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My father, 77yo on apixaban for Afib, was diagnosed with a…

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Hi, My father, 77yo...

Hi, My father, 77yo on apixaban for Afib, was diagnosed with a Bosniak 3 right upper pole complex cyst incidentally 4 months ago, a decision was made to reimage in 6 months than intervention due to his wishes. But last weekend he bled into the cyst, grew to 9cm, with inflamation around the cyst, pleural effussion. Anticoagulation and plavix was stopped, improved now, got one unit of blood. The question was he has to get back on his AC, so didnt agree with wait and watch. Am i wrong, would you advise intervention and if yes, when?

Doctor's Assistant: In general, how has your health been lately?

In general, he is 77yo Afib on AC, CAD on plavix, but completely functional , prcatcing physician untill this event

Doctor's Assistant: Anything else in your medical history you think the doctor should know?

No surgeries in past, CKD with GFR 50 for many years. Other than this no issues.

Submitted: 10 months ago.Category: Urology
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Answered in 1 minute by:
9/23/2017
Urologist: DrRussMd, Board certified internist replied 10 months ago
DrRussMd
DrRussMd, Board certified internist
Category: Urology
Satisfied Customers: 65,673
Experience: In internal medicine we deal with prostate, bladder and kidney diseases, including cancers.
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Hi.
Welcome to just answer. I am here to answer questions for education and information. I will respond shortly with an answer, or a question for you

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Urologist: DrRussMd, Board certified internist replied 10 months ago

Without his anticoagulation he is at risk for stroke, which will be devastating.

I am not sure what your exact questions is, no we are not going to disagree with his nephrologist. Is the nephrologist ok with this?

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Customer reply replied 10 months ago
Seen by a urolgist, he thinks this wont happen again and just wait and watch. His Hg dropped from 11 to 7.5. With all this just not comfortable to restart AC waiting for a second event with a 9cm cyst in there.
Urologist: DrRussMd, Board certified internist replied 10 months ago

It is an educated guess.

The risk of more bleeding v. the risk of stroke.

If his hemoglobin is stable [ I would transfuse him a unit of packed cells] then I would go with the doctors assessment, not a hands off assessment.

OK, let me know if you have more questions.

Also, please click a positive rating on the rating scale. [This must be done manually]. In fact, a 5 rating squares me with just answer and allows me to provide prompt and accurate service to you, but does not increase your cost. And, I will be here for any follow up needed.

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