Husband won't seek help with AL hepatitis

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Old 06-08-2014, 10:42 AM
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Husband won't seek help with AL hepatitis

Hello, and thank you in advance for reading or commenting. This is my first post on this site although I've tried searching for similar situations for the last week or so.. can't really find anything.

My DH age 66 who has been an alcoholic for many years appears to be at the stage of Alcoholic hepatitis. He has probably been there for a year or more, but I thought it was his IBS-irritable bowel syndrome. He has 90% of the symptoms.. along with huge digestive issues he also has, fatigue, weakness in his legs, edema in his ankles/feet.. and more. He hasn't eaten solid food in almost 2 weeks.. He will not see a doctor because of his fear of failure or being scolded. (He can't handle authority figures or people telling him what to do!)

He spends most of his days in bed.. as of right now he hasn't left the house in two weeks. He is retired, and has no obligations thankfully. Oh, I must mention he has depression and anxiety, too.

I've never been a nag but I do lovingly advise him what is probably going on with him so that he has information in which to decide on his choices. Although he won't read up on his own condition, he listens to me when I tell him. He is not in denial of any kind.. he knows that if he continues to drink he will eventually die a painful death. (By reading some of the stories, I for sure know this to be true).

So, where do I draw the line? How long do I wait to force the issue? Until there is a crisis when he is unconscious? Actually, there have been several crisis' over the last 18 months. 4 separate falling incidents - the worst being down a flight of stairs where he cracked or bruised some ribs. For this one he went to a chiropractor about 4 days after the fall who helped adjust him and helped him mend. He'll never allow me to take him to the ER because he is afraid they'll put him into detox/rehab. He was there once before and never wants to return.

I am looking into "luxury" rehab somewhere for him. He said he'll consider it. But, we don't even know how sick he is.

So, I guess along with support I am looking for advice on what to say to him to get him to the doctor to evaluate how sick he is.

Thanks again!
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Old 06-08-2014, 12:19 PM
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Hi Hopeful!

Welcome! I don't have any experience of this but I know we have members who have dealt with loved ones getting severely ill from their alcohol abuse. Hang tight and I'm sure someone will drop in to share their experiences. Weekends can be slow around here, but don't give up.

Just from where I'm sitting, it's hard to force someone to see a doctor -- but it sounds like by his refusal, he's also putting you in a situation where you become a caretaker? Do you have the option of having a doctor come to the house?
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Old 06-08-2014, 12:51 PM
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Are you saying he won't go to the Dr. or won't stop drinking? Or both?

In any case, I don't know of a way to force anyone to seek help. I hope everything works out.
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Old 06-08-2014, 12:51 PM
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Thank you for responding lillamy! I'll hang tight and hope Monday will bring some other words of wisdom!

So far I really don't have to do anything for him yet (other than worry and buy his vodka so that he won't go into withdrawal).. He still gets out of bed for the bathroom and to get some water or vodka. When he cracked his ribs I had do to more. Actually, I know in my heart that these are the good days, and it'll only go downhill from here. I don't believe there is anyone in our area that would make a house call. Besides, he needs blood tests and most likely an ultrasound.. and so many other things that would require a medical facility. Thanks for your suggestion though!

Taking 5 - we cross posted. He won't do either.. although I think he is drinking a little less because he is scared.. and rightly so.
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Old 06-08-2014, 01:22 PM
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I hate to say this but there are no words of wisdom in this situation. If he's in liver failure and you don't stop buying him alcohol, he'll die. Even if he quits, he may need a liver transplant to live. My husband did, at age 62-- he's 68 now. He quit drinking a year before the transplant but the damage had been done. A nd in the last year he started drinking again. Now he's living in an apartment, because I'm not doing all that again. He's quit again but he's on his own this time--I'm not holding his hand.

Last time, he quit cold turkey--without any effects, he says, I wasn't even in the country at the time. His doctor told him he was going to die if he kept drinking. He was still quite functional at the time, but went downhill fast.

If you don't buy him alcohol, is there another way he'll be able to get it? What would he do if you DIDN'T get it for him? It sounds to me like you have the control here over how much he drinks. Maybe you should use it. Feel free to PM me about anything--sounds like we have somewhat similar situation.
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Old 06-08-2014, 02:00 PM
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Hopeful4Change---I have heard of having someone from the AA organization to do a 12th step. Sometimes another alcoholic can reach another alcoholic when no one else can. (they will come to the home).

You might also consider having a hospice volunteer come to the house to visit him in regards to planning the final days at home---that might scare him bad enough to consider accepting care. In this vein--you might get pictures of funeral homes--caskets, headstones, etc. You might also discuss getting his important papers and documents in order.

This might seem too strong for some people--and I understand if it is...but, I am in the medical field and seen people get really bad--and then get so scared that they will then accept help.

