Jacques wrote:beach sunrise wrote:A signature would be a great idea for more help...
...
BUMP - Still no signature. Still not enough information about the patient to make any kind of assessment or to do a proper "situation analysis". In the information previously given there are already several "red flag" issues that need to be resolved, but more information is needed in order to do this.
Questions
1. What kind of doctor prescribed these five medications? When did the prescription for these five medications start? Did the doctor explain what each of these five medications was for? Did the doctor explain how/when to take the medications? Did he explain the restrictions to be followed when taking the medications? Which of these meds are to be taken twice a day, every day, no matter what (BID), and which (if any) are to be taken only if and when they are needed (PRN)?
2. Did the doctor explain why an antibiotic was prescribed and how many days it would have to be taken? Did the doctor explain what kind of infection it was that required this particular antibiotic?
3. How long will these particular prescriptions last? What will be the plan when the next chemo cycle starts? Same prescriptions? Different prescriptions?
4. Did the patient report the abdominal cramps immediately to the doctor as required by the protocol? What did the patient do to cope with the abdominal pain, and was this done with the approval of the doctor? Note: Some pain meds are contraindicated for persons who have compromised livers.
5. Did patient have any instruction on the types of food to prefer ; types of food to avoid? What kind of diet was the patient following when he experienced the abdominal pain? Were any special dietary restrictions imposed by the doctor when the medications were first prescribed?
Dear Jacques,
Thank you for your help and input. We are new to dealing with cancer and may not know everything we should. Please accept our apologies for any misunderstandings.
I would like to inform you that the patient had a blood test on 04-04-2023 after the first chemo cycle with a 20% dose reduction and Avastin (bevacizumab) on 28-03-2023. The next chemo session will be on April 11th. The abdominal pain experienced on April 6th has resolved.
I have updated
my signature with the patient's case information. If you have any tips or thoughts about it, we would appreciate your advice.
Additionally, here's a summary of the blood test results after the first chemo cycle:
CBC showed increased WBC and reduced Hemoglobin, Hematocrit, MCV, MCH, MCHC, and RDW, with an elevated Platelet count.
Coagulation Profile indicated prolonged PT, PTT, and slightly increased INR.
Differential White Blood Cell Count showed decreased Lymphocytes.
Liver Function Tests revealed normal ALT and AST levels, but elevated Direct Bilirubin.
Pancreatic Function Test, Amylase level, was within the normal range.
Creatine Kinase (CK) was within the normal range.
Electrolytes and Kidney Function Tests showed decreased Potassium, Sodium, Creatinine, and BUN levels.
We would appreciate your thoughts on these results and the medications the patient is still taking and their potential impact on the patient's condition.
36M, diagnosed with moderately differentiated invasive adenocarcinoma in sigmoid colon (biopsy on 06/Mar/2023). Multiple hepatic lesions suggestive of liver metastasis (CT Abdomen on 02/Mar/2023) and nonspecific lung micronodules (CT Chest on 02/Mar/2023). Prostate lesion detected in abdominal ultrasound (15/Feb/2023) but not in CT scan (16/Feb/2023). Undergoing treatment with FOLFOX (20% dose reduction) and Avastin; started cycle 1 on 28/Mar/2023 and cycle 2 on 11/April/2023.