For the past few days, the state of the President of the Republic’s health has been the subject of speculation among the general public. Miloš Zeman has long been treated for diabetes, he suffers from neuropathy. From the Central Military Hospital in Prague, where the first person in the republic has been hospitalized since Sunday, new information leaks about hepatic encephalopathy as a possible cause of liver cirrhosis.

Several doctors from military hospitals and government officials who spoke to Seznam Zprávy spoke on condition of anonymity that the president’s current problems are related to this serious illness. He was the first to report hepatic encephalopathy N’s Diary with the president said to be disoriented and saying “unclear things” due to his illness.

The official castle site is silent. Even First Lady Ivana Zemanová, speaking at the press conference, did not eliminate the questions faced by the entire political world in relation to the post-election situation. “I find speculation about the diagnosis and prognosis unethical, to say the least,” he said, without elaborating on the president’s health.

At the same time, it was her husband who said two years ago that people are entitled to this information. “In the case of the president of the republic, it is his duty to let citizens know about reports on the state of his health,” Barrandov said on October 24, 2019, on the president’s TV program Týden.

If the head of state really suffers from hepatic encephalopathy, the prognosis in such a case is not at all encouraging.

Experts who spoke to Seznam Správy about the course of the disease agree on this. At the same time, the questions do not concern the head of state, they are asked on a purely general level.

As professional sources state, hepatic encephalopathy has neuropsychological symptoms, behavioral changes are increasingly seen in affected people. The cause can be found precisely in chronically poor liver function, which loses its detoxifying function. Harmful substances such as ammonia affect the central nervous system.

At the first stage, the patient is slightly confused, changes in behavior appear. The second, personality and thinking disorders already exist. In the third stage, he suffers from impaired consciousness, he experiences disorientation. The final stage is accompanied by a coma.

Encephalopathy is damage to brain function due to increased production of ammonia and an imbalance of other substances. It manifests itself in impaired concentration, mood swings, memory disturbances, sleep and wakefulness disorders, apathy and disorientation,” explains Pavel Trunečka, head of the hepatology clinic of the IKEM Prague Clinic Hepatogastroenterology, when asked by Seznam Zpráv about the consequences of the disease. In the past, as a leading hepatologist, he participated in the initiation of liver transplant programs and liver transplantation in young children.

As he says, the manifestations of encephalopathy itself can fluctuate rapidly due to other complications, such as infection or bleeding, but also improve as a result of treatment. “However, long-standing encephalopathy causes changes that are only partially reversible,” he says.

According to Pavel Trunečka, encephalopathy that occurs acutely can be quickly corrected as a result of complex treatment, but if it is a manifestation of an advanced chronic disease, this correction may not be complete.

The psychiatrist Cyril Höschl also repeatedly discovered this disease in patients during his professional life. “In addition to a decrease in cognitive functions, such as memory, attention, performance and the like, this disease manifests itself, among other things, in a reduced state of orientation. And that in all qualities, it means place, time, person,” he also explains in general the complications what the disease does to people.

Höschl adds that the course of the disease is not the same for all patients and changes from time to time for everyone, one day the condition is worse, the next day better. “As with all metabolic conditions, its manifestations can fluctuate greatly. What applies today may not apply tomorrow, but overall the prognosis is not good,” stressed the leading Czech psychiatrist.

As he also says, the solution for some patients may be a liver transplant, which removes the root cause. However, it is certainly not a solution for everyone, a number of conditions must be met before the organ is transferred from the donor body to the recipient’s body. It’s about long-term abstinence.

Pavel Trunečka, the aforementioned transplant expert from IKEM, expresses himself in this spirit. “Many other factors influence the outcome of liver transplantation, and age is one of them, however, even being over 70 is not a contraindication in itself. It always depends on the overall condition of the patient – the so-called biological age,” he said.

Psychiatrist Cyril Höschl is also thinking about who should determine whether a patient with hepatic encephalopathy is capable of more complex intellectual activities.

“If a normal citizen, his legal capacity will usually be assessed by a forensic expert from the field of psychiatry,” Cyril Höschl explains standard practice.

Questions about President Miloš Zeman’s health caught the attention of other Czech constitutional officials. The head of the Senate, Miloš Vystrčil (ODS), decided to request information from the castle office. On their basis – that is, in the event that the president is unable to carry out his office – the chambers of parliament can decide on the transfer of power to the prime minister and the chair of the Chamber of Deputies.

“I don’t want to investigate whether the president was alert or not. I don’t want to investigate what pills he took, I’m not a doctor and that’s not our role. It needs to be approached humanely and sensitively, but we need to know if he’s capable of the job.” explained the Senate Speaker in an interview with Seznam Zpravy, adding that he requested the information in a letter to the Office of the President of the Republic on Monday and is still awaiting a response.

“We decided not to explain our next steps. We don’t want to push anyone against the wall. We have a two week deadline to see if we get that answer or not, we’ll see what happens in that period. After that, we’re ready. reacted very quickly,” he added.

The outgoing Chair of the Chamber of Deputies, Radek Vondráček (ANO), testified on Thursday that President Miloš Zeman personally signed off on the decision to convene a new session of the Council of Deputies on Monday, November 8. “He carried out his actions (signing the decision) very clearly,” said Vondráček.

Note: We will be bringing the entire interview with IKEM specialist Pavel Trunečka about liver disease in the next few hours.