I was posing a lengthy question to you and I lost it. I will start over continuing from last answers.
After getting unit of blood on 9/22 Mrs was released to home from hospital with a follow up appt for CBC on 9/26, Urology followup on 9/27 and appt with her Oncologist on 9/30.
Mrs. released weak, blood in urine still present.
Blood Work results were pleasant for a change.
Dramatic change from pre unit in hospital draw.
On 9/27 appt with Urologist Mrs basically had two ?s. When is bleeding going to stop or Do we have to do something else?
Urologist indicated at this point he does not know when bleeding will stop however he is not jumping at other solutions. " Less aggresive is better and at present he would not actively pursue embolization or removal of left kidney"
He indicated several symptoms could force more aggresive action such as plumetting BP's, severe kidney or back pain, increased blood flow and loss, fatique "
But he has a sense this will resolve itself.
Stated there are no active clots and they were not able to to find or isolate clot, diagnosis of Renal Vein Thrombosis is now a Patent diagnosis.
Set follow up in a month.
Urine is cranberry colored.
Oncology appt on 9/30.
Mrs weight down to 112 at home. She is weak. Appetite so/so BP's 115/90 temp normal, still bleeding, horseness in voice, a bit short of breath, fatiqued.
She is just "OK".
Ordered a chest x-ray which was done that day. results unknown.
BP's...Doc told her to eat six times a day, increase fluid intake, salt her food and in effect make her own saline solution.
Blood draws once a week. No evidence of RVT on renal arteriogram(?)
Doctor prescribed a biggie however in order to stop bleeding. A drug call Amicar. Clotting med.
She actually started this today 10/6. 1000 milligrams, 3X a day.
This drug is scary both to Mrs. and the family. Her mother died of pulmonary embolism, and is very mindfull of clot dangers.
Given all factors, including no sign of metastatic cancer, Lungs good, heart good, all of the tests in hospital pointing to a non specific bleed from kidney and now the addition of Amicar, what are the options of that have not been medically pursued?
If Amicar does not work can that drug just be stopped?
Can Amicar cause a life threatening clot?
Despite no signs of metastatic cancer are there other tests which could be done to possibly point to a source of blood loss?
Are we just facing a yet undiagnosed progression of post Whipple Pancreatic Cancer? and that bleed is a first sign other cancer issue in lining of kidney, ureter lungs etc.?
What about a PET scan?
What about a blood test MD 70? ( I think this is correct) Should we request another CA19-9 at next blood draw?
Or should we just manage the blood loss until other symptoms present?