Karen Hoyt is a blogger who has a story about hepatitis C, cirrhosis, end-stage liver disease, liver cancer, and liver transplantation. This excerpt first appeared on Karen’s I Help C blog.

A build-up of toxins in the brain can lead to confusion, memory and mood changes, depression, and even delusions. Psychotic episodes and hallucinations with hepatic encephalopathy (HE) can be some of the worst things a person with end stage liver disease (ESLD) can have. If you or someone you love is dealing with this, it takes a great amount of patience and encouragement. With help, they can get the right meds and try to reverse the effects.

Downward Spiral

Depression — HE can start as depression. After telling my doctor I didn’t have the energy to decorate for Christmas, he put me on an anti-depressant. Well, that turned my reverse sleep pattern into insomnia. At bedtime, I took Ambien and xanax. I also hired someone to put up the tree.

Confusion — This was tough to pin down. At first, I traveled all day, scheduling the harder things in the morning while chugging caffeine. After lunch, I often slept in my car for an hour. Eventually, I went back to the classroom teaching high school and college. I was good at my job, and my students did well on state test scores. All of my work related goals were met, but I was on autopilot.

Mood Changes — At home, I locked myself in the bathroom and cried myself to sleep. I didn’t know what was wrong, and sleep was my best friend. On a few occasions, I became belligerent and threw the remote control across the room when the noise of the television was too much for me. The Ambien probably stayed in my bloodstream 24/7.

Who’s That Girl?

Memory — I took my Franklin Covey planner everywhere. It was my brain. Inside my own head was a swirl of mush, and I have only spotty remembrances of the last 18 months before my liver failed. Many times I came home from a big box store with no purchases. Other times, I had the whole trunk of my car filled and didn’t remember buying it.

Hallucinations — I was wandering around in a dream and even went outside at night chasing armadillos with a flashlight. I was convinced the critters were eating my flowers. In one of my hallucinations with HE, I even transplanted weeds from a field into my flower beds, trying to lure armadillos to eat them. I thought my mother was trying to give me secret messages and talked of it constantly. I’ve heard of people who accused their family of trying to poison them with lactulose or xifaxin.

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