Oh, dear. All the empty platitudes apply of course: one day at a time, try to control the things you can control (diet, exercise) and try not to stress too much about the things you can’t. First and foremost, breathe. Let yourself cry when you need to, and scream, and tell the trees how unfair this all is. It *is *unfair, and it sucks, and it’s totally okay to be mad as hell about it, and scared, and sad. And, of course, vent here all you want.
Okay, that said, the fact that the doctor wants to address the ammonia build up through diet is a good thing. It means it’s not so severe yet as to warrant more aggressive (drug) therapy.
There is a drug (usually Lactulose) that they may decide to give to him eventually. It binds to the ammonia and makes him poop it out. He may also give him aggressive antibiotic therapy eventually - the ammonia is actually made by bacteria in the gut. If the ammonia level can’t be brought down by diet and Lactulose, antibiotics can kill the bacteria in the gut that make the ammonia.
Diet guidelines your doctor gave you trump anything I say, of course, but in general, you want:
low fat - the liver makes bile, which breaks down fat, so fat digestion is difficult when the liver isn’t working well
low protein - protein requires a lot of work from the liver to digest, and a diet high in protein increases toxins that his liver can’t clear right now. Vegetable proteins may be easier on the liver than animal proteins, and less likely to cause ammonia buildup.
low simple carbs - blood sugar gets hard to control when the liver is out of whack
high complex carbs - he needs to get his energy from somewhere! Complex carbs are the least strenuous foods on the liver.
Lots of vegetables and whole grains, some but not too many nuts, few meats, cheeses, refined sugar, white flour, etc. Alcohol, of course, is right out. You’ll notice, of course, that that is a pretty good diet for most people, so you should consider joining him on his new diet, with the addition of a bit more protein for you. It may help him - and you - to feel like you’re “in this together”.
No Tylenol! It’s *really *hard on the liver. Ask your doctor what he should take for headaches and such instead. Remember that Tylenol (aceteminophen) is “hidden” in a lot of cold and flu remedies, so read labels carefully. It’s really best to run any medication, including over-the-counter stuff, past your doctor or a pharmacist before he takes it. Pharmacists are usually quicker to get hold of; if you have any medication questions, pharmacists are trained to know and be able to answer many patient questions, so don’t forget them on your list of professionals who can help you.
Don’t give him vitamin supplements unless they’ve been approved by your doctor. Excessive vitamins are hard on the liver. He may need a special kind of supplements for fat soluble vitamins; your doctor can give you a prescription for those.
If there’s anything I can help with, any terms or anything you don’t understand, please don’t hesitate to ask. I’m not an expert by any means, but I’ll do what I can.