Family faces the most unexpected challenge Alcohol not the only cause of cirrhosis
Don’t spend what you don’t have, Cancer
Dear Amy: I married my husband three years ago. We’re in our early 40s. His younger sister has two children, 8 and 2, who were in a very bad situation, which ultimately led to them being sent to live with my in-laws two states away.
My husband and I are child-free by choice and have, frankly, no desire to raise a family not our own.
This is causing anxiety and stress, but we are unified knowing that we might need to step in when his parents can no longer handle things.
I’m struggling to reconcile my selfish feelings of not wanting a family, and taking on the family of someone who was irresponsible.
None of us want this, but foster care isn’t an option. I don’t know what to do with any of this. — Reluctant
Dear Reluctant: I applaud your realization that you will make a choice to benefit these children. Family members who pick up the pieces and raise innocent children caught in the crossfire of family dysfunction or crisis are unsung heroes to a generation of children.
I hope you will start the process to make them your own. You should take this in stages, starting as soon as possible. Getting to know the children when they are young will help all of you make a transition toward living together.
You and the grandparents could start by sharing parenting duties. Even if you are the primary parents, the grandparents could be enormously helpful, possibly giving you and your husband opportunities to travel a bit.
Yes, this is NOT what you had planned for. Yes, you are angry, and yes, you will mourn the radical shift in your plans. But this is what life is about. Illness, job loss, random acts of violence or kindness will turn many of our lives upside down.
A professional counselor could help both of you to come to terms with this, and arrive at an action plan.
Dear Dr. Roach: I am a 78-year-old woman who was diagnosed a year ago with primary biliary cirrhosis, which is an autoimmune liver disease. I had no symptoms other than high liver enzymes from time to time.
When I mention this disease, my friends look at me with jaws dropped open and say they never knew I was a heavy drinker. I have never been a drinker. Perhaps you might explain to your readers that not all people with liver cirrhosis are alcoholics. — J.V.W.
Cirrhosis of the liver is the end stage of many different illnesses, all of which cause progressive destruction of the liver cells and cause fibrosis — a thickening or scarring — of the liver. Alcoholic liver disease is the single most common cause of cirrhosis referred for liver transplant, which may be why people tend to think of alcohol as the cause of all cirrhosis. The second leading cause is hepatitis C, a viral disease that is now curable. The third cause is non-alcoholic fatty liver disease, as the liver can be damaged from metabolic changes that occur in obesity, especially in people who have abnormally high blood sugar. Alcohol, in reality, accounts for a minority of people with cirrhosis.
Primary biliary cholangitis is, as you said, an autoimmune disease of the bile ducts of the liver. Most people have no symptoms early on. If people do have symptoms, they’re likely to be nonspecific symptoms like tiredness. Itching can be a clue to the involvement of the liver. Blood testing usually shows elevations of common liver tests, especially the alkaline phosphatase. A specific blood test, antimitochondrial antibodies, makes the diagnosis likely, though a liver biopsy is sometimes done to be sure.
Making the diagnosis early is important, since treatment with ursodeoxycholic acid (Actigall) has been shown to reduce the likelihood of death or transplant in some, but not all, studies.
Today’s Birthday: Creative projects grow this year. Disciplined actions win your heart’s dream.
Virgo (Aug. 23-Sept. 22) (7) Peace and quiet soothes and restores. Keep confidences and secrets. Work behind closed doors to get productive.
Libra (Sept. 23-Oct. 22) (8) Social events bring interesting opportunities. Enjoy parties, meetings and gatherings.
Scorpio (Oct. 23-Nov. 21) (8) Take advantage of a professional opportunity. A lucky break presents itself. Intuition shows the way.
Sagittarius (Nov. 22-Dec. 21) (7) An exploration calls to you. Stick to reliable routes. Learn from elders without being inhibited by past worries.
Capricorn (Dec. 22-Jan. 19) (7) Revise the family budget to suit current circumstances. Learn from experience. Prioritize savings.
Aquarius (Jan. 20-Feb. 18) (8) Collaborate for shared gain. Clarify misunderstandings immediately. Push, but gently. Ask for what you want.
Pisces (Feb. 19-March 20) (8) Make a beneficial connection. Physical efforts provide satisfying results. Strengthen your heart by getting your blood pumping.
Aries (March 21-April 19) (7) An obstacle lies between you and a romantic objective. Avoid gossip or rumors. Keep an open mind, and stay flexible with changes. .
Taurus (April 20-May 20) (7) A domestic matter has your attention. Slow to avoid accidents. Family communication works out a mess.
Gemini (May 21-June 20) (7) Ask probing questions and gather valuable information. Facts don’t support a prior assumption.
Cancer (June 21-July 22) (8) Potential income appears. Follow a hunch or brilliant idea. Find new inspiration in an old dream. Don’t spend more than you have.
Leo (July 23-Aug. 22) (9) As you grow stronger more options appear. Talk your way through surprising circumstances. Rely on trusted allies.