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t2k@vcn.bc.ca  
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 More options Jul 24, 7:38 am
Newsgroups: sci.med
From: "t...@vcn.bc.ca" <t...@vcn.bc.ca>
Date: Wed, 23 Jul 2008 19:38:10 -0700 (PDT)
Local: Thurs, Jul 24 2008 7:38 am
Subject: Health problems since fall
Here's the story as it happened.

My 80 yr old dad had a fall between Dec. 10Th and Dec 14Th of 2007. He
tripped over
the curb of a sidewalk. He refused to have himself checked out until
the Dec. 23rd when
the pain at the ribs continued. X-rays at the hospital showed only two
to three ribs are
broken and nothing else. Doctors tell us the ribs should heal by
themselves.

My dad also told the doctors that a few days after the fall one of his
ankle became
"very swollen". This was the ankle of the same foot he had tripped
over the sidewalk.
But the ankle had returned to normal when we were at the hospital.

On Jan 28Th of this year he informs me he's been constipated since
then and now feels
pain because he can't get rid of the stool.

They did some tests on him but found nothing. They did manage to get
the stool out and
gave him something to help.

Bowel movements then return normal. But sometimes he's constipated.

On March 1st, he says he saw blood in his urine! A doctor gave him
Co Trimoxazole DS 800/160. Since then he's urinated a few times with
no blood. On
the morning of March 2Th he says his urine is clear like water. Doctor
gives him an
appointment with specialist.

On May 28Th he felt dizzy after eating breakfast. On May 30Th at 3am
my dad says he
saw "deep red" blood in his urine. He had another blood test which the
doctor says didn't
show anythings wrong other than low iron. He's then scheduled for an
examination on June
13Th and a CT Scan on July 25Th.

By this time he's been given Palafer GSK 300mg, Macrobid 100mg and
Synthroid 100mg.
Most days the urine is clear. Other days, some blood.

On June 5Th, dad is given: Nitrofurantoin 100 MG.

On June 15 there was blood in urine again. The hospital gave him more
Nitrofurantoin. Slight
blood in urine on the morning of June 16Th.

First week of July: my dad tells me that both legs are now swollen! I
was unaware of the
swollen legs thinking that the one swollen ankle he had back in
December was all he had and
had gone away. Instead, it had now spread to the other leg!

He goes to doctor on July 14Th and given a blood test.
The doctor says results of the blood test shows evidence of a blood
cloth
and told to go to hospital for an ultrasound. But the ultrasound
doesn't
find any blood cloths.

For the CT Scan this coming Friday (July 25Th), he's told to take
Mucomyst Acetylcysteine
Solution 2000 mg/10mL (mucolytic and antidotal Agent for acetaminophen
poisoning).
He's to take 3mL of it twice daily "with 15-30 mL of orange juice
starting the day before and day
of test morning and evening".

We can't wait for the result of the CT scan. Hopefully it will tell us
what's going on.


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J  
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 More options Jul 24, 9:49 am
Newsgroups: sci.med
From: J <xnswex@nalid;"no>
Date: Thu, 24 Jul 2008 00:49:22 -0400
Local: Thurs, Jul 24 2008 9:49 am
Subject: Re: Health problems since fall

Hi there,
I'm from Canada, ontario.

Constipation can be caused by a tumor, enlarged prostate, poor diet and/
or poor dentures, pain while chewing for some reason, swallowing problems,
hypothyroidism and probably a number of other issues.
I hope you mean 0.100 mg of thyroid replacement. If he's just been
diagnosed with that recently, they slowly increase the dosage. If his
thyroid is enlarged, they increase it until it -unenlarges but stays
within normal ranges.
TSH Normal Range : 0.35 - 5.00 mU/L
Free T4 Normal Range 10-20 pmol/L

There's a number of possible reasons for blood in the urine.
Some are listed here
http://www.nlm.nih.gov/medlineplus/ency/article/003138.htm
They don't mention prostate cancer, but I think that's a ;possible as
well.
Lupus is listed there. My brother "diagnosed" my uncle with it (due to
butterfly rash and other signs and symptoms).
He was a bit younger than your father, at the time. Brother told him to
get to doctor and he did and was taken care of, medically as best possible
from thereon, but died short of 80 years old.   I think prostate/rectal
cancer, but can't remember for sure.  That was 20'ish years ago.

http://www.nlm.nih.gov/medlineplus/ency/article/003139.htm
"Dark brown or clear urine is characteristic of a liver disorder such as
acute viral hepatitis or cirrhosis"

We just lost 2 uncles recently - other side of family, both early 80's
last year uncle fell or tripped and anpped femur near knee, so they
repaired it but analysis showed cancer (unknown primary).  They could not
determine which type of where the original was so all they could do is
radiation therapy after repairing the knee (for pain palliation and to
stop progression of that bone area. Later that summer he convinced the
surgeon to re-operate so he could ben his knee, instead of needing help
with showering and hopping from one place to another. He and his wife
wanted less "strangers' in to help. Unfortuately he developed pneumonia
after the 2nd surgery, undetected, no x-ray, no fever, and died in his
sleep.

