help please

my wife has been told she has alcoholic hepatitis and cirrhosis which i understand the root cause but i dont feel we have been given enough information to support her condition.

doctor on the discharge summary that her lille score at 7 day indicated a 6 month mortality of 75 %. does that mean she will die within 6 months?

Can someone explain this blood result :bili 383 ALP 150 ALT 38 ALB 23 CRP 53 HB 124 (MCV 98.8) WCC 12.1 neutrophilia plt 121

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Hi, I was far too out of it to understand any information I was given (if any) when I was in MHDU, but I was diagnosed with cirrhosis and given less than six months to live. That was two years ago. I tested negative for hepatitis, and the cirrhosis diagnosis has since been downgraded to "severe alcoholic liver damage" because - in spite of varices, spider nevi and ascites (in other words, all the symptoms of cirrhosis) my liver has healed 100% without even a single scar. I don't want to give you false hope, but cirrhosis *can* be diagnosed as the worst case scenario and turn out not to be present at all.

What I am able to tell you is that your wife will be put on a salt-free diet, and - if needed - will be given an ascetic drain (she need not be concerned about this, as the area is so powerfully numbed that you don't feel the procedure of the drain being inserted at all). She will also have a gasteroscopy to check for varices, and any severe ones will be banded (I didn't have this happen, since varices were either closed or minimal). She will also have to stop alcohol completely (there were meds in one of my drips that help the drying out process - even more important if she is epileptic), and she will be offered counselling for this.

Please know that you're not alone. We're always here to support and advise. Wishing you and your wife all the very best, and please feel free to ask me anything, at any time.

Gemma xx

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Evening

ALP 150 ALT 38 are inflammation markers, these are released into the blood stream when Liver cells die. This is the "Hepatitis" part it meaning the Liver is swollen and being damaged. If she stops drinking alcohol this should subside.

Bilirubin 383 The Liver clears the bilirubin out of the blood, Im not sure if your measure is umol of not, but the normal range is bilirubin: 0.3 to 1.9 mg/dL. This means that the Liver cannot carry its task of clearing the bili. A liver down to 25% of its cells can still show normal bili, so this shows how poorly her Liver is.

Its ongoing Hepatitis that causes the scarring of the Liver (Cirrhosis) When the Liver becomes inflamed the body tries a rather feeble repair attempt by sending in the white bloods, its this mechanism that leaves the scarring, Chances are that the inflammation has been going on for years but because the Liver doesn't feel pain she was unaware of the ongoing damage being caused. Its only when the Liver goes below 10-20% of its cells working when all hell breaks loose.

Its sounds like she has been given a diagnosis of Child Pugh C or "end stage Liver disease" Cirrhosis. Cirrhosis is not reversible and its progressive, its a disease process where the Liver can no longer repair itself and when it tries it caused more damage.

Nobody can tell her how long she has left, some actually pull back alot of Liver function when they stop drinking, because like I said earlier once the damage to the Liver has been stopped, the inflammation should subside. Fat should start to disperse and perhaps some early F1 and F2 scarring may heal. But the stats are correct, alot do die fairly quickly and there are numerous complications from the condition . Bursting Varices in the stomach, throat and intestines can lead to death, Hepatic Encephalopathy where the Liver cant clean the blood of toxins and ammonia start to build up in the brain, can cause a coma and death, Ascites where the Liver cannot process nutrients and this leaks into the body cavity and leads to the person looking pregnant, this can become infected. She will have to be careful with any illness, flu or a cold would be extremely hard on her because the Liver cleans the blood so she would have to try and fight infections in an already weakened state. Because the Liver is struggling the kidneys have to work harder to try and clean the blood, this can result in serious kidney damage and failure.

Its going to be hard work taking care of her, you need to be informed, her condition can change from one minute to the next. She needs a Liver friendly diet and some luck here. A story that springs to mind is Andy Fordham the darts player, he was in "end stage" but pulled it back with being sober, he still has his native Liver 10 years on.