tachycardia , thyroid , and general unwellness

[BeckyMcclean]

hi im new to this site , and really need some help ,

if a patient has past and present history of

t3no scc of supraglottis 2011, treated with radio and chemo therapy [remission]

hypothyroidism , [from radio therapy treatment], [present] , copd , [present] ,peg to assist with oral intake [present] ,

then developed , atrial fibrillation , productive cough ,anxiety , weight loss, nausea , breathing difficulties , along with pulmonary congestion, secondary to lower respiratory infection which has been ongoing now for 8 months, antibiotics have been prescribed which have helped a little bit,but atrial fibrillation still causing a problem

weight loss within the 8 month period has reduced from 74 kilos to 60 kilos, and patient showing signs of hyperthyroid though blood results showing tsh within range at 12.75 mu/l [0.35 - 4.94] which i thought was elevated .

free t4 also within range at 15 pmol/l [9-20], only other elevated result is CRP which reads 124 mg/l [

an ebus with fine needle aspiration was performed , results only showing inflammatory changes, though also was told then that patient had no glottis again due to radio therapy.and only other visible signs of possible illness is discharge from site of previous tracheotomy which is taking its time to heal, skin colour looks like a greyish whitey blue, with a bubbly breathing sound, and anxiety very noticeable. a recent check up for squamous cell carcinoma showed the vocal folds not opening properly , though voice is okay

does anyone else think it could possibly be the thyroid causing the problems as this was the only medication changed just before the additional symptoms came.[ levothyroxine 100 micrograms changed from am to pm though past 2 weeks has been changed back to am] weight loss on going problem though nutritional diet administered via peg , could dosage of levothyroxine 100 micrograms be to high now due to weight loss? also patient showing dehydration signs from time to time [not continuous ] with little urine output ,i have searched for every answer possible that could be causing this, also discussed the matters with health professionals but i was not taken seriously, patient prescribed multiple different medications , eg ,rivaroxaban 20mg , digoxin 125micrograms , and verapamil 80 mg 3 times per day,[all taken together with levothyroxine] just cannot understand why thyroid has not been addressed and ruled out , i feel like im going mad , can anyone else please point me in the right direction with this , any help would be very much appreciated thank you

[Esme12, ASN, BSN, RN]

Is this a patient you are caring for?

[edmia, BSN, RN]

You don't mention any imaging, so I was thinking lung mets. The symptoms you describe are all common in advanced cancer...

[BeckyMcclean]

hi thank you for your replies , yes this patient is actually my partner im extremely worried about him , his had so many tests done including ct scans which was where they discovered a shadow on his chest , this was later diagnosed as pulmonary congestion due to lower respiratory infection. an ebus was performed about 2 months after with fine needle aspiration , biopsies taken and all came back okay apart from inflammation, i asked the consultants about a secondary cancer and they said no , its an infection, i have an appointment with him today at the respiratory clinic , i will post back on later with any results they may provide, thank you once again for both your replies.

[edmia, BSN, RN]

I'm sorry about this difficult situation. Since this is your family, I would find a clinician on his team to talk to. Posting on a web forum for professional nurses will not give you the insight that a good clinician with eyes on the patient can give you. Your partner's medical problems are many and I don't think any 1 thing is causing the symptoms. More likely a result of many little things happening together. Talk about prognosis with your partner and the clinicians. Ask for truthful answers.

[Esme12, ASN, BSN, RN]

Welcome to AN! The largest online nursing community!

I am sorry your partner is experiencing illness...but as per the TOS we cannot give medical advice...

[h=3]Medical Advice:[/h] ALLNURSES.COM, INC or it's members do not offer medical advice. Any requests for such will be taken down. If you have a medical problem, please seek attention from your health care provider. You are not allowed to ask for medical advice related to a health situation that affects you, a family member, or someone you know.

I wish your partner the best

Thread closed