Scan reveals deadly cause of toe pain in man

When a mysterious pain started in a man’s right toe, he thought nothing of it. Five years later, he was told he had only four days to live.

When Richard Bernstein started experiencing a mysterious pain in his right toe about five years ago, he didn’t think much of it.

The 62-year-old from New Jersey, USA, went to his podiatrist because he thought he had broken his toe.

But the doctor couldn’t find anything wrong.

Two years later, the pain was creeping into his ankle, so he saw a sports doctor, who thought he had spinal stenosis – a narrowing of the spaces in the spine that is sometimes treated with physical therapy, the New York Post reports.

His foot and ankle pain persisted and slightly affected his mobility. Then, in March 2022, his right leg swelled noticeably.

He went to his GP who made an abdominal scan during the examination. The doctor then referred him to a urologist who delivered some disturbing news.

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“He told me I had four days to live,” Bernstein said.

The abdominal scan showed that the married father of one had a large cancerous tumor and a tumor thrombus that had grown through the renal vein and filled the vena cava, the main artery leading to the heart.

Mr. Bernstein was admitted to another hospital where three doctors, including a cardiothoracic surgeon and a vascular surgeon, performed a complex procedure to remove the tumor.

But preoperative testing revealed more pressing medical problems.

Two of Bernstein’s main coronary arteries were 99 percent blocked and his liver was failing because the malignancy was interfering with his function.

“He was walking on a tightrope,” Dr. Michael Grasso, director of urology at Phelps Hospital in New York, told me. The mail

“You have two situations that are life-ending in a very short period of time and happen at the same time.”

The trio of surgeons had to both remove the tumor and perform a bypass in an operation that took nearly 12 hours.

First, they had to “control circulation” by cutting off blood flow without damaging the brain.

To achieve this, they connected Mr. Bernstein to a lung and heart machine that cools the body.

“We can’t just open the vena cava and scoop out the clot and close it again because the bleeding is heavy,” said cardiothoracic surgeon Jonathan Hemli. “We want to completely stop circulation.”

As the body underwent the two-hour cooling process, Dr. Hemli and his team out of the coronary artery bypass. Then the trio went about removing the kidney and tumor.

“We opened the vena cava and they opened the heart on the right side [and] cleared the tumor. I freed him from below, pulled the hose out and they repaired the vena cava and started to warm it up again,” said Dr Grasso.

The “snake” – the tumor and tumor thrombus – was about 30 cm long and weighed about 1 kg.

“I can’t say I fully recognized the complexity when I walked in, although Dr Grasso told me it was complex. I couldn’t do much about it and [that attitude] got me through it,” Bernstein said.

According to Dr. Grasso’s pain manifested itself in Richard’s foot, ankle and leg because there was a venous blockage.

“The vena cava was blocked. There was pressure in his lower extremities,” said Dr Grasso.

Kidney cancer presents notoriously late, when the tumor has had time to progress. The signs may be vague, such as back pain, although urine in the blood is another indication.

Mr Bernstein said he had a small lump on his chest that his doctor had sent away. However, he feels happy.

“If my whole leg hadn’t swelled up, I would have dropped dead,” he said.

He was sedated for three days after surgery and the following week he underwent rehab where he built up his strength.

He now walks unaided and is slowly regaining the 13 kg he has lost.

The doctors think they’ve removed all of his cancer, so he doesn’t need any additional treatment. His focus is now on recovering from the intensive surgery.

“I still have a bit of fog,” said Mr Bernstein.

“There was no severe pain at all. My advice is if something is wrong and they can’t find it, don’t give up the search.

“Trust your feelings about your own body.”

This story originally appeared on New York Post and is republished here with permission

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