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DrRussMD
DrRussMD, Board Certified MD
Category: Medical
Satisfied Customers: 65329
Experience:  Board certified Internal medicine and Integrative medicine. Many years of experience all areas.
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My mother is a long term alcoholic and has been diagnosed with

Resolved Question:

My mother is a long term alcoholic and has been diagnosed with end stage liver disease. She is in hospital now and has been for 4 months. She has gone through 5 or 6 cycles of treatment and draining fluid from her abdomen. Each time they stop the treatment she simply fills back up and becomes confused and breathless.
The team treating her are now saying that they feel they should stop the treatment and let her decline and pass away. Whilst I accept that opinion and understand that the only thing at present keeping her alive is the cycle of treatment that they cant repeat again and again (For her sake if nothing else) I want to be armed with the correct questions in the meeting this week.
I know transplantation is not an option (Shes 67) but need to make sure that I check that all other options are explored and explained.
If the liver is not responding to treatment and it is alcoholic cirrhosis I assume that means there is no hope of the liver ever recovering given time as cirrhosis is scarring and therefore not repairable?
Just want to be armed with the right information.
Submitted: 2 years ago.
Category: Medical
Expert:  DrRussMD replied 2 years ago.
Hello
Age is not a deterrent to transplantation.
If she has not been evaluated by the transplant team, then this needs to happen.
If she is still a drinker this can disqualify her.
You should ask about hospice care, and in fact, paracentesis can be done in home hospice.
I see no reason to stop that treatment, as it is keeping her comfortable.
The liver might not recover, but the liver can stabilize...it all depends how much damage there is.
I would not want to go along with such decisions...and besides, that is her decisions, without a hepatologist, hospice specialist, and transplant team asssessment.
OK, so that is an initial answer….
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Customer: replied 2 years ago.

Thankyou

She now admits and has committed to alcohol treatment (Although despite requesting nobody has been to see her at all)

They do want to discharge her if we make the decision to a nursing home (Although they say they cant do the paracentesis there (possible that we have been suggested the wrong type of home))

If we are told that the liver is too damaged to stabilize or they suggest that the quality of life she gets from just being in this cycle do we suggest that there are other things that could be tried or accept that.

Appreciate its her decision but in her confused state I would prefer we had some input into helping them help her make that decision.

Thanks

Paul

Expert:  DrRussMD replied 2 years ago.
Actually there are no other treatment options other than support and an attempt to stabilize her.
This can be done in hospice.
Yes if they can not do paracentesis in the home, then it is the wrong home in my view.
Another option is to transport her to the hospital periodically.
Please use reply to expert if you have further questions. When you are ready, please click a positive rating [hopefully excellent]. If you forgot something, come back. I am here daily.
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