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Hypercalcemia
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Mr F became very poorly on Sunday, resulting in admission to hospital.
Tests so far are showing he has Hypercalcemia. Not really sure how this happens, they have hinted it may be linked to the lung cancer he had a couple of years back.
Went to see him yesterday, and I was shocked and scared, quite used to him being forgetful, but this was something else again.
Rambling incoherently, seeing stuff that just was not there, (a fully operational Post Office in one of the bed bays, and water from the ceiling and so on.
And yet, amongst all that he was able to direct me to the box and receipt for his Rolex watch, which in 28 years I have NEVER seen.
Also, it appears he attacked another patient who went across to him, thinking he was taking the "P".
Any insight into this condition would be greatly appreciated.
Tests so far are showing he has Hypercalcemia. Not really sure how this happens, they have hinted it may be linked to the lung cancer he had a couple of years back.
Went to see him yesterday, and I was shocked and scared, quite used to him being forgetful, but this was something else again.
Rambling incoherently, seeing stuff that just was not there, (a fully operational Post Office in one of the bed bays, and water from the ceiling and so on.
And yet, amongst all that he was able to direct me to the box and receipt for his Rolex watch, which in 28 years I have NEVER seen.
Also, it appears he attacked another patient who went across to him, thinking he was taking the "P".
Any insight into this condition would be greatly appreciated.
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No best answer has yet been selected by ferlew. Once a best answer has been selected, it will be shown here.
For more on marking an answer as the "Best Answer", please visit our FAQ.// There is a small chance....perhaps not that small, that it is linked to his lung cancer.//
I would say ( not having seen the notes etc - oo-er like that doctor at GOSH) that there is quite a large chance it is related to the ca lung or another
in which case it could be suppressed by steroids
but it is quite possible that his condition is NOT caused by the high Ca++ so you get it under control and he is still out of it
I think we all know Sqad and Slaney are doctors
I would say ( not having seen the notes etc - oo-er like that doctor at GOSH) that there is quite a large chance it is related to the ca lung or another
in which case it could be suppressed by steroids
but it is quite possible that his condition is NOT caused by the high Ca++ so you get it under control and he is still out of it
I think we all know Sqad and Slaney are doctors
May I ask what type of lung cancer he was diagnosed with?
If it was adenocarcinoma, they can test for mutations called ALK and EGFR to determine if he's eligible for tyrosine kinase inhibitors. If it's either the aforementioned or a squamous cell they can look for something called PDL1 expression to determine whether immunotherapy with Pembrolizumab is indicated but there would need to be PDL1 expression in at least 50% of his tumour cells.
In the first instance they will probably commence him on Dexamethasone to improve his functional status and then arrange to graduate his whole brain.
It's unlikely that he will be fit enough to receive conventional palliative chemotherapy.
If it was adenocarcinoma, they can test for mutations called ALK and EGFR to determine if he's eligible for tyrosine kinase inhibitors. If it's either the aforementioned or a squamous cell they can look for something called PDL1 expression to determine whether immunotherapy with Pembrolizumab is indicated but there would need to be PDL1 expression in at least 50% of his tumour cells.
In the first instance they will probably commence him on Dexamethasone to improve his functional status and then arrange to graduate his whole brain.
It's unlikely that he will be fit enough to receive conventional palliative chemotherapy.
Just back in from today's visit, and in answer to a couple of questions....
He is cheerier today, although dreadfully worried about this chap that keeps telling him we are having an affair !! Not quite as confused as the day before.
What sort of cancer? I have no idea, they took a lobe out of his lung is all I know. Background of smoking, working with coal and asbestos dust. Given the all clear last autumn.
Also diagnosed with Pulmonary Fibrosis, lungs are mostly white scar tissue. TBH how the hell he has made it this far I have no blinking idea.
Home next week with a full care package was the answer I was given this afternoon. "Fast Tracked"
Because the confusion has lessened a bit, they are now not sure about cancer in the brain. A brain scan has been ordered, but the general consensus is that in his state of health, and at almost 80, they will do nothing invasive. Weeks to months is what they are saying.
Thanks for all kind thoughts, much appreciated :)
He is cheerier today, although dreadfully worried about this chap that keeps telling him we are having an affair !! Not quite as confused as the day before.
What sort of cancer? I have no idea, they took a lobe out of his lung is all I know. Background of smoking, working with coal and asbestos dust. Given the all clear last autumn.
Also diagnosed with Pulmonary Fibrosis, lungs are mostly white scar tissue. TBH how the hell he has made it this far I have no blinking idea.
Home next week with a full care package was the answer I was given this afternoon. "Fast Tracked"
Because the confusion has lessened a bit, they are now not sure about cancer in the brain. A brain scan has been ordered, but the general consensus is that in his state of health, and at almost 80, they will do nothing invasive. Weeks to months is what they are saying.
Thanks for all kind thoughts, much appreciated :)
yes I think you do need to apol Anne my sweet
and not only to Ferlew -
I will economise on the lovey dovey bit Furl and say - get him (Mr Furl) on the palliative care pathway
get him home - get the GP involved - get the Macmillan nurses involved as it is obvious you know the score ....
Dexamethazone is good for a high Ca - two of us have said that and your doctors will know that too
and oops sorry Furl - a little bit of hijackery
Nomervy - I have a DBCL lymphoma (CD20+) R-CHOP - 2012 - remission but relapsed rt orbit 2015 and given R - GCVP 2015 - with now no disease
what next for my next relapse ? or is it wait and see ?
I would have delayed but I think the rudemess on AB may make you take off
and Yes anne if you understand nothing about molecular genetics and molecular genomics - follow your own advice and shut up!
and not only to Ferlew -
I will economise on the lovey dovey bit Furl and say - get him (Mr Furl) on the palliative care pathway
get him home - get the GP involved - get the Macmillan nurses involved as it is obvious you know the score ....
Dexamethazone is good for a high Ca - two of us have said that and your doctors will know that too
and oops sorry Furl - a little bit of hijackery
Nomervy - I have a DBCL lymphoma (CD20+) R-CHOP - 2012 - remission but relapsed rt orbit 2015 and given R - GCVP 2015 - with now no disease
what next for my next relapse ? or is it wait and see ?
I would have delayed but I think the rudemess on AB may make you take off
and Yes anne if you understand nothing about molecular genetics and molecular genomics - follow your own advice and shut up!