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colon semi oclusion

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colon semi oclusion

Posted by
Razvan Gaspar on March 10, 2001 at 16:10:42:

Dear dr Stoll,
I am writing you again and first I want to confirm again, if necessary, that the treatment for chronical constipation of small children you indicate - METAMUCIL AND MINERAL OIL -is very efficient, thank you again. We have a 3 year old boy with chronical constipation from a treatment with isoniaside and for two month we are in a stable situation and it's great, after a year of constipation.
Now back to the main issue. I have a friend who had collon cancer, treated with all the known methods. Now she has a semi oclusion problem from more than a year and all the treatments were ineficient. I saw an answer you posted to Barbara Dusel in December 1998 saying that "The real problem is that the scarring from this terrible burn will likely cause an obstruction later on which will have to be surgically corrected " and I found it interesting because of the link between the radiation and the oclusion.
We have tried everything so any advice it will be considered.
Thank you for your time,
Razvan Gaspar




Re: colon semi oclusion (Archive in cancer.)

Posted by Walt Stoll on March 12, 2001 at 09:27:58:

In Reply to: colon semi oclusion posted by Razvan Gaspar on March 10, 2001 at 16:10:42:

Hi, Razvan.

The answer to your first question is confirmation. See the constipation archives for nuances.

It is likely that surgical removal of the scarred part of the colon will be necessary since these radiation strictures always get worse. There is no reason to wait till she is totally obstructed and have to do emergency surgery.

Let us know how she does.

Walt



Re: colon semi oclusion (Archive in cancer.)

Posted by
Razvan Gaspar on March 12, 2001 at 17:10:49:

In Reply to: Re: colon semi oclusion (Archive in cancer.) posted by Walt Stoll on March 12, 2001 at 09:27:58:

Hi, dr Stoll,
Thank you for your time. We apreciate your answer; I am trying to help my friend to contact you directly - she is in another town than me - to have a better comunication.

Thank you again.

Razvan Gaspar



Re: colon semi oclusion (Archive in cancer.)

Posted by
RAZVAN GASPAR FOR PIA MIHNEA on March 20, 2001 at 15:34:38:

In Reply to: Re: colon semi oclusion (Archive in cancer.) posted by Razvan Gaspar on March 12, 2001 at 17:10:49:

Dear Dr Stoll,
A week ago a good friend of mine, Razvan GASPAR, contacted you to ask for
help on mjy behalf. I have health troubles for two years and as I know
you help a lot of people I put my hope on you. In the attachment you will
find the history of my disease.

I need your advice regarding the possible treatment and advised food.

Something more; do you know something about the hyperbaric oxygen
therapy? If you do what do you think about its performance and whether it
could be of any help for my particular situation. Are there any medical
units in Europe that practice this method?

Thank you very much for your kindness and your time.
Yours sincerely
Pia Elena MIHNEA


The history of deseases

FIRST NAME: Pia Elena
SURNAME: MIHNEA
Sex: Female
Age: 61


Patient was surged on 14 October 1999 at Fundeni Hospital (Bucharest) by Prof. Dr. Irinel Popescu to have removed a malign tumor situated in subsplenic position of the big intestin(colon).
The ADK of 4 cm length had the degree of anaplasia :G1- G2; two little limpho-ganglions in vicinity of the proximity of tumor invasion were observed at histological analysis. Ascitis and metaplasia desease were not present.
After one month from the surgical intervention the patient was treated in Constanta Hospital with cytostatics. The adjunctive chimiotherapy was performed with 5-Fluorouracil and Leucovorin.
There were five cures each of four days with 3000 mg 5-Fluorouracil and 200 mg Leucovorin . The treatment was well tolerated no nausea or vomiting being present. After five cures during 5 months, a radiotherapy with cobalt was started. A total number of 28 exposures were performed from Monday through Friday, excluding holydays. The treatment was interrupted because the patient state was critical. As the sate of patient became worse she was adviced to be consulted by the same Fundeni team of surgens. They found that the radiation induced enteritis and an intestinal occlusion.
Patient undergone an intensive treatment ( perfusions and bile drainage) during two weeks to avoid a surgical intervention. As the occlusion could not be removed she was surged on 20 May 2000 to solve the stenosis of bowel ileus.
THE POST SURGICAL STATE
A number of adhesions have occurred producing a permanent sub-occlusion state. The bowel vili seemed to be seriously damaged : abdominal and rectal discomfort, diarrhea, dehydration and malabsorbtion. Symptoms are sometimes very severe with abdominal pain and a lack of gases transit. A decrease of some ions (K especially) and the presence of bile into the stomach are very frequent events. She needs to be perfused with 7000 ml liqui/24 hours, usually using NaCl solution, Ringer solution, glucose 10% solution, Inphesol (amino acids), intralipid (lipids of different sorts and essential metals) and KCl added to N aCl solution.
The patient is cachectic: she lost in weight aprox. 10 Kg from the second surgical intervention.
The analysis of the main biological parameters on 12 03 2001
Assay Result Reference Range

