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What Causes Discomfort Chest Area In A Rectal Cancer Patient?
Question: Hi.
Mother is preparing for rectal cancer surgery. It is Stage-3, 58 Years old, 150cm, 66kg.
5 weeks has passed since chemoradiation. (6-8 weeks timing between chemoradiation and surgery is told to be normal)
Blood test have been done many times, everyting are ok.
She has some health related problems, but not so severe.
1. Weak heart, I dont know how to express the severity of the weakness. in normal life, if she controls herself, everyting is ok.
Like when she gets angry, she feels serious heart related discomfort. Needs to take pills. However electrocardiogram did not show anything serious.
If she is on diet, she almost have no blood preassure issue. High preassure if she is not in diet or gets angry.
2. 15 Years ago one of her kidney was removed.
3. She is diabetic. It is not serious also i think. If she takes pills, "Diabeton Mr", The sugar level is 7(before meal). If not taken pills for a few days, it raises to 12 (before meal)
4. She has some psychological problem. Especially after kidney operation, She gets angry for very simple things. She can't sleep if she hears clock ticking sound.
5. She has varicose vein in legs. I dont know its grade, but they are not looking very ugly.
I want to know, are the problems above serious enough to cause complications in surgery ?
The surgeon wants to have surgery in 4-5 days, because he will go to vacation and be back after 3 weeks. So we dont have enough time to treat the things above before surgery.
We can just ignore them or postpone the surgery or just arrange another surgeon.
Please advice us.
Mother is preparing for rectal cancer surgery. It is Stage-3, 58 Years old, 150cm, 66kg.
5 weeks has passed since chemoradiation. (6-8 weeks timing between chemoradiation and surgery is told to be normal)
Blood test have been done many times, everyting are ok.
She has some health related problems, but not so severe.
1. Weak heart, I dont know how to express the severity of the weakness. in normal life, if she controls herself, everyting is ok.
Like when she gets angry, she feels serious heart related discomfort. Needs to take pills. However electrocardiogram did not show anything serious.
If she is on diet, she almost have no blood preassure issue. High preassure if she is not in diet or gets angry.
2. 15 Years ago one of her kidney was removed.
3. She is diabetic. It is not serious also i think. If she takes pills, "Diabeton Mr", The sugar level is 7(before meal). If not taken pills for a few days, it raises to 12 (before meal)
4. She has some psychological problem. Especially after kidney operation, She gets angry for very simple things. She can't sleep if she hears clock ticking sound.
5. She has varicose vein in legs. I dont know its grade, but they are not looking very ugly.
I want to know, are the problems above serious enough to cause complications in surgery ?
The surgeon wants to have surgery in 4-5 days, because he will go to vacation and be back after 3 weeks. So we dont have enough time to treat the things above before surgery.
We can just ignore them or postpone the surgery or just arrange another surgeon.
Please advice us.
Brief Answer:
Go ahead with Surgery
Detailed Answer:
Hi
thanks for writing back to me.
Stage 3 rectal cancer requires surgical intervention at the earliest. Her Electrocardiogram and as she is on blood pressure controlling medication her ailment should not be a risk factor for her.
I would suggest you the following preoperative evaluation which can be done in consultation with the surgeon
1. Complete blood count
2. Coagulation profile
3. Renal function test
4. Serum electrolyte panel
If they are normal there should be any risk for surgery.
I would suggest you to go ahead with Surgery.
Sorry for late reply as was busy in OR
Take care
Best Regards
Dr Deepak
Go ahead with Surgery
Detailed Answer:
Hi
thanks for writing back to me.
Stage 3 rectal cancer requires surgical intervention at the earliest. Her Electrocardiogram and as she is on blood pressure controlling medication her ailment should not be a risk factor for her.
I would suggest you the following preoperative evaluation which can be done in consultation with the surgeon
1. Complete blood count
2. Coagulation profile
3. Renal function test
4. Serum electrolyte panel
If they are normal there should be any risk for surgery.
I would suggest you to go ahead with Surgery.
Sorry for late reply as was busy in OR
Take care
Best Regards
Dr Deepak
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi.
Thanks for help.
Do you think antidepressant before the surgery is ok for patient ?
Thanks for help.
Do you think antidepressant before the surgery is ok for patient ?
