I have questions about Hepatic Encephalopathy

Posted by sharonagnes @sharonagnes, Sep 17, 2021

My husband has been diagnosed with stage 4 liver disease. We are waiting for an appointment to see if he can be put on the transplant list. Prior to his diagnosis and even after a hospitalization, he has signs of HE. Hallucinations, personality changes, irritability and impulsive behavior. He no longer has hallucinations but he still has the others on some level despite being on lactulose. Question about HE - Is there any other ways to treat this besides lactulose? After transplant (if he is eligible and if we get one) will these symptoms and changes go away? Is therapy helpful for HE? As a caregiver how do I handle the anger, moods, impulsivity?

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@sharonagnes

We have an appointment tomorrow. We are hopeful to see if he is healthy enough to be put on a transplant list. He wasn't healthy enough to be considered when we last saw them. Prayers, please.

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Prayers on the way for you and your husband.

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@rosemarya

Hi, @melody12. I absolutely love your creativity! We patients learn so much by sharing with others.
I was fortunate to never had the Lactulose experience, so from what I am reading it must have been awful. Are you still taking it? If so does it get less awful over time? What has been your favorite 'recipe'?

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Thankfully, No! It was only for Pre-Transplant for about 6 mos. For me the taste wasn’t as bad as the thickness. After awhile it just became the norm. Using it with regular syrup on something (waffles, pastries, french toast, pancakes, sweet breads). Now, if your watching your weight I say “who cares”, this drug is a MUST HAVE!!!! So, get creative and share your ideas.

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@melody12

I think we all can agree we wouldn’t give Lactulose to our own enemies. When in the hospital for 10 days I decided to try adding it with my syrup for French toast and pancakes. I also added it to my hot fudge sundaes, and I am sure we could find other ways. It wasn’t the best, but it was MUCH better. Maybe we could swap other ideas?

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Agreed and probably an excellent idea! But I was rapidly going downhill, so trying to stay as fit as possible in hopes of getting on the list, so no pancakes. Besides I’m very small boned, so even at 5.5 I weigh in at 110. But I had gained so much ascites weight I had a new found appreciation of what it means to be pregnant with twins (I’ve not been pregnant before…)!

It was so foul, I didn’t even think of mixing it with something cause I figured it would be dreadful anyway! But, your right, maybe with fruit so it would be healthy, but less gagging? I just swallowed it as quickly as possible and downed a lot of water afterwards. And, my care giver, while she was at work, would always txt me after my med time to check to make sure I had taken it!

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I totally understand, however days now have so many versions of everything (diet, gluten free, high protein, low sugar, sugar free, vegan, etc.) Just some suggestions to get some alternatives. Anything to “make the medicine go down, medicine go down”. Maybe sing the song to yourself as your taking it.

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@contentandwell

@athenalee It was not a constant fog at all, it was episodes of confusion and irrationality. The PCP I had at the time called me on the phone and told me she thought I had Alzheimer's! The neurologist literally laughed at that as did another of my doctors. That was when I changed PCPs.

I really was miserable to not know what was wrong with me though. I was pretty sure it was not Alzheimer's but I did worry that there was something wrong with my brain. I was depressed often. It was actually a relief to find out that I had cirrhosis and needed a liver transplant!
JK

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Oh man…Alzheimer’s! Seriously. I’m sure you were depressed. That’s so sad that you got that diagnosis.

I thought it was bad enough when primary finally ran blood tests (after complaining for years about PBC symptoms), and then telling me I had stage 3 liver cirrhosis and I should get treatment for alcoholism! So, quit my social drinking that day, saw a great liver specialist, got diagnosed with PBC, and didn’t go back to the primary.

And, to think we both would have been much better served by an earlier diagnosis. Had I had labs done to check for autoimmune diseases when I first had symptoms I may have survived for many years with needing a transplant. And, you at least could have had an earlier diagnosis and less psychological trauma.

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@melody12

I totally understand, however days now have so many versions of everything (diet, gluten free, high protein, low sugar, sugar free, vegan, etc.) Just some suggestions to get some alternatives. Anything to “make the medicine go down, medicine go down”. Maybe sing the song to yourself as your taking it.

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True enough. Join our Transplant Recipients Culinary Arts webinar series and we can have a special segment on “tips for taking pretransplant meds and post transplant meds.” I myself had a lot of difficulty swallowing big pills after my surgery, so the nurses always brought me apple sauce. Worked like a charm!

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@athenalee

True enough. Join our Transplant Recipients Culinary Arts webinar series and we can have a special segment on “tips for taking pretransplant meds and post transplant meds.” I myself had a lot of difficulty swallowing big pills after my surgery, so the nurses always brought me apple sauce. Worked like a charm!

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I will certainly look into and try my best for webinars. Thank you for the suggestion.

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New to all of this and just have posted a few times. Can you tell me how I find all these webinars?

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@melody12

New to all of this and just have posted a few times. Can you tell me how I find all these webinars?

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You bet, here’s the link to our original posting which will provide the details - https://connect.mayoclinic.org/discussion/transplant-culinary-arts-zoom-sessions/

Our first event will be on Thursday, October 7 at 4 pm western / 6 pm central / 7 pm eastern. It’s open to anyone on Connect, including transplant recipients, patients on the transplant waitlist, and caregivers.

I’ll add you to our list. We’ll send you the Zoom link through private message (if you haven’t used this yet, you’ll receive a notice, just like you receive your regular Connect notices). We’ll post a reminder and the recipe we’ll be cooking in advance as well.

Let me know if you have any questions.

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@athenalee

You bet, here’s the link to our original posting which will provide the details - https://connect.mayoclinic.org/discussion/transplant-culinary-arts-zoom-sessions/

Our first event will be on Thursday, October 7 at 4 pm western / 6 pm central / 7 pm eastern. It’s open to anyone on Connect, including transplant recipients, patients on the transplant waitlist, and caregivers.

I’ll add you to our list. We’ll send you the Zoom link through private message (if you haven’t used this yet, you’ll receive a notice, just like you receive your regular Connect notices). We’ll post a reminder and the recipe we’ll be cooking in advance as well.

Let me know if you have any questions.

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Wow! Thanks for all of that.

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