Hi, NYrican and welcome. I'm so sorry that your dad is going through such a hard time. It sounds as though he has cirrhosis from autoimmune hepatitis or possibly from a fatty liver. Sometimes (rarely) there is no known cause. You say that he is on meds, but don't specify which ones. Is Lactulose one of them (used to control encephalopathy from high ammonia, and brings the ammonia level down through bowel movements.) I have no personal experience with high ammonia, but many others here do. I'm sure someone can give you more input than I. It could be that your father overdid it with the laying tile and painting. Whether this would raise his ammonia level, I don't know.
My prayers will be with your you and your father and family.
hi nyrican, there r a lot more people here that can help u more than i, but i will tell u that ammonia levels can go up in a matter of just an hour or less it could have been something he ate or if he didnt have enough bowel movements that day, that is so inportant and diet, my father also had the same thing but was much older and didnt stand a chance. i will tell u it is like a roller coaster ride day in and day out. the coma ur talking about no brain damage in my father eighter he was out about 4 times depends how fast they get him cleaned out. nobody gets used to it as a caregiver it will take all u have and more to deal with this horrible disease. good luck my friend.
my prayers r with u and your dad.
there r many people who can help u with the rest of the questions.
I agree with PG about the high ammonia. My husbands ammonia did go up a few times for no apparent reason. Once he started taking Neomycin every day it stopped it. Also if his blood got low it would make his ammonia go up. So there are other things that make the ammonia go up. Just keep reading and reading and reading about the disease. I'm here to tell you there are not enough hours in the day or days in the week to learn it all. But the more you know the more empowering you become. Hang in there.