Stogierogie, the Diabetes moderator copied your post over here. I hope you will come here for the reply.
My first suggestion is that your dad be seen by a hepatologist (liver specialist.) Other doctors really are not educated enough in diseases of the liver to be of much help, though apparently they did the right thing in the hospital with the Lactulose. Since he's a diabetic, they may need to come up with an alternative, though as far as I know they are all sugar-based. As you've learned, the confusion/coma state is hepatic encephalopathy. This usually happens in end-stage liver disease. It sounds as though he hasn't had a firm diagnosis yet. He most likely has cirrhosis, also. Only a hepatologist can give a firm diagnosis and treatment plan. There is a lot to go through before someone can be put on a transplant list. It could be that your dad's other medical problems would preclude his being listed. However, to find out he must see a specialist.
Please feel free to post here at any time.
Post Edited (hep93) : 6/2/2009 1:28:17 PM (GMT-6)
Stogie, it's good to have you here. If your dad starts retaining fluid again, he may need to go back on at least one diuretic. I am on both Lasix and Aldactone. The problem is that Lasix depletes the body of potassium, which can be dangerous to the heart. So the Aldactone helps prevent that, and is also a mild diuretic.
If your mom can manage to eliminate beef, it would help a lot. He can still eat poultry and fish. I get ground turkey and mix it with A1 Sauce. I then grill it on my contact grill and I swear it tastes like a regular burger, especially if I use ketsup on the bun, though I usually use cranberry mustard. She can also up the amount of fruits and veggies, fresh if possible. I don't have diabetes, so I don't know how much fruit he could have without it playing havoc with his sugar levels, but I guess it would take some experimentation. If he absolutely insists on having beef, just try to make it no more than once a week. It's the hardest thing for the liver to process. However, you are correct that we need protein, and there's no reason to go completely vegetarian. I do more with beans in the winter and also eat a lot of ratatouille (a vegetable stew), but in this warmer weather I don't want to be bothered. It would be a good time for her to make more main meal salads, though, with grilled or roasted turkey or chicken strips. Just a few suggestions.
The transplant process is such an odd thing. One must be sick enough to need a transplant (REALLY sick), but at the same time healthy enough to go through the surgery with a good chance of survival.
Just keep educating yourself. Knowledge is power!
Post Edited (hep93) : 6/3/2009 7:33:51 PM (GMT-6)
Stogie, it's true that the only sure way to know if a person has cirrhosis is through biopsy. A specialist may be able to detect it through physical exam (the liver will feel hard and lumpy), and sometimes there are other symptoms such as muscle wasting.
I love the idea of complaining to the dog. And you have a good sense of humor. That's really necessary when dealing with a long-term, roller coaster illness like liver disease. I remember when I had liver cancer (a virtual death sentence), my sister telling me I looked really good for a dead person. You do have to keep a sense of humor.
Post Edited (stogierogy) : 6/8/2009 3:26:32 PM (GMT-6)
Post Edited (stogierogy) : 6/9/2009 1:33:26 PM (GMT-6)
Stogie, I'm so sorry that the outlook seems bleak. It does appear that he needs home care or perhaps a nursing home. If he starts falling at home, then a NH will become necessary--and possibly a W/C, too, whether or not he likes it.
Try to make sure that he is getting enough fluid so he doesn't become dehydrated. Let us know the results of his blood work when you find out.