keverhar
12-06-2006, 12:55 AM
Sorry about the length of this but I'd really like some information from anybody that has any...
My wife has alcoholic hepatitis. She was showing signs of jaundice for maybe 4 or 5 months before she finally went to the doctor, who put her immediately in the hospital after her lab results came back. Her alcohol consumption was close to a fifth a day although I never actually saw her drink, couldn't find any alcohol in the house - all typical alcoholic behaviors of course. Anyway, she was in for 12 days (with a focus primarily on helping her through withdrawals) then discharged and not in very good shape - I stayed home from work on leave to provide care for her since she was unable to perform even the most basic personal functions without assistance.
About a week after her discharge, she was complaining of breathing problems so I took her back to the hospital and she was admitted. This time, the focus was more on her liver than her withdrawal from alcohol. They removed a bit over 6 liters of ascites. Her mental state had degenerated considerably due to ammonia and she was put on lactulose (enulose). A scope revealed no varices. This time she was also in for 12 days.
Now, she's home. I'm on 3 months leave but will eventually have to go back to work. She's better than she was just before the second admission but the word "better" is hard to use for someone as sick as she is. She walks - actually shuffles - with extreme difficulty... most of the time with my help. She can shower since I put a chair and handrail in the shower stall, but needs help drying off and getting dressed. She can feed herself ok, but never wants to eat - says it makes her sick.
Her GI put her on cholestyramine to help the pruritis (she was clawing herself bloody from the itching) and she was put on lactulose and xifaxan to help keep ammonia levels down and metoclopramide to help her not feel so full all the time, as well as nexium, a couple of diuretics and potassium, and multivitamins. She's also taking milk thistle and SAMe as a "well it can't hurt and there's anecdotal information that it might help" type of homeopathic philosophy.
She had labs last week and on Friday, her GI called with some guarded optimism as her albumin levels had gone up and her bilirubin count had gone down (I'm not sure the bilirubin count is that much of an indicator anymore though because of the cholestyramine). Anyway it looks like it's possible her liver may be starting to function a bit better. The diuretics were discontinued because of dehydration and the potassium was discontinued due to a high count.
That's the history, now the request for information:
She feels absolutely horrible all the time, can barely walk, functions at a minimal level. Is this typical? If she is destined to recover, what can we expect in terms of time, continued symptoms - will the weakness ever go away? She can't write legibly (she used to do calligraphy a lot) - will fine motor skills come back?
I know, I know, nobody can really answer these questions, but information from people who have been there about their experiences (or from people who have known people that have been there) would be greatly appreciated and very supportive.
Thanks.
Oh, and to answer the obvious first question, no she hasn't had any alcohol of any kind since her first admission. We've moved into a 1-story house from our 2-story house (I moved us while she was in the hospital the second time - I can't afford our old house on my income alone anyway and it will be a long time before she can work again). She can't drive and the only way she could get any alcohol (or anything else actually) is if I gave it to her.
My wife has alcoholic hepatitis. She was showing signs of jaundice for maybe 4 or 5 months before she finally went to the doctor, who put her immediately in the hospital after her lab results came back. Her alcohol consumption was close to a fifth a day although I never actually saw her drink, couldn't find any alcohol in the house - all typical alcoholic behaviors of course. Anyway, she was in for 12 days (with a focus primarily on helping her through withdrawals) then discharged and not in very good shape - I stayed home from work on leave to provide care for her since she was unable to perform even the most basic personal functions without assistance.
About a week after her discharge, she was complaining of breathing problems so I took her back to the hospital and she was admitted. This time, the focus was more on her liver than her withdrawal from alcohol. They removed a bit over 6 liters of ascites. Her mental state had degenerated considerably due to ammonia and she was put on lactulose (enulose). A scope revealed no varices. This time she was also in for 12 days.
Now, she's home. I'm on 3 months leave but will eventually have to go back to work. She's better than she was just before the second admission but the word "better" is hard to use for someone as sick as she is. She walks - actually shuffles - with extreme difficulty... most of the time with my help. She can shower since I put a chair and handrail in the shower stall, but needs help drying off and getting dressed. She can feed herself ok, but never wants to eat - says it makes her sick.
Her GI put her on cholestyramine to help the pruritis (she was clawing herself bloody from the itching) and she was put on lactulose and xifaxan to help keep ammonia levels down and metoclopramide to help her not feel so full all the time, as well as nexium, a couple of diuretics and potassium, and multivitamins. She's also taking milk thistle and SAMe as a "well it can't hurt and there's anecdotal information that it might help" type of homeopathic philosophy.
She had labs last week and on Friday, her GI called with some guarded optimism as her albumin levels had gone up and her bilirubin count had gone down (I'm not sure the bilirubin count is that much of an indicator anymore though because of the cholestyramine). Anyway it looks like it's possible her liver may be starting to function a bit better. The diuretics were discontinued because of dehydration and the potassium was discontinued due to a high count.
That's the history, now the request for information:
She feels absolutely horrible all the time, can barely walk, functions at a minimal level. Is this typical? If she is destined to recover, what can we expect in terms of time, continued symptoms - will the weakness ever go away? She can't write legibly (she used to do calligraphy a lot) - will fine motor skills come back?
I know, I know, nobody can really answer these questions, but information from people who have been there about their experiences (or from people who have known people that have been there) would be greatly appreciated and very supportive.
Thanks.
Oh, and to answer the obvious first question, no she hasn't had any alcohol of any kind since her first admission. We've moved into a 1-story house from our 2-story house (I moved us while she was in the hospital the second time - I can't afford our old house on my income alone anyway and it will be a long time before she can work again). She can't drive and the only way she could get any alcohol (or anything else actually) is if I gave it to her.
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andy19096
12-06-2006, 10:30 PM
Has she had a liver biopsy? While her symptoms can be a severe case of alcoholic hepatitis, generally A.H. will improve more so than you have indicated with the removal of alcohol. She could well have end stage cirrhosis with the symptoms you mention. A biopsy is the only way to tell for sure which it is. As a matter of fact, she could have both alcoholic hepatitis and cirrhosis at the same time.
If she just has alcoholic hepatitis, you can expect her to gradually improve. If she has cirrhosis the prognosis is not so good as the symptoms would indicate she has decompensated. In that case you can expect her to need a new liver in the not too distant future as decompensated cirrhosis would indicate her liver is failing and you can't live without your liver.
I'd get her in front of a hepatologist (liver specialist) for a firm diagnosis, and if she has decompensated cirrhosis I'd look to get her evaluated and listed for a liver transplant ASAP.
Good luck!
If she just has alcoholic hepatitis, you can expect her to gradually improve. If she has cirrhosis the prognosis is not so good as the symptoms would indicate she has decompensated. In that case you can expect her to need a new liver in the not too distant future as decompensated cirrhosis would indicate her liver is failing and you can't live without your liver.
I'd get her in front of a hepatologist (liver specialist) for a firm diagnosis, and if she has decompensated cirrhosis I'd look to get her evaluated and listed for a liver transplant ASAP.
Good luck!
andy19096
12-06-2006, 10:40 PM
Also, the link below is to a great board with a lot of info and some very knowledgable people as far as getting your questions answered.
http://forums.delphiforums.com/n/main.asp?webtag=liverfailure&nav=message&lgnJR=1
http://forums.delphiforums.com/n/main.asp?webtag=liverfailure&nav=message&lgnJR=1
jagatnibas
01-10-2007, 02:10 AM
Dear Sir,
How much does it cost for liver transplant ? I am in India and I am curious if it is affordable here
How much does it cost for liver transplant ? I am in India and I am curious if it is affordable here