@Nurse Gen I do not want to put you on the spot AT ALL with this! Can you help us with this report at all?
I don’t understand the conditions described. Or point me in the right direction?
Again, not putting you on the spot to have an answer or answers.
@Michael0808 this was the perfect time for you to join WS. Your fresh perspective and collegial style is just what we needed when we're all feeling devastated and grumpy about the kids MOO
When the ME report for AxC came out, I was just disappointed that it didn't seem to be poison and failed to analyze it carefully.
On review, it really does look like it was natural MOO again. Article at link is pretty technical but here are some key points:
-ME report states Pulmonary system shows multiple small (micro) focally organizing pulmonary embolisms (PE) Translation: these were chronic PEs that had been there long enough to attach to the blood vessels in the lungs. This is not rare; it's associated with lower limb thrombi/clots that are also chronic. IMO this fits with the idea that AxC, a long haul truck driver at risk for chronic lower leg thrombi aka Deep Vein Thrombosis (DVT) developed Chronic thromboembolic pulmonary hypertension (CTEPH) which the article describes. The pattern of how the embolisms are located also fits with that diagnosis.
Chronic pulmonary embolism: diagnosis
ETA AxC would have been exposed to a lot of second hand smoke in Truck Stops and also if he often spent time in Las Vegas, and that would add to his risk for developing DVTs
The ME report mentions hemangiomas in the liver. Those are not life threatening and interestingly more common in women per this from the Mayo Clinic
Liver hemangioma - Symptoms and causes
The final abnormal finding in the autopsy is that "the proximal duodenum is notable for hyperemia of the mucosa with no sub mucosal or serosal abnormalities"
Translation: the top of the small intestine that connects to the stomach had increased blood flow
Duodenum:
The Small Intestine - Duodenum - Jejunum - Ileum - TeachMeAnatomy
Hyperemia:
Hyperemia: Definition, Causes, and Different Types
It's interesting to note that the ME report says that there is no abnormality in the duodenal tissue itself, also not to the actual blood (no sub mucosal or serosal abnormalities). You would expect to find those if AxC had the most common cause of duodenal hyperemia: duodenitis or inflammation.
Gastritis/Duodenitis: Types, Causes, and Symptoms
So if we are still looking for signs of poisoning, this is where we should look- inflammation in the gut. But unfortunately (because I was ride or die on team poison) duodenal hyperemia is also caused by DVT.
One more thing IIRC Melani P did mention that vascular problems did run in the Cox family in one of the interviews she and IP did.
It could just be Karma, Cox family Karma. Who knows?
Oh, one more thing MOO
