Question about Encephalopathy

Old 01-19-2006, 11:24 AM
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Question about Encephalopathy

Wondering if anyone can share their experience with me. My mother is 74 years old, been an alcoholic for at least 30 years. The doctors told her she had liver problems probably due to alcohol (she lied about her drinking to them) at least 10 years ago. About 2 years ago her doctor told her she was in the end stages of cirrhosis and would die if she continued to drink. After telling everyone "I can quit on my own, I don't need help", she continued to drink (what a surprise). In the past year she has basically stopped caring for herself, her house and her dogs. My brother and I have had to step in and manage her affiars, I have taken her dogs as they were being neglected and relieving themselves all over her house due to her not letting them outside. She has been going back and forth between home and hospital and skilled nursing homes since October with problems with acites, cellulitis, congestive heart failure just to name a few. She lives alone and craves attention since she has alienated all of her friends and no one cares to see her anymore. My brother and I are the only ones around now.

Anyway, my question is about Encephalopathy. She has had several bouts with this in the last couple of years, where she just seems to stare through you and not at you. Even the simplest of tasks are difficult. Then she seems to come out of it. A few days ago she told me that my father came to visit her. My father died 40 years ago, when I was two. She spoke in a monotone voice - no emotion at all. My father died in a fire and she was telling me that when he came to see her he had ashes on him and went in to detail about some other weird things. She was able to keep up this conversation about what transpired for about 20 minutes. We talked about a few other things and then said good bye. I assumed that this was another episode. She is currently in a nursing home so I know she wasn't drinking. I have to say that the conversation had me pretty upset.

A few days later when I spoke to her she seemed back to normal and a little more clear headed. I didn't bring up the conversation about my dad but she did. She told me that she only said that so that I would be more concerned about her and come and visit her.

So...my question is this: When someone experiences encephalopathy, do they remember what they did or said after they come out of it? Being as sick as she is, I find it hard to believe she could orchistrate such a detailed conversation, but on the other hand she can be very manipulative. Most things I've read about this have said that the person doesn't remember what they did during an episode of encephalopathy. If she does remember, then she really was just "working me".

I am getting so weary of this. I am so close to washing my hands of this whole situation. The emotional roller coaster is literally making me sick. I have had 3 sinus infections, bronchitis and the flu in the past 3 months and I know it's due to the stress of dealing with being her caretaker. I usually never get sick.

The next challenge will be to find her a permanent place to live as she needs at least 12 hours of care per day. We'll be renting out her house in order to pay for her care in a place which I am sure will not be up to her standards.

I really need to work on my detatchment skills I guess.

Sorry so long, any input or info about your experience with this would really help.
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Old 01-19-2006, 11:38 AM
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So sorry that you are going through this. It sounds terribly painful and stressful.

Sorry, but I don't know the answer re: encephalopathy. I'm sure others here will have some advice, though.

In my opinion, if your Mum made up that story, then she is a pretty good storyteller.

Keep coming back.
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Old 01-19-2006, 11:48 AM
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For those that don't know

What is Encephalopathy?
Encephalopathy is a term for any diffuse disease of the brain that alters brain function or structure. Encephalopathy may be caused by infectious agent (bacteria, virus, or prion), metabolic or mitochondrial dysfunction, brain tumor or increased pressure in the skull, prolonged exposure to toxic elements (including solvents, drugs, radiation, paints, industrial chemicals, and certain metals), chronic progressive trauma, poor nutrition, or lack of oxygen or blood flow to the brain. The hallmark of encephalopathy is an altered mental state. Depending on the type and severity of encephalopathy, common neurological symptoms are progressive loss of memory and cognitive ability, subtle personality changes, inability to concentrate, lethargy, and progressive loss of consciousness. Other neurological symptoms may include myoclonus (involuntary twitching of a muscle or group of muscles), nystagmus (rapid, involuntary eye movement), tremor, muscle atrophy and weakness, dementia, seizures, and loss of ability to swallow or speak. Blood tests, spinal fluid examination, imaging studies, electroencephalograms, and similar diagnostic studies may be used to differentiate the various causes of encephalopathy.



This certainly sounds as if it is a disease caused by your mothers drinking for all those years.

I think the best thing to do is ask her doctor, voice your concerns and go to Al Anon to learn how to take care of you and detach from your mother as much as you can.

I don't know about where you live, but the weather has been so crazy around this part of the US, that many many people are getting sick with sinus infections and such ....... your illnesses may not be caused by stress because of taking care of your mother. If I were you, I'd get myself 100% well and ask your brother to step in while you recuperate.
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Old 01-19-2006, 12:40 PM
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Hi Flower, I am so sorry you are going through this. I know that alcohol has longterm effects on the brain. From a spiritual side, maybe she is seeing your late father. I know hearing about this may hurt you but the mind does funny things. Your mom may have been thinking about him and thoughts of her own mortalitiy may be worrying her. I hope you have the support of someone aside from your brother. I took care of an aging realitive till their death and it is very draining. I will keep u in my thoughts and prayers!!!
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Old 01-19-2006, 02:08 PM
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Thank you Robina...I will keep coming back. There is so much comfort to be given and received on these boards.
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Old 01-19-2006, 02:16 PM
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Reader,
Yes, I thought at first that she might have actually received a "spiritual" visit from my father. Who knows...
I do have emotional support from other friends and family (which has been a lifesaver), however making the decisions about her affairs and getting her house cleaned out and ready to rent and research about finding her a decent place to live remains the responsibility of my brother and I. Working full time and having two children and a home two hours away from her makes it rough. Repeat...It's just a season, It's just a season...It will pass...It will pass.
Thanks so much for your prayers...much appreciated!
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Old 01-20-2006, 12:18 PM
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flower.....it will definitely pass. I wish I knew what to say. The other day you said a lot to give me comfort and I only wish I could give you the same. What you are going through right now, is what I have to look forward to. It's scary but it will pass.
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Old 01-20-2006, 04:14 PM
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A doctor will probably tell you they don't know for sure

I would say no she wouldn't have remembered the conversation, but encephalopathy is only one thing going on. mental confusion , dementia, electrolyte imbalance, it could be a mixture of a million things, episodes may present the same way but be of different combinations of things going on. There are those old manipulations but there is also a progressive illness going on. I think you are making wise steps, very practical and sensible. Maybe one of the nursing homes willnot only meet her medical needs but provide some social stimulation as well. She has made her life require 12 hours of care form someone else. That will increase not decrease. You aren't in a position to give her what is best so there is no need for guilt. The day will come when there will be no doubt, but for now, think of the energy YOU need to get through this and spend your time and energy wisely. You didn't drink her into this situation.
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Old 01-20-2006, 06:01 PM
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mallowcup...Thank you for your insight. I suppose it's time to stop trying to figure everything out and just let things take their course. Thanks for the wise advise. It really helps when people redirect me to taking care of myself so I can live a balanced life and be a good wife and mother. I am feeling better today about things!
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Old 01-20-2006, 06:13 PM
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Thank you jen. Just knowing I have people "around" that know where I am coming from is what matters!
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