3GenFamily Blog

What do you do when anemia keeps coming back?

In a previous post on Anemia, I talked about my 84 year old Dad’s recurring problem with fatigue and anemia. He (and I) thought the doctors had found the problem and taken care of it with medical procedures to stop the bleeding, most recently in his bladder,  and by making changes to his regimen of nine medications.

I was so relieved that the bleeding has stopped! Several units of blood later, my father was starting to look and feel a bit better. His kidneys were failing, though. He would need to start dialysis right away and he was willing to try it.

I believed that Dad could now start to recover some quality of life. For most of his over 40 life, he has been able to bounce back from serious illness with a determination that was ferocious at times. As nervous as I was about his current fragile condition, I felt confident that he would gradually get better like he had in the past.  

And, at first, it appeared that was happening.

Dialysis is an amazingly complex procedure for life support that involves the dialysis machine, doctors and nurses to monitor your blood and provide the right medications (such as Procrit for his anemia), and counselors and dieticians to help you adjust to a new lifestyle. And, Medicare pays for a substantial portion of the costs. It seems like a miraculous new lease on life when your kidneys are failing.

Day by day, Dad seemed to be getting better. He mostly slept through the four hour treatments three days a week. Our phone conversations centered around making the arrangements for my father to leave the skilled nursing home where he was staying. He was tired of being poked and prodded. He just wanted to go home.

But after a few weeks, his condition began sliding downward again. He wasn’t interested in talking on the phone. The confusion and delerium which had plagued him when his kidneys failed came back worse than before.

I spoke with the nurses at the dialysis center. Were his blood tests showing any imbalances? Not really. His electrolytes were within normal range. My father’s red blood cell count was low but seemed to be improving. They were watching it closely. He shouldn’t be having these symptoms but he was.

A few mornings later I got a phone call from one of the nurses at the nursing and rehab facility. They rushed Dad to the hospital. I got on the first available plane flight to be at his side.

In the ER, they doctors determined that my father had a massive urinary tract infection along with extremely low blood sugar (he is a diabetic) that made him unconscious.  He was admitted to the hospital, again.

Once admitted, the doctors ran through a series of tests including a routine chest xray. In his review of my father’s chest xray, the radiologist noted a pleural effusion, an accumulation of excess fluid in the space surrounding the lungs.

The lung specialist called in to consult with Dad’s regular doctor told me there were three main causes of this excess fluid: congestive heart failure, bacterial infection or a tumor. He would draw a sampling of the fluid to have it analyzed.

I spent an agonizing weekend waiting for the test results.

On Monday morning, the doctor reached me on my cell phone as I got to the second floor of the hospital. Test results showed the cells were abnormal - lung cancer.

So, we finally had the answer to the anemia that would not go away. Various tumors are hemolytic. They destroy red blood cells.

Now, Dad’s choices were limited and the outlook bleaker than ever.

I was grateful to have an answer that finally made sense because now I knew what I needed to do.