someone help please

[susy50]

This is susy daughter my mother is still in hospital as she said before her treatment had to be cancelled ,she is now very confused she has delirium and she does not recognize any of us -THIS IS VERY DIFFICULT she has come in and out of it but not much ,she was delirios on saturday just repeating her self shaking and having small seizures this is scary ,CAN SOMEONE TELL ME what is going on doc says from liver disease cause all other test are negative ,Does this go away and how often can it return ,is this the end of liver failure or how close is it ? any help would be great

[HectorSF]

Unfortunately this complication of End-Stage Liver Disease is quite frightening to someone who has to see their loved one in this condition. As their mental state and behavior can be quite scary. If you learn more about End-Stage Liver Disease it will be less frightening because this is a common occurrence in patients with very advanced liver disease.

As was said your mother is experiencing hepatic encephalopathy. This is a common complication of End-Stage Liver Disease. Since your mothers liver is not functioning well it is unable to clear toxins from the blood stream.

This is one of the liver's functions. When we process food in our gut ammonia and other toxins are created. Normally these toxins are removed as the nutrients pass from the gut and through the liver. Since your mother's liver is so damaged it is unable to perform this as a normal healthy liver would. Since this is such a common complication of ESLD they should be able to stabilize her within a few days. The hospital will probably be giving her lactulose enemas to clean out her gut. This should reduce the toxins and she will return to her old self.

There are many other complications that your mother may also experience before she gets a transplant. They are:

* Ascites - fluid retention in the abdomen that makes both woman and men look like the are pregnant.
* Bleeding varices - This happens when small veins burst due to high blood pressure and the patient either vomits blood or defecates blood.
* Hepatic Encephalopathy - The onset often is insidious and is characterized by subtle and sometimes intermittent changes in memory, personality, concentration, and reaction times. In its final stages the patient may become unresponsive or be comatose.

All three of these complications can be life threatening! Someone who either lives with your mother or sees her on a regular basis should be aware of these complications and know that they may need urgent treatment. Contact the transplant center and go directly to the ER.

Unfortunately in the case of Hepatic Encephalopathy your mother may notice nothing usual when she is behaving in a strange way. She probably won't remember a lot of what has happened in the hospital either.

You ask when can this happen. Really anytime. But their are medicines she can take that will help minimize the symptoms and manage this complication. Also she should no longer eat red meat as it is hard to digest and creates many toxins that will go to her brain. The transplant center will tell her all this. The most important thing is that she needs someone to keep an eye on her from time to time as if she continues to have episodes of Hepatic Encephalopathy she could go into a coma and be unable to help herself.

There are 4stages of  hepatic encephalopathy:

stage I: sleep disturbances, restlessness, mood fluctuations, talkativeness, impaired attention/concentration, often slight finger tremor, worsening of handwriting or loss of other small hand movements

stage II: flapping tremor called "asterixis"), ataxia, changes in reflexes (usually diminution), dysarthria

stage III: increased impairment of consciousness,aggressive behaviour, monotonous voice, Slurred speech, increased reflexes, clonic spasm,pyramidal symptoms, increased muscle tone

stage IV: coma.


"Is this the end of liver failure or how close is it ?"

There is no saying how sick she is. Only her doctor knows for sure.
I have had End-Stage Liver Disease for 2 1/2 years now and I am still able to have a decent life. I am disabled but I can still do certain things on my good days. Each person is unique as far as the particular symptoms, complications and how severe they are.

The best this you can do from your mother is to support her and help her get through this difficult time until transplant and then after transplant she will need even more help. Also it helps if you have a basic understanding of liver disease and liver failure so you will understand what is happening to your mother and realize everyone waiting for a transplant is going through own ordeal also. A fatal condition such as End-Stage Liver Disease is a very scary thing and it is a roller coaster ride of emotions as your mother faces her own morality. We all struggle with it every day.

Your mother's transplant center should have written information so you can learn about liver disease and transplantation.

Here is a link for Nurse Practitioners but I think the layman can understand, about how to caring for a person with End-Stage Liver Disease.
http://www.nursingcenter.com/pdf.asp?AID=802972

Here is a good site to learn about liver disease and liver transplantation.
http://www.cpmc.org/advanced/liver/patients/topics/default.html

Best of luck to you and your mother!

Hector

[Bill1954]

Thanks, oneoftheclub. I have a dial-up connection and it takes forever sometimes to open pages and look at background.

Susy50’s daughter;

I looked at some of your mom’s history and it appears she’s struggling with cirrhosis of the liver. I agree with SusieS2010’s comment; it’s impossible for anyone in here to guess how ill your mom really is. Ask the doctors at the hospital how she’s doing; they have her charts and will be in a better position to explain this to you.

My very best to you and your mom,

--Bill  

[Ironpony]

Bill, susy is a friend of mine on here..she was about to do her 5th week but was hospitalized because her sodium and pottasium levels tanked. (Life threatening levels.) She got her 4 wk UND result only to be taken off tx due to levels:( she is end stage if that helps. in her first wk she did turn jaundice and they have been fighting for weeks to get her levels up.

Susy's daughter: I wish I had an answer, at this point hopefully the doctors can shed some light on it for you. I'm sure other members will chime in who are familar with end stage liver disease.
I'm so sorry this is happening, I wish u and your mother the best.
Laura

[1oftheclub222]

http://www.medhelp.org/personal_pages/user/2024274

Susy posted about a week and a half ago, she had to quit treatment and was admitted to the hospital...I think this is Susy's daughter

[SusieS2010]

I'm sorry you have to watch this happening to your mom. When the liver is severly scarred ammonia builds up in the body and goes to the brain. This causes something called hepatic encephalopathy. And that causes the confusion, sleepiness and possibly seizures. It can often be controlled through diet and medication.

No one can tell you how close your mom is to her liver failing completely. Has anyone suggested that she be evaluated for a liver transplant?

Again, I am sorry. Your family is in my prayers.

[Bill1954]

What is the state of your daughter’s liver;

Should have read, "What is the state of your mother’s liver;

[Bill1954]

What is the state of your daughter’s liver; was she previously diagnosed with cirrhosis? You aren’t providing much background on her.

Why did they cancel her HCV treatment?

Please tell us more, and good luck-

--Bill