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How high is to high

My Father's last labs showed that his ammonia levels were the highest they have ever been.  Last week they were 173, this week 234, while under a grueling Lactulose regimen it went up.  I have been told that he is at a very toxic level and could suffer irreversable damage, even coma.  His doc said that he suspected the begining of the end.
His doc is so calm and says to double the current Lactulose regimen.  I am confused and frustrated, but mostly frightened.
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