* 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

*

NYC MAN WITH NONVERBAL LEARNING DISORDER, AN UNRECOGNIZED PSYCHIATRIC CONDITION WORLDWIDE AND IN THE UNITED STATES, ASKS FOR TREATMENT OPTIONS.

"Hello Dr. Rowjee. Are you familiar with a neurological disorder called Nonverbal Learning Disorder?"  (Nicholas, New York City)

Hi Nicholas,

I have heard of this disorder however, in medical school, this condition was not taught or elaborated upon due to not being in the Diagnostic and Statistical Manual, the "Bible" of psychiatric conditions.  More specifically, nonverbal learning disorder is not listed as a diagnosis in the The DSM-5 (Diagnostic and Statistical Manual) and ICD-10 (International Classification of Diseases); yet, there is plenty of literature on this condition as well as avenues of developing research.

Nonverbal learning disorder, also known as nonverbal learning disability, is characterized by an individual with verbal strengths; however, visual-spatial, motor, and social skills difficulties exist.  People with this disorder have difficulty comprehending nonverbal cues, such as tone of voice or facial expression, and these individuals have challenges with mathematics.  Thus, I understand that this disorder has effected aspects of your life including maintaining employment.

 You replied," Hello Dr. Rowjee. I asked you about this disorder because I was diagnosed with it back in 2009. This disorder causes me lots of problems especially with regards to social skills and executive functioning. I often feel like I can't learn many things effectively to become proficient in it. I will do just about anything to rid myself of this condition. I hear that autologous stem cells are a good treatment for neurological conditions. Can you offer any advice on treatments for this disorder that is a permanent fix either here in the US or overseas? "

.

Besides Medical Tourism Company- Affordable Healthcare, Surgery Abroad/ PlacidWay (http://www.placidway.com/) company in Austria, I was able to locate an article entitled, "Stem Cell Crusader Sparks New Hope for Fighting Diabetes, Heart Disease (http://www.bloomberg.com/news/features/2016-06-27/stem-cell-crusader-sparks-new-hope-for-fighting-diabetes-heart-disease)  listing companies with ongoing stem cell research in Japan.    Essentially, the article is a" Who's Who" list of global contacts that could lead to the exact area of ongoing research you  desire. 

After approximately a month of elapsed time, I was thrilled to hear "Hello Roshin. I found a clinical trial using stem cells as treatment for neurological disorders in Florida-Margate, Florida to be exact. I already contacted the clinical trial director to inquire about participating in the trial. If it wasn't for your article on the stem cell treatment in Japan I wouldn't have found the clinicaltrials.gov website.

Nicholas,  I am humbled that we, collectively, were able to find an ongoing research protocol that could end your distress with the manifestations of nonverbal learning disorder.  Please stay in touch, as I wish to learn your progress, praying for a marked improvement in overall quality of life.

Thank you for your trust and question.  God Bless you and God Bless New York City.

Respectfully,

Dr.  Roshin

*

  PHILIPPINE LADY LIVING IN SAUDI ARABIA ASKS FOR HELP.   HAS PERICONITIS

"Hi Doc.. Doc please advice me on how to cure a swollen gums around my wisdom tooth😢😢.. It's really painful and I just try to ask you of any home remedies. I can't eat or even drink water. It's really hardto swallow because I felt that my throat is swollen too..  Please Doc.. thank you.."  (Ms. Mary, Philippines)

Dear  Ms. Mary,

After visiting with you, with urgency on Facebook this past weekend,  more than likely, your wisdom teeth need  removal.   Wisdom teeth are given that name due to typically growing during adulthood years.  You said " Im 28 yrs old doc.."  However, not everyone is able to keep these teeth due to a small mouth size causing both crowding and improper growth of teeth.  However, my conclusion was established after you mentioned " Lower jaw left side Doc.. Yesterday doc i felt it was swollen and pain.  my wisdom teeth i felt it was painful and hurt when i try to touch it from my tongue." 

When I asked are you having difficulty breathing, you said " No Doc.."  In addition, you said  " I dont have fever today,  Its painful Doc when it (a toothbrush) touch.., No blood so far Doc (in saliva),  but i felt lately that Im having a headache.. Doc it really hurt me so much."   Finally, when I asked you "does every tooth hurt or only the wisdom tooth on your left lower jaw?"  you said, "Only the wisdom tooth as well as the gums Doc.."  Your swollen gums might indicate a condition called pericoronitis, inflammation of the tissue surrounding the wisdom tooth.

Both the possible extraction (pulling out) of all four wisdom teeth along with diagnosing and treating a possible pericoronitis requires a clinical examination by a dentist.  I realize you are working in Saudi Arabia and are "afraid that it will affect my work here in Saudi.." but the pain you are presently feeling will get worse if you do not immediately visit a dentist.   Thus, I am glad to hear " But I can try to ask permission to go to a dentist Doc..buy for now i want any temporary cure for this pain and hurt I felt.."

Since you "dont had any allergic reactions " there are some home remedies that can temporarily help with pain until you see a dentist.  These remedies include clove oil, peppermint tea bags, vanilla extract, hydrogen peroxide rinse, garlic, salt water treatment, and a liquor (alcohol)-soaked cotton ball.  

