To me it sounds like classic textbook early H.E. or hepatic encephalopathy symptoms. If he rufuses to go to the doctor you can only guess though.

In my opinion ammonia levels are unpredictable. They can rise with little warning and then lower. I had an incident about a year ago at work. I worked midnight shift at a call center. When I woke up to get ready for work, something didn't feel right. I was forgetting things like where I put my car keys. By the time I made it to work, I was in daze. I could remember how to answer the phone, which way the lunch room was and people were asking me what is wrong. Finally, my boss called me over and told me to home early, he was concerned about me driving but somehow convinced him I was OK. When I got to the car I tried to dial for my uncle to come get me but I could not remember how to use the cell phone. I sat there for a while closed my eyes trying to gather my thoughts. Then, I began to drive home. From there it was a blur, I drove 20 miles past my exit and was finally pulled over by the police. From there I recall very little till next morning. I remember a breath test (which I passed, I knew that it would I wasn't drinking) and a blood test for drugs. I was put in jail and was released on bail. I was charged driving under the influence. I knew I was innocent but it looked as if I was under the influence. Well, the blood test came back negative and it is behind me now. But thank the Lord I didn't kill someone.
I am more careful now, I drive very little (to the store, see my family and my son when he is in town). I realize that someday I will not drive at all. Lactuose does help a lot I take 1.75 ml three times a day (sometimes more). I also take 550 MG twice a day of rilfaximin . It is an antibiodic that treats symptoms from hepatic encephalopathy. It not a complete cure but keeps me from feeling like I am losing control. Pray this helps.

Thank you Steven for the information. Steven, did your symptoms go away without treatment at any time? I ask because my husband is not on any treatment and he exhibits symptoms of elevated ammonia to me but I cant be sure. What I do is ask him a series of questions and I check his reflexes and basically say a prayer to keep him safe and thats all I can do. His symptoms are usually more obvious in the late afternoon early evening and by bed time he appears to be ok. He also doesn't show symptoms in the morning. This is what confuses me because his symptoms are off and on. He takes medication for Bipolar disease ( Seroquel) so Im not sure if his behavior changes are more related to his mental health situation versus Ammonia levels. He also still continues to drink and so sometimes I think that perhaps hes drunk and has a stash of booze I just have not found but I just cant tell. His breath doesnt smell like booze. What I have smelled before is a fruity breath scent. I thought that maybe his breath was related to elevated sugar levels but NOPE i checked his blood sugar level and it was normal. His blood pressure does tend to be elevated however when he is going through one of these mystery episodes. I know everyone of you are different regarding disease symptoms but I am trying to get as much information as I can to help my husband and be on the look out for progression of this awful disease. I also am concerned that I am putting others in danger if I let him drive when I see this odd behavior manifest. I often take the keys away from him and dont allow him to drive if I feel something is up. Of course he gets mad at me and often leads to an argument but I would much rather be safe than sorry. Any advice is much appreciated!

Taking the keys is a good idea. Whether it is ammonia or he is drunk. Either state could as you know involve an accident. I have voluntarily limited my driving, to doctors appointments, grocery store, etc. Ammonia levels can rise fast and with little warning, Thank the Lord I have found the right combination of medicine and haven't had any issues in a month. I take lactuose, which is not pleasant, it will rid your body of harmful chemicals but it is through loose bowel movements (three or four a day). At first, like many was taking to much and got cramps. I also take 550 mg of Rifaximin, it is an antibiotic that treats the harmful effects.

I am sorry don't know much about bipolar disorder. As far as the alcohol consumption, just because you can't smell it or find it doesn't mean it is not present. I know you know this. However, us alcoholics are masters of masking the smell and hiding the product. I hid mine in closets, outside behind the garbage cans, in my car under the seats. You find ways, I have known alcoholics to drink rubbing alcohol. That is horrible. It would tear a hole in your stomach.

I pray this doesn't scare you but pray it scares him. Unfortunately, his only hope is to quit now. The sell kits at pharmacy to test for alcohol but I doubt he would submit to doing that, one thing you can do and I hate to mention it. If you think he is drinking and driving, or is drunk at home, call the police. I know the time I spent in jail was time for me to think and sober up. Thankfully, it was only three times (the last one was the one I mentioned above and I wasn't drinking but still thought about my choices in life). Please do not take it the wrong way, I know you love him. If you didn't wouldn't be going through this. So, if calling the police offended you I am sorry.

God Bless Rummi, you will be in my prayers,

Steven

I am sorry Rummi, I missed a part of the question. The answer is yes it will go away overtime. How long depends on high the level. The risk you run is the harm it can do to the brain. Coma, in some case, has occurred. The more time the ammonia has to work on the mind, the more damage it will do. However, if treated properly you can rid it from the body.

