An intelligent guess !

An intelligent guess ! 

Guessing the age of a person sometimes surprises your speculation. The visual information doesn’t match the actual age of a person. The same happened to me when I saw an old man in emergency room. I assumed his age to be 70 years. To my surprise, his real age was 90 years. He had been physically fit throughout his life. I felt like saluting him for his body physique. 

He was a country man. He survived his life with farming, working in fields. He barely trimmed his nails. He put on shoes on occasions. He was an innocent simple man that lived on earth. He probably never imagined that he would visit a hospital.He noticed progressive fatigue and lethargy for 2 months. He couldn’t carry out his daily activities. He was short of breath and had palpitations on walking a short distance.  He was fatigued even while going to washroom. The limitation of walking didn’t bother him as much his appetite did. He had aversion to food. He didn’t feel like eating his favorite food. He occasionally smoked cigarettes. The decreased appetite bothered his family members and abdominal fullness disturbed him more than anything else. His stomach was just like a full vessel all the time. What do you think the grandpa had been suffering from ? 

It’s an obvious guess that he had low oxygen carrier I.e hemoglobin in his blood. One day, he had severe shortness of breath when he returned from latrine. He had been experiencing some swelling in his ankles and cough while sleeping  since  a few days.  It never happened to him before. He was a silent man who wouldn’t prefer to visit a hospital. His son forced him to go to a hospital. When he visited local  hospital, he was paper white. The lab technician didn’t believe his thin blood sample and ran the test twice before dispatching the report. It was hard to believe that he had his hemoglobin 1.8 g/ dL. He was sitting on a bed quite comfortable with only minimal distress. The report was retested in the teaching hospital and it was the same. The local lab was a reliable one. 

The grandpa was full of surprises. His heart was just beating 64 times in a minute, which was not expected by the doctor. The doctor counted his heart rate twice with a hope to prove himself wrong. But, he was exactly right again. He was slowly transfused five pints of blood. When his reports arrived, he had insult in his liver as well. His liver scored high in enzymes but didn’t cross 5 centuries. The prothrombin time was prolonged by 8 seconds. He didn’t have jaundice though. His X-ray chest showed blunted angles on the lower outer corners. His heart was a big one.  What is your intelligent guess ? 

On enquiry to the reason behind anemia, it was found that he had been losing blood from stool. He had black color sticky stool for months, which indicates  blood loss from upper GI tract. In fact, he never bothered to mention the stool color. He would just flush the sticky stool with more water than usual. 

What might be the cause for the loss of blood in his stool? Everyone would guess the cancer of stomach giving all supporting points of anemia, appetite loss and blood loss in stool ( melena ) in an old grandpa of 90s. That’s a genuine guess. No surprise, many would have angry  looking gastric ulcer. The ulcer later on would prove a cancer.  If luck wanted it to be a nasty one, the cancer would be found elsewhere also. No one would dare  to help the old guy when he had high complications with surgery. The family members would later take to home for the rituals. 

With all these  ill looking expectations, scope was inserted into his stomach. It was really shocking to find the hundreds of round worms swirling in the stomach. The more astonishing was the recovery with four tablets of albendazole, three tablets in three days and one tablet after two weeks.