I am sure that a minister would come to the house to talk to him...as another thought.

Another thought---does he think that in-hospital detox is uncomfortable--like cold turkey? This is not true---they are monitored and given the necessary meds to keep them out of withdrawl.

Have you threatened to just pick up and leave...?

I am only trying to give you some ideas for your situation...

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Old 06-08-2014, 09:33 PM
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Sadly if he has mental capacity there is so little you can do. You can't MAKE him seek help/cut down. I do see you are in a difficult situation re buying vodka - if he stops drinking completely he may well go into withdrawal and without medical supervision this could be very serious. Is there any way you could limit the vodka? I guess you have suggested AA? Would he see a private counsellor who specialises in addiction as an intrim before rehab? At least if he is considering rehab there is hope? But you have to take care of yourself and realise he is an adult, and forgive me for sounding hard, if he really wants to drink himself to death and is aware of the risks, there is nothing you can do about it! Do take care of yourself and do PM me if you need to - you sound like me a year ago. My AH is 75 and still drinking despite a brain op last year and gout/lupus/high blood pressure, bladder problems, cough and now low sodium which could well indicate a liver./kidney problem. He has cut down to half a litre a day which is way too much but I have over the last year accepted it is HIS choice. I am sure others will be able to offer much more constructive advice than me but my main message to you is to take care of yourself and try to get some support for you via al anon or other methods - I live in the UK so am not au fait with what is available in the states. Very best wishes and I don't want to sound hard as I am sure you love your husband very much and are very worried indeed - late stage alcoholism can be horrible way to die.
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Old 06-09-2014, 01:57 AM
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Hi Hopeful4Change

I think there gets a point where a person needs to have medical attention.

If you can 'force that issue', I'd force it...if you can't, things are just likely to get worse and worse, and put you in an untenable position of being effectively a nurse/caretaker responsible for some else's life.

I hope you can convince your husband of the unfairness of this for you, and the dangers for him, and get him to agree to some kind of professional medical support.

D
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Old 06-09-2014, 04:53 AM
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Hi there~ I really feel for you in your situation as well. My son is an active drinker and drug abuser, and has serious liver disease. The only reason he isn't where your husband is, is because he's 40 years younger. (Although he doesn't look it, at this point.)

If someone really really doesn't want to get medical help, as you know unless you go to court and get authority over their affairs, or (as you suggested) he's unconscious when he's transported, there is nothing you can do. I am sure you have explained everything as clearly and informatively as possible and if your husband, being of sound mind, declines help, then you are stuck. Even if you were to have him brought in while he was passed out, if he wanted to leave as soon as he woke up he'd be free to do so.

You mentioned the idea of "luxury rehab." I don't know what that is, except that it certainly sounds like more fun than the state hospital! If your husband has any interest or inclination towards such a program, maybe that's the angle to work from. One caveat, which you don't need to mention to him, is that if he has too many medical problems, that they're not equipped to deal with, they may not accept him either. But you can cross that bridge if/when you come to it.

To be honest, and I'm sure this is horrible to hear but, it sounds like he is in the winding down phase for sure. If it were me, I'd make sure that I had everything in order (e.g. know where all your assets are, make sure they are held in joint title if they aren't already, find out his wishes for a funeral and disposition). It can also help if he would sign a medical power of attorney or a general power of attorney and/or a living will. (Not that he would necessarily do this, but it could make things easier.) Of course nobody can make a diagnosis from this remove, but it doesn't sound like the prognosis is too terribly hopeful.

Take care,

Jane
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Old 06-09-2014, 08:06 AM
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Thank you all-here's where we stand..

Thank you to everyone for your advice and support! Here are some things I have been thinking about since I wrote yesterday… He has 4 siblings around the country and 2 of them know he has a “problem”. DH’s pride and need to hide his problem from most people (which is why he won’t agree to go to the doctor) is his biggest motivator. Last night at about 5:00 PM I went into his bedroom and told him that he MUST get medical attention, and if he didn’t agree to it by tomorrow (which is today) I would contact all of his siblings and have them come here for an intervention. That got his attention, but he asked me to give him one more full day. I agreed and said that by Tuesday morning if he didn’t agree to make an appointment at the doctor for this week I would call them all. He said okay.. It is now 10:00 a.m. and I haven’t seen him since. I’ll check on him soon.

At this point it is his depression/anxiety that I believe has kicked in and made him bed-ridden. He basically hasn’t left the bed since Friday afternoon when I shared with him my “internet” diagnosis of Alcoholic Hepatitis. Whatever long-term medical and mental health help he gets, it must be BOTH – there is definitely a dual-diagnosis that must be healed. (I learned that term from researching facilities that he could check into).

