Friday 26/01/24
Blood taken – Full Blood Count, Haemoglobin A1c, Serum
Ferritin, Vitamin B12. Liver function
tests, Lipids, Thyroid Function Test, Prostate-Specific Antigen, Bone Profile,
Renal profile.
Blood results show severe anaemia with haemoglobin of 57g/L
(normal 130-170) Go straight to nearest
A&E as may require blood transfusion.
Visited A&E and admission requested with following
Clinical Summary
Presented to SDEC referred by
gastroenterologist for admission and under investigation by gastroenterology
for anaemia and weight loss.
Weakness, lethargy, poor appetite
and tiredness. One episode of melena 2
days ago.
Given 2 units of blood and post
transfusion Hb was 73 and then received 1 gm iron transfusion also.
OGD was on 3/02/24 which
revealed: Malignant tumour in distal
oesophagus and GOJ junction bleeding ulcerated several biopsy’s taken.
Recommendation: Urgent CT CAP (requested) upper GI MDM
referral (given)
After OGD on the same day patient was unable to pass urine and catherterization was done.
Patient has been reviewed by the
consultant and declared medically optimised for discharge.
-
Continue regular medications
-
- Omeprazole 40 mg BD
-
- TWOC clinic referral for catheter removal
-
- Upper GI MDM referral (done on 3.2.34)
-
- CT CAP (requested on 3.2.24)
CT Scan Medway Hospital.
Results of camera and scan.
Malignant Oesophagus Tumour
confirmed – lower part of the food pipe.
CT scan shows that it is NOT
early stage and that it had already breached the walls and was therefore NOT OPERABLE.
Some treatment may be available such as chemo and/or radio but before that a PET scan was needed to be undertaken at Maidstone and then to wait for result before deciding on any treatment. However any treatment would be to extend the timescale to up to 2 years rather than none.
There was also fluid showing in the stomach and they were not sure yet what it was.
Diagnosis:
Cancer of oesophageal gastric
junction, provisional stage T3N0M0
Osteoarthritis
Current medication: Omeprazole.
PET scan
Ultrasound guided ascetic tap.
Multi-disciplinary team reviewed the CT images and there were a few indeterminate lung nodules and an incidental finding of large infra-renal aortic aneurism, ascites and left side pleural effusion. Surgery is not an option.
Phone call regarding shakes to be
given on prescription as unable to eat anything other than soft food.
Confirmation that within the
stomach there is an Abdominal aortic
aneurysm The left artery aorta goes to the belly button and joins the arteries. This aneurysm is 5.5cm and usually requires
major surgery. The wall of the artery is
weakened and was probably hereditary and had been growing slowly for
years. The risk of rupture up to 6cm was
very small and it was best to wait for outcome of PET scan. However Mick was very frail and surgery may
not be possible.
--------------
On Saturday 18th May at 4:03 in the morning after a horrific time too awful to document Mick died with me beside him.
He knew I was there although he was unable to open his eyes or speak anymore. 999 had to be called twice prior to his death as he had tried to walk and had fallen over and although he was skin and bone I could not lift him back into bed.
My heart broke as I saw the tears in the corner of his eyes and all I could do was hold his shoulders as the rest of him was so thin and I had to tell him that I didn't want him to suffer anymore and if it was time for him to go then to go. His breathing slowed down between in breaths and out breaths until he didn't breath out anymore.
I think it will take a long time before the horror of the past months eases and when I am able to sleep all night again.
I don't know who I am anymore, what I can do to survive but this is the end of Mazs Ramblings. I now will attempt to continue on my new blog.
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