I have someone in my life who is in his early 60's who has been diagnosed with Cirrhosis a few years ago, he remains under the care of a dr at the local hospital.
He is also being monitored for the last 18months with the expectation to go onto a transplant list.
My issue is that he secretly drinks; anything from 2 cans a day to half a bottle of Brandy.
He doesn't drink in front of anyone, we find the remnants and there is categorically nobody else in the house that drinks so it can only be him. he is a true alcoholic and 'works from home' so at least he isn't out driving to endanger anyone else. He drinks to the point of drunk daily.
He tells anyone who will listen, including the Drs that he quit drinking 2/3 years ago on Cirrhosis diagnosis, nobody seems to challenge him although last time the paramedics came to see him as he was vomiting blood, they did say 'that's not true now is it' and he didn't respond
He will not allow anyone to accompany him to Dr Appointments.
He seems to either elude the medical profession as he stops drinking a few days before each blood test and they don't do hair strand tests, his medication has not been adjusted which is why I believe him to be eluding the Drs or, more likely he is lying about the outcome of the appointments.
I would be utterly devastated if he made it to the transplant list as he is so undeserving of another liver as he cannot control his addiction.
How would I intervene in this to prevent it? we have different drs
He has had the banding redone several times now
He is weak, barely eats, unstable on his feet, has had several falls in the home too which he blames on heatstroke or food poisoning, there has been more than one occasion where he has dropped his dinner on the carpet when taking to the table as he cannot either hold the plate because of weakness or drunk.
His eyes are yellow, his skin ranges from grey to yellow with blotches of red.
He sleeps a lot.
He has a supportive network to reach out to however he has boxed himself into a corner with asking for help as he thinks we all believe he doesn't drink.
We do not confront him as the person he exists with would be verbally abused by him and at the moment I would rather protect them as they put up with enough just existing with him.
Any suggestions on how to move forward?
Any life expectancy experience?
Anyone been in this position themselves and had a lightbulb moment?
It is so very sad, addiction has gripped him and all we seem to be able to do is watch while he kills himself and wastes valuable resources doing it
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gettingirritated
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I would imagine that this persons medical team is very well aware of his continued drinking as any regular monitoring blood tests will tell them all about it (one test which is likely to be elevated is his GGT level).
Usually if considering listing for transplant UK transplant centres demand a minimum 6 month 'proven' period of abstinence - the fact he's now at 18 months of being monitored show that transplant isn't likely to be being considered and sadly your friend is gradually making himself worse and worse.
He is obviously very poorly and is displaying some serious late stage symptoms & like you say he is unwilling or unable to tackle his addiction.
We have been told he's possibly depressed but refuses medication, it's like he's given up however he loves to play the martyr too so we're never 100% sure.
I shouldn't, but I feel very insulted every time he lies to us that he isn't drinking.
Is there any signs we should be looking for? The varicies banding has burst twice already and in told that fatality after each one increases
I'm concerned the person who lives with him will find him dead one day
GGT is often elevated in liver disease, not necessarily ALD, also NAFLD and others. I stopped drinking about twenty months ago, and while my GGT has dropped two thousand five hundred points, it is still elevated.
Maybe they check MCV or EtG. Or have a look at the big picture.
When a person who has been banned from driving for certain alcohol related offences applies to the DVLA for their licence back, they have to have a medical.
It was commonly believed that you could cheat the test simply by not having a drink for a week or so. This is no longer true.
Just like a diabetic can have a blood test that gives an average blood glucose over a three month period, there is now a test which is used to give a similar result for blood alcohol. Its called the Carbohydrate-deficient Transferrin or CDT test.
I don't know if this test is used routinely in clinics, but it certainly would help detect if somebody is trying to deceive their medical team.
MCV stands for mean corpuscular volume, I believe. Its normal range should be between 80 and 99 fl. Values above usually are related to vitamin B deficiency, a certain kind of anemia (macrocytic?) and chronic heavy alcohol intake. EtG stands for ethyl glycuronide, a byproduct of the ethanol metabolism, if I understand well. Being too sensitive in urine tests, it seems promising as a hair and nail test for chronic alcohol abuse. As mentioned above, CDT is useful, too, for identifying alcohol use. EtG hair tests seem to be able to distinguish between abstinence, use and abuse, according to what I read.