He has had very little to drink in the last few days. Maybe 1/8 of a “handle” bottle. Part of his meds prescribed by his psychiatrist is an anti-seizure med.. I think that is helping with withdrawal. There is very little left in the bottle and I am thinking that I will get him one more fifth, just to take the edge off. Then, that is it.. no more purchasing by me now that I realize how ill he must be. I don’t know if he has the strength to go to the store and get it himself. If he has bad withdrawal symptoms I’ll call an ambulance. That’s a way to get him to the doctor!

To comment specifically to things that were said:

- I’ve been considering leaving him for years. About 2 years ago I decided that I would stay until death do us part. He is my entire family (no parents, sibs or kids) and I would not be able to turn my back on him when he needs me so much. I just want to help him be as comfortable as possible and support him in any way I can. He is a good man, and because of heredity and upbringing has the addictive gene and a rebellious nature. Of course I’m angry and resentful that he couldn’t pull himself together, but I know that it’s not in my control. He has always wanted to, but felt helpless to do so. Yes, I am an enabler and codependent and I plan to start working on that with Ala-non meetings. My 1st meeting will be tonight and I’ll go to a few more this week in a nearby city.

- He refuses AA and doesn’t like to think of handing himself over to a higher power. As I look for places that may fit for his recovery I am looking for non-12 step programs. When he was in detox for 4 days a few years ago (which he HATED even though it really wasn’t bad at all) they did have an AA fellow come in and talk to the group, and he did seem to be hanging on his every word. He was this radical biker kind of a fella, and my DH likes “wild” people. I guess I could consider having someone visit if he refuses to see a doctor.

- Regarding religion – priests and ministers - we both believe in God but are not religious people and never attend any kind of services except for weddings and funerals. I was raised Jewish and am now pretty much just spiritual. He was raised as a Christian, but non-practicing.. His family never went to church.

- His psychiatrist – who he only sees a couple of times a year to refill his meds, is a great guy.. but, their time together does not include any kind of therapy. I’ve tried to convince him to go to a therapist to talk, but he has always refused. He has deep, deep (did I say deep?) issues, but refuses to talk about them with anyone but me – and only because I force him to talk. I read lots of self-help books and have over the years given him some insights to his issues.. But, he refuses to talk to a professional. I am hoping if he agrees to a 30 day program he will get the therapy he needs.

- I am truly scared to death that I will be a nurse/caregiver eventually. I can do the basics, but when it comes to things like diapers and bathing.. well, I don’t think I have the stomach for that. I’d have to get some help from a local agency. My DH is so strong willed that if it came to that I think he would will himself to die. He has too much pride.

- We have living wills and I am his Power of Attorney for health care, but since he still has his “faculties” that wouldn’t come into play at this point. Our affairs are in order and I know his wishes for both life support (he doesn’t want it) and cremation when he dies.

- “Luxury” rehab is a holistic approach to healing – mind, body and spirit. It’s usually at a beautiful location – such as seaside or in the mountains. Along with helping him heal physically and mentally (plenty of therapy), they have many other spiritual modalities – yoga, massage, acupuncture and much more. He would get a private room and bath, gourmet meals and could bring his laptop. It’s more like a hotel than a medical facility. I think he would agree to this. As I said, he is “considering” it. He may be too sick to go though.. This I have to find out.

Thanks again for all your advice, well wishes and support. You have helped me greatly. I will keep you posted as new events occur.

((Hugs)) to you all!
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Old 06-09-2014, 08:14 AM
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I hope that you realize that your internet DX of his health could be completely wrong. You are not qualified to make the call of his anxiety or his depression.
Call his physician today to make an appointment. Call his siblings. It could be a myriad of other physical problems given his age and general poor health. Getting him MORE BOOZE to "take the edge off" is not really in his best interest, you might make things WORSE.

He does not seem capable of sound judgment at this point, make some decisions that might save his life.
Luxurt rehab could be used after he gets a History and Physical from a qualified doctor. don't wait, he might be dying.
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Old 06-09-2014, 08:58 AM
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He basically hasn’t left the bed since Friday afternoon when I shared with him my “internet” diagnosis of Alcoholic Hepatitis.
Wait, so this was not diagnosed by his Dr.? You are unqualified to make a diagnosis. It could be less or more severe. He could already be cirrhotic for all you know.

If you want him to get help, which certainly includes a Dr. visit and subsequent diagnosis, I totally support that. Openly posting that he has alcoholic hepatitis when a medical professional has not been consulted on this, is a bit ingenuous.
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Old 06-09-2014, 09:14 AM
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I second the notion to have him medically evaluated as soon as possible. As a medical professional, not having any solid food intake for over 2 weeks is extremely concerning. You have no idea what may be wrong and unfortunately how close to death he may be. Ignoring it doesnt solve the problem. He may end up being ok but what if he is not? Would you be able to live with yourself if God forbid something happened to him tonight or tommorow?

