Does anyone here have any ideas/suggestions that I can approach the Doctor with? The RO and Oncologist are both on vacation.

During RT, my husband was throwing up til he threw up blood. He ruptured his esophagus. The RO believed he 'possibly' had a virus but most likely stress.

The same thing has happened again. It affected his hemoglobin level and they thought a transfusion might be needed. His BP on the first day was dropping from 60/50 when he stood up but a 'normal' low laying down.

He has lost between 35 - 50 pounds on a 5'9" male. The BP problem is new and he has had the feeling of passing/blacking out for a few weeks.

I have him scheduled for a Dr appt Monday. That doctor told him they would intervene if he lost another pound so that will be dealth with. My question is what about now? He is getting sick if they give him food. He is on IV fluids now.

He is convinced this is different than the other ER visit so he wouldn't tell them about it. He was angry with me for telling them that he was fatigued all of the time but he is.

Let me know if you have any thoughts on this. His blood is ok but the Hemoglobin was low initially. Thanks

Hi Stacey,

After reading your post, the best suggestion I can give you is to tell the doctor EVERYTHING your husband has been experiencing. They can't treat him if he doesn't tell them everything.

We men are stubborn to a point of negligence to ourselves....I too, have had my moments but my partner and caregiver won't have any of it! She comes out and tells them stuff I don't ~lol~

That blood pressure reading is awfully low. Is he on BP meds? If so, they should look at the dosage. If he's lost that much weight, they may need to lower it. They just did that to me as my BP was getting low. I've lost a bit of weight since this whole thing started last year.

Positive thoughts and prayer...

"T"

The faint feeling, low blood pressure, is most likely due to the blood loss, which reduces the number of red blood cells, which contain hemaglobin carrying oxygen throughout the body, and the loss of plasma also, but there could be other underlying causes, such as the reduction of RBC, plasma, by the bone marrow not producing enough due to radiation, treatment, and others like pain medication. Normal hemoglobin is between 13-17dl in males, slightly less in women, so he can still be low, but high enough not to need more transfusions, and each place is different, but should be under 10, and my place was even less with being under 7. RBC continuously die off, and are continuously replaced by the bone marrow, and have a cell cycle of 120 days. I have chronic anemia, and had a number of transfusions, and receive procrit or epogen shots to help the bind martow make RBC, but during treatment, with active cancer, it's not good to have these injections, and have minimal transfusions until the hemoglobin gets really low or in distress, even if it's not extermly los, since the first can cause an increae in tumor size, speed up cancers, and 2nd may increase recurrences, and have other risks, but it does improve QOL. Transfusionx last longer, and act in a few hours, as opposed to the procrit/epogen injections, which take several weeks to be effective with weekly shots. When the hemoglobin is low, you do not want to do anything, even eating, thinking, talking, standing is an effort, causes shortness of breath, dizziness, lack of energy, and I know how this feels.

Good luck with relaying information to his doctors.

Stacey, sorry to hear you are having issues still with your husbands recovery. You sure have your hands full with him!

Several factors can contribute to the low BP. Pain mads can make BP low, so can illness. Dehydration can cause it to drop as well. Major weight loss will many times result in low BP. So many things can affect it. During my hospitalization for malnutrition and dehydration my BP was so low the nurses kept waking me up as they were concerned my BP was too low, it was running 62/48. I felt ok, except for the major issues which causes me to get admitted.

Make sure you discuss everything with the doctor. Without full info the doctor will be guessing and not able to properly assess your husbands true condition and help him. Why make it harder to find the problem? No reason not to cooperate and help the doc to help your husband. If your husband gets mad then he does, he will get over it when he realizes what you do is out of love and for his own good. Stay strong, you are doing the best you can in a difficult situation.

There are shots that can boost your husbands blood count numbers. I believe one of the names the shots go by is called nupogen (SP). When his blood count numbers are very low he runs a high risk of getting infections so needs to take extra precautions like washing hands frequently, using antibacterial hand sanitizers and avoiding sick people, public places and crowds.

Recovery can take a long time, up to 2 years for a full recovery. It cant be rushed no matter how much the patient wants to be well. It takes time. Many OC patients become frustrated at how long it takes to bounce back from treatments. His body has been thru the war and it will be a while to get back to normal. His nutritional intake still must be 2500+ calories per day and 48 oz of water. He should be using high protein whey powder added to drinks to help speed his healing.

Good luck!



PS.... I know you have your hands full right now. Please remember to take some time for yourself. Caregivers need TLC sometimes too.

My husband had low hemoglobin after his second chemo. At the time, the MO said the only way to boost hemoglobin was through transfusion, but John's count was not so low as to justify it. The body is really on a very delicate balance during treatment and every little thing can tip it. Your husband will take a long time to overcome the fatigue. It is the number one side effect of radiation and can last for months. Talk to the doctors about how you could get nutrition into him at this point and let them know you are having difficulty getting him to comply. Maybe the doctors could read him the riot act. He may not listen to you but maybe he will pay more attention to the doctors. All the very best to you. Caregiving is a hard job and you are doing your best.

Thank You! I am grateful for all advice, knowledge, thoughts and I appreciate having this forum and that we can all help and talk to each other.

Update: He was released from the hospital today. My first post said esophagus rupture but it was esophagus tear, I think the situation is different than what I initially thought too. I am not worried if he gets angry with me over telling the truth. I told him to eat food and drink fluid or the next time that he would be home alone. (I feel horrible about this by the way. I didn't mean it and he knows that..he sort of laughed.)

The pulse (140 - 190) and the blood pressure dropping to 60 over 50 (for example) when he stands up are not heart problems per the Cardiologist. They are from Dehydration and Starvation (his words). I am sure that someone has experience with this but how can someone receive IV fluids for 4 days and still be dehydrated to the point of the BP and heart rate issues?

The lung X-Ray showed a spot on the upper left lung but the hospital says that spots are normal. The lymph node cancer was on the left as well. We have an Oncology appt Monday afternoon.

One of my many concerns is: If a hospital with an IV drip (the Dr said he was doubling the amount) can't keep him hydrated then how can we? If his heart rate is so high and his blood pressure drops so much due to dehydration then isn't it going to get worse now?

I do not know.

The IV drip usually runs very slowly. To me it sounds like your husband skimped with his intake for so long that he really was in pretty bad shape with being dehydrated. Plus throwing up on top of it. He was so low with fluids that his body is still playing catch up from when he was shorting himself. He really was starving and dehydrating himself to a critical point where that type of situation can become life threatening.

Is he able to drink? If so I suggest bringing a few of the small water bottles. Those seem to be much easier to get down than the 16+ oz other sizes. By drinking 4 of those little ones its like drinking 2 of the larger bottles. Put them in front of him and tell him he will need to begin helping to help himself with this and his body needs more fluids so drink. If he wont drink room temperature water, bring them in a little cooler with an ice pack to keep them cool. It should keep them chilled for at least 12 hours.

As the patient he is also responsible for his health and trying to help himself recover. I feel the patient really should be more responsible for their own health. You as the caregiver can only do so much with such a stubborn patient. You can lead a horse to water but you cant make him drink. Im not trying to be funny, but it seemed like that phrase was relevant to your situation.

Hang in there! Sometimes caregivers just have to play the "nurse from hell" role and tell their patients how it is to get them to understand. Hope you are using this time while your husband is hospitalized to do some nice things for yourself and to relax.

Best wishes!