I have been diagnosed as having cirrhosis and liver cancer. Most of the cancer lesions were treated with direct chemotherapy which has reduced most of the larger lesions but left me exhausted and profoundly weak. Initially I had acites which led to esophageal varices. Abdominal fluid was drained and the portal hypertension seems to have leveled off. Blood ammonia levels are high requiring lactulose. No visual jaundice yet although bilirubin levels are twice normal. I have become too weak to stand and can no longer feed myself due to profound weakness in my hands. I also have trouble swallowing and frequently regurgitate medicines and the soup my caretaker is feeding me. What might be causing my difficulty with eating?