Hello, Moonbeam, and welcome to the forum! I'm sorry you are having problems with elevated ammonia levels. What type of liver disease do you have and when were you diagnosed? Is there a GI doc you could go to? While a hepatologist is preferred, a gastroenterologist has more knowledge regarding liver disease than a primary care doctor. We have a member here in NC who had a similar problem, and he gets seen at a major hospital's transplant center, though he is stable and not in need of a transplant. (Sorry, I can't recall the name of the hospital.) I am in FL and seen at Mayo's Transplant Center, though I've never been a transplant candidate. So that is something you need to look into--a hospital that can treat your liver disease. A teaching hospital can be a great resource.
Regarding the "blackouts." That is most likely hepatic encephalopathy from elevated ammonia levels. This happens with end-stage liver disease, but that doesn't mean you will die next week. Patients can become quite beligerent and nasty during these spells. The treatment is Lactulose. Has it ever been prescribed for you?
There is a lot of information in the folder at the top of the page entitled Hepatitis Resources. I encourage you to read that.
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