Posts by Jerry Sullivan2

It seems we’re running through the same old record again, even though he was seemingly fine and relatively stable just a short while ago. He spent two weeks at the hospital, they discharged him, and then—just two days later (today)—he’s back in the ER. His abdomen is incredibly distended, almost like a balloon; he isn't urinating, and I suppose all the fluid is just pooling in his abdomen. They’ve kept him admitted because his sodium levels are low, but honestly, I guess there isn't much else anyone can really do at this point.

Hello,
here is the situation:
A male patient, 66 years old, dealing with alcoholism, liver cirrhosis, polyneuropathy, ascites, and several other secondary diagnoses.
Following an acute flare-up of the cirrhosis and a 12-day stay at a local hospital, he spent four weeks at a rehabilitation center to try and improve his mobility regarding the neuropathy. So, he has been sober for four weeks now and is strictly following his medication regimen (including Furosemide, among others), yet the abdominal swelling isn't just failing to subside—it actually seems to be getting larger, if that’s even possible.

While he was hospitalized, they ran all the standard tests—ultrasounds, gastroscopies, and even a paracentesis to sample the fluid in the abdomen. From what I could gather in the discharge papers, there was some mention of suspicious cells found in that fluid. He has a follow-up appointment with a gastroenterologist in about two weeks, but in the meantime, I suppose I am looking for some insight. Why would the swelling not be going down?

The exact same thing happened about a year ago, but back then, the swelling completely resolved by the end of his stay at the rehab facility.

Thank you.

vividsailor7 said:The patient has ascites and free fluid buildup in the abdomen.
Given the medication list, he’s likely on Lasix, Aldactone, Propranolol/Carvelol, and things of that nature.
Neurobion and Milk Thistle can stay, but I suppose there isn't much point in keeping the rest.
If his neuropathy becomes particularly bothersome, maybe Katena or Lyrica could be introduced.
Regarding abstinence—strictly speaking, this doesn't qualify as true abstinence, though considering everything else, one could arguably be relatively satisfied with the situation.
GGT levels are highly variable; they depend on many factors, such as the degree of liver and kidney failure, and so on.

Thanks.

vividsailor7 said:The result is high.
But you can't make a clinical assessment based on that number alone; you'd need a Childov score and the presence of complicating factors from alcohol use—like portal hypertension, encephalopathy, ascites, etc.
To be perfectly blunt, the situation will likely play out this way: the patient returns to drinking, and depending on those additional complications, they'll end up needing more frequent hospitalizations.

Thanks; unfortunately, we’re already well aware of the reality regarding the relapse.
During the first hospitalization (ever) back in November of last year, his condition was quite dire. I don't have the actual records on hand, but there were arrhythmias, high blood pressure, fluid in the abdomen (edema?), and I believe they mentioned "ascites."

What I'm wondering about—at least theoretically—is how long it takes for that specific lab value to return to a normal range once someone actually abstains.

The thing is, he claims that during that first hospital stay, he was admitted with a level of 900, and it dropped dramatically day by day—to 700, 500, 300... whereas now, after a week of sobriety, the result is 823, though it started at 995.

So, I find myself questioning whether he made up the numbers from the first time, if it's truly impossible for the levels to improve that quickly, or if his condition is actually worse now, which might explain why it only dropped by 170.
Are we talking about a recovery period measured in days, or perhaps months, to get that value back to normal?
I'm also curious if having one glass of red wine a day would even be considered abstinence (for someone who used to consume—during heavy binge phases, which occurred about six times a year for several weeks at a time without any detox periods—at least a liter of wine, several hard liquors, and maybe a few beers; while during the rest of the time when he wasn't "drinking," it was "only" a few drinks a day).

He hasn't had a drink in 12 days. Tomorrow, he's heading to some private lab to redo the GGT test because he doesn't trust the hospital's results (???!!!).
As for the fallout, his walking is currently labored (alcoholic neuropathy?) due to weakness in his legs, along with a general lack of motivation. He's taking four medications prescribed by an internist (since that first hospitalization); one is for blood pressure, and he'd have to check the names of the others.
He's also taking Vitamin B (two Neurobion tablets, which he just started), Vitamin E, Milk Thistle (for the liver, a herbal supplement), and Ginkgo (another herbal preparation).

Right now, what I am most interested in is the typical pace at which GGT decreases, if such a thing can even be estimated.

Male, 66 years old, chronic alcoholic (untreated and only recently diagnosed intermittently over the last year). Following a multi-week binge, he ended up hospitalized. Height 5'6", weight 170 lbs.

His GGT was 7.8 on admission—actually, wait, it was 995—and today, upon discharge after a week of sobriety, it sits at 823.

The internist’s diagnosis is alcoholic hepatitis and chronic alcoholism. As one might expect, the only recommended course of action is total abstinence, nothing else.

I would appreciate some commentary on these GGT values and perhaps an estimate of how long recovery might take.

thanks 🙂

But then again, these matters are strictly PRIVATE...

Whatever you experienced—whether it was a one-off thing or if you're still feeling off—it simply can't be caused by Dove moisturizer, or any skin cream for that matter. I suppose if you had gotten some directly in your eye, you might have felt a bit of irritation for a few minutes, but that would be about it. However, the fatigue, nausea, weakness, and everything else you mentioned? There’s just no logical connection there, which is what Tyler James5 was trying to point out to you earlier.

