Concerns about My Father's Health: Liver Cirrhosis and Diabetes
Hi everyone, I’m reaching out in hopes of some guidance because I’m feeling quite lost about my father’s situation. My dad, who is 60 years old, was diagnosed with liver cirrhosis in 2020 and spent some time hospitalized, during which he lost roughly 15 kilograms and a significant amount of muscle mass. He succeeded in stopping his alcohol consumption for about a year; however, he has recently resumed drinking, though I’m uncertain about the quantity. A couple of years ago, he experienced a week where he was frequently fainting and had to be taken to the hospital. He claims that the doctors could not determine the cause of those fainting spells. Fortunately, he has not had any more fainting incidents since then, but he did share with me that he has developed diabetes. Additionally, he has been dealing with unpleasant breath that seems acidic. There was an alarming occasion when he struggled to even stand for more than a minute at a time. When we communicate, which is challenging since I live about 300 miles away, I often can't tell if he is intoxicated or just not making sense; our conversations can be quite difficult. His eating habits have diminished significantly, and he also suffers from high blood pressure. I’m particularly worried because he’s very secretive about his health and downplays his diabetes, referring to it as mild. Yet, in the past few years, it feels like he has aged drastically. When he first went to the hospital, the doctors warned me that if he did not change his lifestyle, he might not reach retirement age. Now that he’s 60, I’m increasingly anxious about what the future holds for him.
Answers (1)
3/17/2025, 9:40:45 AM
OpenHealth AI
It's understandable to feel concerned about your father's health, especially given the complexities of his conditions like liver cirrhosis, diabetes, and hypertension. To address your worries, let's break down some important points and recommend specific actions you can take.
Key Points:
- Liver Cirrhosis: This is a serious condition that affects liver function, and continued alcohol use can worsen it significantly.
- Diabetes Care: Managing diabetes is crucial for overall health, especially to prevent complications related to both diabetes and liver disease.
- Monitoring Symptoms: His fainting spells and recent struggles with standing could indicate worsening health, which requires attention.
Explanation:
- Alcohol Resumption: Resuming alcohol consumption can severely aggravate liver cirrhosis, potentially leading to liver failure. The liver's ability to recover diminishes with ongoing damage, meaning your father's choices significantly impact his health trajectory.
- Diabetes Management: Diabetes can be tricky, especially if he downplays its severity. Poorly managed blood sugar levels can lead to complications, including issues with vision, heart health, and even cognitive function.
- Fainting and Weakness: These could stem from various factors like dehydration, low blood sugar, or further complications related to his existing conditions. It’s concerning that he experienced these symptoms previously, suggesting that his health may be fragile.
Next Steps:
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Encourage Open Communication: When you speak with him, gently encourage him to be more open about his health and remind him that you care. It may help to express your concerns rather than making him feel judged.
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Diet and Nutrition: Advocate for a balanced diet that is low in processed sugars and rich in complex carbohydrates, lean proteins, and vegetables. Proper nutrition can help manage both diabetes and liver health. You can share easy meal ideas or even help him plan his meals.
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Hydration: Ensure he stays well-hydrated, as dehydration can exacerbate weakness and fainting spells. Suggest keeping water accessible at all times.
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Limiting Alcohol: If possible, help him understand the risks of resuming drinking. Encourage him to consult a healthcare professional regarding any support programs available for those looking to quit alcohol again.
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Regular Health Monitoring: It would be beneficial for him to have regular health check-ups. If he is open to it, you can help him schedule appointments for blood sugar tests and liver function tests, and discuss management strategies with his healthcare provider.
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Seek Support Groups: Look into local or online support groups for liver disease and diabetes. These can offer him a community and additional support mechanisms.
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Emergency Plan: Discuss creating an action plan for emergencies, like fainting spells or sudden changes in health. Having a system in place can offer you both peace of mind.
Your father's health situation is delicate, and showing him your support while being informed about potential next steps can help. If you continue to have concerns or notice significant declines in his health, please consider encouraging him to seek professional medical support sooner rather than later.
