Sorry - I'm back........

Actually, I'm keeping a low profile with him, because he has a lot of difficulty receiving praise, thanks to his abominable childhood.

I'm just watching with interest. He isn't toughing it out, he's just cut his drinking down gradually from 15 cans a day plus whisky, to no whisky and (at the moment) three cans.

He tried campral once, and said it didn't help - but he wasn't in the right frame of mind to even be trying to stop drinking then.

I suspect, as a wife of many years' experience, that he's watching me coping well with my valium tapering and stopping smoking, and watching me make the effort has clicked something in his brain.

GOOD LUCK ADE - you can manage without fags!

When I have time, I'll PM you with his life story.

That's really encouraging to hear he's cut back so much. Do be aware of the Alcohol Deprivation Effect though, if that kicks in he'll start drinking more. Not saying that he will, but if he does then you'll know why. Seems like he's been managing quite well though so far!

Thanks for the encouragement, it would be great to be able to do without the butts. 

Thanks to all of you who have responded. Angel, there is always a right time to kick addictions. You just haven't reached it yet.

Don't forget, it took me 40 years to start coming off sleeping pills and diazepam.

Alcohol is very hard to give up, from what all you guys have been telling me, and it's so readily available.  That makes it more difficult.

Will be back in touch with you later honey bun. Love Tess

strong reply Tess. Great forum for everybody and I salute you for your strenght! Robin

Can you remember where I posted about my husband's drinking improving and asked what vitamins etc he should have?

RHGB gave me two good answers but although we've now got all the meds he recommended, he won't take the lactulose - he says it tastes disgusting. Does anyone here know how important lactulose is?

Have you tried adding orange juice to it for him, then just drink it? However my mum who was diabetic bought some and her GP told her not to take it. Different circumstances though

Hi. I'm not sue what to do. Our doctor doesn't want him to take it because of the diabetes, but RHGB said the GP was wrong. I'll ask for a telephone consultation tomorrow and try to sort this out. Thanks for your input. XX

It's not Vodka Vicks, that would be like adding orange juice to cough mixture, it just doesn't mix.

Ask your GP, ask him specifically where he has his information about diabetics not being able to use it. There may be something about your husband that I don't know about, that your GP does, that precludes him from using it and only he can answer that and I strongly suggest you speak to him.

But, ask him if he is solely ruling it out for the sugar element and whether he really knows about lactulose and please come back and tell me. He may know something I don't, that is his job, what he has been trained at, but I would like to know what his objections to lactulose are.

Now, I don't get my knowledge from Wiki, I've been taking the stuff for two years, been given it by the liver specialists in hospital, been told to keep taking it by my gastro last month, told by my GP it will be a life long thing for me, and by Christ, I have researched it. Until I get my latest bloods in a couple of weeks, I am still mildly prediabetic.

So, look it up on Wiki. A small snippet from it; Lactulose is not absorbed, does not affect the absorption of spironolactone, and may be used by diabetics. It is used in people with cirrhosis/hepatic encephalopathy to limit the proliferation of ammonia-forming gut organisms and increase the clearance of protein load in the gut.

Oh, and see where it mentions spironolactone, I take that too and I can talk the hind legs off of a donkey about that too. My kitchen is a pharmacy.

Used to drink vodka and orange at 16 ugh!! I only suggested adding juice as that's how the nurses gave it to my husband following his heart op. However he preferred to just knock it back straight, job done. They said most patients preferred it with juice, very slimy!

I'm going to ask the GP those very questions. I'll get back to you if anything interesting comes up at the appointment.

Oh, forgot to say that the pharmacists where we get our prescriptions also said diabetics shouldn't take lactulose.

So, at this point, I have no idea what will happen - but I do appreciate your help and advice.

Ask them and let me know what they say. Ask them to check their info.

Here is the patient.info words about it.

https://patient.info/medicine/lactulose-for-constipation-lactugal

'Because of this, lactulose is also prescribed for people with a liver problem called hepatic encephalopathy.'

Find anything on that page that says, not for diabetics and I'll be impressed.

Cirrhosis can cause diabetes. Lactulose really does help the brain problems from cirrhosis.

