Rapid Cirrhosis Progression?

[Liverquestions]

Hi Everyone, I hope all is well!

While searching Google about cirrhosis I stumbled upon these boards and have been reading ever since. I've signed up because I just was wondering if anyone has experienced a similar situation as mine.

On October 31st my father was brought the the ER. After multiple tests, it was determined that he had cirrhosis due to alcohol. After a couple week stay, he was stable and they released him. They continuously assured us that he was not yet at the point of requiring a transplant.

After being home for about a week, he was having issues with breathing because his ascites was pushing up into his lungs. Besides this, everything appeared fine. We took him back to the ER and they proceeded to complete a tap on him. Basically since then, he has declined rapidly. His creatinine levels are in the 300s now, and he is no longer responding to Albumin 25.

Tonight he was placed in the ICU from the ER, and he is intubated and on dialysis.

I guess my question is - how did he go from walking out of the hospital the first time, to literally being about to pass within the period of a month? Has this happened to anyone else before? Any help would be greatly appreciated. I guess I just really need someone to talk to. Thank you.

[Kristian]

It seems from your post that your father's cirrhosis was quite well advanced when he was admitted the first time. Particularly if he already had ascites. As such, there is always a risk of a rapid decline from what appears stable to being in a pretty bad way. So to answer your question, yes it is possible.

There are numerous reasons for this. Susceptibility to infection is much higher, the body's reserves are much lower, the kidneys rely on the liver to work properly as well as a myriad of functions the liver does that the body relies on. There is no hard and fast rule as to how quickly people may deteriorate. From my experience things were pretty stable for a long time but noticeably deteriorated over the last 12 months pre-transplant and even more significantly during the last 3 months. I appreciate your dad's deterioration has been much faster. However, the principle is the same, once decompensation has set in there is always the risk that further deterioration can happen pretty quickly, even from what appears to be a reasonably stable position. Like your father I went from a stable position to dialysis in ICU. The time period was less than 24 hours as I developed sepsis as a result of an infection caused by the fluid build up in my body. I was very fortunate and managed to recover from that, it did though speed up the need for my transplant.

Hope that's helpful. There's not a lot of comfort I can offer i'm afraid, but he's in the best hands. ICU nurses are fab!

Kristian

[Liverquestions in reply to Kristian]

Thank you Kristian! How long did it take for you to recover in the ICU? Today is day 4 for my father and they took him off of intubation. He was off it for a few hours, but then his oxygen levels started to go down again. As of tonight he's intubated again. It's one thing after the other really. What kind of dialysis were you on? Was it CRRT?

[Kristian in reply to Liverquestions]

I was there 7 days but fortunately managed to avoid being intubated. I was on heamofiltration not sure how that relates to CRRT, it was only for the first couple of days though. It's good they took him off intubation as there's at least signs he's trying go do things for himself. Even though they had to return to it there is at least some positive there. Hopefully they'll give it a bit longer and next time he'll do better. Just be prepared it may be a slow process. My levels kept dropping too so was often back on the CPAP machine before just having the nasal prongs to deliver it as the week went on.

[Hidden]

Hi liver and welcome to this “fantastic forum” 😁

Not a nice situation for your father nor for you. I think that it’s worse for the relative than the ill person- but that may not be a widely held view!

Only can recount my experience. I was going to a liver clinic every 6 months for about 18 months - noone ever mentioned the word cirrhosis to me, and I was as naive as hell and always kept my head one foot in the sand...

Anyway I was eventually told give up drinking or else. So I did, but too late! 12 months laterI was like a balloon, couldn’t hardly sleep because of a horrendous chest cough, on back was only way to try and sleep and even then..

Like an idiot I did nothing but waited and waited for my next clinic appointment. My daughter wheeled me into the consultants room (couldn’t walk by then) and within 15 minutes I was tucked in bed in the hospital in the clouds with all the angel nurses around 😁. Well that’s what was in my brain!

Trying to cut my verboseness down -

After about a week (I don’t know any of this - just what I’ve been told - consultant told my wife she was going on holiday and was asked where wife wanted me to die - home or hospital- because I wouldn’t be “around” when she (consultant) got back. Nice!

So pretty similar to your father (i.e. from nothing to everything in a month) it seems except I wasn’t worth putting in ICU . However, I made it and I really hope your father does too.

Please keep coming back and talking to us - there are lots of interesting people on here with lots of incredible stories.

Good luck to you both 🤞

Miles

🇧🇧

[Liverquestions in reply to Hidden]

Thank you Miles. I'm glad you pulled through!

[Porphyriamaniac]

I've just winessed alarming progression liverquestions. Partners grandma was admitted with ascites Sept, she had a big bleed while there, both ends, they drained her and got her bloods as stable as possible, and discharged her, She wasn't well enough to be discharged in my opinion, couldn't keep food in either end, covered in sores, itching, breathing impaired. 4 days after discharge, back in! the drugs they gave her to help the ascites caused her kidneys to fail, dialysis or death they said, she wasn't strong enough for dialysis though. They were pumping albumin, various meds and fluids in at an alarming rate and the drain was more or less permanently in her tummy. She finally managed a little urine output, and bloods and kidneys as stable as she was going to get, so a home care plan was put in place, discharge in sight. Less than 48hrs later we got the horrible phone call, get to hospital, end of life they said, she passed away 9 hrs later, she'd developed sepsis, pneumonia took her in the end. Death certificate said liver, kidney failure, pneumonia, septicaemia. That was mid Nov, it was under 2 months from start to end. Just to add though grandma had a few co-morbidities, lung disease and diabetes, which made her extra susceptible, the latter of which I'm pretty sure is how she got cirhossis, she never drank, as far as we were aware till first admission she just had fatty liver. I believe the sepsis was either from the drains or the sores/scratching. It's a bit of a horror story, but your dad sounds much stronger than grandma was, they doubt even attempt dialysis on her, but it highlights how unpredictable and rapid this awful disease can be. Hoping for the best outcome for your dad, you and your family. Stacie. Xxxx