* PHILIPPINE LADY ASKS WHY SHE HAS DEVELOPED CONSTANT EAR NOISE? 

"Roshin?  May i ask what is this nuisance noise in my ears? If you try to cover your ears with your fingers that is the kind of noise i hear even my ears are not covered Its disturbing Thank you.. I really wish that we could talk. Sometimes im thinking perhaps im near to die? Please help me about this.  Thank you." (Eve, Philippines)

Hi Eve,

With regards to your question, "I would like to ask what is this noise in my ears that wont stop its annoying," I believe, after our conversation on Facebook (Nov 15, 2016), the ear noise, that is bothering you, is medication induced.  You asked me  "to close your ears with your two fingers and thats axactly the sound buzzing in my head."   Your description of the ear noise has many possible etiologies, and based on your reply to my questions, I ruled out many of the potential causes, arriving at the conclusion that the medicine, Idezar, you are taking for your hypertension, may be the most likely explanation for your ear noise. 

How did I arrive to this conclusion?  You stated, " I notice this noise maybe 2 weeks ago and sonetimes its quite disturbing."  You also said, "I remember then when im still a child but im not sure if my mother or father had some problem also in ear noise and put a whole pepper or ginger in the ear hole.  The sound i hear is like when you are in the forest and you hear some insects sounds. Or somewhat like try to cover your ears with your fingers its like that."

You said, "The doctor prescribe it, The idezar only 150mg,  to me for hypertention."   You said your blood pressure readings this past month have been " 130/80 120/80 120/70"  and " Maybe 5 timea 140/90."  However, you also told me that you take "75mg on and off" not "150 mg once a day."  When I asked why you do not take a 150 mg tablet as prescribed by your doctor, you said " Im only taking 75 mg a day bcos i dont feel good taking 150mg.  I feel a little dizzy. I feel my heart hold my breath." 

Furthermore, when I asked was your blood pressure normal when you took the 150 mg medication as prescribed, you replied, " Yes.. even i dont take it i feel im ok.. only the sound and some shaking."  You said "Sometimes i feel my body is trembling.  I feel my hands shakes my legs something like that." 

I believe the trembling might be due to your blood sugar levels fluctuating from normal.  In fact,  you mentioned,      "Im sorry.. i thought its only maybe my over dieting. My food intake is not the same. I reduce sugar intake, from rice and other."   Fluctuations in blood sugar can cause dizziness and trembling. 

Most importantly, all my questions regarding other causes of ear noise [such as trauma, ear infection, respiratory illness, throat pain, cardiovascular disease, occupation, circulatory problems, anemia, allergies, an underactive thyroid gland, intracranial hypertension (also called pseudotumor cerebri), Meniere's Disease,  and diabetes] allowed the final conclusion that not being compliant with the dosing of Idezar is causing your ear noise.   Hypertension causes ear noise (referred to as tinnitis).  Thus, when you take 75 mg of Idezar, instead of 150 mg as prescribed, your blood pressure rises, and this is why " Maybe 5 timea 140/90" readings occurred.  A blood pressure greater than or equal to 140/90 is Stage I hypertension, a serious condition that must be controlled before worse complications occur. 

What do I recommend for you?  Visit your doctor, and mention that when taking the 150 mg Idezar,  " i dont feel good."  Your doctor should be able to easily change your blood pressure medication to a different hypertensive medicine that will not cause you adverse side effects.  You should also ask your doctor to check your blood sugar levels, and prescribe appropriate medication, as needed, to keep sugar levels in the normal range. 

The two hours we spent visiting on Facebook was well worth the time.  I believe these suggested conservative measures may easily remedy the present medical concerns you have expressed.  Thank you for question(s) and trust in me.  God Bless you and God Bless the Philippines.  Stay in touch.

Respectfully,

Dr. Roshin

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   * 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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