Hepathic Encephalopothy

Ive been thru more HE episodes with my brother than I care to count.  In frustration, I asked his doc how can I prevent this from happening all the time?

He said "Lactulose, Lactulose, Lactulose!"

When my brother started with the shakes and get confused, the ONLY thing that helped was the lactulose.  Sometimes you need to start with once every hour like they did in the hospital (when he was almost unresponsive) or sometimes they give a lactulose enema first (like in the ER) and then tons of lactulose until he starts to come out of it.  Im not sure if hubby gets it as bad as my brother, but that is all that worked. BTW, he was also taking xifaxin.

The trouble is, by the time the patient has HE, he/she is too confused/stubborn already to realize the importance of taking the medicine!

Also, on a weekend inpatient episode over at Mayo, the doc (not on tx team) restricted his fluids while prescribing high doses of lactulose (big mistake, damaged his kidney).  I guess he was worried about the ascites, thankfully he didnt need dialysis.

If you cant affort the meds, someone here can steer you in the right direction for need-based prescription assistance Im sure :)

Good luck, hepatic encephalopathy really s**ks and can be very dangerous!

Mae

Mike once told a 4 year old grandaughter there was no Santa....out of the blue. she had a major meltdown...

He was so sorry, but he seemed to have no control over his mouth.

Even now, when he is not feeling 100% we get a peek at Mr. Grouchy.

Hugs,

Carol

I myself am a Alcoholic Cirrhosis patient . My wife never felt threatened by me even when the HE was at it's worse , Don't get me wrong I was a combative , insulting and a few choice other descriptions that can't be used here . She took most of it but wasn't afraid to give some back either when she had enough . She has two children from a previous marriage and we found it best for me not to have them in my care alone , The potential for me to say something stupid or not be able to take proper care of them was not worth it . The wife's family live close by so they watched the kids while she was at work . I knew I couldn't take care of me much less a pair of kids .

 You just don't think rationally when HE is running amuck and the male ego tends to worsen the effects even further . If your not used to taking orders or being barked at by everyone ( Wife , Doctors , Family , You name it ) your in for a bumpy ride as a patient . I hope he comes to the conclusion as I did that he's gonna have to be a " Yes " man if he wants to survive this . Swallowing your pride and eating crow aint for everyone but , not everyone will survive either . Tell him he can play the boss when he gets better .  

 A. Ziffle  

Exactly . Ever notice guilty people are usually the first to point the finger .

There has always been a little debate as to how much a HE suffering person is aware of there behavior . My perspective is that the only time I was unaware of my surroundings or delusional was when I was hospitalized and even then felt as if I was dreaming ( I saw what was going on in a second or third party sense ) , My perception of reality at that point was difficult to grasp . Going through what I consider average HE consisted of myself fighting perceived insanity , I tried to be normal and the harder I tried , the more insane I felt . My mouth could not coordinate with my thoughts or by the time my mouth opened the thought's were gone . Sounds crazy I know , But reality was always there , my cognitive skills drifted in and out rapidly . This makes you feel and look insane .

 People are like animals in the sense they don't typically like being backed into corners , Nature's defense mechanism kicks in and we come out swinging or biting . Problem is animals and humans can do more damage to themselves with this defensive posturing . Sometimes the best thing is to back off ( As you've done ) and let everything calm down , Hopefully he will begin to see that your hand is there for helping not hurting .

 My best to you both ,

A. Ziffle