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About how long does it take hepatic encephalopathy (from alcoholic cirrhosis) to progress from Stage 2 to Stage 3/4? Brother in law has had Stage 2 about three years now but lately he seems to be getting worse. He stopped drinking 3 years ago at age 51 when he experienced severe vericeal bleeding and 8 day coma - at that time doctor told him he had 3 years. He does take all his meds. Thanks for any help. Just trying to find some real answers. He does not qualify for tranplant.
In my own opinion, they wouldn't know that they shouldn't drive. Usually they possess a strong will to do what they want, and as you seem to have noticed they can turn angry...even violent when they feel provoked. Which if ask not to drive may seem to them a provocation.
You have to understand they are not in thier right mind as to say when this happens.
When I lapsed into stage 3 I was told that I became violent, I tried to get away from the nurses (I must have felt provoked by them) though I don't remember any of it. They even said I had tried to hit a nurse Julie, she had always been very kind and nice to me. Though at the time they were trying to restrain me to the hospital bed. I didn't know what I was doing as stage 3 can become very severe at any time. they can be the nicest person, and then just go off and be very violent unpredictably, and they can also become very very strong and hard to control. It's hard to tell when it could get this bad, as my stages of coma were acute where chronic is slower as you said he's been in stage 2 for awhile now.

I would ask his doctor for his advice and your concerns, and I would ask the Dr. not to mention to him it was you or other family that brought up this concern, your bro. inlaw might take this as a provocation and become upset which is not good.
To me it sounds like he maybe entering into a form of stage three, the outburst you mentioned over trivial things seen by him most likely as provoked. The other signs you have mentioned also in my opinion suggest it.
It's hard to say if or when it would turn to stage four, I pray it doesn't.
Don't lose faith, It's in us and all around us.

I wish I had more positive things to say...I was told by my neurologist basically I had died in stage 4, was pronounced "Brain Dead" for 2 weeks, the EEG he said showed "signs non-conclusive of life"
He asked my Girlfrend (as my family had not arrived yet from out of state) what my wishes would be, which she replied "he want's a full code" in terms means to do everything posible to keep me alive. We are not together anymore...ever since the coma...though I'll never forget her and still love her deeply, she also called my family or they would have never known to come. I remember before I slipped from stage 3 to 4, a Priest came to give me my "Last Rights" and I had a moment of total clarity and told him "I didn't need them, it wasn't time for that yet" that is the last thing I remember before lapsing into another place. I know this site don't like talk of this, though it's the truth...I was somewhere, not unlike here though surrealistic. Then after I don't know how long two voices spoke, a woman and a man...they asked where I was..I said I didn't know and asked who they were. They said who they were wasn't important, what was is getting me back to where I belonged...after that it was dark till I realized I could see again, and it was my Family with my Girlfrend with them. I was in and out of consciousnes, I was told I babbled like a took four day's before I could form a sentence...I awoke to see the doctor there and was able to ask what happened (he had no answer). I seen the neurologist after leaving the hospital to seek help for the residual effects, that I still have till this day. I explained to him what I experienced, he had nothing to say but what I went through had to be real (an experience) not a dream as my EEG showed no signs of activity, so that I could not have been dreaming it would have shown on the EEG if I was.
When I share this with others they say "your a miracle" and I have to tell them "I'm not, but what had happened was"

Sincerly,with my prayer's

JW - can't tell you how much I appreciate you sharing your life experience with me. You are a miracle for sure!! You are meant to be here now!!! What an amazing account of your experience! And you are right - those are things most people don't share on these postings.

I agree with you completely on having the doctor talk to my bro in law about driving - that is what I'm encouraging my sister to do and I think that is a very good idea.

He drank every day heavy for 30 years before this really hit him. And three years ago when he had his bleeding (varices) and was in an 8 day coma that is when he stopped drinking! So every day now is a blessing - we have all learned so much through this. But what I know is his ability to stop drinking has given him these days, months, years - however many we all have together. He's had quality time with his grandkids and made peace over other things. We are all very aware the outbursts are from the HE so we handle them accordingly. Still easier said than done! He hasn't been physical yet, but we are prepared! It's taken him almost 3 years for us to start seeing some progression - so maybe this is going very, very slowly. I am learning - to cherish each day. He is real good about taking the meds and eating right - and his doc is very good. We do what we can - that is really all you can do - the best you can, right?

I keep rereading the part about your experience of the man and woman talking to you and that it could not be a dream. That had to be reassuring for you! My best friend of many years had a somewhat similar experience after losing her baby to SIDS - you wonder how many people have that kind of encounter. I don't know how long ago you encountered your stage 4 - but I am so grateful you came back and have stayed strong - and are so "open" and sharing with total strangers like me who get so much out of understanding this better. To say thank you seems inadquate. Yes we are praying the doctor is wrong (they are wrong every day) and we have lots more time. Thank you JW. Stay strong, and know you are appreciated. Another big hug your way. Sandy
I started a new post looking for anyone who has survived a stage 4 w/ HE from fulminant hepatic failure, and have had no replies...:(
I've been looking since 1994, and haven't even found a doctor who has heard of anybody. I just was wanting to know how others have been dealing with the residual effects.
I was reading about chronic HE and found that if the person is getting worse to look for any underlining causes that may be adding to the progression of the HE. That if you find any, could be diet, med's, anything that could effect the liver or renal (kidney) functions, the kidneys excreate most of the toxins built up in the liver, ammonia, bile and other unknown toxins.
By eliminating the cause, it could be something so minute it's overlooked. His condition may inprove. Have you checked out wikipedia about HE, they have some useful info & mabye a few links.


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