Kidney function test seems normal. Passageway in liver seems ok. No endoscopy (procedure involving tube inserted through mouth) needed. Ultrasound semed to indicate issue in passageway. But MRCP (MRI) of abdomen has confirmed no issue.
But gall bladder has stone. This has caused caused pain. It MAY cause pus, jaundice, fever in which case surgery (Laproscopy) will definitely be needed no matter how frail the patient is. On gallbladder stone: https://www.healthline.com/health/gallstones. On Laproscopic stone removal: https://www.healthline.com/health/gallbladder-removal-laparoscopic
The uterus wall is 10mm thick which is abnormal. The urine culture, cystology test results removed the possibility (80% removed) of malignancy in the urinary tract. Mild antibiotics prescribed for the infection. Another followup urine test is suggested to ensure infection is removed.
A Transvaginal scan for Endometrial thickeners is requested in 6 weeks. This will confirm or rule out malignancy in uterus. The option of biopsy is not advised considering the frail condition.
Things to be done immediately
Additional Reading
Things to be done immediately
- Start antibiotics (1st), finish 5th. Finished
- Get 2nd opinion (SR) at Amman st. (2nd to 7th). Cancelled
- Meet gynec to confirm combined (ASAP but after 2nd opinion), get estimate. Done. 40-50k
- Inform ashwins (by 10th). Copy of policy, aadhaar, both dr reports to initiate cashless thru river dept - 2 days prior to admission. Done
- Get tests done
- Asha billing estimated cost Rs12k for blood heart tests excluding 10% discount. Doesn't include urine test. Get estimate for urine test also.
- Other lab estimate 4.4k for blood, 700 for urine culture, cardio, echo etc almost same as asha.
- Get river estimate: 2970 for surgipack, 350+480+950 for the three cardio. River best.
- Cardio test on 6th noon (Less waiting). Other tests (blood surgipack), urine culture, review check by cardio, a little before surgery. This date to be coordinated with moni.
- Confirm with gynec on 4th. (13th to 20th is fine for surgery). Historoscopy, bladder test cystoscopy together about 40-50k. On date of admission, all or concerned specialists will see her. Coordination wont be a problem. Gall is the bigger issue and CM will be the admitting surgeon.
- Confirm with neuro (checked on 4th. Medicines can be continued. No conflict)
- Meet CM Basu - Done
- Anyday ok except sunday
- Inform him one day in advance so he can minimize waiting time for admission. Even if he is in surgery.
- Anytime is ok for admission. noon is fine.
- He will call manager and expedite admission, room ready etc
- 6th Mar
- Echo x ray cardio done.
- Insurance initiated
- Gave aadhaar, policy doc, ashwin url email, vadivel basu gynec reports and test reports scans to srid insurance.
- Left insurance form, jyoti vaishnavi surgery recommendation copy with 3rd floor reception to be given to art (CM's assistant) / CM who will fill it and give it to insurance. Needs followup.
- 7th Mar
- Cardio opinion ok.
- Blood, urine test conducted. Blood report same evening. Urine report on 11th / 12th
- Anesthesiologist opinion will come after showing blood report.
- Moni replacement arrived at noon. Moni will leave 9th morning and planning to come back (maybe after 3 weeks)
- Meeting work CM at 1130, 9th Mar. Admission, surgery details, dates will be finalized after he sees anesthesiologist ok.
- Planned date for admission Monday 11th. Semi private. Cashless likely as per sri. Come alone first, fill in forms. Then being patient. Patient can wait in emergency (10 beds) if required.
- Planned date of discharge 14th Mar as per CM. Gynec came and said she is doing fine and will let me know once biopsy results come in. It did look benign she said once again (though lab result could be different). She suggested cranberry juice to prevent urinary infection.
- 12th
- 11am started
- 1245 gynec confirmed that 2cm long polip removed from uterus which looks benign at 1st sight. Sent to lab. (biopsy done) . Bladder is fine. https://www.mayoclinic.org/diseases-conditions/uterine-polyps/symptoms-causes/syc-20378709
- Stone started 1pm, finished by 1:30PM https://www.mayoclinic.org/tests-procedures/cholecystectomy/about/pac-20384818
- 20th Histopathology Report on samples from surgery
Stitches removed. Everything fine.
Additional Reading
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