Obviously you cannot force him to seek help. Can you call an ambulance? Are there family members that can help you get him to a hospital? At least then, you will know you did all you could to help him. Being bedridden and not eating are not at all good signs. They are an indication his body is likely shutting down. Although without a medical evaluation no one knows for sure.

Hang in there and take care of yourself. He may or may not be ready to embrace change but maybe this will be enough to scare him into recovery.
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Old 06-09-2014, 09:20 AM
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Yes, you are all right.. Although he has almost all of the symptoms (other than jaundice), he needs to be diagnosed by a doctor. I just had another conversation with him and he will NOT go to the doctor. So, how am I supposed to get him there? Possibly if I call and tell the doctor everything and then tell him that the "cat is out of the bag", then he will be angry at me, but the fear of being found out will be over. Maybe he'll go then.

He forbids me from contacting his family. I'm still not sure what to do about that. I think I'll just call the sibling who is closest to him.. she has a nursing background.

He has been diagnosed with anxiety and depression, so that I know for sure!

I can't wait until my first ala-non meeting tonight!
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Old 06-09-2014, 09:28 AM
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How can he "forbid" you from doing anything if he is in bed and weak? He doesn't have the energy to be angry. Dr. Google is often wrong, either have him admitted or wait until he is unconscious?

You are an adult, make the sane decisions, he is not capable. someone with a "nursing background" also cannot make an accurate DX. He needs to be admitted to a hospital. seriously, you have been waiting since last Friday, 4 days and he has not improved, he has not eaten, he is elderly and an alcoholic. Waiting is not helping him.

I hate to say this, but you can be held responsible if you do NOT get him medical attention.
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Old 06-09-2014, 09:59 AM
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Originally Posted by Hopeful4Change View Post
Yes, you are all right.. Although he has almost all of the symptoms (other than jaundice), he needs to be diagnosed by a doctor. I just had another conversation with him and he will NOT go to the doctor. So, how am I supposed to get him there? Possibly if I call and tell the doctor everything and then tell him that the "cat is out of the bag", then he will be angry at me, but the fear of being found out will be over. Maybe he'll go then.

He forbids me from contacting his family. I'm still not sure what to do about that. I think I'll just call the sibling who is closest to him.. she has a nursing background.

He has been diagnosed with anxiety and depression, so that I know for sure!

I can't wait until my first ala-non meeting tonight!
You can get him there by not buying him any alcohol whatsoever.
That will get him out of bed if anything can.

My mother would crawl over broken glass with a lit cigarette and her oxygen tank to get the store for more beer if I wouldn't buy it for her.

He is manipulating you and although your intentions are very good,
what is happening is not healthy for you or him.

Call the siblings and get some back up. This is too much for you alone.
Take care of yourself
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Old 06-09-2014, 10:14 AM
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I did not say he was weak and in bed.. I just said he was in bed..

I called the doctor and made an appt for him for Fri.-the soonest he could get in. I don't think it's ambulance/hospital time yet. If I did, I would call. He's only going because I gave him a choice of calling his siblings or go to the appt. He chose the appt.

The acute forms of hepatitis include jaundice and confusion. He does not have those symptoms. He has all the beginning symptoms. I do appreciate your advice, but I really don't think I am at the risk of going to jail for failure to call the ambulance just yet. He is coherent and is an adult still able to make decisions for himself. Not the right decisions, but he is still able to have a say in his care.
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Old 06-09-2014, 10:24 AM
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I'm sorry, Hopeful -- this all sounds very hard for you. I'm glad you got him to agree to seeing a doctor on Friday, that sounds like a very good start to getting to the bottom of all of this.

Hugs to you!
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Old 06-09-2014, 01:06 PM
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Originally Posted by Hopeful4Change View Post
I did not say he was weak and in bed.. I just said he was in bed..

I called the doctor and made an appt for him for Fri.-the soonest he could get in. I don't think it's ambulance/hospital time yet. If I did, I would call. He's only going because I gave him a choice of calling his siblings or go to the appt. He chose the appt.

The acute forms of hepatitis include jaundice and confusion. He does not have those symptoms. He has all the beginning symptoms. I do appreciate your advice, but I really don't think I am at the risk of going to jail for failure to call the ambulance just yet. He is coherent and is an adult still able to make decisions for himself. Not the right decisions, but he is still able to have a say in his care.
My husband had cirrhosis-- and received a liver transplant one year later-- without ANY jaundice. High bilirubin isn't always noticeable. He was also fully functioning and had no confusion until the VERY end stages-- the month or so before his transplant.

Anyone who doesn't get out of bed for days, doesn't eat and drinks needs medical intervention -- and I'm an RN, but I had no idea my husband had such advanced liver disease. Because he's overweight, I really didn't notice the ascites-- his doctor did.
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