Unbolts the stomach swollen legs
Dear Mark Azrielievich! I ask to help my sister to ease the condition! Local oncologists do not suggest anything, the patient suffers at home, severe ascites, swelling of the legs, I'm afraid that the fluid from the legs will flow, the stomach is huge, it is bursting. There can not, can not sleep. They do not take me to the hospital.
1. Accurate information on the diagnosis (as proven as treated).
14.11 - 29.11 branch # 4 of the FGKU "GVKG im academician NN Burdenko" MO
Diagnosis: Cancer (low-differentiated cyst-cell adenocarcinoma) of the body of the stomach pT4NxM1. Multiple (mts) of the liver, peritoneum. Oncolonization. carcinomatosis. Ascites.
deterioration from February 2013, after 4month of pain in the epigastric region, ultrasound revealed a polyp of the gallbladder. November 2013 EGF: bleeding, biopsy: volumetric formation of the upper third of the stomach.
Diagnostic laparoscopy (25.11): cancer of the body of the stomach, multiple metastases of the right lobe of the liver, peritoneum. A radical operation is not shown. 4 clinical group. Needs symptomatic treatment.
Four times the liquid was pumped from the abdomen (totalcomplexity of 10 liters, most recently 28.01. 1.5 l, the doctor said no more, there are nodes only. The patient insisted that there was still liquid on the other side.
In December, 2 weeks in the oncological hospital. Now she is at home.
2. All the latest research methods (clinical and biochemical blood test, general urine analysis, ultrasound, chest X-ray, ECG).
Colonoscopy (22.11) 25 cm from the anus of the intestine is fixed from the outside, further progress is impossible. Biopsy, cytology. Conclusion: indirect signs of peritoneal carcinomatosis involving the large intestine.
Ultrasound of the abdominal cavity.
The liver is of normal size, the bile ducts are not dilated. Focal liver change (mts). Contours equal, precise. The structure is not homogeneous. Gallbladder: on the right side wall of the polyp.
Cysts of the sinus of the left kidney.
CT of the abdominal cavity.
In the right segments of the right lobe, multiplesoft-tissue formations of rounded shape with uneven, fuzzy contours, diameter from 10.2 to 25.4 mm. Accumulation of contrast medium along the periphery. Accumulation of contrast in the lymph nodes of the peritoneum. Presence of free fluid in the abdominal cavity. Ascites.
Conclusion: Signs of secondary liver damage, hyperplasia of the lymph nodes of the abdominal cavity, ascites.
Histology. body of the stomach: malignant low-differentiated tumor with the predominance of cricoid-cell elements.
Histology of the parietal peritoneal (mts) formations, large omentum (25.11.13): four gray pieces of tissue. In the fibrous-fatty tissue, the infiltrative growth of the cricoid-cell carcinoma
Blood in the hospital (in December) was not taken, wrote an analysis in the extract themselves. In the clinic I was assigned to donate blood 3.02.14, afterwards I will write. Hemoglobin can be seen that no. Pale skin and eyelids, almost transparent.
The last blood test (28.11): hemogl 117, erythror 4,2, watering can 6, p.y. 5, s.ya. 73, mon 1, lim 30, cos 15.
3. Age, weight, consciousness, physical activity, concomitant diseases, allergic reactions, pressure, pulse.
55 years, 45 kg, pressure 100/75, pulse 97, allergies are not revealed, strong weakness, walks a little independently, in consciousness, in a half-asleep state. Chronic gastritis.
4. Where does it hurt, where does it give it? The nature of pain (presses, whines, burns, etc.). Unbent stomach, presses all organs in the abdomen, a constant sensation. Periodicchie there is a sharp pain, especially on the right in a stomach or belly.
5. What, apart from the pain, does it bother (shortness of breath, constipation, micturition, etc.)? All complaints in detail.
Shortness of breath, heart, almost can not speak,lack of breathing. Practically does not eat, the state of hunger is absent, the food does not climb, through force tries to eat something, basically liquid. At night, I vomited repeatedly. Stool liquid black with mucus. The abdomen is very swollen, hard. Ascites strong. Legs swelled strongly, hard, poured with liquid, especially on the right knee like a blister. At night he does not sleep. Sleep irregular short-term, wakes up from pain.
