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Mental Status Test to monitor for encephalopathy (scale of 1 to 10)

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Posted 9/24/2012 9:44 PM (GMT 0)
Hello everybody!
Can anyone help me on how i can get a mental status test in order to monitor for encepalopathy ?
Thank you!
Posted 9/24/2012 9:56 PM (GMT 0)
Antonis, as far as hepatic encephalopathy (HE) goes, an ammonia test will determine if one has that, and also a doctor can determine if behavior is "off," such as confusion, personality disorder, etc. Do you have liver disease?

Hugs,
Connie
Posted 9/24/2012 10:12 PM (GMT 0)
Thank you very much!
Diagnosed with autoimmune hepatitis since 2001. 'm 29 y.o.
From 2004-lately everything was under control (or i thought so because ihadn't any symptons nor exams).
but 3 weeks ago ''the beast in me'' woke up. Resuts allreaddy better. I had ascites that was gone fast enough within 15 days of Lasix treatment.
Prednisolone 30mg and Calcioral.
Sorry about my English,i'm Greek.

Post Edited (antonis.marky) : 9/24/2012 4:15:35 PM (GMT-6)

Posted 9/24/2012 10:39 PM (GMT 0)
One of our posters told me if she could play her piano she was okay for that day.
Posted 9/24/2012 11:16 PM (GMT 0)
I could tell by tying my shoes. If it took more than a few seconds, it was time to down a second dose of lactulose. If things didn't clear up within an hour, it was time for a third dose...
Posted 9/24/2012 11:31 PM (GMT 0)
My co-moderator, Dany, has AIH and is doing well. If you know when you are not feeling your usual, you can take extra doses of Lactulose, as David mentioned.

Hugs,
Connie
Posted 9/25/2012 4:30 AM (GMT 0)
My hepatologist has told me anything about lactulose or HE, do you think I should ask him? Thank you for all your support, it's nice to know that I'm not alone. Recently I also heard about Liv.52, do you think it's a good ideas to use it? I currently take 30 mg. of prednisone and Calsioral._
Posted 9/25/2012 5:58 AM (GMT 0)
Yes, you should describe your symptoms and concerns to your doctor and ask if an ammonia test (blood test) could be done to see if it's HE.

I've never heard of Liv.52, but in general hepatologists do not want patients on herbal or over-the-counter (OTC) remedies, with the exception of milk thistle (though that hasn't been proven to be helpful.)

Hugs,
Connie
Posted 9/25/2012 10:12 PM (GMT 0)

If you think you are having HE issues, definitely ask about having your ammonia checked.  How long have you been on 30mg of pred?  If it's been awhile, that could cause cognitive issues as well as temperament problems.  Has your doctor discussed putting you on an immunosuppressant?  They are "steroid-sparing" medications and can help you get off the pred.  You should also speak to your doc about having a baseline bone density test as the pred thins bone.  As well as asking about taking a multi-vitamin.  Some say don't take one with iron but ask your doc.  I take one with iron and an iron supplement as I usually have low hemoglobin...and I don't have cirrhosis which may also be a reason why some people are told not to take additional iron.

I wouldn't try the Liv 52...it's herbal and generally frowned upon as it generally isn't known how those affect someone with a liver disorder...it's one thing if it doesn't adversely affect a "normal" person but they aren't worried about their livers :-)   

Posted 9/25/2012 11:17 PM (GMT 0)
Dany, the iron issue is rather confusing to me. I was told no iron before transplant, when my liver was so messed up with hep C, cirrhosis, and liver cancer. However, now that I have a new, pristine liver, I'm still being told no iron, even though I'm a little anemic. I think I'll question this the new time I see my transplant coordinator.

Thanks for the info you gave to antonis!

Hugs,
Connie
Posted 9/26/2012 11:49 AM (GMT 0)
I'm taking 30 mg pred last 3 weeks only as i had a flair-up. Today it was reduced to 25mg and i will keep up reducing the dose every some weeks if exams are better. Allready talked with my doctor and he said that i have no HE issues so i better not worry about it yet. Apart from pred i also take Calcioral(for my bones).
Thanks for the advice & sorry about my English.
Kind regards
Togethet we stand,devided we fall...
Posted 9/26/2012 4:07 PM (GMT 0)
Antonis , Your English seems to be just fine and good to see your able to reduce the meds . Feel fortunate about no signs of HE .


