hypercalcenemia and blood in stool

codavis · February 2012

Hi

The last four months have been difficult for me. I haven't been diagnosed with a recurrence, but I've been convinced several times that it was back. I've had sore achey ribs,tender spots on my sternum and the areas around my mastectomy. I've had swollen lymph nodes on my mastectomy side. I've had chronic heart burn, and I injured my shoulder/upper arm, and was convinced it was bone mets. I had a shoulder MRI and bone scan, and got the all clear. During this time, I've had a difficult time passing stool. I didn't feel constipated, but sometimes it would take me 30 minutes or more. And it was very painful. I assumed hemorroids or that the tissue was thinned because chemo had pushed me into early menopause. Occasionally, I'd see a little bit of red on the tissue. A few weeks ago, I saw blood in/on my stool. That happened a few times so I called my onc to see if I should go to my primary care doc, or what. He referred me to a GI doctor, but I couldn't get in to see him for three weeks. In the meantime, I continued to have painful movements, occasional blood and stomach cramps. Two weeks ago, I started having a tingly feeling in my legs. Especially in my lower legs, and I noticed it mostly when I got up and walked after sitting for a while.

I saw my onc on Tuesday last week, and told him all of this. He didn't think the tingly legs was a side effect from Femara or Foxamax, and he said let's see what the GI doctor said. He said I might have a fissure or something similar, and that would cause pain and bleeding. After I left I realized that he hadn't really addressed the tingly legs issue.

On Wednesday, I got a message from my onc that my calcium level was elevated (10.9) and he wanted me to come by to give another blood sample so they could recheck it. On Friday, I saw the GI doctor. He asked me about my symptoms, said that he'd received a note from my onc, and he recommended a colonoscopy! He didn't even examine me. He just asked me to schedule the proceedure because of my breast cancer history. He did say that he was 80 - 90% sure it was not cancer, but he wanted to be positive. I'm only 45, and know that colon cancer increases after age 50, but still... I also know that breast cancer mets to the colon or stomach are rare, but they do happen.

Anyone out there have an experience like this? I think my blood calcium level is high because one of the symptoms is tingly legs, but I won't know till later this week when the second blood test results come in. But it doesn't seem like the increased calcium would be caused by bone mets because I just had a clean bone scan two months ago and the only thing that showed up was some degeneration in my lower back. I think increased calcium in the blood is from severe bone mets.

Also, my follow-up mammogram and breast MRI are this week and next so I think I might be feeling anxious about that, and it may be causing me to worry when I don't need to. Who knows?

ma111 · February 2012

10.9 is a slight elevation and might be the cause of a small bone lesion that can be radiated to prevent fracture and decrease pain.

If you do have a fissure, Maybe, during the colonscopy they can sew it up for you. I would recommend Mirlax and/or Senokote.

rubyjune40 · February 2012

Hi Codavis, I am sorry that you are going through all this, I also had bright red blood in my stool. lots of constitpation and pain. onc sent me for colonoscopy, it wasnt as bad as I dreamed it would be. I have severe diverticulitis. I have to be sure to have lots of fiber. When I am not regular I drink my cocktail of Metamucil, it became the family joke. But it works, one time the pain in my lower back wass so bad i went to the ER, I was told you are constitpated. I was sure the cancer had spread but it had not. hope yours has not either.

codavis · February 2012

rubyjune40:

Thanks for the response. I hope it's something like that and not more cancer. Until I had 6 months of chemo, I'd never had trouble with constipation before. Now, with the hormonals I'm taking, I just assume it's going to be a new way of life.

I think the thing that has me worried is the increased calcium level combined with the other symptoms. And the routine screening. It's just a 'busy' time for my body, I guess.

My mammogram is later this afternoon. I'm sure I'll feel better after that.

codavis · February 2012

ma111.

Thank you. I guess I should have asked the GI doc about the possibility of a fissure. I was really surprised that he didn't even do an exam. If there's a fissure on the outside, and he saw it, couldn't I avoid the colonoscopy?

Racy · February 2012

codavis, I understand your symptoms are worrying but you are doing the right thing having them investigated.

When you see your onc again, don't forget to ask again about the tingling.

