Last night, at about midnight, mom woke up! She spoke to the nursing home staff, asked about James, and wanted to speak to him. The staff politely refused to call James, since they knew he'd be there first thing in the morning, like he is every day... When James did arrive, mom chewed him out. She thought he'd been off golfing all this time. And, boy was she mad! (In reality, she's been the one who left the building. James has been by her side almost constantly since this episode began over a week ago.) Jill dropped the twins and I off at the nursing home at about 10:00 this morning. (Jill had an appointment.) My brother (Mike), and his wife (Kristie), arrived a few minutes later. (They arrived from Coeur d'Alene, Idaho last night.) Mom was awake and relatively alert. She made eye contact with me for the first time since this bout of encephalopathy began. And, she coaxed smiles from both Hunter and Grace, who promptly returned the favor. Mike gave her his patented "12 hugs" with kisses to match. It was a very happy room! So, mom is now coming out of her encephalopathy. Last week, she was at "Grade 3" on the 1 to 4 scale of encephalopathy (where 4 = coma). Today, I would say that she's at "Grade 2." She is awake and communicating, though still groggy and having difficulty finding words to express herself. She even fed herself part of her lunch. And, no wonder - her ammonia level has dropped to 106 as of yesterday morning, and is likely still falling as the lactulose seems to be doing its job. I've not spoken to her doctor, but my hope is that her short-term prognosis is now much improved, since she is responding well to treatment. Hopefully, by this time next week, mom will be back to baseline. Though, it is not outside the realm of possibilities that mom could slip backwards. And, quite certainly, mom's long-term prognosis isn't good. The ammonia will be back, and with it will come the encephalopathy. This has been a very scary experience for all of us. Now that mom's regaining consciousness, I'm certain that each of us will find a way to communicate to mom how much she means to us. James, especially, was bouncing around and beaming, today. His girl is on her way back! It was clear to see that he is incredibly happy, which helps mom tremendously. One last bit of news to report today: James went ahead and signed mom up for hospice care. The hospice admitting nurse met with all of us today. She explained the services offered by her team. And, she examined mom, looked at her charts and spoke to the consulting hospice physician about mom's meds. They're going to add something for the itching, as well as a medicine to help with the disorientation/confusion associated with the encephalopathy. More as we know it... Many thanks, again, to everyone who is keeping mom and the rest of us in their thoughts and prayers. We can feel the love!