Brain liver disease

[songofsongs]

Does anyone know exactly what the change in behaviors that happens with this disease look like?  This person has had Hep C for 30-35 years and was told approximately 4 yrs. ago that he has brain liver disease which from what I understand is that the liver no longer processes ammonia and other chemicals like it should. There are several signs that have progressed, but within the last year, he seems to have had a total change in personality.  As I have researched this topic, I have only read that there are changes in personality, but I need to know how this progresses and if anyone has any info, I would greatly appreciate it.  He was placed on some liquid meds for this, but now does now want to take it.  

[songofsongs]

Thanks for the comments.   He has tried treatment for Hep C twice and neither time was able to finish.   His liver has become more coarse over the last 4 years.   He does not drink and has not for over 13 years now.   However, his muscles have deteriorated, his coloring is very pale, and he sleeps a lot during the day.   He does withdraw and seems to be somewhat depressed.  His personality is totally different, and he becomes angry about little things.   He does not like taking Lactulose, and feels that it does not make any difference.

One of the symptoms of this disease is the sweet, musty odor that he gets quite frequently.   He does not want a liver transplant as an option, so I really don't know how this disease will  progress.   In January, he decided to go on a 40 day fast.  He was on it for 21 days, then stopped.   After feeling like he had gained some weight, he went back on for another 10 days.   Since that time, he eats very little, makes himself walk atleast 1.5 to 2 hrs. per day and his caloric intent is probably less than 1000 calories.

Thanks for your help.

[evangelin]

I can tell you what changes I saw in my husband as he became cirrhotic.  He was exhausted all the time, no matter how much he slept.  He became irritable and could get really angry over trivial stuff that never bothered him before.  He also withdrew from those closest to him.  He lost most of his muscular shoulders and arms gradually but noticably.  His face looked very pale.  
That was 6 years ago.  He was not successful with treatment but has improved a lot with supplements.  He takes Lactulose which I'm assuming is the medication you described above.  Lactulose is good although it causes you to have to visit the bathroom more often.   If your friend won't take that, he probably wouldn't take all the supplements that my husband takes either.  We had a new baby when Joe got sick which I think gave him more motivation to fight for his health.  That being said, I had to pretty much bring each dose of whatever to his mouth with something to drink.  I made it as easy as I could for him.  

You didn't say anything about whether of not your friend has tried treatment or not. Has your friend been back to the Dr.?  These are important particulars to know in giving you advice.  

If you could persuade him to take the Lactulose, he could probably be able to think more clearly to make good decisions.  I can remember back when Joe was sick, when you asked him a question, he would have a very long pause before answering...to the point of you thinking he didn't hear you.  He would also kind of hold his forehead a lot , like someone with a bad headache.  He did not seem in touch with how different he'd become.  Our family was all walking on eggshells, trying not to irritate him but it was impossible not to.  It is quite unsettling to see someone change so much.  

He is pretty much back to normal most days .  He gets a little cranky now and then and sometimes needs an afternoon nap, but it is much ,much better.  We had to do some big dietary changes and take lots of the right supplements to see this turnaround and I can't know if it would work for your friend or not.  Alcohol makes things much worse and we had one advantage in the fact that Joe didn't drink. I don't know if this is a factor with your friend.  

A good Dr. could help immensely.  Some are better than others.  If your friend is very far along with cirrhosis, he might be a candidate for a liver transplant.  Lots of people do very well with that procedure.  You also never mentioned a biopsy.  Was he biopsied 4 years ago?

Well, I don't know if I've been helpful but I hope so.  Some people seem to have more to report on personality changes than others.  There is a lot of variance with Hep C and cirrhosis but a well informed Dr. is really important, no matter.
Best Wishes,
Ev