Day 2: November Hospital Visit

After speaking to the medical doctor last night, I wasn't convinced that they would do right by Mom. Every other doctor and nursing staff says that the doctors confer with each other and that Mom's hepatologist would be consulted prior to her release. It was, after all, he that stated 3 weeks ago that he wanted her in the hospital to run some tests as an inpatient. But when I brought this up to the medical team doctor last night, she stated that "she can see him as an outpatient," and dismissed the idea of letting him see her. I called his office this morning to ask him to see her before they release her, and he said he would try to see her today. They close the clinic at 2, so I'm hoping that he can have time to go see her.

Mom hasn't been able to flush her system of the ammonia yet. She's been having problems at home (she's sort of clogged) and the medical team doc said that this is the likely cause of her symptoms getting worse. I am rather concerned that the medical doctor is not a hepatologist and doesn't quite understand HE as well as I'd like. She doesn't understand that severe personality changes and mood swings are symptoms (she keeps asking about bipolar....no, Mom doesn't have a "psychosis", she has HE!), and she says that HE isn't something that's always a problem. Like, it comes and goes. I agree that the symptoms get worse or better, but it never goes away unless you have a liver transplant. There's no cure for this, and if the medication doesn't work great for a particular patient, they have episodes like this. But it doesn't mean that they "don't have HE" the rest of the time. It's just a matter of how much it affects her at any point in time.

Mom called me a little while ago. I can tell that her body's fighting. The conversation started off angry and confused. She is convinced that I'm not letting her come home and that I have ultimatums or I'll kick her out of her own house. I may not agree with or understand everything the medical doctor says, but if her hepatologist says she's okay to come home, then I accept his decision. He knows her, he knows her baseline, he knows that she can be snippy (though she's been working on that), and that she's not normally in cop-calling mode. Am I the only one who thinks it's not a coincidence that her last episode with babble talk and a splitting migraine just happened to be days away from her calling the cops on me for not making an egg burrito? She started to break through a little bit; she told me she loved me and she knows I love her. She's starting to waiver on her severe anger, but the mood swings are still there. She still hasn't cleared her system - she's still clogged, even though they're giving her meds - and I think that once she does, her head will clear up quickly.

I hope they don't release her too soon. It'll just make things worse if she's home AND this bad. I'm hoping that we can get someone to help us when her head is clear. If we can sit down and put something in writing about what to do the next time *I* think she needs to be in a hospital, and have it in print, maybe that'll help her not to feel like she was tricked. But honestly, I don't know that she'll ever think she wasn't abused when she goes into a hospital. The whole reason of being there is that she's so confused and HE-ridden. Her hepatologist said to bring her in 3 weeks ago. She said she would if she got worse, and didn't follow through. Her PCP told her he wants her in a hospital (but he lacks the cajones to do his job anymore. I really have lost all respect for him as a person and a doctor), and the hepatologist on call at the hospital also told her to go in. She told me she'd go if we got her meds to take with her so she wouldn't go without krystalose in the waiting room and could get a head start on it. I got her meds. We went to the hospital. There was no trickery. But she's deadset on the delusion. After all that, she still thinks this was all my idea and that I'm trying to kill her. I don't know that having a plan (which I thought we had, and I was following), even having it down on paper, would make her calm down about going to the hospital. But I think having it down on paper and having it talked out and planned out with someone else (like her hepatologist or a family friend), would make it easier to explain to a doctor the next time, and they'd understand this is less of a social worker issue and more of an HE issue. Then maybe they'd understand why I still went out and bought vitamin water and brought it back to the hospital, because that's what Mom wants to take her krystalose with, even after all the horrible things she said. These people strike me as illogical. They're shocked that I'd do her such an unnecessary favor after how vicious she was, yet they don't believe me when I say her anger and mood swings are part of the illness and not normally this bad. Maybe they think I'm insane. I've been called worse...by Mom, no less. =P

I think another part of her problem is that she hasn't been taking the krystalose as she was prescribed. The pharmacy said they issued an 18-day supply. As of last night, they said she should've run out 10 days ago, yet she has a few packets left. She doesn't understand how that could be true, because she believes she's been very good about taking her medication. I don't know what to do at home with her. I can't micromanage her without her raising hell, and I can't even observe if she's taking her meds with her door closed all the time. I know that sending her home will just repeat this cycle. She understandably wants her independence, but isn't taking meds like she should and isn't able to keep her HE under control on her own....I just don't know what the solution would be here. A few people have mentioned Hospice, but when Mom's head is clear, she says she's not ready to go yet. When her HE is as bad as it is now, she says she wants to die just to spite me, and then she says that I'm trying to kill her, so she'll live to spite me. There is no easy answer here. I wish I knew what to do to, and I wish she could get on a transplant list for HE, but they don't count HE as a problem. Trust me; it's a problem.