LFT Blood Tests

[Smithy92]

Apologies for another new thread, but GP is being more than unhelpful.
Dad is drinking 1L vodka daily, has Gastritis, not sure how bad his liver actually is but is somewhere between Fatty liver and Cirrhosis (long term heavy drinking so presumably rather damaged now), mental health is poor, incredibly wobbly on his feet now and struggles to walk without falling, fully fully dependant.

My question is, and I get this will be different for different circumstances but my dad's Blood Tests / LFTs have been recommended to be upped from 1 every 5 weeks to 1 every 2 weeks. Presumably this implies his liver / situation is much much worse than last time? Has anyone experienced anything similar i.e. GP shortening duration between tests?

I would imagine they are looking at a bigger picture now regarding his bloods rather than “ just “ his liver … looking for issues such as his kidneys beginning to struggle or signs of bleeding ( his hb dropping ) .

@Adm1010 ahh I see thanks. Not sure if it's something you've seen ever, but are there signs of alcoholism becoming life threatening before Jaundice? I.e. we don't know if he has internal bleeding / ulcers, or if his liver has cirrhosis etc. From speaking to a friend they realised it was irreversible damage wise when their parent started to get yellow eyes.

Sorry to hear you are going through this @Smithy92. Cirrhosis is actually quite “rare” among drinkers as less than a quarter will get it - or sadly will die from other reasons before it develops. Kidney and pancreatic failure could happen - this is what happened with my dad. His liver function tests weren’t actually too bad but he developed diabetes due to his pancreas being shit to pieces and then quickly kidney failure. He wasn’t a candidate for dialysis and died quite soon after. Inability to clot blood is also quite common so bleeding and bruising easily, especially vomiting blood and passing fresh rectal blood are not good signs. Despite knowing all this, I ended up abusing alcohol myself and have not been able to go longer than 5 weeks without a blow out so I know how hard it is to give up.

The problem with the liver is it doesn’t give many symptoms in the early stages , once symptoms appear it’s generally at the irreversible stage I.e symptoms can be managed but the damage will never reverse .
Early symptoms possibly might be fatigue and loss of appetite or the ability to only eat very small meals . Some people get full aching upper right abdominal area ( where the liver is )
Varices / bleeding tends to present acutely ( vomiting blood )
Basically I guess what I’m getting at is by the time symptoms present it’s often late stage and possibly critical .

Dull not full

Ascites, large abdomen, fluid running down the legs , nose bleeds, this is what happened to someone I worked with. The person ended up having a liver transplant shortly afterwards.

I’m sorry about your dad.

Thanks for the info all, my mum thinks he has ascites for sure, he doesn't eat often (unless spoonfed small amounts by my mum), he's bruising easily, but we're not sure about blood coming out either way as he's still secretive about that. He gets a lot of abdominal pain but he also keeps getting gastritis / gerd so that's causing pain too, he only gets out of bed to walk to the shop for topups and is then absolutely breathless by the time he's back (he can barely walk now then as his balance is so bad, he falls over multiple times a day due to bad balance / weakness). He's also now finding when he falls he can hold his bladder (or that's what it seems at least as that's also a regular occurance now). I guess these are all bad signs, and the one noone will be able to answer which were all looking for is how bad / how long do we have to turn him around.

Oh gosh yes these are not good signs . I’m really sorry x

@Smithy92
If you aren’t happy with the support provided by the GP, could you or your mum go with your dad next time and push for more assistance. You don’t say if your dad acknowledges his drinking problem and would address it, he must be in pain.
You sound like you could all do with more support.

If your mum hasn’t already done so I’d look at claiming Personal independence payments /benefits in respect of your father. She’s providing his care and feeding him, he would qualify based on his alcoholism. This must be incredibly difficult for you all.

@Suzi888 @Adm1010 thanks both. He still hasn't accepted it fully. He went to rehab last year and has been detoxed in hospital twice now but is now too dependant to acknowledge the issue.

He can't get to the GP at the moment unfortunately as he's being sick too frequently / unable to walk more than a minute or so and the acid reflux is too painful (I think the gp is worried re his bloods being needed more frequently plus his instability, so she's advised we try to get him to hospital tonight, let's see how that goes as previously he's plain refused).

It may well be a stupid question and I appreciate it's a bad situation anyway, but are there any tell tale signs I should be keeping an eye out for aside from what's mentioned above? I.e. anything that's a super urgency?

Oh to add as well @Suzi888 were trying to get dad to agree to let us access his file which would resolve all issues, although he's not there mentally at the mo to understand what we're asking.

He may now have alcoholic brain disease and neuropathy which could be why he keeps falling over and if he has a swollen tummy, is breathless because the fluid is pressing on his lungs and is bruising easily then his liver is affected. What fikes do you want to access.

