* NEW JERSEY FATHER ASKS WHY SON'S LYNCH SYNDROME NOT DIAGNOSED EARLY ? WHAT TREATMENTS?

“Hi Dr. Roshin.  I'd like to invite you to my house. My wife is a Japanese girl XOXO. She makes life wonderful and she's a real good cook.  The patient is my son Raymond. He's 27 and married. By the way I'm fortunate enough to have all 4 of my children living with me and plus the 2 wives of my sons. About a year ago the pains became too much and when Raymond went to the emergency room, it took awhile but they discovered a problem. They ended up removing the descending part of the colon. Raymond had the bag and went through about 4 or 5 months of chemo. After a few more months they did an operation to reattach him and discovered more cancer on the small intestine. As I was explaining I'm adopted along with my half brother and sister. We are all from the same mom. They both experienced colon cancer in there 40's. My sister got a positive report for Lynch Syndrome pretty recently. Although we've suspected for awhile. I assume I must have it. One strange thing is that the first report from the Dr's said that Raymond did not have it. And when I showed them my sisters report then they said he did. I assumed it would be more black and white. Dr. can you check about Radio Surgery. Dr. Gil Lederman is on the radio 710 am. Thats the station. Gotta head to work. Good luck in your ministry. God Bless You --- Bruce and XOXO"

Hello Mr. Bruce,

I have to admit, I am baffled by your comments that your son’s Lynch syndrome was not the initial diagnosis afforded by his doctors, with expedient treatments, both screening and curative, provided as early as possible.  Lynch Syndrome, often referred to as hereditary nonpolyposis colorectal cancer (HNPCC), is the most common inherited cause of colon cancer; thus, from the onset, your son’s family history, in other words, his genetic history should have been extensively explored, with an immediate realization that a link to his present symptoms exists.  In fact, for people with Lynch syndrome, colonoscopy cancer screening exams should be scheduled every one to two years beginning in their twenties.  Time is survival; thus, excuses and apologies are unacceptable.  Your son developed colon cancer of the descending colon, which was appropriately resected, used a colostomy bag for four to five months, and underwent a successful surgery to reattach the digestive system tract.  However, during that reattachment surgery, cancer was found in the small intestine, and you wish to discuss radiosurgery. 

Radiosurgery is a procedure that targets tumors using a large dose of radiation, focused on that precise cancerous lesion, for eradication.  Since the high dose of radiation is localized to a small area, as opposed to chemotherapy which floods the body with toxic medication to kill the cancer cells, radiosurgery would be an effective procedure for Raymond’s small intestine cancer.  Radiosurgery, in combination with chemotherapy, is often more effective to ensure total purging of the cancer from your son’s body.  However, the radiosurgery procedure does render many adverse complications not limited to the following:  skin blisters, inability to hold bowel, fatigue, erectile dysfunction in males, vaginal irritation in females, blood in stool, painful bowel movements, and urinary irritation (burning, blood in urine).  There are multiple treatment options on how to deliver the radiation, as well as numerous other treatments options available for bowel cancer; thus, a final decision should only be made after contemplation with Raymond’s physician.

Bruce, I am humbled by your invitation to visit your family.  Thank you for your question(s) and trust.  Please stay in touch, as I wish to know your family’s final treatment decision and most importantly, the outcome.  If you have any questions or simply need a second opinion, feel free to call or write, at your convenience.  In the meantime, although I do not have a ministry, your thought sounds like a reasonable calling, worth considering.  God Bless Raymond, God Bless you, and God Bless New Jersey.

