If you want to know what liver failure “looks” like, read on, because that’s what I’m going to share today. If you don’t want to know and you read this anyway, don’t say I didn’t warn you!

Liver failure looks like hope and then heartache, hope and then despair, hope and then sorrow. One day, his ammonia level is down and he’s clear-headed, though very weak. We leave late in the evening, after he’s settled for the night, enthusiastic about the day — he’s going to rally! — and looking forward to the morning.

And then morning comes and he’s groggy and confused, less able to stay alert or hold a conversation. Our euphoria from the prior day dwindles; perhaps today is the beginning of the downward spiral, the end of clarity.  It’s like a seesaw from childhood. One moment, you are dangling in the air, legs swinging, laughing. The next moment, your teeter totter “friend” has jumped off their seat and you’ve come crashing down.

Physically, as his liver failed, his skin has taken on a yellow tinge and the whites of his eyes have become yellow. If you’ve never seen this color change before, at first, it’s hard to recognize. On my olive-skinned husband, it looked initially as though he’d gotten a little sun. In comparison to my very pink Irish skin, his yellow tinge is very apparent.

If you think bodily functions are gross, you won’t appreciate this next part:  his urine is the color of teak wood. It just so happens, due to other cancer complications, that he has a catheter so it’s easy to pay attention to changes in urine color, in the collection bag hanging from the side of the bed.

To keep the ammonia level — and the confusion — down, they give him an orange-colored, corn-syrup-thick liquid called lactulose. Ken says it tastes awful. It also causes horrible diarrhea.

Another symptom of liver failure is his exhaustion and weakness. He literally doesn’t have the strength to get out of bed by himself. Yesterday, we went for a walk around the floor with the mobility aide but we only got a few steps before he needed a walker. Once he had that, though, they had to ask him to slow down!

When he’s alert, his mood is pretty good. He’s more peaceful, most of the time, than he has been through this whole horrible illness. That’s not always the case, though, and as his ammonia level increases, so does his irritability.

The GI doctor did a procedure on Friday to open his bile duct up. They put a camera down his throat, through his stomach, into his intestine, to his bile duct. (Do I sound knowledgeable? I’m actually a really good sponge (or parrot) but I don’t really know what it all means, beyond high school biology.)

Anyway, they were looking for blockages in his bile ducts as well as any stuff that might be clogging things up. The expected 30-minute procedure was more than two hours long. There were blockages everywhere. The doctor could only put in two stents, in the largest bile duct and its right branch. Monday we’ll know if they are going to propose doing more. The bilirubin level continues to rise and he’s terribly confused today so I am not sure their efforts could be defined as successful.

Thank you again for all your thoughts and well-wishes. I have been sharing them with Ken and he’s very appreciative.  Maybe tomorrow I’ll talk about how Ken is dispensing the stuff that is meaningful to him. It’s painful but perhaps it is reassuring to pass on things of personal significance while he can still explain their importance. Take care ….