@gaylea1 You had some very severe ones. I do remember one where I was basically catatonic. I sat on the sofa like a zombie yet I was aware of most of what was going on around me. That was one of the episodes that did land me in the hospital. My hospital stays were never more than 3 days. Initially I just used lactulose but when I went to a hepatologist she prescribed xifaxan and that kept me HE free for almost a year. When I had another episode it was assumed that my condition had worsened so then I had to take lactulose along with xifaxan.
An HE episode was also the first thing that triggered the search for a cause in me. I had shaky hands, declining platelet counts, leg cramps, feeling cold all of the time before that but those symptoms were never added up with the HE episode so it took a long time (almost a year and a half) to get a diagnosis. When you had an HE episode was cirrhosis immediately suspected? I have no idea why it was not for me, but as I have said many times, I will never again rely on the local medical community to diagnose me with anything more complex than a cold.

@johnshaw That's wonderful that after having such a severe HE episode your MELD has now decreased and you are doing so much better. Congratulations on being in good shape now, I hope it continues. If the time does come when you need a transplant try to not worry about it though, it was not bad at all for me.
What have you done to improve your MELD so much?
JK