The 2nd one had some shaking hands in March (this year) so we all thought
parkinson's.  While waiting for appointment with neurologist and MRI of
his head,  He felll while going to the bathroom and broke his hip.
They repaired that and got his MRI and neurology report in hospital. Mild
stroke, but meantime he'd stopped eating and was sleeping a lot.  So they
put a feeding tube in. His wife, my aunt said he suffered a lot. He died
of liver failure, cirrhosis and he was a non-drinker, non-smoker and had
been very active and healthy until then - no known reason for the
cirrhosis, unless he drank some tainted water during some of his travels
to various  foreign countries for vacations.

Sorry to be so long-winded.
I have some points.
Your father may be similar situation to this one I describe right above.
If it turns out the same, get hospice to help out at home. Feeding tubes
are cruel if a person will be dying soon.
Better ice cream or whatever he likes (ginger ale, beer, orange juice,
popsicle) and craves for hydration.
There's a limit of how much testing can be done on an older person -
"searching for a blood leak" - discomfort and risks to invasive tests,
often have to stay in hospital for long periods while tests are scheduled,
or one can't be done, until XXX days after another (etc).

I hope they find the problem and it's not too serious, but sometimes it's
hard to "fix" an aging body..
So if they give you bad news or choices and he'd be comfier at home,
visited by friends, neighbors, relatives, his favorite pet and "comforts",
do try to keep him out of hospital.

It's not easy losing our grandparents, parents, uncles, aunts (etc). They
meant the world to me.
Love him while you've got him and accept if nothing more can be done.
I'll be here caring and thinking of you all. please keep us updated.
Sending cyber hugs (assuming there's you and other family).
[[[[[hugs]]]]]]
Do you have family to support each other?
Great hospitals out there (BC?) I hope they'll be supportive of you all.
J


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J  
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 More options Jul 24, 10:00 am
Newsgroups: sci.med
From: J <xnswex@nalid;"no>
Date: Thu, 24 Jul 2008 01:00:52 -0400
Local: Thurs, Jul 24 2008 10:00 am
Subject: Re: Health problems since fall

J, no> wrote:
> "t...@vcn.bc.ca" wrote:

> > Here's the story as it happened.

> > My 80 yr old dad had a fall between Dec. 10Th and Dec 14Th of 2007. He
> > tripped over
> > the curb of a sidewalk. He refused to have himself checked out until
> > the Dec. 23rd when

PS I forgot to mention:
If he has a tendency to fall, get him a wide-mouthed bottle to keep beside
where he sits and one beside where he sleeps, so if he has to pee, pee into
it, instead of risking falling going to the washroom. He could sleep or lie on
a pad that would soak up spills and keep handi-wipes nearby for his
handcleaning. Just make sure he doesn't mix it up with something (juice) left
there for him to drink.
Whatever would help prevent him from falling (again) might be very helpful.
(walker, wheelchair, cane?,  nonslip slippers, remove rugs anything he might
trip over - may need eyeglasses or new glasses?
Hospice could probably help with lots of these things. There is a website
which shows where each hospice is.
Let me know if you'd want it or ask the hospital or his doctor.
Good luck with the testing.
J

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t2k@vcn.bc.ca  
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 More options Jul 26, 8:28 am
Newsgroups: sci.med
From: "t...@vcn.bc.ca" <t...@vcn.bc.ca>
Date: Fri, 25 Jul 2008 20:28:38 -0700 (PDT)
Local: Sat, Jul 26 2008 8:28 am
Subject: Re: Health problems since fall
Thanks for the responce. I'm from B.C.

My mistake: The Synthroid is 100mcg.
He's also taking Furosemide 20mg. And the doctor
recently gave him Centrum Select for 50+ .

He's been healthy for most of his life except for a liver
surgery about forty years ago. He still has his original
no-problem teeth and has never seen a dentist.

Thanks for the responce. We'll have the result next week.

