Carlismineforever, I'm so glad you decided to post. Welcome to the forum. I'm very sorry that you, your husband and family are having to deal with his liver disease. I do want to clear up one thing: Your husband would not be denied a transplant due to prior drug use, if it has been that long ago. Undoubtedly, that's how he contracted the hep C. I did, too, in the same manner. What would prevent him from being considered for a transplant is his drinking of 2 beers a day. If that is all he is drinking, it should be easy for him to quit. He may feel that's all he has left, but those 2 beers a day are speeding up the damage to his liver. He already has cirrhosis, so it's like throwing fuel on a fire. He is making it worse. He would need to be alcohol free for 6 mos. and have it documented by participating in alcohol counseling or going to AA meetings, before he would be evaluated for liver transplant. Has he been told that he would not survive a transplant, or is that just what he is telling you? Stage 4 generally means cirrhosis.
First of all, you need to get educated about liver disease. If you'll go to the first topic on the page, Hepatitis Resources, you will find a lot of educational information in there. The addition of Lactulose to your husband's meds is to lower his ammonia level. Damaged livers cannot process certain chemicals and they become toxic. In the case of ammonia, it will build up in his brain, causing personality changes and even coma. You need to make sure that he is taking the Lactulose as prescribed. It will cause him to have several bowel movements a day, which is how the ammonia will be excreted.
Is he being seen by a hepatologist or at a transplant center? It seems he has taken a fatalistic view of his disease and is not willing to do things that will slow down the process. He should refrain from eating beef as the liver finds it very hard to process. He can eat chicken and fish, beans, cheese, etc., for protein. He should eat a lot of fresh fruits and veggies. He CAN help himself feel better, but it will take changing a few things, including giving up alcohol altogether. The main symptom of hep C is fatigue. However, it can lead to cirrhosis and complications of that, as well as liver cancer. Has he ever had hep C treatment?
The esophageal varices and big belly are very common in End Stage Liver Disease.
Read some of the older posts here and you will gain a lot of information. Ask questions about anything you don't understand and some of us will try to answer.
Your husband needs to go on the liver transplant list,or doesnt he want to? Do you go with him to his DR. appointments? If you dont or havent in awhile maybe you should,maybe he is confused or just in denial.
Good luck....my thoughts and prayers are with you,
You are right about him having to stop drinking. If its only 2 beers a day ,he can and should stop. Thats why I was wondering if he is confused or just doesnt want to be on the list. Does he have other medical problems that might make him ineligable for transplant? and thats why he continues to drink,even though the 2 beers a day are damaging his liver quicker. The more we know the more we may be able to help her with her questions. I wish her and him the best and they are in my prayers,as you are Connie. How are you feeling?
DeeDee, I am feeling wiped out still from the surgery, but otherwise okay. Hope you are doing well.
Decompensated cirrhosis means that his liver is not functioning correctly. That is also what is causing the ankle swelling. The "water pill" (diuretic, probably Lasix) should eliminate the fluid build-up. He should also curtail his intake of salt. Don't cook with it and don't add it to foods. Get salt substitute instead, or use lemon (which tastes salty) on veggies. Avoid canned foods, which are loaded with salt. He should also elevate his feet. Walking will help, too, as long as he doesn't overdo it.
Please do read the educational posts in Hepatitis Resources. You can get all your questions answered by reading that. Also, with a MELD score of 9, he is not bad enough to place on the transplant list yet. They usually wait until a patient's MELD is in the mid to high 20s or higher.
If he is not willing to stop drinking, there's really nothing you can do. He just needs to be aware that he is speeding up liver failure by drinking. Also, doctors do not look too kindly on a patient with liver disease who continues to drink. They can do their part, but the patient also needs to hold up his end; otherwise, whatever efforts they make mean nothing.
Here's hoping he comes to his senses. Has he applied for SSD?
I think you should talk to the DR. about the meds hes on,the risperdal is given in low doses can be used for sleep problems,as ambien is, neurontin is used for seizures and neuropahty pain,atavan is for anxiety,lithium and risperdol are mood stablizers and for depression, Some of these meds combined can make him more depressed and the beer on top of it will make it worse not to mention intenseify the affects. I'm not sure of the effects it has on the liver but you can ask the pharmacist and they can tell you or ask the Dr. Some times they say the benifits out way the risks,but I'm no doctor.
You said his meld score is 9, mine is 12 and I'm on the transplant list,[low on the list] the higher my score gets the higher I get on the list. The hospital he went to for the transplant evaluation should have given him a diet plan on what to eat and what to stay away from. No red meat ,no salt, how much protien he should have or not ect. You should ask to see a nutitionist .
I hope I helped alittle. Take care and my prayers are with you both,
Thanks to DeeDee and mer for your informative posts. I'm in agreement that Carl may be over-medicated. Since alcohol is a central nervous system depressant, it may keep the antidepressants from doing their job...or can also cause drowsiness. If he drinks with the Ativan, he will have more of a depressed effect. When they are trying to battle both anxiety and depression with meds, it can be quite a balancing act. Does your husband's doctor know that he is still drinking?
Mer, smokers are slower to heal, and of course there are also breathing issues for smokers when they undergo anesthesia...both reasons that doctors encourage patients to stop smoking.
Carlismyforeverlove, when he complains about his ankles swelling, tell him to elevate his legs and cut out salt. If he won't do so, then tell him not to complain about it then. Something tells me he wouldn't be willing to see a counselor to discuss his feelings, but it would be good for him if he would consider it.
A man's ego is so dependent on working and providing for his family, that when he becomes unable to work, it can cause enormous depression. My father actually committed suicide because of it. Counseling regarding his self-worth and the loss he feels by not being able to work would also be invaluable.