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# 7-Month-Old Child with Abernethy Malformation - Exploring Treatment Options ## [7-Month-Old] Identified with Abernethy Malformation (Congenital Portosystemic Shunt) - Treatment Methods? **Age:** 7 months **Gender:** Female **Height:** Age-appropriate **Weight:** Currently 9 kg, was 2.8 kg at birth **Ethnicity:** Asian **Duration of Symptoms:** Present since birth **Location:** Uzbekistan **Pre-existing Health Issues:** Abernethy malformation (congenital portosystemic shunt), liver hemangiomas, chronic jaundice, anemia **Current Treatments:** Supportive management --- ## INITIAL PRESENTATION (June 2025 - July 2025) Our daughter arrived on **June 27, 2025**, presenting with: - Birth weight: **2.8 kg** - Marked jaundice (yellowing of skin and sclera) - Pale or clay-colored stools - **Bilirubin level: 245 μmol/L** (typically <20) An immediate ultrasound indicated multiple liver anomalies, initially thought to be hemangiomas. --- ## FIRST COMPREHENSIVE ASSESSMENT (August 1, 2025 - 1 Month Old) ### Multislice Computed Tomography (MSCT) with 3-Phase Contrast (August 1, 2025): **RESULTS:** - 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7 Months Old) - **Weight:** 9 kg (good growth rate in spite of condition) - **Jaundice:** Continues to be present (yellow skin) - **Stools:** Remain pale/clay-colored - **Development:** Achieving appropriate milestones - **Energy:** Appears to have a good energy level - **Feeding:** Normal appetite --- ## QUESTIONS FOR r/AskDocs We have been informed this is **Type 2 Abernethy malformation** (portal vein present). **Three treatment avenues have been proposed:** ### Option 1: **Endovascular Coil Embolization** (minimally invasive approach) - A catheter is inserted via the leg vein to access the shunt and deploy coils/plugs to close the abnormal vessels - Pros: No surgical incision, minimal discomfort, short hospital stay (2-4 days), no scars, enhanced safety - Duration: 1-2 hours - Recovery: 2-4 weeks for jaundice to show improvement ### Option 2: **Open Surgical Intervention** - An incision in the abdomen to ligate abnormal vessels and redirect blood to the liver - Pros: Direct visualization, effective results - Cons: Surgical scar, longer recovery time (7-14 days in hospital) - Duration: 2-4 hours ### Option 3: **Liver Transplantation** - We have been advised this is not necessary as the portal vein is functional and liver health is improving. --- ## SPECIFIC QUESTIONS TO CONSIDER: 1. **With a functional portal vein (6.1 mm) and improving liver function (ALT normalized), is it advisable to pursue endovascular closure as the preferred treatment?** 2. **Despite ALT levels improving, the bilirubin remains consistently high (242). Should this be a cause for concern? Is there a prospect for it to normalize post shunt closure?** 3. **Are the hemangiomas/nodules (11.6×20.7 mm) linked to the shunt? Will they likely resolve following shunt repair?** 4. **How urgent is the proposed intervention? Is immediate action required, or is there flexibility to wait a few months?** 5. **What complications should we be vigilant for during the waiting period?** 6. **Regarding endovascular closure - what is the average success rate for infants aged 7 months? Are there concerns regarding the shunt size (9.9 mm)?** 7. **The measurement of the portal vein has shown improvement from 6.1 mm to 3.9 mm; should this be perceived as a positive sign or a reason for concern?** 8. **Are there special directives (diet modifications, medications) we should consider while awaiting the procedure?** 9. **Post-procedure, how long should we expect it might take for:** - Normalization of bilirubin levels? - Return of stool color to normal? - Resolution of jaundice? - Regression of hemangiomas? 10. **Can you recommend any specialized centers for pediatric Abernethy malformation treatments? We are located in Uzbekistan but are prepared to travel (to Turkey, Russia, South Korea, etc.)** --- ## ADDITIONAL INFORMATION - No family history of hepatic diseases - Pregnancy and delivery were normal - No additional congenital defects identified - Immunizations up to date - No history of bleeding disorders - No signs indicative of encephalopathy - Child is alert and engaged --- **I can supply actual MSCT images and comprehensive lab reports if they would be of assistance.** We sincerely appreciate any insights you can provide. We are striving to make the most informed decision regarding our daughter’s care and highly value expert medical opinions. **TL;DR:** 7-month-old diagnosed with Abernethy Type 2 malformation (9.9 mm portocaval shunt, patent portal vein). Liver functionality is improving (normalized ALT) while bilirubin remains elevated (242). Evaluating options between endovascular coil embolization and open surgery. Seeking expert advice on optimal treatment strategy and timing.