Tony

On Jul 23, 9:49 pm, J <xnswex@nalid;"no> wrote:


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t2k@vcn.bc.ca  
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 More options Aug 9, 8:25 am
Newsgroups: sci.med
From: "t...@vcn.bc.ca" <t...@vcn.bc.ca>
Date: Fri, 8 Aug 2008 20:25:48 -0700 (PDT)
Local: Sat, Aug 9 2008 8:25 am
Subject: Re: Health problems since fall
Here's some new information:
My dad says he previously had blood in his urine once 10 years
ago. And the the cause then had not been investigated. He
remembers it wasn't as bad and they had given him some pills it
had cleared up. Last month, his D-dimer was said to have been high.
The broken ribs in December was said to be "more like a crack". The
eight rib had a crack. The ninth may have had a crack as well.

And here's an update:
While the CT Scan didn't show any thing's wrong, another doctor
phoned him today and told him there is a polyp on his kidney. The
doctor doesn't know if it's malignant. He's to call again next week.

Tony

On Jul 25, 8:28 pm, "t...@vcn.bc.ca" <t...@vcn.bc.ca> wrote:


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 More options Aug 14, 8:09 am
Newsgroups: sci.med
From: J <xewsnswex@nalid;"no>
Date: Wed, 13 Aug 2008 23:09:14 -0400
Local: Thurs, Aug 14 2008 8:09 am
Subject: Re: Health problems since fall

"t...@vcn.bc.ca" wrote:
> Here's some new information:
> My dad says he previously had blood in his urine once 10 years
> ago. And the the cause then had not been investigated. He
> remembers it wasn't as bad and they had given him some pills it
> had cleared up. Last month, his D-dimer was said to have been high.
> The broken ribs in December was said to be "more like a crack". The
> eight rib had a crack. The ninth may have had a crack as well.

> And here's an update:
> While the CT Scan didn't show any thing's wrong, another doctor
> phoned him today and told him there is a polyp on his kidney. The
> doctor doesn't know if it's malignant. He's to call again next week.

> Tony

Thanks for the information, Tony.
You''re doing a great job of getting the details sorted out.
Just for me (and others), since I bottom post...a review.
We're takling about your father who is 80, tripped over a curb, has one, possibly two,
cracked ribs which cause him pain.  Has been diagnosed with a thyroid conidtion which
is being treated. Has bouts of constipation, which is being treated.  Is being given
something for clots?  His D-dimer is elevated.  He's had on and off blood in the urine
and is anemic.  Ct-scan showed nothing, but another doctor says he has a polyp on his
kidney. [maybe he had an ultrasound elsewhere ] rhetorical if you don't know]

Perhaps they'll be doing a biopsy? One is described here
http://www.nlm.nih.gov/medlineplus/ency/article/003907.htm
Details may vary. If you're there with him, ask the people to make sure he has
something soft under ribs, so he has the least pain possible from the ribs.  Also tell
them about the anemia, in case he has breathing problems due to it.
(I'm talking about in the procedure room).

There's some benign conditions mentioned here, along with kidney cancer.
<
http://livingwith.urologychannel.com/hc-forum/kidney-stones_peer-to-p...


I'm hoping it's something benign that they can cauterize to stop the bleeding so he
can get on with his life.
Note: I'm not an expert so I'm not sure how they deal with a bleeding polyp.

You might want to make a list of the conditions mentioned there.
If it is cancer, I think the first priority is a CT? scan of all his bones and
referral to a radiation oncologist at the (closest)  BC Cancer Agency.  There is a
process, where the surgeon sends a request for consult to the BCCA and probably a
waiting period. Radiation therapy can treat bone pain and stop progression of bone
mets.  Since you mentioned his liver surgery and acetaminophe poisoning, the more pain
can be helped by RT, the less pain medications he might require, thereby protecting
his liver.  Removing the kidney could slow it down quite a bit.
Well, I'll leave this. The surgeon should know how to best handle an 80-year old with
anemia.
As long as they handle him with care.  It could get very tiring for him.
Are his legs still swollen?  Ask the doctor if he should wear compression stockings
for part of the day. They might decide not, if he's also got clots.

Thanks for the update. I'm hpoing it's benign and will be corrected soonest so he can
get on with recovering and getting on with his normal life.  If it is cancer, come on
over to alt.support.cancer or sci.med.diseases.cancer
Steph works for the BCCA and is our expert if you have questions.
Meantime I'll watch for your further updates here.
Try not to worry too much. I think BC has the best health care in all of Canada.
J


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t2k@vcn.bc.ca  
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 More options Aug 18, 6:18 am
Newsgroups: sci.med
From: "t...@vcn.bc.ca" <t...@vcn.bc.ca>
Date: Sun, 17 Aug 2008 18:18:16 -0700 (PDT)
Local: Mon, Aug 18 2008 6:18 am
Subject: Re: Health problems since fall
Thanks for responding.
Here's what occured since then.

