Here is a concise summary of the provided text:
**Case Overview**
* JB, a 27-year-old musician, presents to the emergency room with hematemesis (vomiting blood) after years of excessive alcohol consumption (3 liters of rum daily since age 13).
* His condition is critical, with hypovolemic shock, a blood pressure of 62/40 mmHg, and imminent risk of multi-organ failure.
**Medical Condition**
* Decompensated cirrhosis: liver failure due to prolonged alcohol abuse, leading to:
+ Bilirubin buildup, causing brownish-yellow skin and eyes
+ Hepatic encephalopathy (brain disorder) due to ammonia accumulation
+ Variceal hemorrhage (stomach/esophagus bleeding) from blocked blood flow
**Treatment and Prognosis**
* Immediate treatment: blood transfusion, rubber band ligation, and medications to stop bleeding and reduce blood flow
* Long-term solution: liver transplantation (without which, mortality rate is 70% within 3 months)
* Challenge: finding a matching donor, with average wait times exceeding 3 months
**Outcome and Lesson**
* JB receives a liver transplant after some time and recovers with social support
* Cautionary tale highlighting the dangers of excessive alcohol consumption, emphasizing the importance of human support in overcoming alcoholism.
Here are the key facts extracted from the text, each with a number and in short sentences, excluding opinions:
**Patient's Profile**
1. JB is a 27-year-old man.
2. He has a younger sister named Kristin.
3. JB was part of a band called "Mother McCree's Uptown Jug Champions".
**Medical History & Condition**
4. JB started consuming alcohol at age 13, introduced by his father.
5. He gradually increased his alcohol intake to 3 liters of rum per day.
6. JB presented to the emergency room with hematemesis (vomiting blood).
7. He experienced hypovolemic shock due to low blood volume.
8. JB's liver is completely non-functional and scarred (decompensated cirrhosis).
9. He has hepatic encephalopathy, a brain disorder due to liver failure.
10. JB's skin and eyes turned brownish-yellow due to unprocessed bilirubin.
**Physiological Effects**
11. Red blood cells live for approximately 120 days before being destroyed in the spleen.
12. The liver breaks down red blood cell remnants, producing bilirubin.
13. Normally, bilirubin combines with bile from the gallbladder for digestion.
14. Ammonia, a byproduct of protein digestion, is usually processed by the liver.
15. In liver failure, ammonia builds up in the blood, affecting brain function.
**Treatment & Prognosis**
16. Immediate treatment for JB included stopping the bleed, blood transfusion, and decreasing blood flow to abdominal organs.
17. Temporary solutions for JB's condition included rubber band ligation, octreotide infusion, and a transjugular intrahepatic portosystemic shunt.
18. Without liver transplantation, JB had a 70% mortality rate within three months.
19. The average waiting time for a donor organ in the US was 149 days (as of 2016).
**Outcome & Additional Facts**
20. An organ donor was eventually found for JB, and he received a successful transplant.
21. The story is loosely based on Ron "Pigpen" McKernan of the Grateful Dead, who died from variceal hemorrhage in 1973.