Poor Joe finally had his endoscopy today. He's been on a liquid diet in anticipation of having it each day since admittance. They were waiting for his INR to get low enough to do it. They were really afraid of a massive bleed if there was anything to cauterize, biopsy, etc., since he has had a great deal of recent bleeding.
The procedure showed nothing drastic, just a polyp in his stomach which was snared and cauterized. They're usually benign in the stomach,. And there was some irritation, so they upped his Protonix.
He will go back on Heparin tonight, and we'll see if there is any bleeding from it.
Glad things look good for now. Make sure he gets something good to eat. Most hospital food is so bad it isn't worth looking forward to. Hope he can tolerate the Coumadin without any more problems.
How are you doing with all of this? I hope you are taking care of yourself too.
I don't know what the source of the bleeding was. It was pretty extensive. His crit went from 30 upon admittance in the ER to 25 the next morning. So that's a lot of blood. He had a high INR prior, however, the bleeding has been going on for a while I do believe. His stools were black.
He takes iron pills and they also cause black stools, so it was masking this problem.
Joe's hematologist has been having trouble maintaining his blood level for a few months now, in spite of Procrit three times per week and iron and folic acid each day. He's had a couple of other transfusions within the past two months.
They are gingerly starting him back on anticoagulation and doing blood draws every 8 hours to see if the count maintains.
Thanks for the post, Nancy. At least it seems Joe isn't on a downward trend. When I had the upper GI bleed last year I was able to avoid any transfusions because my blood count usually runs above normal. In other words, I had room to spare. The actual source of the bleeding was never proven but thought it was either a duodenal ulcer or bleeding from the area damaged the year before from transient ischemic colitis which was right where the ileum becomes the colon. That area was biopsied when I had the colonoscopy two years ago. When I developed the bleed I was started on prevacid and then was scoped from above a few months later and other than a hiatal hernia nothing worth noting was discovered. Since then I have been doing fine. I do know though the delicate balance of being on anticoagulation and having an unknown source of bleeding though. The uncertainty can weigh on your mind.
I hope this episode is soon behind the two of you and just becomes another thread in tapestry of his health history.
It sounds very similar, doesn't it? They are convinced that it was in the upper GI area. His cardiologists had just recently raised his INR from 2.5-2.5 to 3.5-4.0. Perhaps Joe's delicate system could not handle that.
The reason they raised it was to try to prevent infarctions that were occurring (his spleen and eye).
So he's a "high wire" act with a very narrow balancing pole. It's sheer frustration for his docs. They have said his treatment margins are terribly narrow.
In spite of it all, he's continuing to improve. He went for a short walk today and enjoyed his solid food, no matter how bad it was.