My brother is suffering from high ammonia levels from his cirrhosis

He has been unconscious for a week now. His body was really restless and they had to sedate him to stop his body from moving so much so they can medicate him. His ammonia level at the highest was 75. He also had esophogeal varicies, and was vomiting up blood. They put a shunt in his liver to stop the bleeding. So far that has helped to stop the bleeding and his ammonia level went down to 48. He is still unconscious, though, and on a respirator. He also has MRSA and is running a fever. They have him in isolation. They act like he may recover from this, but it looks pretty bad to me......
To make matters worse for me, my husband has cirrhosis too. He has seemed worse off than my brother, until this just happened with my brother last week. I told my husband we need to get his ammonia levels checked. He says his are "fine". I have been seeing confusion going on with him for a few months now, but not nearly to the degree that my brother has. I hope he doesn't have the same symptoms as my brother.... does it always end up like that? Is my brother going to recover????

[orphanedhawk]

We aren't doctors. I can't address your brother's problems.

If your husband has cirrhosis and encephalopathy which is caused from high ammonia levels, he should be taking lactulose. Of course, he should not drink alcohol, at all.
He needs to be on a low salt and no red meat diet.
But most of all, he needs to see a good hetalogist, a liver doctor.
These problems need a doctors attention, now.

[dianamcokc]

my husband stopped drinking 289 days ago. he very rarely eats red meat. he is a chicken/ pork type guy. he doesn't use much salt at all. I notice his confusion alot, but he rarely sees it. I try not to say much about it. he is in denial about it, about his whole illness, he admits he has it, but tries to hide some of the symptoms, even from his doctor... I try to tell her things right in front of him. we need to be truthful. She is a GP and he doesn't want to know details so he will only go to her as she has agreed to just try to keep him as comfortable as possible. He hates hearing what my bother is going thru because he has to face things he may have to go thru.

Thanks for answering me!

[HectorSF]

If your husband has cirrhosis he should be seeing a hepatologist at the transplant center. A GP is NOT qualified to treat him. Get a referral if you need one.

Both of them need to never ever eat red meat or pork. Chicken and fish only. No exceptions. When we say they should not have salt or sodium we mean zero salt added to food. No exceptions. He must avoid all high sodium processed foods including restaurant food. He needs to read the labels and keep his sodium intake below 1500 or 2000 mg per day. As his hepatologist will tell him. Your husband needs to stop manipulating others and come out of denial. Sticking his head in the sand will only make things worse and he will in time end up like your brother.

"Is my brother going to recover?"
Only the doctors treating your brother have an idea about his prognoses. How can we, who are not doctors, and have no medical data, know the status of your brother's health and if your brother is going to recover?

Get your husband to a transplant center ASAP were they have experienced doctors who work with cirrhotic patients every day. That will be the start of moving in the right direction. Delaying treatment and not facing up to reality when one has a life-threatening illness (End_stage Liver Disease) assuming your husband is as ill as your brother, is not a choice that someone who wants to live will make. In time only a liver transplant can save their lives.

Good luck to you.
Hector

[HectorSF]

As far as your brother being in a coma due to HE (hepatic encephalophy) it is not uncommon.  This can occur at the late stages of liver disease as the liver begins to fail more and more and is unable to clean the blood of toxins as it does in a healthy person.
Ammonia levels do not always correspond with HE. 75 is not that high. I have ammonia levels that high on a regular basis. Then again I'm sure many on this forum thinks that explains a lot. Vomiting blood due to varceal bleeding in also a common common complication of ESLD. The hospital preformed the TIPS procedure to lessen his portal hypertension which  caused your brother's varices to burst. Unfortunately when this procedure is done it can cause HE.
Because he was in the hospital it appears that he got an infection (MRSA ). For persons with ESLD any type of infection viral, bacterial or fungal can be life-threatening.

Anyone in ICU is not going to look good to us who are not used to seeing someone in critical condition. It can be quite frightening. Luckily modern medicine is able to work wonders due to the medical expertise and technology that is available now.

I hope your bother recovers and gets the treatment he needs to help minimize the complications of his liver disease and your husband too. I hope this is a wake up call to both men to take care of their condition before it is too late.

Good luck to you.
Hector

  

[orphanedhawk]

I was like your husband when I was first diagnosed. It was beyond me to think I could be so sick. Delaying treatment for a year, didn't help and I landed up getting a liver transplant.

Tell your husband that if he wants to keep living, he has to see a specialist, now! Otherwise, be sure his will is in order.

I'm not trying to be mean but sometimes tough love works!

[dianamcokc]

Today, they told us my brother will not make it. Tomorrow we will hear from his 3rd and last doctor about what his opinion is, but the other 2 say if they take him off the respirator he will die. We all already know in our family that none of us want to be kept alive by artificial means, but we do want one more professionals opinion.
My husband is taking it particularly bad because he has known about his condition for nearly 8 years longer than my brother.

Thanks for your responses!!!

[jerialice]

sorry to hear this- i lost my sister to a chronic illness that was not pretty and it's tough. if you can, go in the room and hold him and tell him you love him and forgive him- those words will serve you later when you look back whether he survives or not. You will feel lightened- or at least i did. And he will be given some peace in his soul after what sounds like a long hard life.
We are with you and your family. I hope your hubby will pull up and get help too.

[davidallen]

I see a gastroenterologist for hep c, and cirhosis, a vally fever doc for my valley faver. My liver enzymes are up and down like a basketball. 20 percent of cirrhosis turnes to cancer. Im stage 4. The injuuctions he can do hiself and just check his blood once a week. My numbers for hep 3 went from 5.5 million to 0 after 16 weeks of interferon and ribivarion. Sadly the same week i got vally fever so they stopped treatment for hep c and its back to 6.8 million. If I could have maintained the 0 undetectable level for 6 months I would have been given a SVR and only less than 10 % it wold come back. I pray he can get real and benifit from the better meds they now have to treat with less side effects. <3

[t56160]

Hi My brother is in the intensive care at the hospital,he startered bleeding thru the veins and they went in and tied them off and also some polyps. He hasent woken up either. He was diagonesed with cirr. of the liver 3 years ago and given 2 years to live, He had been doing well and even was having excellent blood work his liver had started to repair itself, untill he started sneaking drinking again and I talked to him about the drinking and he said he wanted to test his liver, I didnt know he was probly not thinking straight, when I got him to the hospital 4 days ago his amonia (ammonia) count was at 175. They keep saying he has a 50/50 chance, moves around tried to take the tube out of his mouth and they had to restrain him. I wonder how to they know if he is in a coma or just not waking up.? That is my question. It is so hard to take when everyday life seemed as if he was ok, so sudden looking back I know now the signs it is a hard disease to understand if you dont know alot about it, he was also being treated by a MD who was doing not much for him. I learned alot just reading these posts, but how do you convince someone who wont give up drinking he never got any therapy for the drinking and thought he could do it by himself. Anyone that has this needs treatment mentel health as well to understand why they drank and to accept that they cant drink again. I sure miss him as he has been living with me and I am hoping and praying he will come home. I just wish he would wake up. Prayers to all of you. One day at a time is how I can handle this.

[Bill1954]

Hi there, sorry to hear of your brother’s health issues. Rather than commenting on a thread that was started in 2011, you can open your own thread by clicking on the orange ‘post a question’ button near the top of the page. Include mention of cirrhosis in the subject line so others will see it and offer their thoughts. Good luck to you both,

--Bill