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Liver transplant - Let's support each other

Transplants | Last Active: 21 hours ago | Replies (1623)

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@flagal22

@tgshomes The diagnosis I was given was NASH. I had one severe HE episode 7 months prior to transplant. I woke up one morning very incoherent and combative about getting dressed and going to work that day. I tried to text my work supervisor but could only type nonsense into my cell phone. Luckily my daughter was visiting and called my husband to come home. I was hospitalized for 3 days but do not remember the first 2 days. My ammonia level was too high and affected my brain. They increased my Lactulose and brought the ammonia level down. The downside of the Lactulose was having severe diarrhea and needed to wear Depends. I was no longer allowed to drive. I also noticed short term memory issues. My husband was my primary caregiver and thank goodness he would remember what the medical staff at Mayo in Jacksonville would explain to us before and after the transplant. I was also very fatigued and would fall asleep frequently each day. As the months went on my health declined very quickly with 3 more hospitalizations due to kidney failure. I also started to have ascites and needed a paracentesis once a week to remove between 8 to 9 1/2 liters of fluid. The week prior to my liver transplant I was again released from the hospital and became very weak especially in my legs and was barely eating anything. I also had edema in my legs and needed shoes 2 sizes larger than I normally wore. I was hospitalized again after a week out of the hospital with a MELD of 44, over the 6 to 40 scale that we were told that there was. I did receive the liver transplant that night.
Since my liver transplant 8 months ago, most all of these symptoms went away. I do feel the HE episode and memory issues did create some changes to my brain. I have trouble remembering a word to use in the middle of sentences frequently. It takes me a few seconds and I usually can recall the correct word.
I hope your father receives a liver very soon. You sound like a wonderful son and an asset as a caregiver along with your mother. My children stepped up when we needed their help during my illness and appreciated all they did for us.

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Replies to "@tgshomes The diagnosis I was given was NASH. I had one severe HE episode 7 months..."

@flagal22 they didn’t tell you to titrate the lactulose yourself to achieve the desired effects? I generally took about 30 - 35 ml, 3 times a day but if that wasn’t doing it increased it to 40 or so. When a hospitalist put me on over 60 ml, 4 times a day, all heck broke loose and that was when my husband had to get disposable underwear for me. When I decreased it things normalized with controllable loose bowel movements, 3 or 4 times a day.
Your MELD is one of the highest I’ve heard of. You must have really felt miserable. The last time before transplant that mine had been calculated was a few weeks before. Things were going downhill fast so I wonder if it was calculated again when I went in for the transplant.
I didn’t buy new shoes, I had some Ugg slip on slippers and they were the only thing I could get on my feet.
These conversations make me wonder if the little memory problems I have could be due to my HE episodes, not simply old-age.

@racing212 ammonia levels can really fluctuate greatly which is why testing ammonia randomly is not a good indication of an impending HE episode. I was discharged from the hospital after an HE episode but was back in a day and a half later, ammonia up again.

@gaylea1 when I had HE episodes I went to my local hospital. I was very uncontrollable so my husband needed to get me somewhere fast. My local hospital apparently knew nothing about HE, and initially I had not even been diagnosed yet, so I got no sympathy and little help from most of the nurses. To them I was a problem patient. 😥. I hope I NEVER have to be in that hospital again, it would give me nightmares.
JK