Should you check an AMMONIA level?

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Ammonia isn't as helpful as many people think it is (unfortunately)

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Doc Schmidt

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It's so cool to see behind the curtain into the medical world in a way that isnt some tv drama

brendenporterfield

Every hospitalist I know needs to know this.

TheMango

My brother died less than a month ago because of failed (?) liver transplant combined with many things. He certainly was confused when he was at his worse, and at the end got into liver coma.

iloklok

As a nurse who has worked in a liver unit with dozens of cirrhosis patients this is an awesome breakdown. Do more of these

AT-yjgl

My mother just recently passed away. She had non alcoholic fatty liver disease that turned into cirrhosis. She also had both side heart failure and pulmonary hypertension. This was all discovered 5 years ago when she became increasingly confused and started hallucinating. She had high ammonia levels. I always wondered why they didn't follow up more on the ammonia levels. This helped me to understand. Thank you.

denisesheppard

That’s super informative!! Sometimes families ask me why the doc didn’t order ammonia levels, now I know what to tell them!!!

ryannpalermo

Yes, finally an understanding of seriel NH levels. I would reject them for rationale.

These shorts are great for Step 2 and PANCE readiness. If Doc could just post 100/ day 😏

ianlondon

YouTube GI Consulted; appreciate recommendations

Love your vids, man! These little clinical pearls are great.

hoobz

These educational shorts are some of the highest quality resources I've seen. You're consistently teaching more high yield clinical pearls in 1 minute than I get in an entire day of clerkships.

mathnerdm

This is super interesting, thanks! My dad has chronically elevated ammonia levels because of liver issues (not from drinking, he doesn’t drink and never has—he has polycythemia vera that developed into leukemia, and a cascade of complications and surgeries from there led to the liver problems) and he’s been hospitalized many many many times.

He explained to me recently that the medication he’s on to deal with the ammonia is basically just a fancy laxative. It makes him have a ton of bowel movements per day. In his words, “really annoying, but a lot better than being dead.”

I will always have a soft spot for GI doctors. All my dad’s serious life-threatening bleeds have been in his GI tract, and incredibly knowledgeable and skilled GI docs are the reason I didn’t grow up without a dad. His first brush with death was when I was 3–more than a brush honestly, my mom was told he wasn’t going to make it—and I’m 24 now and I still have my dad. He’s still active, working, happy, and here. He’s had fucking skin cancer at the same time as having leukemia and that was barely a footnote. During his most recent hospitalization 2 years ago, when the hospitals were still super clogged with COVID patients, he was in the hall waiting for a bed and was really craving mac n’ cheese (which was alarming to me because he is a very strict healthy eater), and I lived near the hospital so I ran out and grabbed some Panera mac n’ cheese, microwaved it, and brought it to him in the hallway. His skin was so yellow; he was so jaundiced. I remember standing in that hallway with him in his cot, trying not to break down because he was so cheerful and sweet as always and yet he looked like he was on the brink of death, and I wondered if this was the last moment I would have with him. But it wasn’t, and he’s here still.

Sorry this was lengthy, I am just so grateful to the doctors and surgeons who have been so dedicated to helping my dad live. He’s the most wonderful person I know, and they’ve only ever seen him at his very worst, and they pulled out all the stops for him. Thank you for your work. I can’t even begin to express my gratitude. The gift my dad’s surgeons, doctors and nurses have given him, me, and my family is immeasurable.

guyanomaly

More videos like this please!
Would love to see you put out more teaching videos too. Maybe start another channel? You could collaborate with other Youtubers like Strong Medicine, Medlife Crisis, Glaucomfleken etc. ;)

joshyantony

Pharmacy student here, we talk a decent amount about liver disease and Child-Pugh scores for dose adjusting. I never really understood how hepatic encephalopathy was caused or really what it was, so I really appreciate the simple explanation!

Rosabellajoy

My grandmother's doctors need to know this !!!

amandafields

A hard video to watch. A local friend is currently on a DNR due to liver failure, her first signs having been confusion and elevated ammonia. No matter what, thank you for keeping people informed.

sandraodell