Oh dear! Totally agree he does not deserve a transplant with the way he is going. I would make an appointment to see his doctor and say; you know he can't give you any information but you can still tell your side of it and the doctor can listen.
yesi agree with tc64... speak to his doctor.... you can give them information.... but not the other way around. its a waste of a precious liver.... it will be ruined by his drinking again. Good luck best wishes cazer.
Thank you all so much for your replies - it's put my ignorant mind at rest that there is a chance he isn't eluding the medical profession. This was one of my main concerns as I'd hate for him to waste an organ that could be given to someone who has worked hard to kick their addiction.
I would imagine it's just a case of managing this until he passes on now as he is either scared, incapable or unable to tackle this addiction.
don't apologise-I know where you're coming from on this...you're in an invidious position. ultimately if has to be the person concerned who takes responsibility for his/her own health-
I don't think we should ever use the term 'deserves' a transplant. That's a very negative view and damaging to those who are struggling with whatever is preventing them from being eligible for life saving treatment.
The concept of the deserving and the undeserving recipient opens up all sorts of discussion, non of which is helpful.
Do we then divide us all into groups ?
As 90% of all liver disease is preventable that makes an awful lot of us 'not deserving'
If somebody is having difficulties is dealing with their drinking, that does not make them 'undeserving', it simply means they need extra support and understanding.
I apologise if my terminology has offended you I would just hate to know that a donated organ went to someone who is still struggling and has no desire or tools to change their lifestyle in order to become healthier and appreciate the phenomenal gift of a second chance they'd been given.
I believe personally that if you have a disease directly caused by personal choices you've made (not 'you' specifically, hypothetically) and you're told to stop drinking or you will die and you neglect to do that either by lack of desire or assistance then you are not worthy of the second chance against someone who has done everything within their power to improve their life and reverse or halt any damage caused.
Sadly he has been given ample opportunities to access assistance, he has support groups locally, he has no contact with his 4 children because of his addiction, he is consistently ill, he visits the Dr a lot, he continues to have the support of a partner, 3 step-children and his father, he is an intelligent man who has been gripped by the terrible disease of alcoholism and there's no easy answer. He has been supported for a number of years by people close to him, we have an alcohol free house, he goes and gets it himself daily, hides the bottles and we check his hiding places daily and there's always fresh empties which he then disposes of on his next trip to the shop as they are never in any bins. It's so very sad and soul destroying however I am unwilling to confront him as he will verbally and emotionally abuse the person he exists with and that person has been through enough.
what's going to happen is that the liver will probably fail and he'll end up in A&E and whether he survives or not will be in the lap of the gods-this happened to a friend of mine in early 60's who survived the failure but succumbed later as the liver was so weak. wish you well on this one-not an easy predicament-good luck
Everything you just wrote I can relate to 100%. I went through it with my dad. And unfortunately he hit rock bottom when he didn't have much longer to live. Quit drinking in June '16 died of cirrohsis in oct '16. It was terrible. I wish I could offer advice but I can only offer an ear to listen and to share my experience with you and know you are NOT alone. My dad was 63.
Not a problem - healthy debate is never a bad thing.
My point of view is from somebody who had no problem at all with stopping using alcohol, but still had to go through hoops to convince the team that I was suitable for transplant.
Perhaps, ironically, as I was too ill to drink anything remotely alcoholic, I was fortunate. I'm not aware of how ill your friend is, and I don't wish anything bad on anyone, but perhaps he needs to experience how dreadful and unpleasant liver disease can get, before he changes.
Pity I cant have five minutes in a room with him to show, firstly how bad in can get, secondly, how good it can be and most importantly, that there is life without alcohol.
I was a bit upset for somebody posting here very recently, who said her husband was afraid that if she stopped drinking, she 'would become boring'. Strangely, I can understand that. When drinking dominates so much of your life, you do wonder what will take its place. The reality is that without alcohol, your life is suddenly brighter and you can pay attention to all the things that drink took away replacing it with nothing but darkness.
Maybe you should let him see your post and the responses. Might help him to understand that there is another way and exactly how much you worry and care.
