Many would move to have a doc like that !!
Have you tried lactulose to reduce ammonia levels
to get rid of the 'brain fog'? Have you had your blood ammonia levels done?
If not, ask your doc to do it and get a script for lactulose.. it sits there, gathers up all the extra ammonia and takes it on a trip where it can no longer create 'frogs'.. until the next build up, that is..!!
I am 1a, 3rd stage cirrhosis.my VL was down to 373K in April, then suddenly 2.2mil in July.