Defining ‘Safe’ Alcohol Consumption

Nancy Reau, MD

Nancy Reau, MD

By Nancy Reau, MD

Statistics often feel unrelated to everyday life, however the recent BMJ report on the increasing incidence of alcohol-related liver disease in our younger population mirrors my real life experiences in clinical practice. In the last few months alone, I have seen an increase in young adults being admitted for alcohol-related liver injury.

Many of these young people struggle with depression or addiction and often use alcohol as a coping mechanism. While most recognize they’re drinking, they don’t realize how dangerous their habit has become until they present with jaundice, malnutrition and multi-organ failure. Unfortunately, what is often accompanied with the progression of liver disease, several of these young patients have died.

As both a parent and a physician, it is a challenge to care for these young patients who should have a long life ahead of them. But instead, I find myself speaking with their families about hospice and end-of-life arrangements. From my point of view, this means there is an urgent need for physicians to speak with their patients, especially those who are younger, about alcohol consumption. Alcohol is ever-present in our society, from advertising to social events, it’s around every turn. Meaning it is our responsibility to discuss what safe alcohol consumption really looks like with our patients and discuss it often.

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Remembering the Families of Transplant Patients

By Debbie DiMartino

I had become quite familiar with Mrs. M since her husband was placed on the liver transplant list at Rush. He had been in and out of the hospital multiple times for the many complications of liver disease we commonly see. He suffered all of them: life-threatening bleeding from the upper GI tract, ascites, muscle wasting, kidney failure and chronic encephalopathy, or state of delirium caused by the liver’s inability to clear toxins.

Not knowing his age (early 60s), I would have guessed he was 75 or 80. The few conversations he could have made little sense. Some were humorous, even to Mrs. M, who couldn’t help but smirk when he asked the nurse if his dialysis catheter was really a tracking device to prevent him from escaping.

She knew this was not her husband. She probably hadn’t seen the man she knew, the man she married, for six months or so, since before the cirrhosis took over. Yet she spent every day at his bedside. Even when he was well enough to leave the hospital (or more appropriately, not sick enough to stay), a nursing home was not acceptable. She was his 24-hour caregiver. His life outside of the hospital depended on her. It was the least she could do while she waited and prayed for that one phone call. Continue reading