Lung Line Nurse...please any ideas

[windsong]

please do you have any ideas about my posting (down below a bit) " 7 year old coughing up blood" ?

[Bsth41]

My 77 year old father has pneumonia for the second time in a month after an initial hospital stay. He is apparently aspirating food/water/salavia into his lungs starting of the infection. He is back in ICU again. We can't seem to get an answer (if there is one) to what will keep this from continuing to occur. He has a feeding tube now, but what keeps his own salavia from triggering it as soon as he is off anti biotics?

Thanks

Nick

[National Jewish]

I recommend that your son be seen by a pediatric pulmonologist.  The source of the blood is probably the lungs, although it could be the digestive tract.  It could even be some type of congenital abnormality of the blood vessels in the throat or in the lungs.  This is something that should be thoroughly evaluated, especially since it is not the first time that this has happened.

[windsong]

Thank you concerned lady :)
My son went to see a respiratry consultant at a specialist hospital yesterday.We had been referred there by an ENT surgeon who wanted a sleep study carried out before he made a decision about removal of tonsils.
We told her about the coughing up blood..the hospital hadn't mentioned it in the referral letter, so since they havent been actually asked to investigate it, they are going to call the hoapital where he usually goes..hopefully they will ask her to fully investigate it.
She seemed shocked that nothing had been done, either during the 5 days he was admitted coughing up large amounts of blood, or in the 3 months since. she did a chest x ray which she said was clear, and he did the spirometer which i gather was normal as she didnt say otherwise.
She says he needs to have a bronoscopy, shes going to discuss it with everyone else. They may not want to do it until they find out the results of the sleep study, which will take months on the waiting list, as if he does have his tonsils out they can do it then whilst he is under anethsetic.
I get the impression that she didnt think the blood was coming from his lungs.
The only certiancy is that the blood is not coming from his stomach,as he has had a Nissens fundoplication, after which the contents of the stomach cannot come back up. The Nissens is still working and there was never any feed in the blood that was coughed up. Towards the end of the coughing up there were large long sticky type clots of blood...bright red still.

I was thinking about all of this and going back over the years for any other clues and several things struck me.
He had a chest x ray at age 2 which showed a 'consolidated mass'..they checked again the next day and it had gone.
approx 3 months after that when drawing up through his NG tube I drew up a couple of clots of fresh blood.
As a baby he had streaks of blood in his vomit several times, this was put down to mallory wise (due to forceful vomiting with the reflux)...and there have been plenty of times when aspirating through his gastrostomy the past few years flecks of old blood have been in the syringe.Plus the fact that he coughed up blood on a previous occasion 2 years ago.

I don't know if those have any relevance or not.
the surgeons obviously don't think that there is an ulcer in the oesphagus, or they would have put him back on rantitdine etc...although that is a real possibility.
The ENT surgeon was adament the bleeding couldn't be from the tonsils, although he didnt actually have a look to see.
Once the stomach and tonsils have been ruled out that doesnt leave a lot.
His blood pressure at the hospital was 105/75 which she said was a little high but not concerning

[Concerned lady]

I urge you to telephone the LUNG LINE nurses, to discuss your son's complicated case with them.

The source of your son's bleeding MUST be figured out! The blood IS coming from SOMEWHERE. Ask your son's doctors how they plan to find out the SOURCE(S) of the bleeding. Might there possibly be a complication or partial failure of the Nissan operation? Ask the surgeon who did this operation, about this.

And, you can call Dr. Lack, M.D., for more advice, since he is in London, and he's a good doctor.

I wish the best for your son.

Sincerely, Concerned lady

[Concerned lady]

A LUNG LINE nurse said that the following doc, used to work at Nat'l Jewish Medical & Research Center, years ago. I would think, this means he's a very good doctor! And, a patient in England who saw Dr. Lack recently, said she thought he was a very good doctor.

You can telephone Dr. Lack, and ask for advice, about whom to take your son to see, now, in England, to get some better help.

Dr. Gideon Lack, M.D.
Consultant Allergist & Immunologist
London, England
Telephone: [phone]

Have you gone back to the surgeon, yet, who did the stomach operation on your son? This surgeon needs to know about what's happening to your son, now!

Also, sometimes tarry (black) stools can mean stomach ulcers. Coughing up blood can also mean a bleeding stomach ulcer. But, you really need some expert docs to help you to correctly diagnose your son!

You can also call the LUNG LINE nurses, tomorrow, at 1-800-222-LUNG(5864), between 8 am and 4:30 pm, Colorado time. Ask your phone operator for help.

Sincerely,
Concerned lady