@lisalucier thank you, Lisa. Hopefully one or more of them will contribute something. There are negatives with Botox, but right now I am taking Trospium and that is one of the drugs that can contribute to getting Alzheimer's. I am hoping that once I have the Botox I will be able to drop the Trospium.
Ever since the really dumb PCP I had when I first had an HE episode told me on the phone that she thought I had Alzheimer's I have been very conscious of it. One HE episode out of the blue and she thought it was Alzheimer's? When I mentioned that to the neurologist, and also to my endocrinologist, they both were incredulous. She really should not be a doctor, maybe a PA. I switched as soon as I could find a different PCP, one who is a doctor of Internal Medicine since our doctor friends told me they are generally better at diagnosing than family medicine doctors. Even so, the internist did not diagnose me, the neurologist did!
JK