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Stopping Lactulose

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Posted 12/7/2012 5:30 PM (GMT 0)
My mom has been in the hosptial for almost 3 weeks, and it's a roller coaster. I have a very quick question...

She's been on Lactulose - 2 times a day and it cleared her mind, for the most part. But, it's been causing diarrhea and is pulling everything from her kidneys. Now they've stopped it and I keep wondering if the HE will return with her mind. Any thoughts???

Posted 12/7/2012 5:50 PM (GMT 0)
Hi, SB. The Lactulose does cause diarrhea. That's how it works. The ammonia is pulled from the brain through BMs and patients taking this med have multiple loose stools or diarrhea as long as they are on it. Without it, she most likely will develop HE (hepatic encephalopathy) again.

Do you know why the med was stopped? Was it due to kidney function or too much weight loss? In an earlier post you said she was skin and bones.

Hugs,
Connie
Posted 12/7/2012 10:59 PM (GMT 0)
They could give her xifaxin, which would help, though combined with lactulose is the best way to combat HE.
Posted 12/13/2012 10:01 PM (GMT 0)
They ended up putting her back on it, so her mind has stayed stable. Just today for the first time did I hear her words slurring.

She's now in a nursing home, but the doctor there called me after evaluating her to ask if anyone has discussed hospice with me. I'm just getting so many mixed signals from doctors.

My personal opinion is that things are not good and I don't see how her body will do a full recovery from this. She now has "soft heels" since she hasn't walked in so many months.

Her kidneys are also showing signs of failure and she's very anemic. She got 2 things of blood last wed or thurs and already yesterday her hemoglobin number is down to 8.7. I just don't see positives out of all of this.
Posted 12/13/2012 10:35 PM (GMT 0)
Sb, I agree with you. Since the doctor brought up Hospice, this may be the time to look into it. They will see her (and you) at the NH. They would probably also meet with you privately at home.

Hugs,
Connie
Posted 12/13/2012 10:38 PM (GMT 0)
Connie,

How do I really know if this is the end though? That is what I'm struggling with so bad?

I just get so many mixed signals and it's totally confusing. I don't know how to truly act or what move to make next...
Posted 12/14/2012 4:46 AM (GMT 0)
Sue, Hospice gets involved when a patient is believed to have 6 months or less to live. Since her doctor recommended it, that gives you a guideline. But it's very difficult to know exactly, as every person is different. Some go downhill rapidly, while others are very sick for a long time. This issue is addressed in the Hepatitis Resources folder at the top of the page.

Are your mom's affairs in order? Does she have a Living Will and Advance Directive stating whether or not she wants to be resuscitated and under what conditions explicitly. Does she want to be cremated or buried? These are the things that should be decided upon NOW. You may also need to get Power of Attorney if she isn't able to handle her own responsibilities, such as banking, paying bills, etc. You can also access her medical records with this.

Hugs,
Connie
Posted 12/14/2012 2:52 PM (GMT 0)
sbdancer,

  You don't know if it's the end.  That's the short answer.  It is what I and many others have also struggled with.  The Doc and Hospice can only give you an educated guess.

  My husband has been dying from ESLD for over 2 years now.  Hospice was just called in and they said he's not "actively dieing" but to be eligible for Hospice Dr has to be able to say "wouldn't be surprised if he died in next 6 months."

  You can't know when, dr can't know when nor hospice.  Hospice can usually tell if she's hours from death, but our hospice has told me people get discharged from hospice and some live a long time more.

   This is really a hard hard thing...but like Connie said, go ahead and get everything in order...then get on with life, because you really don't know when the end will arrive.  I feel stupid that I have "waited" around for 2 years trying to make "the end" the best for my husband, when I should have been more concerned about living a joy filled life. 

  I, like you, wish we knew, but......

I am sorry you are going through this, it is very very difficult.  Thinking of you on this shared journey.

Angie1953

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