In the early 90’s my wife was diagnosed with diabetes and told she also had a fatty liver.  They said the fatty liver was common and mostly benign but it would be good to lose a little weight.  She had a hard time controlling her diabetes and a few years later her legs got big so they gave her water pills.  After a while she got an irregular heartbeat so she got a pill for that and her blood pressure was getting quite high so she got a pill for that.  Her left foot got very painful from the diabetes and we were afraid she might lose it but some meds helped that but walking was hard.  In 2005 she started bleeding from her throat.  The EMT’s took her straight to ICU and 4 units of blood saved her but they said she could easily have died.  They said she had esophageal varices and wondered why they hadn’t been banded.  We had no idea as no one ever told us.  More testing and she has NASH and cirrhosis.  They say stage 4 but that didn’t mean much to us.  Over the next year she had 7 varices banded and had a lot of pain,  She also developed ascites and they drew 7 liters of fluid from her belly.  In some ways this was the easy time.  Her liver got worse and they put in a TIPS shunt to ease pressure on her liver but that led to ammonia in her blood and hepatic encephalopathy.  It made her a crazy, mean, angry person.  Not at all the woman I’d loved all these years.  They gave her lactulose to control it and it did help some but it gave her frequent diarrhea.  It got bad from there. One day near our anniversary she was pretty good and wanted to go out and celebrate our marriage.  We went to her favorite place, she managed with a walker.  It was a tender moment but she became distressed and had to leave.  She had an attack of uncontrollable diarrhea. She wore an adult diaper but it failed and she left a trail of excrement on the floor as she tried to get out. She never left the house again except by ambulance.  She lasted another year but it was a time of great pain and she spent her last two months in ICU with tubes everywhere.  No one should have to go through that.