You know your stuff!! I'm sorry you have this illness, may you stay well!
I have decided, due to the incredible emotional damage this person did to me, I do not feel comfortable supporting them in this. He has family and others. Ty
“Transition to a decompensated stage is marked by the development of any of the following complications: variceal haemorrhage, ascites, encephalopathy and jaundice“
Mild ascities like I have which are only noticible with ultrasound is still considered decompensated. Pronounced ascities with the patient appearing pregnant having difficulty breathing due to the retention of fluid pressing on the diaphragm or loss of appetite because of the fluid pressing on the stomach area making the patient feel full and so not hungry is a definite sign of decompensation and liver failure. A rush of having this fluid is it can suddenly become infected called SBP (spontaneous bacterial periodontitis) this can cause death from massive infection. Treatment for duretic resistant ascities is the person being drained periodically of the excess fluid or putting in a shunt bypassing the liver to reduce portal hypertension to prevent the ascities from forming.
However, having a shunt placed then increases the risk of HE (hepatic encephalopathy)
“Therapeutic paracentesis may be performed in patients who require rapid symptomatic relief for refractory or tense ascites. When small volumes of ascitic fluid are removed, saline alone is an effective plasma expander. The removal of 5 L of fluid or more is considered large-volume paracentesis.”
“Refractory ascites is defined by an inability to mobilize ascites despite maximal doses of diuretics [10] and has a significant morbidity [7]. Therapeutic options for refractory ascites include frequent paracentesis, transjugular intrahepatic portosystemic shunt (TIPS) placement, and liver transplant”
Is ascities always w decompensated?
Cirrhosis is ESLD in other words the is no higher level of liver damage above cirrhosis so cirrhosis is called end stage liver disease.
But then there is very advanced decompensated liver cirrhosis. Specifically, decompensated cirrhosis is defined by the development of jaundice, ascites, variceal hemorrhage, or hepatic encephalopathy.
The 1-year mortality is 20.2% in decompensated patients. So for those with decompensated cirrhosis the odds of dying within a year are about 20% so the odds of living a full year is about 80%
Until a patient is at late end stage in liver failure there really is no way to know. Once in very late endstage it might be 6 months to a year.
But, for example if he has untreated esophageal varicies the could burst and he could bleed out and be gone tomorrow. Or the ascities could become infected called SBP and he could pass away from bacterial infection of the ascitic fluid.
I never heard of chronic leukemia so I googled this.
“Survival rate for chronic lymphocytic leukemia. CLL has a higher survival rate than many other cancers. The five-year survival rate is around 83 percent. This means that 83 percent of people with the condition are alive five years after diagnosis”
As far as cirrhosis it is really impossible to say. I have had cirrhosis for over 10 years. But I stopped any alcohol when I was told I had cirrhosis because I was infected with hep c for 30 years at that time. I was treated for esophageal varicies in 2012 and have some small amount of ascities.
My prognosis is greatly improved since I was cured of hep c 3 years ago with Harvoni.
People with cirrhosis even if they continue to drink can still hang on for a while. Does have advanced ascities to the point he looks pregnant? Has he been checked for esophageal varicies? Does he have any hepatic encephalopathy symptoms? Do you have any idea what is his MELD score? Patients need a MELD score of at least 15 to be on the transplant list with most being transplanted at about 30. The max MELD score is 40. However, he is not eligible to be on the transplant list because of his drinking.
The best person with insight on his prognosis would be his hepatologist.