Hello everyone, hoping you can provide your experience and knowledge to help guide us.
Our dad (57) has been a heavy drinker for the past 25 years, was always in denial and refused any help until he became hospitalised at the start of this year. He had developed severe ascites requiring drainage, has multiple varices, one of which required banding and he was diagnosed with decompensated liver disease.
At the time of admission, the medical team made clear that if he continued to drink, he would likely be dead within 6 months and the best case scenario discussed was approx 2 years without a liver transplant.
He's done remarkably well since his admission, has been sober for the past 9 months and has remained relatively well, no further bleeds, some confusion from a UTI, peripheral neuropathy which they are trying to manage but otherwise good quality of life.
Recent review with the Medical Outpatient Team who have said the liver remains decompensated and they are unable to predict the 3 or 5 year survival rate. They are running more tests and putting a referral into the liver team, but we're a little apprehensive about this process. Although doing really well with the abstinence, dad remains a heavy smoker ~20/25 a day which we think could be a bridge too far in terms of getting him to quit. He's also really quite frail. Is it worth going through this process or accepting the palliative route and focusing on maintaining his quality of life for as long as possible?
Thank you for any insights and advice.
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GranolaLover87
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Hi, if he is referred for transplant he will have to quit smoking. He will have a full body mot to ensure he is fit enough to survive what is one of the most complicated and long surgery there is. Try to get him to eat a healthy diet and do what exercise he can, even walking is good to build himself up, 57 is relatively young.He has done really well in giving up alcohol praise him for that.
If you use Facebook please feel free to join our friendly and knowledgeable Facebook group called liver transplant support uk if you feel this would be helpful, thousands of people that have been in your situation
Good Morning GranolaLover, let’s see if I can offer some advice here, and go through several questions if I may please.
Firstly 57 is not too old to be considered for a liver transplant. But, this will depend on a person's health, and how they are now dealing with their alcohol issue.
Firstly the liver, as you’ll know, has remarkable powers of recovery. Even a heavily cirrhotic liver can mend itself well enough to still function, and carry out those 500 different functions it performs. So, if alcohol was the cause of the liver damage, then stopping the cause would allow the liver to begin to recover. Obviously, scar tissues can’t go back to normal, so care is needed here.
Further complications may arise. Your Dad’s liver may have now become insulin resistant, this may mean that he’s now a type 2 diabetic. Other complications may arise, as tumours can start to develop on the liver, so 6-monthly liver scans will become a regular occurrence.
If it is deemed that your father would be better off having a liver transplant, certain factors would have to be considered before the transplant panel need to be satisfied that he is a worthy candidate.
The transplant panel is made up of five or more people, who specialise in certain fields of medicine. They all have an input in making the final decision. There will be a surgeon and anaesthetist, a theatre nurse, and a psychiatric nurse or doctor. Before the patient is interviewed by the panel, they will have to undergo what is called, a pre-assessment test. This will involve a series of blood tests and a lung capacity test. Being a smoker, this could become an issue.
The psychiatric team will need to be satisfied that your father's alcohol abuse is being dealt with and that the chances of relapsing are very small. They also need to assess his mental state and make sure there isn’t a history of possible suicide. Finally, the psychiatric team will need to know how your father is coping without alcohol, and what processes he has in place to deal with triggers and cravings.
Finally, it should be noted, that alcohol abuse is considered to be a mental health problem. Around 84% of people who go on to develop a serious liver condition aren’t actually addicted to alcohol. They certainly have an alcohol problem, but they drink because they choose to, not because they have to.
Alcohol-free beers, wines and spirits are also a no-no. If a person is drinking alcohol-free drinks, then they wouldn’t be accepted onto the transplant waiting list. This is because the flavour is considered too much of a risk for a person to relapse.
This really is your Father’s wake-up call. A person at this stage in their life may find it hard to imagine and world without tobacco and alcohol. But you’ll find a growing band of ex-drinks and smokers who have kicked both of these habits to go on to live normal, healthier lives.
Try and sit down with your father and have a chat about the future. See what he wants to do. Try and remain positive and be supportive. Simply say, “Dad, this is what’s broken, now what are WE going to do to make it right”? This shows that you are behind him and offering to support him through this adjustment. But Ultimately it has to be his decision. He has to want to do this for no other reason than it being HIS choice.
Hello there, your dad has done one amazing thing he has stopped alcohol, he is still a young man and if they are referring him for transplant what a gift of life it could give him. Not everyone is suitable for transplant so the fact they are talking about this is so positive if he can also give up smoking this will be key. Although he may be frail try to get him to up his protein intake as this will benefit his livers health and will help when they run tests for his health for a transplant. His consultant should be able to refer your dad to their nutritionist to help him get fitter for a possible transplant.
Similar to your dad I was drinking a lot and gradually I was getting unwell but would not accept that drinking alcohol was the problem. Then my consultant says your slowly killing yourself and I was scared,then became very ill,multiple drained of fluid and stays at hospital,then at 60years of age after 1year off alcohol my liver never repaired itself and cirrhosis was killing my organs,was put on list and was told I had weeks to live,unless they found a donar match,I'm writing this to you in the hope that me being able to do things now without alcohol and more so the wonderful gift of life I received from my donar there liver. Please show your father the replys on here and give him hope and strength to fight this and change his life fir good. Feel free to ask me anything,even your dad if he ever needs to ask I will answer or talk to him,I never had support from people who had same thing happened to them and someone could help me and especially my family. Luck won't come into these situations,however support from your family,friends and people who have had same issues will,most of all your dad will have to be prepared for his biggest challenge in life to save himself and stay strong for others. Take care and stay strong and remain positive
Thank you everyone for the really helpful responses. He has an appointment with the dietician coming up so that will be helpful and we'll try to have gentle conversations around setting some goals. He's determined to make it to 60 so we'll try to leverage that. Again, I really appreciate all of your helpful advice.
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