History
Mr. O’Toole, thank you for sharing your concerns. You are absolutely right that apixaban can increase the risk of bleeding, and this could partly explain the blood you’ve been noticing. It’s also possible that a sinus infection or irritation in the back of your nose could be contributing to your symptoms.
However, I am concerned about the weight loss you’ve described, and I want to make sure we don’t miss anything serious. One condition we need to rule out is something called nasopharyngeal cancer, which is a cancer that can develop at the back of the nose.
I understand this might come as a shock to hear, but please know I’m not saying you have cancer. It’s just that your symptoms and smoking history mean this is something we cannot overlook. To get to the bottom of this, I’ll be referring you urgently to an ear, nose, and throat specialist. You’ll be seen within two weeks, and they’ll take a closer look at your nose and throat to find the cause of your symptoms. It’s important to stay proactive, and we’ll be with you every step of the way.
Explain to him; Mr. O’Toole, I understand your concern about whether the apixaban might be contributing to the bleeding. You are absolutely right that apixaban can increase the risk of bleeding. However, based on what you’ve described—your symptoms being intermittent over the past 2-3 months, with no active bleeding currently and no signs of significant blood loss such as dizziness or a racing heart—we believe that continuing apixaban is the safer option at this time.
This medication is very important for reducing your risk of serious complications, particularly a stroke, which can occur due to atrial fibrillation. The benefits of staying on apixaban currently outweigh the risks. Of course, we will keep monitoring your condition closely and reassess if there are any changes or if your symptoms worsen.
In the meantime, it’s important to keep an eye on your symptoms. If you notice that the bleeding becomes more severe, such as coughing up a lot of blood, passing black or tarry stools, feeling faint, or experiencing any unusual bruising, please seek urgent medical attention or contact us immediately.