Alcohol-Induced Liver Failure: A Daughter's Plea for Help

Excessive alcohol consumption

I urgently need a doctor’s help to address my concerns.
My father recently experienced liver coma after drinking alcohol.
Before the liver coma, he had sudden fainting episodes, both on the street and while driving.
After the liver coma, he was admitted to Linkou Chang Gung Memorial Hospital, where he became severely edematous.
The doctors indicated that he needed surgery due to internal bleeding, which required repairing the damaged area.
(I’m omitting many details because I wasn’t fully aware of the situation; the surgery took place at night while I was working the night shift.)
After my father was discharged, he has started drinking alcohol again, and now he is swollen like a water balloon again (it’s very serious, and I’m extremely worried!).
Currently, he is often in a confused state of mind, unable to even dial a phone number due to tremors.
He has difficulty using the restroom, often soiling the toilet seat and the floor.

I would like to ask the doctor if it is possible to arrange for hospitalization under these circumstances.
I feel that Chang Gung is not unprofessional, but rather overwhelmed with patients.
My father was discharged without fully recovering, and the day after his discharge, he fainted again on the street.
As a child, I am very eager to alleviate my father’s suffering and then address the root cause of his condition.
Please advise me on how to handle this situation!

AIR, 20~29 year old female. Ask Date: 2020/07/07

Dr. Lin Minghui reply Gastroenterology and Hepatology

Hello, long-term excessive alcohol consumption can lead to brain lesions, impaired cardiac function, hepatitis, cirrhosis and its complications, pancreatitis, avascular necrosis of the femoral head, and alcohol dependence.
If the situation is urgent, it is advisable to seek emergency evaluation.
If there are indications for hospitalization, it is important to arrange for the appropriate specialty department to assist the patient, whether through shared care or integrated wards.
Patients in stable condition can be followed up in outpatient clinics, and if there are special circumstances or the need for hospitalization, arrangements will be made accordingly.
Wishing you peace and health! Sincerely, Dr.
Ming-Hui Lin, Attending Physician, Department of Gastroenterology, Taoyuan General Hospital, Ministry of Health and Welfare.

Reply Date: 2020/07/07

More Info

I'm truly sorry to hear about your father's condition. It sounds like he is facing a very challenging situation due to alcohol-induced liver failure, which can lead to severe complications, including hepatic encephalopathy (the state of confusion and altered consciousness you described), ascites (the fluid accumulation causing his "water balloon" appearance), and potential internal bleeding.

Understanding Alcohol-Induced Liver Failure
Alcohol-induced liver disease is a spectrum of conditions that can range from fatty liver to alcoholic hepatitis and ultimately to cirrhosis. In your father's case, it seems he has progressed to a severe stage, possibly cirrhosis, which can lead to liver failure. The liver is crucial for detoxifying substances, producing proteins, and managing various metabolic processes. When it fails, the body can no longer function properly, leading to symptoms like confusion, swelling, and bleeding.

The Importance of Immediate Medical Attention
Given your father's current state—confusion, tremors, and significant swelling—it is crucial to seek immediate medical attention. If he is experiencing severe symptoms, such as confusion or inability to care for himself, he should be evaluated for hospitalization. Hospitals can provide the necessary care, including monitoring for complications like infections, managing fluid levels, and addressing any acute issues that arise.

Addressing Alcohol Use
One of the most critical aspects of managing your father's condition is addressing his alcohol consumption. Relapse into drinking after a severe episode of liver failure is common but can be life-threatening. It is essential to have a comprehensive treatment plan that includes:
1. Detoxification: If he is actively drinking, he may need a medically supervised detox to manage withdrawal symptoms safely.

2. Counseling and Support: Engaging with addiction specialists or support groups (like Alcoholics Anonymous) can provide the necessary psychological support for recovery.

3. Nutritional Support: Proper nutrition is vital for liver health. A dietitian can help create a meal plan that supports liver function and overall health.

Palliative Care and Quality of Life
You mentioned wanting to alleviate your father's suffering. If his condition is terminal or if he is not responding to treatment, discussing palliative care options with his healthcare team may be beneficial. Palliative care focuses on providing relief from symptoms and improving the quality of life for patients with serious illnesses. This approach can include pain management, emotional support, and assistance with decision-making regarding treatment options.

Next Steps
1. Contact His Healthcare Provider: Reach out to the hospital or his primary care physician to express your concerns about his current state. They can provide guidance on whether he should be readmitted.

2. Consider a Second Opinion: If you feel that the care he received was inadequate, seeking a second opinion from another hospital or specialist in liver diseases may be warranted.

3. Family Support: It can be incredibly stressful to navigate these situations alone. Consider reaching out to family members or support groups for emotional support during this challenging time.

Conclusion
Your father's situation is serious, and immediate action is necessary to ensure he receives the appropriate care. The combination of liver failure and continued alcohol use poses significant risks, and addressing both issues concurrently is essential for his health and well-being. Please do not hesitate to seek help from medical professionals who can provide the necessary interventions to manage his condition effectively.

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