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Posted 4/14/2012 9:39 PM (GMT 0)

Mu husband suffers with hepc genotype 1 and cirrhosis. His ammonia levels have been treated Xifarin. Recenty they added lactose (krisotalase powder form). He was taking 20 mg twice a day. Recenty they increased it to 4 packs a day. He suffers significant abdominal pain and vomiting with 6-7 soft stools per day, carrot col red. He is in the hospital and had a cat scan of the admonal area. kidneys were clear, valves open, no liquid build-up but still can not manage the pain. He has no appetite, sitters with severe headaches, but has a MELD score of 9 which is ver good. He was hospitalised this past February with advanced hepatic encepholaphathy. I am beside myself watching him suffer. Delusions, short term memory loss, can no longer drive or work. Has anyone ever overdosed on lactulose? They claim his pain is from the adominal wall and have out him on a 12-hour pain patch. Amy advice would be appreciated. They also have hin on oxygen tha k you. He is 61 years old.
Posted 4/14/2012 10:32 PM (GMT 0)
Hello, dcowley, and welcome to the forum. From what you described, your husband has end-stage liver disease caused by hep C. Has he ever received treatment for the hep C?

In answer to your question, nobody can overdose on Lactulose. Usually, a person is prescribed Lactulose and if that isn't working well enough, then Xifaxan is added, not the other way around. The abdominal pain he experiences may be from cramping. At this point, the nurses and doctor have to see if his dosage of meds is sufficient. If not, the Lactulose may be increased. Has there been any talk of a transplant? Is he in a hospital with a transplant center?

Hugs,
Connie
Posted 4/15/2012 1:02 AM (GMT 0)
Hi DC,

Welcome to the forum. We are a group of patients and caregivers in various stages of liver disease.

Many are too ill for transplantation or have decided against that route for their illness.

Some are alcoholics who are not interested in getting sober. Some are in varous stages of transplant preparation and some have had transplants.

Our members are dealing with several causes of their liver disease from autoimmune disorders, poisoning, alcoholism, and Hep C.

My partner has Hep C 1a, failed treatement in 2003. He is a recovering alcoholic with 18 months of sobriety. AND he had hepto cellular carcinoma. He will be one year post transplant May 1st! A year he got back from a death sentence!

He is about the same age as your husband as was every bit as ill.

There is help, you have to stay alive in order to get it. It is will over the horrible symptoms!

Post often, ask questions, we are here for you.

Hugs,

Carol
Posted 4/15/2012 5:52 AM (GMT 0)
Dcowley,

  My hubby has ESLD and has choosen not to be evaluated for a transplant.  Currently he is in a nursing home.  He, like your hubby, has very bad pain in his stomach (on the left side...one opposite the liver).  He is on a fentenyal patch for the pain.  His Dr. explained to him that his spleen is enlarged which causes the pain, and that happens because the blood can't get through the liver very well because of all the scar tissue (cirrhosis), which causes the blood to back up into the spleen, enlarging it and causing the pain. 

 

   In the past he has had stomach pain as a result of an infection, but this is different.  Don't know if your hubby's pain is from the same thing or not.  This is a painful disease to have and do hope the pain level decreases for your hubby.

So so sorry that he is ill and I understand your frustration as you search for ways to help him.  My hubby has HE pretty badly somedays.  It pretty much centers around whether he has been able to have 3 BMs a day.  If he has, he mostly makes sense.  If not, his cognitive and memory abilities are very compromised.  He obviously does not work or drive.  Usually he can't use a microwave, radio, tv etc.  he needs help as he can't remember how they work.

We were told he can not overdose on lactalose, so when he was home (10 months of being really sick with ESLD) with me, I upped the lactalose so he could do at least 3 BMs a day.  (doesn't sound like a problem for your hubby.)  Mine also is sick to his stomach sometimes and seems like he hardly eats anything (I give him Boost often, per his Dr....also milk shakes as they help with the BMs).

I find the calmer I am, the better he does.  At first I thought I had to correct him or "help" him get the facts straight...but he can't recall what he said in the last sentence.  So instead of facts, I try to focus on how the conversation makes him "feel".  [I long ago quit trying to tell, No, that is not what the Dr. said.]  Now, I just use a lot of 'maybe", "we'll see" and "could be".    For my own sanity, I had to learn to just say no to some of his requests.  Everyday, he had a list of things for me to do or get (for the last 4 months...everyday).  Now, sometimes, I just say "No, I can't do that today."  [Example:  "Get me pickles", "Get me little chocolate bars"  "Get me more photos but have them enlarged" "Get me some exotic birds" "Get me some orchids" I want to take a trip" "I want to visit my family in Mexico"  "I want you to read to me"...on and on it goes.  And I have to work, and care for 23 horses, 7 cats, a dog, etc, so in order to stay sane, now I just sometimes say No I'm too tired (True).

I am curious as to why they are giving your hubby oxygen.  Does he have COPD?  Asthma?  Do you think the oxygen helps with the HE?

Welcome aboard this forum.  The folks on here are really helpful.  Post often.  We care.

Angie1953

Posted 4/17/2012 2:02 PM (GMT 0)
Thank you friends. my husband has had 4 failed interferon,riboviran treatments, the most recent this past Janiarywith the new drug victrilis. His dr. Stiopped the treatment atweeke five, right before he was to start the victrilis. He has contracted hospital based pneumonia and that's why he is on oxyge, He may have adema in the lungs so another chest x-ray this morning. He was having 2-3 bowell movements per day on one dose of kristolase (powder form of lectolose) and then he started vomiting and experiencing severe abdominal pain. He has been in the hospital for9 days now.
Posted 4/17/2012 2:48 PM (GMT 0)
Dcowley,
So so sorry he is so sick. Hope the pneumonia clears up soon. Thinking of you and your husband through these rough times
Angie1953
Posted 4/17/2012 7:43 PM (GMT 0)
DC

So sorry to hear hubby is still in the hospital.  That is where he needs to be.  Mike had 5 hospitalizations between the time he was diagnosed with ESLD and his transplant.

They had to fix this and that along the way...one episode with sepsis (EColi in blood), twice for acute pancreatitis, and the others for acute kidney failure and hyponutremia (or hyper...I get mixed up...something about the sodium). 

We thought each time we'd lose him, but he soldiered back to us after the pumped him full of albumin or platelets or frozen plazma or vancomycin and flagyl, etc etc.  They'd get him back on his feet and send him home.  They threatened to start dialysis, but he rallied and that was not necessary.

I never thought he'd make it to transplant, especially with how bad his ammonia got...he was a loon for most of a year.  His "best" times were in the hospital because they had all those labs and drips...tweak this a little, tweak, that a little. Drain this or that.   At home you go weeks between tests and adjustments to meds.   In hospital they could change regimes several times a day!

By the time of his transplant he looked really bad.  If he had not been transplanted, and then with his tumor, he would not be with us this past year.

I hope Oscar has a good outcome too.

Hugs,

Carol

Posted 4/17/2012 8:13 PM (GMT 0)
I thought that the protease inhibitor was given the first 12 weeks, along with interferon and ribavirin, and then the 3rd drug was stopped while the two others continued on for a full 24 weeks. Or does it depend on the particular 3rd drug?

Hugs,
Connie
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