A 27-year-old man, JB, is rushed to the emergency room with symptoms of hypovolemic shock, including low blood pressure, rapid breathing, and unconsciousness. JB's condition is a result of decompensated cirrhosis caused by his long history of excessive drinking, which has led to liver failure. He consumes 3 liters of rum daily, and his body can no longer adapt to the liver damage.
JB's liver is completely unfunctional, leading to a buildup of bilirubin, a chemical that makes his skin and eyes turn brownish-yellow. His liver also fails to process ammonia, which causes hepatic encephalopathy, disrupting his brain function. Additionally, his liver's inability to synthesize blood clotting factors results in a bruise that won't heal.
JB's immediate treatment involves stopping the bleeding in his stomach and esophagus, which is caused by varices due to liver scarring. He requires a liver transplant to survive but faces a 70% mortality rate within three months due to the difficulty in finding a matching donor. With the help of social support and eventually receiving a liver transplant, JB is able to recover and live his life to the fullest.
The story is based on Ron "Pigpen" McKernan, a member of the Grateful Dead, who died of variceal hemorrhage in 1973.
Here are the key facts extracted from the text:
1. JB is a 27-year-old man who drinks 3 liters of rum every day.
2. JB's liver is completely unfunctional and scarred due to his excessive alcohol consumption.
3. JB is in hypovolemic shock, a drop in blood flow due to low blood volume.
4. JB has vomited more than 20% of his total body fluid.
5. JB is hyperventilating and breathing fast because his body doesn't have enough blood to deliver oxygen.
6. JB's heart rate is high because his heart is trying to compensate for the low blood pressure.
7. JB's body will begin to shut down and go into multi-organ failure if not treated immediately.
8. JB's liver is unable to process bilirubin, leading to a buildup of the chemical in his blood.
9. JB's skin and eyes have turned a brownish-yellow color due to the buildup of bilirubin.
10. JB's liver is no longer able to produce clotting factors, leading to uncontrolled bleeding.
11. JB has a bruise that never seemed to go away due to the lack of clotting factors.
12. JB's liver is unable to process ammonia, leading to a buildup of the chemical in his blood.
13. The buildup of ammonia in JB's blood is disrupting his brain function, leading to confusion, slurred speech, and stumbling.
14. JB's liver is unable to process blood clotting factors, leading to uncontrolled bleeding.
15. JB's stomach and esophagus are filling with blood due to the bursting of varices.
16. JB needs a liver transplant to survive.
17. The average waiting time for a liver transplant in the United States in 2016 was 149 days.
18. JB has a 70% mortality rate in three months if he does not receive a liver transplant.
19. JB's liver transplant was successful, and he was able to live his life to the fullest.
20. The story of JB is based on Ron "Pigpen" McKernan of the Grateful Dead, who died of variceal hemorrhage in 1973.
Note: Some of these facts may be repeated or rephrased, but I have tried to keep each fact concise and separate.