6. The name of an anesthetic drug, its single dosage, by how much% and for how long reduces pain? Tramadol was prescribed, the patient refused to drink. Once I accepted, said that the state is terrible from him. He does not take anything painkiller, says he does not want to take drugs. The pains are excruciating
7. What medications does it receive at all (name, dosage, effect)?
Veroshpiron 3 r / day 2 tx25mg, the effect was at first,now is absent, urination is difficult. Furasimide 40 mg 1 r in three days, sulfoquine 1 prick 2 ml / 1 p per day. Abisib-ff 2 tbs in the morning and in the evening, Abisib-n 2 tbsp at lunch. There are no effects.
8. Place of residence.
The condition is serious, I ask you to help me choose the symptomatic treatment!
I do not know how to help her.
Today, there is a little less swelling on the legs, yesterdaydrank furasimide. But he was prescribed only once every three days. Can it be possible more often or not? All also almost can not urinate. There are refuses, very much afraid of what will be bad, tells her well when he does not eat. Drink too little very much. Dryness in the mouth is strong. Today he very much complains about the heart, it's hard to breathe, presses the heart, asks for something for the heart. He speaks little, little, he does not have enough breath.
1. There is no ECG. And ultrasound of the abdominal cavity when did? A biochemical blood test is required, including potassium and sodium. Radiography of chest organs or ultrasound of pleural cavities.
2. You do not need to eat by force. ketonal 100mg by the hour 7-15-23, dexamethasone 8mg (2ml) intramuscularly in the morning, omeprazole 20mg in the evening.
3. Veroshpiron 3 times impossible, only in the morning (if it is needed). Sulfocamphocaine may increase dyspnea.
4. While there is no necessary information, I can not advise anything more.
Mark Azrielievich, very grateful that they answered!
1. We'll surrender the blood tomorrow.
ECG From 15.11.13: rhythm sinus with a heart rate of 54 per min. Normal position of EOS. Moderate changes in the myocardium.
The ultrasound was from 18.11.13.
Radiography of WGC from 21.11.13 the lungs are straightened, without focal and infiltrative changes. Pulmonary pattern by mixed type. The roots of the lungs are compacted, the weasels. The dome of the diaphragm is flat, clear. Sinuses are free. Heart, aorta within the age limit.
This all in a hospital in November did before laparoscopy. After the operation, her condition began to deteriorate sharply and the fluid in the stomach fill.
Do I have to repeat some tests?
2. On nutrition matters that you can, what not? She sometimes wants what they write not, although she really eats one spoonful. Yes, and recommendations are everywhere different in products. Tried to feed Nutrizone, from it vomits and vomiting. He wants something liquid, milk with bread.
Once again I thank you!
Mark Azrielievich, hello!
Today have made an electrocardiogram, the cardiologist suspects that inheart also fluid. I commented on the go, because I was asked not to write in a paid clinic. I do not in any way question the competence of the doctor, it was simply not possible to describe in detail the history of the disease.
Has written out a mildronate of 250 mg / 2 r in day. Diver 1 t in the morning.
My sister asked me to ask for your advice.
Here are the results of ECG
They handed over the blood, the analysis will be tomorrow.
The tablets began to drink. Dexomethasone nurse refused to stab until there is an appointment with a doctor's seal, is afraid.
Today it is very hard, the physical load is strongfor her after hiking in polyclinics. The abdomen is dense solid, complains that the spleen is sealed. The stomach is huge like a drum, it presses heavily on the heart and on the lungs. Legs again swelled strongly. There is still almost nothing. At night I did not sleep, there was a frequent stool of liquid black.
Hello, Mark Azrielievich.
Forgive me, I may incorrectly insert pictures, but for some reason it will not work any more.
Today my sister has a very bad condition. The belly is bigger. The pressure is 100/60, it is usually low. In the morning I ate a little. Then the vomiting began, strongly. The temperature is 38.3. The edema on the legs was worse. Very weak, I do not know what to do, how to help her.
1. You can eat everything you want, only in small portions and what does not cause vomiting.
2. Mandatory ultrasound of the abdominal and pleural cavities.
3. Veroshpiron 50mg in the morning.
4. What's with the pain?
To eat almost nothing wants, last weekvomiting. The weekend vomited strongly, two days on the water almost. Today I ate the pear, after two hours everything came back. Strong swelling of the legs. The pain is pressing, but the pill still does not drink. The abdomen is large, bursting, complaining that it hurts because of pressure on all organs, refers to the fact that there is liquid and it must be pumped out. In the region of the solar plexus, it expands, on the heart and lungs pressure. As a result, he does not sleep at night.
On ultrasound I can not imagine how, it is not transportable at all.
The therapist came from the polyclinic, after a two-day walk to the head. Has appointed or nominated to prick iron for a hemoglobin. nothing else.
And with her biochemistry is very bad?
Thank you, Mark Azrielievich.