My husband stopped drinking the minute he was diagnosed with cirrhosis. BUT one month later when his HE (the result of high ammonia levels) came to live with us, the symptoms were like one long BAD drunk state--incoherent, very dazed, very confused, extremely fatigued, aggressive, belligerent, shaking (flappy) hands. Only with medication and emergency room visits with protracted hospitalization would he gain a semi-stable state. To this day, he says that he lost those 6 months of his life. Doesn't remember a thing. And he was NOT under the influence. So, yes, HE manifests itself like the after effects of a long, strong drunk. Medication was his only way back to semi-consciousness.

I don't know if that answers your question. Now I have a question for you: are you still drinking? From your question, I assume you are. Not good if you have been diagnosed with cirrhosis.

Im not that one with the symptoms, my husband is. And yes he still drinks on occasions. However, I am usually aware of when he does because I can smell it. This time I couldn't smell any alcohol like before. He swore up and down that he had not been drinking and I hate to not believe him. However I also know that alcoholics lie through their teeth so I don't trust him most of the time. The problem is that I accuse him and he denies and it becomes a problem. So I want to know how I can distinguish between him drinking and him having raised ammonia levels. I so wanted to take him to the hospital last Friday thinking he had HE however after a few hours he appeared to be ok again so I that is why I ask if HE can go away without treatment. He has never been diagnosed with HE and as a matter of fact he has not been diagnosed with cirrhosis either. He has been diagnosed with alcoholic hepatitis in 2010 and had a variceal bleed in 2006. As of 2012 his last report stated that he did not have any varices and his CT indicated a slight enlargement of his right lobe however the docs failed to diagnose him with cirrhosis. I know, Im confused with his diagnosis too! Not really sure what these docs mean when they say no cirrhosis however he did suffer from varices in 2006. I must add that my husband was a heavy drinker before we got together prior to 2006. Once we got together his drinking decreased tremendously however he never gave it up completely despite my efforts to stop him. To my awareness he drinks a six pack on the weekend and thats it. I dont allow any liquor in the house nor do I condone any excessive drinking around me. What he does behind my back is a different story. This is why I am on this board to try to read the symptoms and figure out whats going on with him. I realize it is not healthy to play detective nor attempt to control my husbands vice however its the best thing I can do for him to help him overcome his awful disease. I love him dearly and will do my best to ensure he is safe and has the best care possible when the time comes. I know that his continued drinking will eventually kill him, nevertheless when I married him I accepted that as part of the deal and now I must do what I can to fight this battle along the man that I chose to love for the rest of my life. Its a tough battle but its a battle that I find worth fighting for.

Rummi,

Sorry for directing my answer and follow-up question to you. I as a caretaker myself I should know that WE, as caretakers, have questions, too. That is why I am here.

I understand and applaud your devotion to your husband. It appears, though, that I cannot really answer your question. Our situations are completely different. When my husband was diagnosed, he was very, very sick. And with all of his elevated numbers, his jaundice, edema and ascites, there was no question that cirrhosis was the culprit. The reality of alcohol abuse evident. My dear husband couldn't and didn't go into any denial. Hard truth slapped him in the face and he listened.

Again, your husband's reality not quite so harsh or clear. Easier for both of you to read confused signs differently.

I hope that someone else can give you more substantive response to your question.

M

No need for apologies. Thank you for your reply. I really appreciate any help I can get to make sense of this awful disease, both alcoholism and cirrhosis. Was your husband an excessive drinker and if so, did he show early signs of raised ammonia levels then and perhaps you thought he was drunk? Did all of his symptoms appear at once meaning the ascites, increased liver enzymes etcc? Just wondering if you reflect back there may have been signs foretelling the future. Thanks for your help again!

Rummi, I candidly answered your questions in a private message. Look for it.

M

Hi Rummi,

My mother has alcoholic liver cirrhosis after decades of alcohol abuse and it is terrible to see her now. She is almost unrecognizable, yellow, bloated, skinny arms, swollen legs. She barely ever sleeps because she is so uncomfortable from all of her ascites (bloating) and she has already had to be admitted to the hospital twice in the past three months. She is only 56 and looks 76 and she swears up and down that she isn't drinking anymore, but I don't believe her for one second, nor do I try to find out if she is because it will drive me mad.

The nature of alcoholism itself is deceitful and you can think they haven't drank when they have. Has your husband tried to go to AA? If he is already experiencing health issues as a result of his alcoholism, he needs to seek help through AA ASAP so he can stop drinking entirely before it is too late.

And have you tried Al-Anon for yourself? It has done wonders for me in how to cope with living with an alcoholic mother. I used to look in her bedroom, in the pantry, in the closet, in the laundry room, under her bed, in the shed...Anywhere I could to see if she had been drinking and you know what that did for me? Nothing but drive me crazy and make me anxious. We cannot control the alcoholic no matter how hard we try and really there is not much we can do for them than help ourselves to stop enabling them and allowing their self-destructive behavior.

If he has not done any irreversible damage to his liver yet, then I hope he decides to stop for himself and for you.

I will add that cirrhosis will not start showing its symptoms until the later stages, so it is best that if you suspect your husband may be showing signs of liver damage to try and get him to see the Dr. and give them a thorough history of his background.

My mother didn't really begin showing any alarming signs in the beginning. She was mostly just having digestive issues where she was constipated for days or would have bouts of diarrhea that would last for weeks followed by nausea and a loss of appetite on and off for a period of 9 months.

