Ernie Last

First post: Apr 13, 2017 Latest post: Apr 15, 2019

After being fairly healthy for most of his life-Ernie has had several health issues since about 2012-torn rotator cuff and surgery to repair. A colonoscopy which found an anal mass, Hepatitis C which caused cirrhosis of the liver before it was found, radiation therapy, return of cancer in his groin and a lymph node, removal of same, more radiation, esophageal varices which broke and caused him to come close to death,a TIPS procedure to prepare for abdominal perineal resection surgery- for rectal cancer which is recurrent  and as of about 10 days ago hepetatic encephalopathy -a nother complication of cirrhosis of the liver.

Loss of brain function - liver disease ( ( ( ( Loss of brain function occurs when the liver is unable to remove toxins from the blood. This is called hepatic encephalopathy. This problem may occur suddenly or develop slowly over time.

CausesExpand SectionAn important job of the liver is to make toxic substances in the body harmless. These substances may be made by the body, such as ammonia. Or they may be substances that you take in, such as medicines.

When the liver is damaged, these "poisons" can build up in the bloodstream and affect the function of the nervous system. The result may be hepatic encephalopathy.

This problem can occur suddenly and you may become ill very quickly. Causes include:

- Hepatitis B infection (uncommon to occur this way)
- Blockage of blood supply to the liver
- Poisoning by different toxins or medicines
More often, the problem develops in people with chronic liver damage. Cirrhosis is the end result of chronic liver damage. Common causes of chronic liver disease in the United States are:

- Chronic hepatitis B ( or hepatitis C ( infection
- Alcohol abuse
- Autoimmune ( hepatitis
- Bile duct disorders
- Some medicines
- Nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH)
Once you have liver damage, episodes of worsening brain function may be triggered by:

- Body is low on water or fluids
- Eating too much protein
- Low potassium or sodium levels
- Bleeding from the intestines, stomach, or esophagus
- Infections
- Kidney problems
- Low oxygen levels in the body
- Shunt placement or complications
- Surgery
- Narcotic pain or sedative medicines
Disorders that can appear similar to hepatic encephalopathy include:

- Alcohol intoxication
- Alcohol withdrawal
- Bleeding under the skull
- Brain disorder caused by lack of Vitamin B1
In some cases, hepatic encephalopathy is a short-term problem that can be corrected. It may also occur as part of a chronic problem from liver disease that gets worse over time.

SymptomsExpand SectionSymptoms may begin slowly and slowly get worse. They may also begin suddenly and be severe from the start.

Early symptoms may be mild and include:

- Breath with a musty or sweet odor
- Change in sleep patterns
- Changes in thinking
- Confusion that is mild
- Forgetfulness
- Mental fogginess
- Personality or mood changes
- Poor concentration
- Poor judgment
- Worsening of handwriting or loss of other small hand movements
More severe symptoms may include:

- Abnormal movements or shaking of hands or arms
- Agitation, excitement, or seizures (occur rarely)
- Disorientation
- Drowsiness or confusion
- Strange behavior or severe personality changes
- Slurred speech
- Slowed or sluggish movement
People with hepatic encephalopathy can become unconscious, unresponsive, and possibly enter a coma.

People are often not able to care for themselves because of these symptoms.

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