There are at least three doctors mentioned in this PDF, so since everyone else seems content to just stand around cracking jokes about contraception through urination, how about this:

placidlynx26 said:so you're still insisting that damage to the mucosal lining of the septum—the part separating the uterus from the bladder—has absolutely nothing to do with pregnancy...

...it would be quite helpful if one of those three gentlemen actually stepped up and shared their thoughts, assuming they feel inclined to do so.

And yes, even if a man doesn't ejaculate deep inside the vaginal canal, there remains a small, ALMOST NEGLIGIBLE chance that sperm could find its way to where it needs to go, potentially leading to pregnancy.

I suppose I should cite the book *Hirsi or a virgin in a cage*, which explores various struggles faced by Muslim women. It includes a specific instance of a girl who actually became pregnant despite being sewn shut. The young man couldn't achieve penetration because of the stitching, but he pressed against her and ejaculated externally; since a tiny opening still exists to allow for menstrual flow, the sperm managed to reach the vagina, resulting in pregnancy. She told her gynecologist that it was impossible because she was a virgin—and technically, she was still sewn shut—yet she was pregnant nonetheless. This whole situation took place in the Netherlands.

Good God!!!!!!!!!!

Anyone claiming to be a "receiver" clearly hasn't a clue about how this works:

-the bladder empties through the urethra

-sperm travels toward the uterus via the vagina

-the urethra and the vagina are not the same organ

-the bladder and the uterus are not the same organ

-it is physically impossible to conceive through the urethra, since the urethra leads to the bladder, and babies aren't formed in the bladder

-preventing pregnancy by urinating is an impossibility, because urine exits the urethra; it doesn't somehow flow backward from the urethra into the vagina to kill off sperm

-the bladder and the uterus are not connected

-nothing from the bladder can reach the uterus, just as nothing from the uterus can enter the bladder

I suppose I have to ask: which part of this is unclear? Does anyone actually have an anatomy or embryology textbook that suggests otherwise? I would love a reference.

placidlynx26 said:t
-it’s hardly surprising that every other pregnant woman is just some arrogant high schooler who skipped eighth-grade biology.☕

It really isn't surprising, given that when they are being "received," they are taught that the bladder has some mystical connection to pregnancy, and that urinating acts as contraception.

So, you’re suggesting that just any random person with a psychology degree is actually qualified to assess someone whose mental state has drifted outside the bounds of normal functioning.

(I mean, if someone is significantly overweight yet remains absolutely convinced they are thin—and can't rationally grasp that they aren't, or even that watching their weight might be a good idea—that isn't exactly a standard perception of reality, I suppose)

Don't you think that role should probably be reserved for, say, a clinical psychologist, or perhaps someone with specialized training in counseling?
Or does finishing a general psychology program automatically make one qualified for that kind of work (and for working with people in general, for that matter)?

But what kind of psychologist are we even talking about, and where would they go? "Psychologist" is such a broad term, isn't it? Are we talking about a school counselor? If she goes to a clinic or a hospital, they might run some psychological testing... but then what? What comes after that?
Which specific specialists actually deal with eating disorders?

Besides, if I'm not mistaken, a distorted body image can sometimes veer into psychotic territory. And once you hit that point, I guess it’s no longer just a job for a standard psychologist.

I have a question regarding a condition that isn't technically malignant, yet it is incurable.

Someone very close to me is currently in the terminal phase of multiple sclerosis. She is immobile, her immune system is practically non-existent, and she has become extremely frail. What is actually killing her are the infections; they trigger fevers that, in turn, cause neurological damage. Her kidneys are struggling—she’s on a catheter—she’s being fed via a feeding tube, and there is fluid in her lungs (though not enough to warrant a puncture). According to the doctors here, she shouldn't have made it past two months, but somehow she stabilizes, recovers slightly, and then every few days, everything resets.

Generally speaking, even when she is discharged from the hospital, things are never truly "clean." We were told that it’s impossible for her to maintain sterile urine because those bacteria can't be fully eradicated; instead, we just wait for a fever to spike and then hit it with antibiotics like a fire extinguisher.
She is currently placed in a private medical facility where she receives 24/7 nursing and medical supervision.

When I asked if there was any way to support her during those brief windows between hospitalizations—perhaps some kind of immune booster—they suggested elderberry. They mentioned it might help slightly with hydration, along with some cranberry tea.

Today, I purchased a probiotic supplement that is supposed to strengthen the immune system, so I am curious about your thoughts on this. Here is what the instructions state:

"Composition: Six strains of live bacteria targeting various intestinal locations. A specialized combination including enzymes. Recommended use: Eliminating harmful residues, pathogens, and mold bacteria from the body; boosting immunity across all ages (pregnant women, infants, children, and adults); normalizing and regulating bowel movements for acute and chronic diarrhea/constipation; restoring intestinal flora and fauna during and after antibiotic therapy, urinary tract infections, and bladder issues..."

I also picked up a different herbal blend for urinary issues, just to give her a break from the cranberry tea. It’s a mixture of birch, nettle, mint, and a few other herbs.

Any advice?