evaluating anemia

[sewlady6]

i am writing concerning my 90 year old father-in-law.
He has had a slow but steady decrease in his blood count over the last few months. We have started a workup with a gastroscopy which was negative. The gastroenterologist favors a single column lower GI xray over a colonoscopy due to his age. I have no problem with either procedure but am concerned about the prep. My concern is that the prep is pretty harsh and worry about dehydration. He  has issues with mild dehydration in the past. I also worry about possible injury if he should fall going to the bathroom or become weak, dizzy or faint.
Would an MRI or CT scan be a better alternative?
He does have a pacemaker so i know that that would be a concern for doing an MRI.

[Yvette BG]

I agree with Angelsongs about talking with his primary doctor-- and you DO have a valid concern about the prep for the procedure.  

My mother, who is in her early 80s and frail, had Clostridium Difficile infection that they were having trouble curing. Apparently it was a resistant strain of the bacteria. They wanted to do a colonoscopy to see if there was anything in there that was causing her to still have the infection, like cancer.

I called and told the nurse of my concerns that my Mom would fall rushing to the bathroom and break a hip. (Heck, I almost fell when I had a colonoscopy and I was in my 40s at the time!) They said they could admit her to the hospital for the prep and the procedure on a 23-hour (or less) outpatient basis and her insurance would cover it. But like you, we chose to hold off on the procedure, and we were glad we did. (One of the reasons we held off is my mother decided if they did find cancer, she didn't want to have surgery anyway after having had a number of other surgeries in the year prior, so she felt there really was no point to going through all that unpleasantness to have the test.)

I think doctors sometimes underestimate how hard these preps can be on older people in particular, especially if they have heart problems, osteoporosis like my mother, etc.

I take it they've done all the necessary blood work to rule out other possible causes for your father-in-law's anemia, right?

Please keep us posted as to how he is doing.

Take care,
Yvette

[Angelsongs]

I would talk to his primary care doctor.

[sewlady6]

Thank you for the response. I did in fact speak to the nurse for the GI doctor and they pretty much dismissed my concern as trivial. Have decided to hold off on the test and am waiting to hear from his personal physician.

[ggreg]

I think you have a valid concern, and therefore you should call the gastro's office and ask to speak to the doctor, altho you may have to wait before you get a callback, or you may wind up having to talk with his nurse, but anyway tell them your concerns about the dehydration, that you're afraid he will become dizzy and fall in the bathroom.  Could be they could admit him to the hospital to do the prep, so they can keep IVs going.

I wish I could tell you the answers to your questions about the CT scan, but it would be up to the doc what other test he would want to do (except no MRI becuz of pacemaker).  But I will say I don't understand why they won't go ahead and do an ultrasound or CT ANYWAY becuz if low blood count is because of bleeding, it could be from OTHER things besides his bowels.