In this stage the liver fails to remove toxins from the body and some of the following symptoms may occur:

  1. increasing  fatigue
  2. acites
  3. forgetfulness and confusion
  4. depression or anxiety
  5. trouble sleeping

A diagnosis, if not already known, generally takes place during this stage and the person may struggle to understand medical information. Other people, close to the person with liver disease, start to become more aware that a serious illness exists. Transplantation, as a possibility, may now be mentioned. News of a possible transplant is overwhelming and reactions of denial or fear are common.

The individual is unable to maintain the same levels of energy and concentration as before the liver started to fail. The demands of usual responsibilities start to exceed abilities as physical and cognitive abilities decline.

The person with liver failure, now has to balance the role of a patient with performance of other roles and responsibilities. The individual, now assuming the role of a patient, experiences decline. Loss of the sense of competence and frustration experienced in stage 1 increase.

In the best scenario, treatment leads to remission or cure, in the worst to death. If transplantation is seen as the best likely course of treatment the person moves to Stage 3.

My experience:  I was working as the Director of Adjunctive Therapy at a psychiatric hospital in Oklahoma. The hospital conducted medical screenings as part of a wellness program. I was told I was very healthy and fit yet I should follow up with my family Dr. about my high liver enzymes.

After nearly two years of continuous testing and head scratching, I was diagnosed with non-A non B chronic active hepatitis, which over time became known as autoimmune hepatitis. Over the next 15 years I experienced repeated flare-ups and was treated with tapering doses of prednisone to reduce the inflammation in my liver. In my case, it was a treatment, not a cure.

What is Autoimmune Hepatitis?

What are the liver diseases that lead to transplantation?

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