The liver doc was happily surprised with Mom's latest blood results. Potassium level is smack in the middle of the normal range, but even better, her alk phos levels are way down. Normal is below 130. Her high point was over 1300. She is now down to 179. Not quite normal yet, but very very close and literally nearly ten times better. The medication for the primary biliary cirrhosis seems to be working, but it could also be due to a decrease in her nausea medication, which notoriously raises alk phos levels.
They did tell her (both the resident training under the specialist, and the specialist re-iterated, and they gave me some paperwork on hepatic encephalopathy (basically toxin-related confusion; read more here) that states that people with it should not drive. They said it carries "tremendous risk", but her primary doc uses the thought of driving as a carrot to dangle in front of her to push her to gain weight and strength. I fear she will tire of her primary doctor's game. He tells her to keep up the good work and that maybe by the next appointment she can drive. That will only hold her off so long and when she realizes that he will not let her drive, she will feel betrayed, never listen to him, and try to drive on her own anyway.
The hepatologist also said that, even with how much Mom hates that I'm always in her business, I'm supposed to be paying more attention and I'm not monitoring her enough. Mom was told to accept help and accept that she can't drive anymore and to allow me (so I guess I was volunteered and not told to do this) to monitor her lactulose intake among other things. This was a bit scary, because we didn't know that her confusion was so dangerous. We were told that if we let this go unchecked, she could fall into a coma, and would likely never come out of it. Convincing Mom to let me do this, however, is another matter, and she resents relying on me as much as she does. She misses her independence, and I can't blame her for that, but with her illness, independence isn't a luxury she can afford to keep and stay alive. I'm trying to figure out a way to keep tabs on what the doctor said I have to pay attention to without bugging her everyday. I did purchase an expensive pill box called a MedCenter (see it here). I'm really hoping this helps her to keep track of which pills to take when without me having to stand there over her shoulder every time. I also put her vitamins in it, which she wasn't taking and the liver specialist said that her abdominal pain is her ribs and not her organs. Her ribs are very painful and it is likely due to her osteoporosis which she has not been treating because she feels she swallows enough pills and has refused to take calcium supplements.
Also less-than-good news is that I'm sick....again. I'm going to attempt to apply for government assistance with medical insurance and see if I can figure out why I've been sick for six months straight. This doesn't have a lot to do with Mom, but it makes it harder to care for her when I'm so exhausted from being ill and I worry about giving her my germs. It means face masks while cooking and it's already hard to breath, and staying away from her in general, which makes care-giving that much harder. Any ideas that would make life a little easier are always welcome.
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