Respectfully,

Dr. Roshin

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PHILIPPINE LADY ASKS WHY HER MOTHER'S KIDNEYS SHRINKING

“ Hi Roshin, I would like to ask, my mother went through an ultrasound and the doctor said the left kidney of my mother is getting smaller.  May I ask what kind of illness is that? this time, they did not yet gave any medicine but only buscopan hyocine and vitamins only. What will I do next? please help me how to find cure for my mother, what to do and where doctor will we go. Thank you.. i'm quite nervous and worry of what will you say regarding the result of my mother's ultrasound, I hope she can be cured the soonest. thank you for finding some time for my mother's case.. I will be online tonight until midnight to catch your time.  gratefulness is mine.. from the bottom of my heart.. my sincere thankfulness to you//”  (Ms. Evelyn, Philippines)

Dear Evelyn,

I am glad we visited on Facebook this past weekend.  After viewing your mother’s ultrasound report and gathering her pertinent medical history from you, your mother’s present day health course has a direct link to past conditions; however, her test results do not indicate any glaring medical concerns, as long as she maintains her prescribed, treatment regimen.

 Specifically, you mentioned your mother has “maybe 20 yeas” of hypertension, and is taking “Plendil 5 - once a day.”  In addition, you mentioned that your mom is taking “vestar twice a day” for “she had chest paint maybe from 6 months.”  You mentioned she had high cholesterol of “300” but “after taking prabastatin, yes they get normal now.”  You said “she loves to eat meat before, mostly pork mybe 4 times/week, with soup, sometimes fry, we she always use soy sauce.”  When I asked if your mother was a smoker, you said, “before yes, when shes still at age 30 to 45.”   Fortunately, your mother has no history of kidney problems, urinary problems, diabetes mellitus, allergies, or cancers. 

Your mom’s past medical history is directly linked to her present state of health.  The sonography report does indicate “small size both kidneys, good corticomedullary differentiation, but otherwise unremarkable.”  Although the report indicates small sized kidneys, her kidney function tests are normal; thus, there is little concern. 

I am of the belief that your mom’s “smaller kidney size may be due to effects on her blood vessels from her past history of smoking, high cholesterol, and high blood pressure.  Smoking causes direct damage to the vasculature, thus blood flow often slows.  Cholesterol is fatty deposits that accumulate in a blood vessel, also preventing blood flow.   Thus, the combination of smoking and high cholesterol makes blood flow very difficult, and the lack of blood flow, causes a backup of blood in the vessels, leading to hypertension (high blood pressure).  Remember, blood carries oxygen, and oxygen is needed by every organ in the body to survive.  Thus, smoking, high cholesterol, and hypertension decrease blood flow to the organs.  When decreased blood flow affects the heart, chest pains occur. 

Fortunately, your mom’s medication regimen has her blood pressure normal (110/70), no chest pains, and normal cholesterol levels.   Now, all she has to do is make lifestyle modifications.   Since she is an 80 year old ambulatory woman, she should take a 15-30 minute walk, if tolerable, every day to help keep her heart healthy.   In addition, you mentioned, “she loves to eat meat” however, your mom needs to limit her meat intake to 1 or 2 servings per week.  Instead of eating pork, she should consider eating lean cuts of poultry as well as seafood.    After our discussion on the importance of a diet change, I am glad to hear that you also agree, “she need to shun from those.”  Eating plenty of fruits and vegetables will also keep her heart healthy, decrease cholesterol, and maintain normal blood pressure.  Please consult a doctor in your area before beginning an exercise regimen or beginning any treatment plan. 

The bottom-line is that your mom’s longevity is in her own hands.  Improved eating habits, a tolerable, exercise regimen, and taking her medications as directed, will literally add years to her life.  Surrounding your mom with family support will keep her mental state healthy too.  Thank you for your question and trust.  God Bless your mom, God Bless you, and God Bless the Philippines.

Respectfully,

Dr. Roshin

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         "THE MAGIC CURE FOR HCV"  - ONE MAN'S STORY

Doctoradvisor,

"As per your request, I have written a brief story of my experience with the HCV.  I hope this helps some of your readers and wish all of them the best in their quest to eradicate this awful disease."

Cordially,

R.S. (Newark, NJ)

"Harvoni - THE MAGIC CURE for HCV"

I had originally heard about the "MAGIC CURE' in 2012.  I was dealing with Hep C since 2002 (at least that was the year it was discovered) and it was rapidly deteriorating my liver.  My prognosis was not encouraging.  My first severe episode was in February of 2007 when the varices ruptured on my esophagus.  Chance of survival is about 30% but I was fortunate.  They were banded and I lived.  

