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Dr. Andrew Rynne
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Dr. Andrew Rynne

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What causes chest tightness, breathing difficulty and fatigue after a colon surgery?

Answered by
Dr.
Dr. Grzegorz Stanko

General Surgeon

Practicing since :2008

Answered : 5768 Questions

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Posted on Fri, 23 Sep 2016 in Lung and Chest disorders
Question: My mom was very strong and healthy until Feb. when she had surgery for colon cancer. It was removed and she was recovering fine. About six weeks after surgery, she started waking up in the night with difficulty breathing and tightness in her chest. She complains of tingling and weakness in her legs and fatigue. She has gone from taking care of herself and her home and being very active to sitting on the couch. We have been referred to a pulmonary specialist who has diagnosed COPD. She quit smoking 25 years ago and has had some shortness of breath with strenuous activity, but I just feel like something else is going on.
doctor
Answered by Dr. Grzegorz Stanko 25 minutes later
Brief Answer:
Please give some more details.

Detailed Answer:
Hello!

Thank you for the query.

Can you please mention about the stage of her colon cancer (or attach the pathologist report). Did she have chest and abdominal CT before or after the surgery? Did she have CEA marker checked?

I`m looking forward to hearing from you.
Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Grzegorz Stanko 54 minutes later
Her surgery was for a right hemicolectomy. Her report says the stage was T1NX. We made an appointment for a follow up with the surgeon because she was complaining that her "stomach feels hard". The surgeon did a physical exam and said she didn't notice anything abnormal. She complains that the hardness in her abdomen restricts her breathing. The pulmonary doctor put her on oxygen and an inhaler. She really doesn't get any relief from either.

The surgeon did mention at the appointment in May that the section of colon that she removed was where B 12 was absorbed into the body and she was deficient in B 12 and iron. She is now on a monthly B 12 shot and an iron supplement. No change. She is on 20 mg of a statin and thyroid med that she's been on for years for a thyroid condition. The endocrinologist said that she didn't feel that her thyroid condition was causing the symptoms she is now experiencing.

What is a CEA marker? I can check with her about that. We also have an appointment with a new primary care doctor on Sept. 16. She has had temporary doctors since her doctor left in January.
doctor
Answered by Dr. Grzegorz Stanko 1 hour later
Brief Answer:
She should have chest and abdominal CT done.

Detailed Answer:
In my opinion she should have abdominal CT and chest CT done at first. This test are kind of standard in case of colon cancer patients. And are very important to determine the final stage of the disease.
T1 makes this cancer very early and probably already cured.
NX is a kind of strange. When you remove a part of colon, you do it with lymph nodes. So the pathologist is always able to answer either it was N0 (no lymph nodes metastases) or N1-2 (lymph nodes metastases). This is very important as with lymph nodes metastases chemotherapy is necessary. This is the question she should ask to her surgeon or find another pathologist report (the one done after the surgery).

B12 is actually conjugated in the stomach. And absorbed in the small intestine (not in the colon!). B12 deficiency can be caused by stomach issues. That is why she should have gastroscopy done.

CEA marker is a protein checked during the blood work. It should be done and monitored after the surgery. Its increase usually indicates disease progression.

So in conclusion:
- chest and abdominal CT
- gastroscopy
- ask the surgeon about right pathologist report (with N determined)

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Grzegorz Stanko 36 minutes later
The surgeon did not recommend chemo or radiation. I guess we'll talk it over with the new primary care doctor on the 16th. Thank You.
doctor
Answered by Dr. Grzegorz Stanko 10 minutes later
Brief Answer:
You are welcome.

Detailed Answer:
You are welcome. Hope she will get well soon.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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