Brief Answer:
Antidepressants are not indicated
Detailed Answer:
Dear Sir
Antidepressants are usually not advisable before surgery .
Do keep me updated about the progress.
Take care
Best Regards
Dr Deepak
Antidepressants are not indicated
Detailed Answer:
Dear Sir
Antidepressants are usually not advisable before surgery .
Do keep me updated about the progress.
Take care
Best Regards
Dr Deepak
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi.
Operation was succesful. she has temporary colostomy.
They used stappler for anastomosis.
Oncologist surgeon told neoadjuvant chemoradiation was very successfull. Ther was very small tumour left.
When they reverse colostomy they will do hand-sewn anastomosis. I think it has risk of anastomic leak ? Any dieatry recommendation ? such as foods that will increase wound healing ?
And another question is, after the surgery, how much should we wait till we start adjuvant chemotherapy ?
And when should the reverse colostomy surgery be done ? I think it is not recomended during the chemotherapy ? I think chemotherapy will take 6 month or something like that.
Please give some overall advice.
Operation was succesful. she has temporary colostomy.
They used stappler for anastomosis.
Oncologist surgeon told neoadjuvant chemoradiation was very successfull. Ther was very small tumour left.
When they reverse colostomy they will do hand-sewn anastomosis. I think it has risk of anastomic leak ? Any dieatry recommendation ? such as foods that will increase wound healing ?
And another question is, after the surgery, how much should we wait till we start adjuvant chemotherapy ?
And when should the reverse colostomy surgery be done ? I think it is not recomended during the chemotherapy ? I think chemotherapy will take 6 month or something like that.
Please give some overall advice.
Brief Answer:
PROPER COLOSTOMY CARE IS IMPORTANT
Detailed Answer:
Dear Sir
.That's so good to know that everything went fine .
Dietary Vitamin C and B complex vitamins will help in wound healing.
I would suggest the following diet
1. Plenty of oral fluids
2. High fibre diet
It is important to wait Atleast minimum of 1 week following surgery to start on adjuvant chemotherapy.
Colostomy closure or reversal is not an urgency . It is ideally done 6 to 8 weeks after completion of chemotherapy cycle. Only important thing is taking care of following
1. Proper colostomy care .
2. Regular blood counts durine chemotherapy
Wishing you and your family a very happy and healthy life.
Take care
Best Regards
Dr Deepak
PROPER COLOSTOMY CARE IS IMPORTANT
Detailed Answer:
Dear Sir
.That's so good to know that everything went fine .
Dietary Vitamin C and B complex vitamins will help in wound healing.
I would suggest the following diet
1. Plenty of oral fluids
2. High fibre diet
It is important to wait Atleast minimum of 1 week following surgery to start on adjuvant chemotherapy.
Colostomy closure or reversal is not an urgency . It is ideally done 6 to 8 weeks after completion of chemotherapy cycle. Only important thing is taking care of following
1. Proper colostomy care .
2. Regular blood counts durine chemotherapy
Wishing you and your family a very happy and healthy life.
Take care
Best Regards
Dr Deepak
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi. Thanks for detailed answers.
I have just one last question.
I have knee and ankle pain when the weather is humid. Dont know how to treat it.
Those days i am feeling pain in pelvic bones also. Is related to the same illness issue ?
Regards
I have just one last question.
I have knee and ankle pain when the weather is humid. Dont know how to treat it.
Those days i am feeling pain in pelvic bones also. Is related to the same illness issue ?
Regards
Brief Answer:
Likely to be due to musculoskeletal pain
Detailed Answer:
Dear Sir
The pain is likely to be musculoskeletal pain and is related to muscle spasm.
I would suggest you the following
1. Hot water fomentation
2. Analgesics like Ibuprofen along with muscle relaxant will be helpful
3. Calcium and Vitamin D supplement will help
Take Care
Best Regards
Dr Deepak
Likely to be due to musculoskeletal pain
Detailed Answer:
Dear Sir
The pain is likely to be musculoskeletal pain and is related to muscle spasm.
I would suggest you the following
1. Hot water fomentation
2. Analgesics like Ibuprofen along with muscle relaxant will be helpful
3. Calcium and Vitamin D supplement will help
Take Care
Best Regards
Dr Deepak
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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