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Diagnoses of multiple illness/conditions simultaneously..?

    • 1 posts
    October 16, 2014 5:10:45 PM PDT

    Hi, someone very close to me is very sick.  I am geographically far away from him and am not family.  Here's what I do know.  53 yo male, chronic alcohlic, recent diagnosis of copd then hep A.  ER admission few days ago, fear of liver failure...turned out not to be (?)...diagnosed w/ pancreatitis, imaging shows tumors on one kidney and in gallbladder (no gallstones present to be causitive of pancreatitis).  My question, besides, "What the hell?" is are all of these related?  What does it mean?

    • Moderator
    • 1957 posts
    October 16, 2014 7:03:39 PM PDT

    Greetings G,

    Thank you for the question. I understand that it is a lot of serious conditions that appears to pop-up all at once. I completely agree with your question, meaning it is similar to questions that I have considered and asked before. My impression is that you may feel ~surprise/shock/disbelief/ when informed of the sudden presence of multiple medical conditions in someone who seemed to be much more healthy. 

    Legal disclaimer:  we do not have a doctor-patient relationship and we cannot give specific instructions of care to you, but we can give you our best effort to find high-quality information that you can consider. If we are wrong, or you don't like what we say, feel free to leave a message and let us know how we can improve the quality of the service. In addition, we encourage other people in the community to contribute their knowledge to the questions that are asked. 

    For example, if you have a rare disease, and had a rare surgery, please simply state "back surgery," and if needed we can explore that further.  If your neighbor or best friend reads this, will be they be able to identify you based on the information given? If yes, please remove the information or change it slightly. 

    BAD example:  I live in Boston, Dr. Patel at MGH hospital diagnosed me with a schwannoma tumor last month, then I traveled to Tokyo and taught English for a year.  

    Acceptable example: I live in the United States, I had a tumor & surgery, then I traveled abroad for work.

     

    You appropriately note that when diagnoses occur, they often occur multiple. The body is a system that works together to maintain health & normal life. 

    However, when tumors occur, for example, some people with hepatitis C who drink alcohol frequently develop liver tumors. These tumors grow while the person is feeling fine and may not notice the slowly developing changes in their body. Such as yellowing of the eyes which sometimes occur with liver failure because its metabolism is not functioning properly. 

    Although they feared liver failure, it is possible that he may still have some liver damage. Like anything in life there are degrees of changes that we describe in medicine. Similar to driving down a road, you press on the gas pedal a little bit, the car goes slowly. When part of the liver is damaged, or some of the cells are not functioning properly, there is a gradual changes. 

    It is common for people that drink alcohol to also smoke. Many of these people develop COPD. Some people have a genetic disease that results in COPD and liver disease at the same time. 

    If a tumor develops in one organ, such as the liver, it can grow there for a while, then it can spread to another place. Meaning, some of the cells break-off, or separate from the main tumor and go through the blood stream, and end up in other places such as the Kidney. Now, I do not know the specifics of your family member, a tumor that developed in the liver is possible. 

    If you want more information this is what he can ask his doctor. 

    1.What are the ICD9 or ICD10 Diagnoses related to your brother. (these are codes that doctors use, and they are designed to be informative both medically and for billing). 

    2. What are the CPT codes that your doctor is applying to your brother?

    3. When can he get a copy of all his medical records

    4. Can he have a copy of his laboratories daily?

    5. Can he have a copy of his progress notes each day?  (they may say no, but in the future this will change as physician-patients become more of a team for better healthcare).

    The vast majority of the people want to get better and if they are able & well-enough to participate in their care, then they should be empowered to do so.

    Now, this may result in patients being left with incomplete information and questions. This is true and it is not perfect, but many would argue that some accurate information is better than none, especially if more can be obtained by researching it through multiple methods. There are a myriad of websites where one can ask a doctor for free, and that is excellent. 

    6. Can he have a copy of his pathology report and radiology reports?

    7. Where do you think the primary tumor came from?

    8. Is the tumor benign or malignant?

    9. What stage is the tumor?

    10. Is there a comparative effectiveness clinical trial nearby that he could have more information? about?http://clinicaltrials.gov

    Below are videos that you may or may not find helpful. They may have done a liver biopsy, if they did, having the results of that, and whether or not there was cirrhosis, would be helpful in determining the liver's relationship to the other conditions that your brother has been diagnosed with. 

     

     

    There is more information on Liver Failure at the Mayo Clinic

    Definition

    Acute liver failure is loss of liver function that occurs rapidly — in days or weeks —usually in a person who has no pre-existing liver disease. Acute liver failure is less common than chronic liver failure, which develops more slowly.

    Acute liver failure, also known as fulminant hepatic failure, can cause serious complications, including excessive bleeding and increasing pressure in the brain. It's a medical emergency that requires hospitalization.

    Depending on the cause, acute liver failure can sometimes be reversed with treatment. In many situations, though, a liver transplant.

     

    I understand that it is a lot of information and multiple systems. The more information you can get from the doctors the better you will be able to piece together these different findings into a chronological story that makes sense.  It doesn’t solve the problem, but knowing what the problem is often helps people cope and make informed decisions about how to respond to it.

    Please consider keeping me updated.

    Kind regards.


    This post was edited by DrSocial Admin at April 26, 2015 3:45:03 AM PDT
    • 445 posts
    April 26, 2015 4:13:58 AM PDT

    Dear reader,

    if you are looking for any information related to COPD, COPD treatment or COPD Apps you may want to read the following forum posts:

    COPD – Ask a doctor for free information

    GOLD COPD Strategy = an app for healthcare providers

    COPD – Healthcare Apps

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