Patient: My husband is an active 65-year-old male, who was in excellent physical shape. For the past ten-year’s bicycles no less than 125 miles of moderate to heavy mountain climbs a week. He is a life long non-smoker, social drinker, who had a complete physical with cardiac work up, which was normal. He was diagnosed one year ago with high blood pressure which is controlled by daily medication.
On October 28, he had a dirt-bike accident causing left side rib bruising and pain. Post accident he continuing to bicycle every other day; but on the 16th day his spleen ruptured. 12 days post surgery he had 3 pulmonary emboli and was hospitalized for 4 days. He began cumidin and was working on achieving a therapeutic level. 10 days later he was hospitalized with acute pancratitus. While scanning the spleen, gal stones were found but the surgeon did not want to risk more bleeding, and at the time, he was a-symptomatic. After reversing the cumidin over a four-day period and managing his pain, they removed his gallbladder. 5 hours post surgery he hemorrhaged, and soon after developed an unorganized abdominal infection. To prevent further complication of clotting, they placed a Cava filter. He has now been in CCU for almost 4 weeks due to the uncontrolled infection. His temperature ranges between 99 and 102, his BP is stable and his pulse rate has not been lower than 115, and higher with fever.
Today, December 30,2005 he has developed blood clots in both legs, (earlier testing showed that he carried a gene that makes him predisposed to clotting). He is receiving blood due to low platelets (4th unit in the past ten days). The infection has begun to organize in the form of 4 abscesses of which they have placed 2 drainage tubes, and needle aspirated a third. Unfortunately the 4th abscess in his pelvic area and must be surgically removed. Because of the clotting they have had to begin blood thinners, and tomorrow we will have to consult a surgeon.
He is being followed by Dr’s of Hematology, Infectious Medicine, Surgeon, Internist, Nephrology, and Pulmonary on a daily basis, but he is not getting any better. He has dropped significant weight and muscle and is becoming very depressed.
My question to you is; am I doing everything I can or is there another specialist I should consult? Have you experienced a similar patient with these complications and what was done.
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