I am so sorry for you and your situation with your Mom. ESLD is so friggin complicated, so different for each person (it seems), and so hard for us as caregivers to understand.
My husband Jim also is ESLD, and it seems like the fewer prescription meds he gets, the better he is. That seems to be because the liver can't process toxins (like prescription meds) the same way a non-liver patient can.
In the hospital, he was up to somewhere around 140ml of Lactulose a day. And of course miserable with the GI outcome. He's now on 15ml twice a day, with none of those problems. And ammonia levels are OK. He was on 2 types of diuretics that sent his sodium and blood pressure crashing, and causing mental confusion and mini seizures. Those were removed for about 6 weeks, he came back almost to himself (physically and mentally) and now he is on a reduced dose of Aldactone for his ascites. Still almost himself.
Finally he is on an antibiotic because he is prone to spontaneous bactial peritonitis and sepsis.
Most of our efforts to keep him well are multi- and certain B vitamins, milk thistle, and a sodium- and fluid-restricted diet.
You may want to check out what they are feeding your Mom in the nursing home. It's very hard to manage a severely restricted diet. I know that the hospitals and nursing home Jim were in didn't do it.
Venita and Jim
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