!) Seric proteints
Albumin Y 60.6 % 52.0 68.0
1 globulin 6.6 % 2.0 - 5
2 globulin 8.7 % 6.6 13.5
globulin 11.3 % 8.5 14.5
globulin 14.8 % 11.0 21.0
Albumin 3.64 g/dl 3.90 5.10
1 globulin 0.28 0.20 0.40
2 globulin 0.52 0.40 0.80
globulin 0.68 0.50 1.00
globulin 0.89 0.60 1.20

A/G 1.54 1.20 2.23
Total proteins 6.0 g/dl 6.3 8.3
2) Seric Ca 8.7 mg/dl 8.4 10.2

3) Seric Na 138.0 mmol/l 137 145.0
4)Seric K 2.9 mmol/dl 3.6 5.0

5) Alcaline phosphatases 59.0 U/l 38.0- 126.0
6) Hb 12.3 g/dl 12.1- 17.2

Tumoral markers ( analysis performed on 3.10.2000 ) The 12.03.2001 ones will be ready after 3-4 days

CA 125 II 31.3 U/ml 0.0- 35.0
CA 19-9 12.4 U/ml 0.0 -37.0
AFP 2.26 IU/ml 0.0 - 7.22
CEA 0.66 ng/ml 0.0 - 3.00

MEDICATION
1) Coordinax/unipride (active compound cisaprid B.P.) 10 mg 3 tab./24 hours, one tab. 30 min before main meal.
2) Debridate ( active compound trimebutin maleat) 100mg 3 tab./24 hours, one tab. Before main meal with30 min.
3) Spasmomen (active compound otiloniu bromid) 40 mg when have pains
4) Carbophos (vegetable carbon, Ca carbonate and neutral Ca Phosphate) 400 mg:
1-2 tab after each meal and bedtime.
5) Imodium (loperamide hydrochloride ) 2 tab. at the beginning and then 1 tab after each stoll unformed.
6) Smecta (diosmectite) 3-4 doses/24 hours.
7) Quamatel (phamotidine) 20 mg 1 tab. Before go bed, when have stomach pains.
8) Pulmocare for entheral nutrition to help the lack of proteins, fatty compounds, vitamins and micro-emements.



Re: colon semi oclusion (Archive in cancer.)

Posted by Walt Stoll on March 22, 2001 at 10:05:55:

In Reply to: Re: colon semi oclusion (Archive in cancer.) posted by RAZVAN GASPAR FOR PIA MIHNEA on March 20, 2001 at 15:34:38:

Hi, Razvan.

Pia is on a "slippery slope" towards her end.

Nothing I can think of, except another surgery to remove all of her damaged gut, will help her now.

If she had only had the opportunity to get a lot more information after her first surgery, and before the chemotherapy and radiation, she might have chosen a better way. IF she can survive another surgery, she still has the choice of trying what would have helped in the first place. However, without the surgery, all she would be doing is making her last days miserable with all whe would have to do with her diet & imagery, etc.

Wish I could give you more hope.

Walt



Re: colon semi oclusion (Archive in cancer.)

Posted by
Razvan Gaspar on March 22, 2001 at 16:40:40:

In Reply to: Re: colon semi oclusion (Archive in cancer.) posted by Walt Stoll on March 22, 2001 at 10:05:55:

Dear dr. Stoll,

I appreciate your effort for reading all our material. Unfortunately, there are no comments to make to your answer. We noted your opinion and will try to inform Pia about the chances in case she can survive another surgery.
Anyway, I'll keep you informed when will have news, just for letting you know.

Thank you very much again for all your help!

Very best regards

Razvan Gaspar

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