Conversation: The conversation between human and AI assistant.
[|Human|] Hello, my grandma is 71 turning 72 in July. She is basically in the end stages of liver failure. She had a tube that was drain excess fluid but she pulled it out because she was frustrated. Now she has a chest tube that is draining all the fluid because her lung collapsed. Her voice was going away for the past couple days but now it is completely gone. Is this associated with the liver failure or is there another explaination?
[|AI|]  Welcome at Chat Doctor !!  I have gone through your case and being your physician I completely understand. Your health concerns... Based upon the history you have provided it is rather difficult to pinpoint the diagnosis since your grandma has the variety of issues. End stage liver disease do presents with loss of speech that is called HEPATIC ENCEPHALOPATHY grade 4...... It is the most common cause of loss of speech in chronic liver disease.  Second probability is hypoxia leading to carbon dioxide retention leading to acid base imbalance that too provokes hepatic encephalopathy and also one of cause of loss of speech.  You better take her to hospital so that appropriate workup has been done, and proper management should be provided to her.  May she get well soon, if u still have any query feel free to ask anytime regards Chat Doctor.