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What do I do, gastroenterologist ?

HELP - Mom in hospital - What do I do -gastroenterologist ? Hematologist? She broke her humorous and it didn't heal over a years time. She finally decided to have surgery , this happened last Wednesday, February 3rd. She has Cirrhosis of the Liver and since she has been in her bilirubin has spiked from 2.1 to 9.7. Her INR score was at 1.2 up to 1.5 and now 1.4. Her Creatinine is at .53, BUN 19. She has had 4 units of platelets over the last 5 days - down to 50K and has had 4 units of hemoglobin down as low as 7.6. Her MELD score prior to surgery was 12, 13 on Friday and now with the spike in Bili it's at 19. She has had a cat scan of her arm and stomach to ensure there is not internal bleeding , both negative.. as they are trying to figure out the bleeding problem. More lab results: albumin 2.3, protein 5.4, SGOT 59, Pro time 14.1. What is your suggestion, there has not been a gastroenterologist seeing her in the hospital. Currently she has an attending that is an internist , a hematologist and a orthopedic doctor. I am scared they are going to send her home, she will continue to decline with platelets and hemoglobin and her liver function will worsen. Any suggestions on what we should do next ?
Asked On : Thu, 11 Feb 2010
Answers:  2 Views:  355
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  Anonymous's Response

All her blood counts are low. What has been the reason for it? Is it a hemolysis like as you have mentioned about altered liver enzymes as well, though it is not that elevated.  Platelet count shall improve. What is the symptoms that she had? Is it a Dengue fever like?

Answered: Thu, 11 Feb 2010
  User's Response
is she had any infection or autoimmune diseases in past? go for bone marrow biopsy first.
Answered: Sun, 10 Apr 2011
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