How sick is my father-in-law?

Question

My father-in-law has been on kidney dialysis for a year and he has diabetes. He has bad circulation in his legs along with hardening of his skin due to nephrogenic fibrosing dermopathy (NFD). This past week, he went in to the doctor to see why he has been having digestion issues (mainly frequent diarrhea) and swelling in his belly. His CAT scan showed that he likely has cirrhosis of the liver.

After reading what I wrote, I wonder why I am even posting this question. I think I am in denial about just how sick he is. I was wondering if there is anyone else out there who has had experience with this combination of diseases. How long can someone live with all of this wrong with them? I think I need to face the truth. My main question is, how long do we have left with him?

He is near and dear to my heart. Thank you to all who respond.

Answer 1

This is not a good outlook for this gentleman...I will explain why.
He was diagnosed with cirrhosis of the liver.
This means that scar tissue has formed in
the liver and that the liver has dead cells.
Therefore the liver is not able to do the
functions it once did to keep the body healthy. One of these is to make a protein,
known as Albumin, and when this protein isn't made in sufficient amounts...the fluid
can start to seep from the vessels and
gather in the abdominal area....this is known
as Ascites. Also because the liver isn't
able to function well anymore, the toxins the
liver once handled are now going out into
the blood and the kidneys are working harder trying to get rid of them from the body. This normally puts an added strain on
them...being on dialysis may help somewhat...but it still may be too much to handle.

With liver disease, not only does the
fluid build up in the abdominal area, but
also in the legs and other areas. This fluid
is known as edema and is caused because
people who have liver disease have an
elevated level of sodium in the blood and
it retains the water with it. Having poor
circulation and this skin hardening is not
good and will add to the problem in the
legs.

No one can really tell you how much longer
this patient may have...the doctors can
only give you an estimated guess based
on his test results. They know the most
about what is happening to him.

I would like to give you some idea how
to help his family:
Hospice is an organization, that if the doctor will sign the papers, a patient can receive care at home and they work right with the family in keeping the patient as
comfortable as possible. Here is a link:
http://www.hospicenet.org/

There is another organization who helps
the elderly and the disabled and that
is your local Area of the AGing. They
have volunteers.
http://www.aoa.dhhs.gov/eldfam/How_To_Find/Agencies/Agencies.asp

The third thing is to have drawn up either
an advance directive or a power of attorney.
The privacy laws even stop family members
from being able to find out anything about
a patient from the doctor and other medical
professional and also in handling any of
his affairs...like insurance, bill paying, etc.
if they don't have a signed document by
him. Durable power of attorney for both
medical and financial is the best.

You would be surprised to know how families can pull away from their loved one
when they are sick. It is very hard emotionally to accept what is happening and
not knowing what to do or say can develop.
It is best to not let this happen. Recognize
that this patient is sick, but also remember
that they need love and consideration also.
Be with them as much as possible and
reassure them that this is where you want to be. Some patients try to push their loved
one away so they don't feel like they are
a burden to them. This should not be, but
it does happen. Every second that you
can do something for them or even spend time with them, is a memory that will last
forever with you....don't waste it or let
it slip away.

Link on cirrhosis:
http://www.mayoclinic.com/health/cirrhosis/DS00373

Best wishes to you and your family.
I hope this has been of some help.

Answer 2

I'm sorry to hear that.

Honestly, he is not in good health.

The fact that he has doctors helping him deal with it is good. But dialysis, cirrohsis, and nephrogenic fibrosing (basically, dying skin) is not good.

You may have many years with him. If his health insurance is good, that is. But it won't be pleasant for him, medically. I doubt it is now.

Make a point to share with him all the things you want to tell him. If you love him, tell him. If you want to hear about his childhood, or his aunts/uncles/parents/cousins, ask him. Work with him to document his life.

That way, even if he died tomorrow (he won't - don't worry - it won't be that quick) you will have had a chance to talk to him and tell him and ask him what you want.

As awful as a slow death can be, sometimes people get killed instantly in crashes or whatever, and their loved ones feel they never got a chance to tell them how they felt or how much they loved him.

It's sad he's deterioriating, but at least you have a chance to make sure you and he can get closure to all the things you want to communicate to each other. It's not optimal, but it may be the only silver lining you find.

I'm sorry, but hang in there. You could make this the best part of your relationship, in an odd way, as this could bring you closer together than before.

Take care

Answer 3

That depends on his will to live and also on his willingness to follow the diet and not do things that will hurt him. Some people hold on for years and others don't.

You can help him by having the right kind of food when you are with him and encouraging him to stick with the diet.

Answer 4

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