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Chest pain and coughing up phlegm. History of bypass operations, high cholesterol and BP. Anything I am missing?

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Internal Medicine Specialist
Practicing since : 2001
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My 73 year old dad has been on dialysis for the past 4 years. In the last 8 weeks, he has been to the hospital 5 times in 9 out of 10 back pain. They calm him down, medicate him, patch him up and send him home. He is currently back in with the addition of chest pain and blood in his phlegm that his coughing up. A blood panel revealed a low hemoglobin count. I have some thoughts such as bleeding ulcer but given my dad's long storied medical history, including 2 different bypass operations, arterial sclorisis, high cholesterol and blood pressure, i am more inclined to believe some a more sinister. When I speak to my parents about what the doctor is saying I get sketchy answers. Is there anything else I may be missing that would contribute to this pain and low hemoglobin?
Posted Tue, 11 Sep 2012 in Hypertension and Heart Disease
Answered by Dr. Ram Choudhary 37 minutes later
Thanks for writing in to Heathcare Magic!
Your father is in quite wrong side of his health mainly due to his renal failure and age. The most troubling component is blood in his sputum and cough.
This means he has got pneumonia and these patient get sepsis and multi-organ failure very soon.
So he must be treated on in-patient basis in an equipped hospital and should be investigated as soon as possible.
If he has some ulcer or any other cause of bleeding then it should be treated.
Kidney patients have inherent tendency to be anemic because they lack the stimulus to make blood-the Erythropoietin- a hormone that is secreted by normal kidneys.
It is usually supplemented by injection to patients on hemodialysis.

If you have any further query please let me know I would try to answer it for you.

Wish you a great health!
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