That was the beginning of the journey.  I had episodes with hepatic encepolopathy and they became more frequent as time went by.  I was moved from Monmouth Medical to University Hospital, and they were able to save my life there.  

The Harvoni treatment was approved by the FDA on December 8, 2013.  I was blessed with a most outstanding Hepatologist, who got me into the program in February of 2014.  At that time my viral load was in the multi-millions.  At the end of the program, no virus was detected.  A true miracle.  My prognosis before treatment indicated that I did not have much time left.  After treatment, prognosis is 15 years or better.

The big issue with the treatment is it's cost.  I was on an 8 week program that cost close to $100,000.  That's something like $1,300 a pill...and you take 2 a day.  Hopefully the cost comes down and everyone can get the treatment.  It is a true miracle.  My doctors now have me on a magic cocktail.  To sum it up, I haven't felt this good in many, many years.

Thank you,

Rico (Newark, New Jersey)

-----------------------

Dear Mr. R.S.,

Thank you for sharing your story with DoctorAdvice4u readers.  You are a walking miracle.

Respectfully,

Dr. Roshin

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       * PHILIPPINE MAN MAY HAVE POTT'S DISEASE?


“ahh ok sir.  u know about spinal cord disease???  we need an ortho doc.but we only a poor family....his bedridden for almost 6mons.  I'll send u the result of MRI.”  (Ms. Lovely, Philippines)

Hi Ms. Lovely,

After spending almost a month in correspondence with you and after scanning numerous imaging and test results you sent, I believe the 32 year old man you referenced with your question, may have either Pott’s Disease or a leukemia.  Pott’s Disease is a form tuberculosis that effects the spine causing tuberculous arthritis of vertebrae joints.  A leukemia is a cancer of the blood, involving white blood cells.  Allow me to explain.

When I asked you has the man had tuberculosis in the past, you said, “n0 sir.”  Yet, judging by this  man’s MRI report (L3-L4 and L4-L5 dessication / posterior disc bulge at L3-L4 / L4-L5 posterior disc herniation causing mild spinal canal stenois), blood results (extremely high monocyte count with low lymphocyte count), and an apparent effect on the adrenal gland (sodium and potassium levels abnormal),  tuberculosis must not only be considered, tuberculosis tests (Mantoux test, PPD) must be ordered by his doctor.   The PPD will confirm active or past exposure to tuberculosis.  If the PPD is positive, you and this man’s contacts must all be tested for tuberculosis.  The other factor that may lead credence to Pott’s disease is that his blood test showed low levels of hemoglobin and hematocrit, which could have been caused by loosing blood orally or rectally.  Multiple medication regimens will treat tuberculosis. 

This man’s monocyte count was 19.1% (2-6% normal range) and lymphocyte count was 4.9% (20-30% normal range).  His hemoglobin was 113 g/L (135-180 g/L normal range) and hematocrit was 40.9% (44-54% normal range).  Pott’s disease, also known as tuberculous spondylitis, is a combination of osteomyelitis (bone inflammation) and arthritis, frequently involving multiple vertebrae of the lower, lumbar spine which may cause vertebral collapse and compression fractures.  The MRI report appears to reflect many of the signs and symptoms you mentioned in our discussions on Facebook.  With urgency, please locate a doctor who will test this man for tuberculosis exposure.  If you require assistance with the location of a Philippine hospital or clinic, simply ask, and I will make contact with doctors in your country. 

Due to the unusual and abnormally, very high monocyte count ( a type of white blood cell), a leukemia should not be ignored.  A hematologist ( a blood specialist) should be considered for making an absolute confirmation of a leukemia diagnosis.  Chemotherapy is a treatment option for leukemia. 

I am humbled by your trust.  Please write and let me know what evolves from our discussion.  A 32 year old man, bedridden for sixth months, is crying for help, and I pray and hope my suggestions, through your efforts, will reverse his health and life’s fortunes.  God Bless the thirty-two year old man,  God Bless you, and God Bless the Philippines. 

Respectfully,

Dr. Roshin

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