I’ve heard a lot of horror stories about these clinics and
the medical staff. If this clinic is representative of other centers, those
horror stories are without merit. I found the clinic to be very clean and well equipped.
The staff was friendly and cooperative. Things felt as though they had all been
trained in the art of efficiency and customer service. I was impressed.
I was also impressed with the demeanor of the doctor that
had been assigned to us. He was knowledgeable and spoke to me as one human
being to another. He didn’t use medical-eze which would leave me running to
Wiki to find out what he had said. He was a real person who used his own
personal experiences to show that he understood what we had been going through.
He explained and when I left I felt we had a plan of action and I knew the
consequences of all the possibilities.
While we were all talking and relating, he was examining
Riley. It wasn’t a huge exam. There was no disrobing or standing and touching
his toes, but rather simple things. To a
lay person it might seem that he did next to nothing of a real exam. That
assumption would have been wrong.
This is what I learned – The liver can, in fact, regenerate new cells and continue to function. However, there must be a sufficient amount of LIVE cells for regeneration. DEAD cells are just dead. They cannot regenerate. The just remain as scar tissue impeding proper function. If the liver has been constantly asked to recreate itself over and over again, it will get to a place where the regeneration cannot replace all the cells that have been killed by the intruding factor. New cells WILL regenerate, but the question is will it happen fast enough?
The only way to really determine how much of the liver is
functioning is to do a biopsy. It’s a simple procedure of inserting a needle
into the liver and withdrawing a sampling of the cells. Without the biopsy
there is no way of telling the percentage of dead cells versus the live ones.
However, the procedure generally causes heavy amounts of bleeding. Alcoholics
are susceptible to having bleeding issues and are not good candidates for the
biopsy. In Riley’s case the risk of him bleeding out is not worth taking the
chance that a biopsy would present. So for Riley -- we don’t know and we won’t
know how much of his liver has the capacity to regenerate.
The same theory works for LIVE cells and DEAD cells in the
brain. However, the brain is not as forgiving as the liver. Alcohol anesthetizes
many of the cells so that they do not function properly. Other brain cells are
simply killed off. As the alcohol stops entering the brain, these anesthetized
cells seem to wake up and start functioning again. But the dead ones are just
gone forever.
It is obvious from observing Riley that he has made a
remarkable improvement. However, he is now about a month from the heart attack
and the condition he is in currently is about as good as he is going to
get. He will have very good days and
very bad ones. But this is what it is and this is what it will be.
I’ve been trying to visit Riley at least every two days.
Sometimes it’s longer. Visiting him less often allows me to see his progress
more clearly. If I see him every day the subtle changes may not be as noticeable
to me. And I DO see changes. His eyes
are much clearer and skin is not as yellow. He doesn’t mumble so much when he
talks. He is able to follow a conversation – to a certain degree. He is also developing
a desire to maintain his personal cleanliness and keep track of the schedule.
He knows that does NOT want to be there. He wants to come home so that he can
drink.S..i..g..h..
This puts me in a Catch-22 position. If he stays in the
facility, he will not drink and live longer and healthier. If he comes home and
can get alcohol, he will most likely die within a year but be happier about
where he lives. I would like to say that this is about the “quality” of his
life. But that is subjective. What would be a quality life for me would
probably make him miserable.
There is the issue of having him come home endangering my
health. Caretaking him has had a huge negative effect on me personally and
medically. I have no desire to die. I
asked Riley how he would feel if he came home and then woke up one day to find
me dead on the kitchen floor. His response was that he would be worried about
who would be taking care of him now. WOW!! There was no expression of regret or
even that he would miss my company. His only concern was how my death would
possibly upset his living arrangements.
The doctor at the clinic has noted in Riley’s file that he
should be institutionalized because he is a danger to himself and others due to
the fact that he will not stop drinking. Even if Riley is not displaying any
outward signs of needing hospice, he is still terminally ill which will only be
intensified by his return to drinking.
On my plate for today, I must request a comprehensive neurological
psychiatric evaluation to determine if he is competent to make his own
decisions. If he is deemed incompetent, he will not be able to make the choice
of staying in a facility or coming home. If he is, in fact, competent he will
be allowed to make his own bad choices. But… really… isn’t that what he’s been
doing all along??