A. Ziffel
Posted 9/26/2012 4:28 PM (GMT 0)
Did he mention anything about going on an immunosuppressant like azathioprine, CellCept or 6-MP?

Posted 9/26/2012 6:01 PM (GMT 0)
Yes I will start with Azathioprine soon enough in order to reduce Prednisolone. Both of them(years ago in another flair up I was taking both) don't give me side-effects as described by others - I guess I'm lucky in that stage.... Thanks alot it feels real good to have you, gives me a lot of power not having the " I'm all alone with that illness" feeling. My family is also a great help but I think it I'd better to share your feelings with people that deal with it for real. Hugs from Greece! Keep strong!
Posted 9/26/2012 6:10 PM (GMT 0)
That's why we're here! It's great to have family and friends to support you but it's definitely better to talk to people who really do understand and have been there :)
Posted 9/26/2012 9:07 PM (GMT 0)
Antonis, your English is fine. And I love Greek food!

Hugs,
Connie
Posted 9/26/2012 9:46 PM (GMT 0)
Greek food is one of my faves!  Greece has always been on my list of places to get to before I kick the bucket.  I grew up in Montreal and had some very close Greek high school friends.  Montreal still has the best Greek food out of all the cities I've lived in :o)  

Posted 9/27/2012 12:16 AM (GMT 0)
Antonis,
Your English is better than many people on here.
Posted 9/27/2012 5:20 AM (GMT 0)
Thank you are so kind. Since we are talking about Greece please allow me to introduce you to my Greek paradise www.mikrobeachhotel.com. This is my family's hotel & the place where I find peace & relaxation. If you ever decide to come in Greece you are all more than welcomed.
Posted 9/27/2012 7:22 PM (GMT 0)
Gorgeous Antonis!  Or should I say όμορφο?
Posted 9/27/2012 8:55 PM (GMT 0)
Haha! Όμορφο is ok with me! Seems like somebody had holidays in Greece or is it something more (Greek roots or something)?
Posted 9/27/2012 9:17 PM (GMT 0)
Also I would like to ask something more. As j already said I have AIH so my diet is strictly non salty with low amount of animal protein, no sugar and I should also avoid fat. I eat a lot of vegetables, beans etc and spaghetti,rice & potatoes with my meat or fish. Any further advice?
Posted 9/27/2012 10:57 PM (GMT 0)
Mikro looks beautiful!  I would definitely find peace and relaxation there!  I live near the ocean but it's the popular coastline of southern California!  Not so secluded smilewinkgrin

As per diet, I haven't really changed much.  You do need to make sure you are healthy enough and avoid fatty liver disease.  Lower salt diet is best for anyone and fluid retention that can happen with any liver disease is better off with a lower salt diet.  You still need protein so don't limit too much.  Just avoid red meat...as much as possible.  Again, since I don't have cirrhosis, I wasn't put on any restrictions...but I don't eat red meat that often anyway.  It is the most difficult for your liver to process...that's why they say to restrict it.  Just like alcohol, it puts undue stress on your liver.  You should avoid alcohol though.  That's one thing I won't risk. nono    Sounds like you're doing great with what you're eating!

Posted 9/28/2012 3:17 AM (GMT 0)
I drink no alcohol at all. It was easy for me to totally quit it ad I never was much of a drinker. The only "sin" I confess is one cigarette & a cup of coffee every evening, I hope it is not that bad, what do you think? I wish I can visit the ocean before I wear " the wooden costume" as we say in Greece. I also consider us lucky even " normal" people think we are not because through our difficulties we are able to judge & evaluate things that really matter. Danny & the rest of you thank you very much for spending so much time answering all my questions, sorry if I am a chatterbox. I'm very lucky meeting people that are so kind & helpful.
Posted 9/28/2012 3:48 AM (GMT 0)
So you didn't succumb to the charms of ouzo? I used to drop into my favorite Greek restaurant in NYC and have ouzo and an appetizer with a Greek painter, Yanni, who had painted the most colorful and and whimsical designs on the walls and ceiling. This was back around 1970. When I visited 3 yrs. ago, after an absence of decades, the restaurant was just the same...same artwork, same menu, and the prices had not even changed that much. The painter had moved back to Greece. And being sober since 1986, I didn't have ouzo. But I did order a nice dinner including lemon rice soup.

Hugs,
Connie
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