I will keep you both in my prayers and hope everything turns out alright. Please keep us posted.

"I will add that cirrhosis will not start showing its symptoms until the later stages, so it is best that if you suspect your husband may be showing signs of liver damage to try and get him to see the Dr. and give them a thorough history of his background.

That's one of the scariest things about cirrhosis. Quite often there are no warning signs until you've already passed the point of no return.

I knew I was drinking to much, never thought I was alcoholic because I'd stop occasionally for two to three months, no withdrawal symptoms or any cravings, so never worried about it. I'd stop about once a year just to doublecheck, but things seemed fine. Always figured there would be some type of warning sign if I was pushing things to hard.

I had no symptoms at all until over the course of about a month things really went wrong. Massive weight loss started, dark urine, jaundice and ascites. Stopped drinking immediately (will be six years in April), but it was to late.

At the end of that month ended up with esophageal bleeding, 4 day ICU stay, another week or so in a regular hospital room, insulin dependent diabetes (5 injections daily) and found out later I wasn't even expected to live through it.

Somebody was watching out for me, but it's a battle I fight every day. Just today saw my GI after an MRI Friday, and I'm back on Lasix and now a new drug that doesn't cause man boobs like Spiranolactone did, not sure of the name, get the meds on Wednesday. Several others including Prilosec which controls a bleeding ulcer which was another side effect that nearly killed me about eight months later.

This past year I finally went to GI appointments and blood tests every three months, but am now once again back to seeing my GI every six weeks.

Frustrating, and although things are stable (except potassium which dropped pretty low), with the fluid build up, although slight, he wants me back on a more agressive treatment/checkup plan.

This is a disease you learn to be flexible with and follow what your doctor says.

Thank you all for your insight on this awful disease. I'm a healthcare educator so I am well aware of the progressive nature of this disease. I decided to join this group a few years ago because after researching numerous journals and books I found that I could only learn so much out of a book and that I needed to gain real life experience from patients suffering with Cirrhosis to really understand the true nature of this beast.

Despite my efforts to become more informed for the betterment of my husband I am sad to say that it has done nothing to improve my husbands outlook in regard to his drinking and disease progression. At one time I held on to hope that I could somehow change his perspective but I have now come the realization that I cannot control him and that I cannot force him to stop drinking. Its so hard to see someone you love slowly lose their life and not be able to do a thing about it. Sometimes you just want to slap him silly to see if will awaken from this denial that everything is ok. I still try the best that I can to impose on his drinking by putting limitations in our home as well as deny myself the enjoyment of a margarita. Although I do feel at times that my efforts are a lost cause because he continues to do what he wants regardless of what I impose.Dont get me wrong he has changed quite a bit and has surely decreased his drinking but I know abstinence is the best way to defeat the progression and he is not willing to give it up completely. And yes he does go to AA but it doesnt change his perspective.

When I married him I knew that this disease would kill him one day but I chose to fight this battle with him. He is a good man and has done almost everything to turn his life around since we reunited. His belief is that he will die anyway and that he does not want to worry about how or when it will happen. He wants to live in the moment and enjoy whatever time he has and he says he delivers his life to God and that he is ready to go when it is his time. His faith is difficult to challenge and even though I do believe he feels this way now but when this disease starts to manifest greater symptoms I don't believe he will feel the same way. I just pray to God that he spare him the pain and lingering effects of this disease. The sad part is that I know this disease is known for its turbulent ride and I know that it has devastating effects not only for the person dealing with the disease but also the families who have to endure the pain that comes from watching their loved one suffer. Nevertheless, I will stand by him through sickness and in health and I will continue to search for answers on how to defeat these two evils that will one day take my love away. God Bless you all!

To my knowledge, cirrhosis can be definitely diagnosed by a liver biopsy. The fact that your husband has had varices indicates that there is a certain amount of liver damage that has caused pressure on the portal vein which in turn caused the bleeding. The damage may not be so severe that he cannot function with what remaining liver tissue he has, but he really has to stop drinking, otherwise what does remain will give up eventually and then it will be too late. Please take your husband back to the doctor and ask how bad the liver damage is. If he stops drinking now, he can still have a full life, maybe the doctor can convince him he is on a dead end street unless he stops drinking. I agree with the Al-Anon too, they can really do wonders for families! Good luck, and prayers to you.

It is good that your husband goes to AA, and of course it does not help for everyone because recovery is based on each individual and whether or not they are truly ready to stop. He, unfortunately is doing things HIS way which is what alcoholics are best at, but look at what his disease is doing to you. You are afraid for his life and that is not a good way to live. No one wants to live where they are constantly fearing for a loved one's life or feeling the need to control someone. Alcoholics and addicts live life by THEIR rules and those that do not change that way of thinking will succumb to their illness. Al-Anon would help you greatly. We can't control, didn't cause it, and can't change it.

I really hope your husband can see a doctor and soon if he hasn't already. I am only saying this because a friend of mine lost her husband a few weeks ago to the disease and had to be the one to find the body, pay for funeral bills, and bury him. I wouldn't wish that on anyone. I fear for my mother's health daily since she is an alcoholic with cirrhosis. She did things HER way regardless of what anyone said or did and here she is, getting drained weekly, having breathing difficulties from ascites. She rarely sleeps, is constantly fatigued, can't work, she gets winded easily, has muscle aches. It is heartbreaking to witness when knowingly, if she'd have stopped sooner, things would have been different, but that cannot be changed now.