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elevated ammonia level

My Mother was diagnosed with evulated ammonia. She was in the hospital for 3 days when her mental status changed to the better.  The Er and Family Doctors do not know much about this.  Family doctor sent her home and told us to give her lactulose and for her to have 3 BM's a day to maintain clear thinking and being able to walk.  4 days later we are back to not being able to walk or think.  We don't know who to take her to or what should be done.  Once her levels go down then what? We are at a loss.  Is the treatment for the rest of her life is to have 3 BM's a day and all will be fine? I've read several things on the net and am worried about a bleed and who knows what.  Mom just seems to sleep and have the runs which concerns me for dehydration. Please help and thanks for any help
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87972 tn?1322661239
Lynnie--

By all means, admit her to ER if you seem to think she needs immediate medical support. I didn
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Avatar universal
Hi Bill and thank you for your response and help.  Mom is 79 and was diagnosed with Hepatitis C following treatment for TB after her skin test was positive and chest x-ray was negative.  She worked for the state who said since she worked with kids they had to treat the TB even though she was a carrier and did not have TB.  She is from Germany and was immunized before coming to the USA for TB.  Now we have Hepatitis C to cirrhosis to hepatic encephalopathy and are lost! We did not get a referral and was told to go home, have 3 BM's a day, the end, have a nice day.  This was in Charleston, SC where my parents have lived for 43 years.  I live in Macon Ga and was in Charleston for two weeks while Mom was in the hospital and then home.  She seemed to be doing better so I went home to Macon to my husband and child who is still in school.  Dad tried to care for her but she only got worse.  He put her in the car with the help of friends and came to Macon.  We do not know if it takes a day,hour or months to recover from the evaluated ammonia level or what to expect after we came home from the hospital.  When she first got the "C" diagnoses several years ago I took her to the GI doctor who told me her liver was not bad and would out live her. She does not and never drank.  I hope this will help you to help us.  Thank you for your concern I will look forward to a response.
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87972 tn?1322661239
Goodness, judging from what you are telling me, she probably needs to be evaluated by a transplant center for TP consideration. I would *insist* on an immediate referral to a gastroenterologist or better yet a hepatologist from your primary care physician. They are the ones to make these decisions; primary care doctors generally know very little about this disease. The GI or hepatologist will then generate a referral if necessary to a transplant center. I
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Avatar universal
Hi Bill and thank you so much for your answers and time.  I can not begin to find the words to tell you how much it means to have someone who knows something, anything about this to be a soundboard if nothing else.  At least I'm getting a response from you and your building my confidence showing me that I'm not being stupid for being alarmed about this.  If this were anyone other than "Mommy" I might could even be a little logical about the whole thing.  If I felt she was getting better or making steps forward I would feel so much better but I think she is maybe even getting worse.  My father and I got her up for dinner tonight and she ate and spoke some but was dead pan faced most of the time.  I told my father that instead of taking her to a new doctor's apt here in Macon I might just call an ambulance and just have her admitted.  In the long run it would be easier on her.  The problem is she has also lost her vision from AMD and is now legally blind in both eyes so my father stays with her during the day and I stay with her all night.  I also try to do as much of the day as I can since Dad in no young chicken (76)and has had two open heart surgeries himself.  I don't think a transplant would even be attempted with her age of 79 and with her eyes and all.  I do know you are right I don't have the answers and I don't know what trees I'll have to shake to find someone who will but I think I'll just have to start shaking which is why I sent the first e-mail out.  Thank you for your words they have helped more than you know.  I would still like to know how long does it take for the ammonia to go out of someone's system and what is the progress one makes?  I saw on another person they said it took two weeks. Mom did so much better when she got home from the hospital.  I had so much hope for her and Dad.  So did Dad he said this was going to be another chance of life for them.  I'll keep you posted and would be really thankful for any information from anyone.
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87972 tn?1322661239
Hi Lynnie,

And welcome to the forum--I wish it was under different circumstances. Please remember that most of us here are Hepatitis C patients with no doctors on board. With that said, has your mom been diagnosed with viral hepatitis any other form of liver disease? Elevated ammonia and hepatic encephelopathy can be signs of late stage cirrhosis and should be taken quite seriously. Has your family doctor discussed a referral to a specialist such as a gastroenterologist or hepatologist? The Lactalose might help reduce the ammonia in her blood, but will not cure the cause of her problems. Can you tell us more about your Mom? Does/has she drank heavily in the past? How old? A little more info would be very helpful. Also, what part of Georgia are you in? Some members here might be near you, and offer some ideas. Let us know what you find out,

Bill
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