Agree it will become so unpleasant and dreadful. Even worse than you could imagine. I thought I went through it all with my dad but his last mos were the worst.
I was in exactly the same boat as you were Jim, abstinence was easy perhaps aided by feeling so rotten. As with you, the truly hard part was convincing the psychiatrist and rest of the team of this. I really hate having my honesty and integrity questioned by strangers, but I know they must get a little jaded. As to the OP's friend, he will not be deceiving anyone, other than himself. It's a cliche, but one has to admit one has a problem.
That's the thing Jim - he's seen first hand how poorly alcohol can make you - he's been hospitalised twice from vomiting blood, each with a 5 day stay and excruciating pain.
His family are old school style drinkers, he doesn't see them now but he's of the opinion, it didn't do them any harm and always has maintained that view as they've lived a very long time.
He spends a lot of time alone, he's socially awkward although very intelligent so socialises through the person he lives with but that person isn't prepared to stay home all the time and exist so no doubt he is lonely too and alcohol is company for him. It makes me sad that we all plan around him, he constantly asks when we are out 'when are we going home' so he can binge drink - hes left birthday parties and weddings early and the minute he's home he creeps upstairs to drink thinking we don't know.
Due to this behaviour and weakness of muscles he can't be trusted to watch his grandchild alone.
I am a smoker and have sporadically stopped and I totally get the 'lost' feeling for the crutch you once had and that's probably why I can't maintain stopping.
You should be immensely proud of yourself for beating the demon - I wish you improving health for the future
I am not, nor have u ever been a drinker, but I understand alcoholism to be the same as any other addiction where it chemically alters the brain and provides a need to drink not a desire.
This makes it a physical medical problem which needs treating appropriately in order to 'cure it or rather put it in remission.
You say that he has been a drinker for a long time so his brain will definitely have been rewired to need alcohol to function- he genuinely believes that. It isn't ea easy as it sounds to recover from this.
You also say he spends a lot of time on his own. I really feel for him over this. Being told that you have cirrhosis, a life limiting condition, can be extremely scary. When you are scared you automatically reach for your usual crutch - in his case alcohol.
Plus he may not actually want a transplant and drinking on purpose. I know a few people who simply can't accept the idea of 'having part of a dead person inside them'.
I know how frustrating it is for you and how angry you must feel, I really do, but please understand that you cannot condemn a man to death because of that,
Perhaps you can explain the situation to your doctor, or his partner can if you are registered at a different surgery,
I know they will not be able to discus his case but they have yo listen to what is worrying you and depressing you. That way you have planted the seed with the doctor so he understands the full situation.
I have recently been in a similar situation with my ex partner not admitting to drinking. We have a 5 yr old child so maintained good contact and in fact still loved each other but I couldn't stay with him while he continued to drink and not accept help (previously hospitalised in itu for a week and I continued to support him for several more months before I had to walk away). He had been getting more and more poorly since christmas. Ascites...falls...jaundice etc.and claiming he'd been to the doctors. I went to check on him a few weeks ago as was worried and sadly he had passed away at home by himself. Post mortem was required as he hadn't seen a doctor for months. The cause of death was severe infraction / infarction of intestine due to umbilical hernia with secondary causes of ascites and cirrhosis. I hope and pray your friend can get help before he too suffers. Alcoholism is an awfuĺ disease and it's so hard for the person struggling with it but equally hard for those watching. X
Oh my word - I am so sorry for your loss and for your daughter.
I applaud your strength to not stay and watch it's so heartbreaking.
I hope and pray that his partner finds the strength to move on however I strongly doubt it.
He has returned today to hospital to have the 7 sets of banding checked and thankfully all ok but we are all clock-watching' especially tomorrow as his drinking will be playing catch up which is just awful as it's the constant worry that he's had another fall or fallen asleep with a cigarette on the go and there will just be a shell and ashes of a home.
Thank you. It is devastating to watch when you know what the outcome is likely to be. In some ways the fact that we left when we did has made it a bit easier for our son although he saw his dad every week he'd been able to do less and less with him. Is your friends partner financially dependant? I think the fact that I wasn't dependant made it logistically easier to leave although still a difficult decision. I wish you all the best and hope he can make some changes x
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