Tnspirit, welcome to the forum. As you can see, you are not alone. I was diagnosed with hep C in '93, liver cancer in '05, and cirrhosis in '07--and I'm still here. Has your fiance been given the option of hep C treatment? How about transplant? When the liver doesn't function properly, ammonia can build up in the brain and cause confusion and combativeness that you described. Usually, the patient is put on Lactulose for this. TIPS surgery may be an alternative to all the drainings. I suggest you read some of the older posts, and also the info in the Hepatitis Resources folder at the top of the page. You will gather a lot of information that way, and the people here are very supportive.
Tnspirit, I would not accept the opinion about a transplant. If you are in TN, try contacting Vanderbilt. It is not until he has been evaluated for transplant at a transplant center that you will know where he really stands. Do you know if he had been drinking at all prior to those episodes of "encephalopathy?" Also, I would not accept one doctor's opinion about hep C treatment. There is also a new treatment in trials now that should be widely available within a year.
Mayo has the shortest wait time in the nation for transplant. At one time, it was 2 1/2 mos., but it may be a little longer now since word got out about it and Mayo Jacksonville now has its own hospital (I am seen at the Transplant Center there, though never a transplant candidate--that's where the hepatologists are.) If he's able to travel, you might also try there.
Don't be so quick to give up!
Tnspirit, I'm glad that Mike stopped drinking so long ago. He was one of the rare ones who listened. I only asked that question to determine if his encephalopathy might have been the result of drinking with a damaged liver. Glad we can rule that out! It's very important that he continue follow-up with his doctors. I'm glad you are there for him and to see that he keeps his appts.
The most common symptom of liver disease is fatigue. It is a very odd sort of body tiredness and it doesn't matter how much sleep you get, you are still tired. This was what led me to a diagnosis of hep C in '93. It is still my worst symptom. I average 12 hours of sleep a night, getting up several times during the night to go to the bathroom. So I think the fatigue and sleeping that Mike was experiencing was due to his liver disease. The medication has made it worse. The only antidepressant that I ever took that didn't cause weight gain and deep sleep was bupropion (Wellbutrin.) Which doctor put Mike on Zoloft? Anyone with a chronic illness can be affected by depression to some extent, but it doesn't always require medication. I would speak to his hepatologist about this, or have him do so.
tnspirit If you are in Tn my husband has his transplant at Vanderbilt. I know they run a really tight ship but their list is small. When Jerry got his transplant there were 130 people on the list. A lot of them with low MELD scores. It took him 17 months while he was on the list to get his liver. A lot of other transplant centers have shorter wait list and a lot have longer. Vanderbilt transplants in the mid 20's while others wait until their score is in the mid 30's. You have to be referred to Vanderbilt by another Dr. I would just keep seeing Dr. until one referred me. I just don't understand that. We were referred by our Gastro Dr. Hang in there and stay on this forum it will help so much.
Wow! That was a lot of fluid. I'm sure the poor man was very uncomfortable and feels much better now.
Thanks for keeping us updated. Hang in there!
Joyce I can relate to what you are going through. I don't even remember how many times this happened to Jerry. I do remember one time that I went 3 nights with no sleep because he was like that. And yes, I did the ambulance thing and called the police to try and talk him in to going. When that ammonia gets high they get really stubborn. Sometimes when he was like that I could get the ammonia down with more lactalose but a lot of the time an infection or dehydration would cause his amonia to spike. A few times I got him to the Dr. by telling him the Dr. just wants him looked at in the ER. That worked a lot. I just took told him they just need to check him out then we could come home. You might try that but I think he needs to be seen ASAP. Hang in there I can tell you after Transplant things are sooooo much better.
Joyce, thank you for the update. I am sorry that Mike continues to deteriorate. Is he on Lactulose for the encephalopathy? My liver cancer was discovered when I had a sonogram, so prepare yourself for possible bad news. There are treatments available, though, depending on the situation.
Don't hesitate to take Mike to the ER if he gets worse. I am wondering if his diabetes is playing into this?
Please keep us posted. Our prayers are with you and Mike.