On August 7 my dad restarted urinating "deep red blood".
He contacted his doctor who told him to go to emergency
if it doesn't stop. He's then informed the CT scan showed
a polyp on his kidney. Not known if it's malignant.

My dad continues bleeding like this until Saturday Aug 9th
evening. Just before 1am Sunday morning, he says his urine
is now black! The next three urine was very black with a bit
of red. At 3am he says he saw no blood. But I'm not aware
of this until wakes me up to tell me.

At around that time he began having pain at his right side
kidney area. The pain grew more and intensified.
VERY intense pain. The pain got so great that he became
short of breath. When he wakes me, I call 911.

At the hospital, they order a new cat scan. When the results
come back, they tell us it shows that he has "a couple of
cysts: one on each kidney". "No kidney stones". It also
showed "an area on the right kidney" that has something
but couldn't tell what it was. The pain became so great at
times he'd vomitt and almost passed out. He received large
amounts of morphine to dull the pain. They said pain could
be caused by blood clot(s) and should go away. They told
us they don't know why he's still in pain after several hours
in the hospital. To know more detail they'll have to go in
and look at the kidneys. He was discharged on august
11Th with powerful pills to dull the pain.

On August 14: We finally see a doctor who tells us what's
going on! The doctor says it's not polyps and it's not
cyst; it's cancer. And that it showed up on the first Ct scan;
the same CT scan we were once told didn't show anything's
wrong. He tells us he has a tumor on his right kidney.
And it's called, Transitional Cell Carcinoma. http://www.emedicine.com/med/topic2003.htm

Unfortunately the treatment is to remove take out his kidney
and his uterer. He says the tumor extends about 1.5cm to 2cm.
He doesn't know if the tumor is actually cancer but the majority
of the time, it is. In fact, he says there's not much else that
gives you this picture. He says he and other doctors will look
at it more closely soon.

The doctor doesn't know why my dad's legs are swollen and
says there may not be any connection.

We're glad we now that we know what's going on and what's
causing the trouble he's been having. We hope he can get through
this.

On Aug 13, 8:09 pm, J <xewsnswex@nalid;"no> wrote:


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 More options Aug 19, 1:48 am
Newsgroups: sci.med
From: J <xewsnswex@nalid;"no>
Date: Mon, 18 Aug 2008 16:48:29 -0400
Local: Tues, Aug 19 2008 1:48 am
Subject: Re: Health problems since fall

J, no> wrote:
> http://www.nlm.nih.gov/medlineplus/ency/article/003139.htm
> "Dark brown or clear urine is characteristic of a liver disorder such as
> acute viral hepatitis or cirrhosis"

 Nitrofurantoin can also cause brown (or yellow) urine. and a number of other
symptoms
http://www.nlm.nih.gov/medlineplus/druginfo/medmaster/a682291.html

Iron supplements have downsides
Palafer
http://bodyandhealth.canada.com/drug_info_details.asp?channel_id=0&re...

Contact your doctor if you experience these side effects and they are severe
or bothersome. Your pharmacist may be able to advise you on managing side
effects.

    * constipation
    * diarrhea
    * nausea and vomiting
    * heartburn
    * dark stools
    * stained teeth (especially with liquids)

Although most of the side effects listed below don't happen very often, they
could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side
effects occur:

    * abdominal or stomach pain
    * chest or throat pain when swallowing
    * black tarry stools with signs of blood

Overdose: Taking too much iron can cause the signs and symptoms listed below.
If you are concerned that you, or your child has taken, have taken too much
iron, seek immediate medical attention and contact your regional Poison
Control Centre. Do not wait for these symptoms to appear.

    Early symptoms of iron overdose

    * diarrhea (may contain blood)
    * nausea
    * stomach pain or cramping (sharp)
    * severe vomiting (may contain blood)
________________________________________________________
I'm worried it's too many medications, especially if they also give him pain
medications.
Would blood transfusions be possible?
J


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 More options Aug 19, 1:53 am
Newsgroups: sci.med
From: J <xewsnswex@nalid;"no>
Date: Mon, 18 Aug 2008 16:53:35 -0400
Local: Tues, Aug 19 2008 1:53 am
Subject: Re: Health problems since fall