I hope your symptoms are benign.

kathleen1966 · February 2012

I have had a fissure, also have diverticuli, have had diverticulitis and the fissure, in my opinion and I am not a doctor, would only hurt at the very end of a bowel movement. Perhaps your constipation, high calcium and tingly legs could be caused by a thyroid issue. I would have my thyroid tested. All that you have described are all symptoms of hyperparathyroidism...http://thyroid.about.com/library/endocrine/blhyperparathyroidism2.htm#symptoms

ma111 · February 2012

Fissures are usually on the inside and it is something you would want anesthesia for like they provide during the colonscopy. You will be as comfortable as possible that way. An exam would hurt in the office.

codavis · February 2012

Thank you for your reponses. It makes me feel better that no one else is surprised the GI doc didn't examine me. Having had cancer has caused me to worry about every ache and pain and to question everything. I know that many, many on these boards have expressed the same thing, so I figure it's normalish. When the GI doc said he got a note from my onc, I assumed that this was more urgent than it probably is. I worried that the GI was rushing to do a colonoscopy because of something the onc said. Silly, I know.

On the plus side, my mammo was normal yesterday--I have one natural breast. Next week I have a breast MRI and the colonoscopy, and then maybe I can relax.

ICanDoThis · February 2012

Just to throw this into the mix

The most common cause of elevated calcium is hyperparathyroidism - other symptoms of which are a low Vitamin D, body aches, bone aches, fatigue, depression, and irritability.

Have any of your docs checked your Vitamin D and/or parathyroid?

37antiques · February 2012

I second Kathleen, please have your PTH levels checked in your bloodwork. High calcium is known to appear with hyperparathyroid, and it makes you feel awful all over, with pain in your long bones (as opposed to joints), fatigue, odd weigh things and a host of other difficulties. Get the colonoscopy, but have that checked too.

((hugs))

codavis · February 2012

When I went back for the re-check on my calcium, the onc also ordered PTH. I'm still waiting for the results. Is hyperparathyroid the only thing that increases PTH levels? In other words, if PTH is increased and calcium is increased, does that definitely mean hyperparathryroid disease?

tenaj · February 2012

My onc found a elevated calcium in my blood work 7/11, repeated it with a PTH, when that came back elevated I was referred to an endocrinologist. He ordered more bloodwork & 24 hour urine to confirm hyperparathyroidism. I then had a parathyroid scan. I was then referred to a surgeon at Mount Sinai hospital in NYC. At my consult with him he did a ultra sound & decided I was a good candidate for surgery. Only one gland had an adenoma. My surgery went extremely well and they are almost always benign which thankfully it was.

codavis · February 2012

tenaj: Thanks for the information. Did you have any symptoms other than the increased calcium? Any stomach issues or blood in your stool? Or constipation?

ma111 · February 2012

Codavis,

I don't think that elevated calcium causes constipation or blood in the stool. Has the constipation and blood stoped? Hopefully you put yourself on the senakot or something to help. I have to take some in the morning also if I take a lot of narcotics. At least take 2 at night.

codavis · February 2012

ma111:

I'm still having bm issues, but haven't seen any blood this week. The GI doc told me to increase my fiber and water, which I have. On Sunday, I have to reduce my fiber intake in advance of the colonoscopy so I don't want to start anything new so close to the proceedure. It's been going on for a long time. I think I can handle another week esp if I get some answer.

I also wonder if all of this is because of the medications I take--femara, fosomax and effexor.

Coincidentally, there's a new study out this week that shows colonoscopy has reduced death from colon cancer by 53% over the past 20 years!

ma111 · February 2012

Constipation can be from your meds.

Glad you are getting the scope.

Let us know

jackboo09 · February 2012

Hi codavis

I have also recently experienced pain and some bleeding on passing stools. I have had x14 Herceptin treatments and am on Tamoxifen. Last week I was constipated and had a very uncomfortable bowel movement. I think this caused a cut inside (is that what a fissure is?) After that unbearable pain again (the next time I went to the loo) so have started using pile cream and its quite a bit better, although still a little blood and painful at the end of the movement.

Having read your story I'm really hoping my onco doesnt recommend a colonoscopy as I think my problem is caused by the episode of constipation!

On the one hand we are told not to be anxious over every symptom, but then sometimes invasive tests are ordered? Hope you get some answers. I also suffer with sciatica and it just seems that I'm constantly on the 'is it/isnt it' cancer train of thought.

Will let you know what my onco says.

