad, I join the others in offering my sincere condolences. I know how much you must be hurting right now. Please know that you are welcome here anytime.