Thanks @MayThePawsBeWithYou we've managed to agree a brain scan with his psychologist but she's wanting him to go through a period Of abstinence prior to this. Obviously cutting from 1L a day will take a long time for that and I don't think it's doable therefor we've managed to get him another detox if he attends 6 weekly sessions which he can then get a scan for at the end of that as we think he may have frontal lobe damage.

That makes sense re pressing on the lungs, after walking a matter of steps he's out of breath heavy breathing (similar to an asthmatic) and my mum does think he has ascites so does tie up to your point.

Were trying to get access to the blood test results taken this week that off the back of, the GP has asked to get him to hospital and increase his yes frequency. Super frustrating to be told he's in a real bad way, and needs more frequent monitoring, but not be told how bad / what the issues are.

Also we know he had fatty liver 9 months ago and has continued to drink up to 1L a day vodka so it's 100% going to be worse. We just don't know how much worse.

@Smithy92 I hope he lets you take him to hospital. I would think if he collapsed anywhere in the house, or became unresponsive you could call an ambulance. Perhaps you could at this stage even- it sounds an awful lot for you and your mum to handle alone. I honestly don’t know, I’ve never experienced it. Would calling 111 give you any advice ? Might be worth a try. He sounds very ill and in need of help. I really am very sorry xx

Is he realistically going to detox again, he sounds in denial. If he is in hospital then they will assess his mental state, blood tests, liver damage. Are you in the UK. Does anyone have power of attorney, does mum live with him does he seem confused and unable to make any decisions at the moment

@Suzi888 I hope so although he's fallen and cracked his head before and refused to go, he fell in December and it took 3 days and me and my mum practically begging him to go til he went (and he had lost a tooth, needed stitches in his mouth, and needed checking for brain bleeding that time) so not positive about tonight.

We've called 111 and 999 many a time unfortunately, and each time he manages to put on a brave face for 5 minutes and convince them he's fine before going back to being in pain. Last time he really hurt himself the ambulance man said keep doing this, and eventually the hospital will have to do something as it's become to costly. Sad advice that that's what it's got to but I'm glad they were honest with us.

@MayThePawsBeWithYou I don't think my mum managed to get power of attorney before he became too unwell. He has been assed psychologically but all help has said they won't help anymore until he is clean (unless we get him psychologically sectioned should he actually have brain damage, but that also involves us getting him to the scan following detox). I'm confident he'd take the detox, but I'm not confident he'd stick to it post the tablets ending. He has been making bad / rash decisions for months now but each time we have someone check him they say he had mental capacity (he most definitely doesn't).

I always assumed my exh was on deaths door when he had permanent diarrhoea, yellow eyes, vomiting blood, lost feeling on his hands and feet, fluid on the heart etc but I don't know how but he is still going and still drinking. I am sorry you are going through this. You are his carer so please get in contact with carers uk. I found the drugfam helpline incredibly understanding and al anon has helped a lot.

@Smithy92 really hope you manage to get some support and your dad somehow improves. I hope you have people you can talk to in real life about this xx

Thanks both, positive news is the Ambulance guy has told him he HAS to come to hospital which he's agreed to today. They've said he has every symptom of wet brain (which makes a lot of sense) , an issue with one of his heart valves, and will run all sorts of tests on him overnight and not to expect him home anytime soon. Fingers crossed we can get to the bottom of it all now.

Oh they've also confirmed he'll need a transfusion which I think is a pretty bad situ too

@Smithy92 glad you have a good outcome, fingers crossed for you all.

Positive update (I think) he's been checked into hospital properly now so hopefully they'll fully assess him again all over and try and help. Thanks for the advice / info / support all.

If he is showing signs of wernickes he will need IV high strength thiamine which will likely be the “ transfusion “ you’ve been told about . Without thiamine wernickes progresses to korsakoffs . I’m not sure where your dad is at in terms of stages and whether the wernickes is reversible but it’s positive that he is in hospital and receiving treatment . Hopefully he’s at an hospital with a proactive alcohol support team who will work alongside staff to manage him . He will likely withdraw as well do staff need to manage that effectively as well . Do they know his alcohol intake ? As in the correct intake not what he will likely tell them ?

@Adm1010 that makes sense re transfusion, I didn't make that link thanks. Unfortunately they think he's progressed to Korsakoff's (his psychologist has thought he's been confabulating for a while now). Frustrating as I've been trying to get mum to push his GP to Focus on B1 and they didn't. Yeah they know his intake, last time he went they gave him withdrawal and craving tablets to help manage that. Fortunately he's ended up in the best of 3 surrounding hospitals so fingers crossed.