Best wishes

Liz

codavis · February 2012

I heard today that calcium was 9.9 and PTH was normal! So there probably aren't any bone issues, and it's not hyperparathyroid. That's good. The nurse said the earlier high calcium was a fluke, and that's why they re-check.

jackboo09: Sorry to hear about your issues. I thought my problems were because of a) thinning tissues due to menopause and loss of hormones or b) because of recurring swollen hemarrhoids. It still could be, and that's why I'm surprised the doc didn't do an exam. Now I worry that I don't need a colonoscopy...Of course, my problems have been going on since at least last fall, so I think it's worth a look.

I agree that it's a contradiction that we worry too much or not enough. The GI doc that i saw basically gave me a lecture (in a very nice way!) about how important colon cancer screeining is. He said that colon cancer is as pervasive in women as breast cancer, but that far fewer screens are done. Most likely because it's such an uncomfortable test. He asked me to spread the word!

ma111: I spoke too soon. Today, I had two very painful bms and there was some blood. I am having more than the recommended daily amount of fiber so it's moving, but painful. I also had horrible heart burn today, which really makes it all feel worse.

ma111 · February 2012

The stool softener that is in the Sennakot will help keep it soft without gas build up. Sorry you have to go through this. I know how bad it hurts. Maybe the extra fiber is causing the heartburn. I have better luck with the sennokot then the fiber or other tings they had me try.

I am glad your testing was normal!

jackboo09 · February 2012

Hi again

Rang doctor this morning and a nurse practioner prescribed a local anesthetic type cream. She said it should give the fissure chance to heal. At this stage they didnt even suggest I have an examination, but to make a further appointment if symptoms persist. Im happy with this for now.

The battle with anxiety over mets is a constant one. However, I agree that you should go ahead and have the tests if your medical team advise them. I have sciatica and became so anxious that I got my doctor to arrange a bone scan. The symptoms then eased and I realised that it was not necessary to put myself through another invasive test involving a cannula in my arm. Next time I will work more closely with my consultant oncologist.

Best wishes to everyone who commented here.

Liz

cp418 · February 2012

I just thought to mention to avoid calcium supplements that are Calcium Carbonate as they tend to cause constipation in many people. Use Calcium citrate supplement instead. I learned this lesson myself..... Smile

ma111 · February 2012

Anesthetic cream, nice, that will help. Glad to hear you will get some comfort!

codavis · February 2012

cp418: Interesting. I started taking Caltrate (Calcium and Vit D) when I switched from Tamoxifen to Femara last October. My onc didn't mention anything about it causing constipation. I just checked and it's calcium carbonate. So it might be a contributing factor, but I've been having problems since before I switched. I do wonder if it's because of the drugs I take--effexor, femara and fosomax. Seems it's always something. Sometimes I just want to have a 'do over.' Wouldn't it be nice to start all over again?

ma111: Thanks for your suggestions. I appreciate it. After the colonoscopy on Friday, I can make plans to help alleviate the symptoms. Assuming they don't find anything.
It's a beautiful, sunny day here in Seattle. A bit cold, but it's pretty to look at.

codavis · March 2012

Hi everyone, I wanted to let you know that I had my colonoscopy yesterday. The prep the night before was horrid, but the proceedure was a piece of cake. Slept right through it. The good news is that he didn't find any polyps or anything else concerning. He said I had a couple of hemorrhoids, which are likely causing the blood. I'm really glad, but it also makes me wonder if I could have avoided the scope. I'm only 45 and the real issue is the consitpation. No one ever examined me, no one ever asked me to try anything other than increasing my fiber intake (I'm pretty sure I'm getting more than the daily recommendations--during the four days of low fiber prior to my proceedure, I couldn't eat anything in the house! We buy everything in a multi grain or whole wheat variety!), no one ever looked carefully at or talked about the medications and supplements that I take. I had to learn here that the calcium supplement I'm taking is in a form that causes constipation. Why didn't my onc or GI doctor ask about that? Or mention that as a potential complication?

While I'm grateful they didn't find anything, I'm annoyed that I still have the problem and the only thing the GI doc said was "work on increasing your fiber."

Sorry - I feel the need to vent a little. I don't mean to be ungrateful. I know this is fantastic news, but I'm irritated--literaly and figuratively!

hypercalcenemia and blood in stool

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