I am just wondering HOW... Lactulose helps the brain re liver problems ?  I have had liver damage ... diagnosed 5 years ago.

Short answer is, the liver processes most of our bodily functions. One of them is to remove toxins. Damaged livers don't function properly and they can't remove the build up of ammonia. Ammonia if allowed to build up in our body, travels up to the brain and makes one go mad.

I've seen someone who has gone mad through alcohol brain disease, when I was in hospital, believe me, it isn't nice.

Thanks RHGB.  What causes the build up of ammonia ?  Sorry, if this is a daft question... but I don't know.

Sure, I'll get back to you after seeing the doc. Thanks.

I actually have a huge box which contains our joint pharmacy. The annoying thing is that one of the cats is always asleep on top of it so I have to move a cat every time I want any meds,

Ammonia is a byproduct of the metabolism of nitrogen-containing compounds, and is neurotoxic at elevated concentrations.

I could go really into detail, but at a basic level, it is normally produced by the liver metabolising foods and then cleared out by the liver. When the liver gets damaged, it stops clearing it out. Lactulose takes over when the liver can't do its job anymore. It does more than that, but that is the main task, to stop it building up in the body/blood stream and entering the brain and causing hepatic encephalopathy

Can it be harmful to take it if your liver doesn't need it?

Not really. There is always going to be someone who has some sort of reaction, but there are no known groups of people who should not take it.

https://patient.info/medicine/lactulose-for-constipation-lactugal

It's available OTC as a laxative, but it is an osmosis laxative and doesn't work like normal ones do and it doesn't cause the squits. For liver problems it is generally prescribed however, as part of a package of medication.

 

Yes, we used it as a laxative when I worked as a nurse. And some patients loved it and some didn't.

I do understand the physiology of its use in preventing encephalopathy and I'm definitely going to make sure our GP understands - because she looked horrified and went on and on about diabetes, and since husband himself hates the taste of it I gave up. However - the GP should know that it's ok for dianetics to take it. It's her JOB to know that and I'm going to see her (horror - she's very intimidating) and give her the interesting information that she is misinformed.

I would not tell her that she is misinformed, that erm, won't get the meeting off to a good start. Just ask her that you seek confirmation that it is not suitable for diabetics and why, because you have read that that is not the case. Mention that it is a nonabsorbable disaccharide and if it is not suitable, what are the alternatives, apart from doing nothing.

I will be the soul of discretion. Oh, and I meant diabetics, not dianetics, obviously...........

I will be the soul of discretion. Oh, and I meant diabetics, not dianetics, obviously...........

The pharmacist I discussed this with today that it depends on exactly how much lactulose is prescribed to diabetics.

He was very knowledgeable about its use in preventing encephalopathy.

Studies have shown that a small proprtion of lactulose does, in fact, get into the bloodstream and can therefore raise the amount of sugar in a diabetic patient's circulating volume. There is a rather complicated table (which he showed me) which assists liver specialists when they are calculating the amount of lactulose which can safely be administered to diabetics.

Well, that's great, at least he is knowledgeable about it and just doesn't dismiss it out of hand. When doctors just say no, without understanding it or if they do explaining it.

I've often read that pharmacists are better with medications than GPs are. In fact it was my pharmacist that actually invited me in for a chat in their consultation room to discuss how I was getting on with my medications, which resulted in a change of the calcium channel blocker.

Since I've been reducing on my diazepam, I had to choose a named pharmacy, so it was his pharmacy I chose. All the staff are very friendly and we're all on first-name terms (since they see me so often.)

They also obviously know that Jim is my husband and all his medical problems, and I agree, RH, that pharmacists definitely know more than many GPs do on the subject of how medicines work.

I then decided to and chat to my former pharmacist (we moved a year ago) and his opinion was exactly the same. So now I've booked a GP appointment and we decided to see one of the other doctors for a change. It'll be interesting to know whwat she has to say.

Hi. My GP has a pharmacist in once a month( who I use) to check on meds taken. Also make Jim watch Pauls video on YouTube xx

Hi just wondered if either you or tess or anyone has heard from misssy?