Confusion Sets In

I found myself back in the hospital on August 3, 2020.  My MELD score had climbed to 28. My kidneys were again failing due to my Cirrhosis, and I was ballooning with fluid.  The doctors limited me to one liter of water per day.  I felt desperately thirsty and begged for more to drink.  At first, I joked around with the doctors, showing them these two pictures and saying my goal was to look young and healthy again, but this is what I would look like when they were done.  

  

We all laughed.  My humor about it held for a while.  At this point in the COVID pandemic, I could have one visitor who could come to see me, so my husband would come on the weekends.   When he would bring a drink that weekend, I would beg him for a sip.  He's not a rigid rule person, so he would say I could have a sip. Then I'd drink his whole drink and try to shake more from the bottle.  Then he stopped bringing his drinks to the room.  

About that time, I began to demonstrate signs of hepatic encephalopathy.  I was confused, I couldn't answer basic questions about the time, who was president, and general questions.  They even moved my room to outside the nurse's station, and I was totally unaware of the change.  I remember my husband sitting there talking to the doctor, then the doctor asking me to put my hands out in front of me. He looked at my husband and nodded.

I was unable to follow their conversation in my state, but I knew what the test was about.  If you have hepatic encephalopathy, when asked to put your hands in front of you with your palms forward, they will move backward and forward (flap).  In that moment, I knew that I had it, I was angry that they wouldn't give me more time to answer the questions (I wanted to prove them wrong), but I was unable to express my frustration.  I soon just fell asleep.  I was doing a lot of sleeping. Sleeping is part of the progression of death from Cirrhosis:  sleeping encephalopathy, coma, death.

After a few days, I began to come to my senses a bit.  The doctor explained that their attempt to limit my fluid too drastically had increased the ammonia levels in my brain, which caused my deterioration.  Once they brought my fluid levels to two liters of fluid per day, I was still pretty foggy, but I could communicate and understand what was happening around me.