Hi - Rick - age 49 - MELD score = 19 - alcohol abstinent - major co-morbidity = Type 2 Diabetes. Transplant is not ruled out. I just work the plan as the doc said, as others have said here.

My symptoms, which have progressed over the last 6-9 months:
-- itching. Big time. I'm not jaundiced but the itching can be intolerable unless I'm actively moisturizing
If I scratch myself in my sleep (see: itching) the odds are better than average I'll end up with some sort of skin breakage or rash, which leads us to...

-- platelet anemia (Thrombocytopenia ) = difficulty clotting.
This was the first symptom I had that got me into the hospital, actually - I had a minor nosebleed that absolutely would not stop. This is a function of the enlarged spleen that goes hand-in-hand with my cirrhosis

-- red cell anemia - this nowhere near critical, but this and the Thrombocytopenia are watched closely like everything else. I've had transfusions but they're not routine.

-- infections are more frequent than the Old Normal. These could be skin breaks, or could be due the stuff going on in the blood/spleen, or both or other

-- ammonia levels are rising... leading to...

These physical things are a pain in the you know what, but they aren't what's really rocking my world right now except in terms of how they drive encephalopathy.

Someone else mentioned they couldn't drive a car when it was bad. That sounds about right re: my case.

Extreme difficult focusing, falling asleep, (ha) getting up, the usual. Lethargy.

Over the holidays I pretty much lost it and wound up in a behavioral health unit getting my psych meds adjusted under observation.

It was then someone pointed out that depression was fairly common / can worsen with encephalopathy.

I do my best to combat the symptoms to take all my meds, drink the prescribed amount of water ( which is less than I want), avoid artificial sweeteners (the old bad ones; Stevia is ok), radically limit carbs and sodium, minimize protein as best I can.