Hepatic Encelphalopathy - even harder to deal with than to spell
January 26, 2012 11:42 AM Subscribe
Tips on communicating with a partner who has medical issues that cause confusion but not quite dementia (and perhaps spotting it earlier)
posted by MCMikeNamara to health & fitness (8 answers total) 4 users marked this as a favorite
My partner, who has issues with his liver that he is going through the process to start treating, was taken into the ER this weekend after vomiting blood clots. This was frightening enough, but given what was found on an earlier upper endoscopy, not hugely surprising, as it was something we were told to watch out for.
However, after the procedure which stopped the bleeding, and after he came out of the sedation, he was very, very confused, and this eventually led to a pretty major personality shift and agitation, and for the next couple of days, an inability to answer simple questions. Examples: When asked, 'do you know where you are?', he was unable to come up with the word 'hospital' He could only remember part of our address. He couldn't communicate that the reason why he wanted to get up was to go to the bathroom and would forget that he had foley tubes up both ends that would take care of that.
Obviously, this was very frustrating to watch, especially as when he was trying to argue with the nurses, he was disappointed to find me not immediately taking his side. I was usually able to calm him down and get him to trust that what we were doing was okay, but it wasn't easy.
Fortunately, he seems to be responding to the treatment, and this morning, seemed much better still. (Initial lab tests show the same thing.)
This hepatic encephalopathy is, like what originally brought him into the hospital, a possible symptom of his liver issues, and though it is something that will hopefully be less of a concern once his liver treatment is completed, if I understand correctly*, it is also something that could happen again if his ammonia levels get too high day-to-day or especially if he has another medical trauma that triggers it. so I'd like to be better prepared next time.
My initials searches this morning return a lot of things having to do with dementia but this feels different -- it's treatable if we know what is happening, and it goes away. But in the moment, he doesn't get that's what's happening (maybe he will next time -- he was able to remember things he had previously known in a clear state more than things we were trying to communicate then) and can't comprehend what we need him to do to get better.
1) If it does happen again, does anyone have any suggestions on how to talk to a loved one when they are in this confused/agitated/frustrated state?
2) Since this confusion/changed mental state can happen more slightly than it has happened this time, does anyone have any tips on what to look out for to spot it? (Particularly some that won't make me super paranoid and overly anxious/on the lookout for false signs.)
Thanks -- and apologies in advance if this repeats a past question or doesn't make sense. It's been a strange week.
* Like everything, I'm going to be discussing this with his doctors as well as his hepatology specialist, so I'm incredibly aware YANMD.