God Bless

Steven

Thank you Steven! I will be extra vigilant to ensure that he does not harm himself or others. For about two weeks now he has had symptoms however it is off and on. I try to keep him off protein and feed him lots of fruits and vegetables to help his digestive system. Although I must say that he appears to have a pretty good constitution. He goes to the bathroom frequently and not to be gross I have even monitored his urine output and it appears clear with no strong odor of ammonia. I know that ammonia builds up in the body and it has to be excreted so that the ill effects will not take place. So I do my best to keep him hydrated and like I said well nourished. I guess thats the best I can do. Im really scared of Hepatic Encephalopathy but like I said I am playing a guessing game with my husband. I wish he would be more helpful however he refuses to accept Cirrhosis as a diagnosis. He always tells me Im crazy and that Im trying to kill him off. Of course thats not the case but I want him to accept the fact that he has to be responsible for his his well being. As for the drinking, he thinks because he no longer drinks like a fish as he used to that he can afford to drink a six pack on the weekends. In order to compromise with him I allow his to drink 2 beers Friday, 2 Sat, and the other two he spreads them out through the week. That is what I allow. Who knows if there may be a stash elsewhere like you described. I just dont have the time to be searching the house for booze. I used to obsess over it but like I said I have resigned myself to God and to him that only they can make the choice to stop drinking. I love him tremendously and I will not leave his side regardless of his diseases but you can imagine my hardship with this situation. I hate to see my husband throw away any hope of a future life by continuing to drink regardless of the fact that he has slowed it down. I wish he would just stop for the sake of salvaging what is left of his life. I truley believe its going to take some severe symptoms to wake him up like suffering a severe HE episode or ascites. He had to variceal bleeds but that did nothing to scare him. He says that it was just from his partying and that he over did it that one time but that other than that he is cool. SO he says! The problem is that he has heard from some of his other party friends that they too have vommited blood or pooped blood and they still carry on so I guess he thinks that it comes with the territory of partying. However he doesnt realize that its much more than that and that the symptoms will become far worse in time. I try to convince him however I have had no success. In fact I even had him watch a documentary on Cirrhosis " Rain in my HEart" and he still argued that those people were different because they were true alcoholics unlike him who soley partied with his booze. I know... he is in absolute denial but like I said what can I do about it. As a caretaker all I can do is pray and do the best I can to keep him alive.

He is in denial. No alcoholic wants to admit to the problem and if he has a group keeping him encouraged to drink that is a bigger problem. I had the same and to this day the wait for me to fall. You see if he quits it may mean they have a problem and that can't be the case. I would drink after the episodes of bleeding but knew there was a problem. I just had given up hope. Never heard that it was a price of partying. I agree you don't have time to find the hiding spots, and what would it help anyway. He would find new ones. Sounds like you have got a hold of the ammonia build up side. That will keep him safe from any long term damage. I wasn't as lucky, I suffer from memory loss, tremors and still have states of confusion forgetting where things are in the kitchen, cooking and general care. However, I have adapted.

He will have to ultimately make the decision something in his mind needs to push him to that decision. For me, it was true rock bottom. I thought I was as low as I could go but when my wife left me it started. Not only was I an alcoholic, I had committed adultery. I know it is terrible. The one person to love me and stand by me, I hurt. Well, out of the house I rented an apartment seeing the same girl that I committed adultery on my wife. Eventually, we got kicked out of apartment. We lived in some horrible hotels pay by the week. We would drink all day and all night. There were prostitutes and drug dealers ( I never did drugs). Eventually able to get another apartment, I ended up in the hospital with a varcies bleed. After that went back to the apartment, about a month after that one night was alone in the apartment with a half gallon of Jack Daniels. My girlfriend returned and she poured out the quarter of the remaining bottle. I was enraged I took her beer out the fridge and began throwing it out in the parking lot. Well, police showed up and took me to jail.

That was bottom, I would return home continue to drink but as reminder the Lord put me back in the hospital. I tell you this to show you the grip it has on him. Some people walk away no problem, others take getting hit over the head. Continue to monitor the situation and pray, I believe in this situation your love for him may pull him through. Don't know why, just got a feeling. Others, may disagree with me and I may be wrong. One thing I do know, is that God has a plan for all of us. My calling is to take what I know and my testimony to minister. I suffer from cirrhosis and may one day die from the disease but I suffer more knowing what it does to people and their lives.

God Bless,

Steven

Steven,
Thank you for your candid testimony. I am hopeful that my husband will soon see the light and make the changes in her life that will allow him to live a healthier life. Like you, my husband is very young to be suffering from this awful disease. It is very sad that alcoholism took such a toll in each of your lives. On the positive end of things both of you are young and have an opportunity to turn things around as long as you stop drinking. You have done the right thing to stop however I am still hopeful that my husband will too. I love him with all my heart and soul and I have faith in God that he will overcome. It may not happen on my time but i know it will happen when God and and my husband choose. For now I will stay faithful and do whatever I can to help his recovery. Thank you for your words of encouragement and know that my prayers and thoughts are also with you. Take care and God bless you!

As Steven said,

"The more time the ammonia has to work on the mind, the more damage it will do. However, if treated properly you can rid it from the body."

I tend to agree with him on this. I'll ask my GI when I see him in February.

I finally had to withdraw from college because of memory issues, I'd was taking classes two, even three times before I could pass.

One of the oddest things is just TV shows from January-March 2013. Know for sure I recorded and watched them, yet seeing repeats now, they're like brand new shows. The only thing in common is they're all from that time period.

I thank God I've never been in jail. My worst incident was an Ambien blackout two years ago where I hit a parked car, which caused me to never take them again.

Maybe my diet changed, ammonia levels for some reason spiked, I'll never know because I don't remember it.

Even though I hate it, probably time to hit the Lactulose again or start up on Rifaximin, which I've noticed has come way down in price.

Thank you Steven