Since you mentioned certain items you already have at your home, these are temporary treatments to help decrease the pain.  Mix a crushed garlic clove (or garlic powder) with some table salt or black salt and apply it directly on the affected tooth to alleviate the pain.  If you prefer, you can chew a clove or two of garlic to get relief.  Onions have antiseptic and antimicrobial properties that control a toothache. It can provide relief from pain by killing the germs causing an infection.  Chew raw onion for a few minutes to relieve the pain. If you are not able to chew onion, place a piece of raw onion directly on the bad tooth or gums.  Mix half a spoon of common salt in a glass of hot water and rinse your mouth thoroughly.  The salt water will help reduce swelling and inflammation, as well as fight the bacteria that cause infection.

I was glad to hear " I will try the onion Doc..Thank you so much for your concern, God be with you always Doc..I will surely update you Doc.."  Keep well Mary.  God Bless you, God Bless Saudi Arabia, and God Bless the Philippines.  

Respectfully,

Dr. Roshin

*

Thank u so much Doc..😊😊😊

Mary Aneesa Abayon

Received: August 7, 2016







*

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

*

         "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

*

       * 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

*

WHAT ARE THE HEALTH BENEFITS OF CHLOROPHYLL?

“ What is the benefits of clorophyll 20% and does it increase the red blood cells.”                      (Lauren, New Jersey)

Chlorophyll is a fat soluble, pigment, found in plants, providing all types of vegetation the ability to absorb light during photosynthesis, a necessary process for plant growth.   Chlorophyll gives plants its green color thus, to obtain chlorophyll in your diet, eat green, leafy vegetables, such as spinach, parsley, kale, collard greens, brussel sprouts, blue-green algae, cilantro, green tea, wheatgrass, broccoli, peas, green grapes, green apples, kiwi, honeydew melon, celery, asparagus, and sea vegetation (seaweed). 

Why eat chlorophyll containing foods?  Chlorophyll has anti-oxidant properties, helps wound healing, is effective against Candida albicans fungus, reduces swelling during inflammation and arthritis, has anti-cancer properties, reduces appetite, and treats constipation.

Your question, “does it increase the red blood cells” the answer is yes, chlorophyll has been shown to restore and replenish red blood cells.  Chlorophyll has a ring structure similar to hemoglobin (the molecule that carries oxygen); thus, chlorophyll has been used in combination with other herbal agents as a treatment for anemia.  More specifically, a derivative of chlorophyll, called chlorophyllin, is highly effective against anemia, providing a healthy level of bioavailable iron in the body. 

You are taking (from a bottle) synthetically made “chlorophyll 20%.”  Although this form is beneficial; remember, there are plenty of natural foods you can eat to aid in maintaining an optimal level of iron in states of anemia. 

Thank you for your question and trust.  God Bless you and God Bless New Jersey and thanks for your work in your community. 

Respectfully,

Dr. Roshin






*

" CHINESE LADY ASKS WHY FACE & FINGERTIPS HAVE PINS & NEEDLES SENSATION?"

“My mom had her thyroid removed so they have to take a lot of other supplements. One of the supplements is calcium. They originally have to take 4 pills (500 mg +D per pill) 2 times a day but it doesn't seems to work for my mom because once in a while, her fingertips and face feels the pins and needles sensation. When she spoke with the endocrinologist, he didn't bother to think of any alternatives but to increase her intake of pills. which means she would have to take additional 2 more pills each time. So my question is should she still take the additional two pills and wont it affect her her kidneys or even makes her constipate?”  

(Ms. Lin, New York City)

  

Hi Ms. Lin,

After visiting with you this past week, your mother presented with “fingertips and face feels the pins and needles sensation,” a term in medicine called paresthesias.  Based on your mom’s past medical history, your mom’s paresthesias have an unknown etiology which must be identified by the doctor.  Specifically, in the medical paperwork you sent me, your mother’s Hemoglobin A1c level was 6.1 (normal <5.7), an indication that her blood glucose levels are likely running much higher than normal.  Why is this important?  Diabetes mellitus could cause paresthesias.  She must work with her doctor to reduce high blood glucose levels, which will help rule out diabetes as a cause of the paresthesias.  In addition, your mom, every day, has been taking 4000 mg calcium (four 500 mg calcium pills morning and night) for the past two years; yet, on the blood test, her calcium level was below normal at 7.1 mg/dL.   Low calcium can cause paresthesias (especially of the face).  Your mom’s doctor recommending she take two additional 500 mg calcium pills morning and night should be followed, if only to increase blood calcium levels back into the normal range (8-10 mg/dL).  Once your mother’s calcium levels have returned to the normal level, hopefully, her paresthesias will disappear. 

However, you are correct, hypercalcemic states, could lead to constipation, kidney stones…etc; however, since your mother had a total thyroidectomy in 2012, the body’s ability to regulate calcium levels became greatly diminished.  Normal recommended daily calcium consumption for adults is 1000-1500 mg/day.  The higher than normal calcium intake might be the new norm for your mom, a value that must be monitored by her physician, and discontinued or modified, if hypercalcemic signs or symptoms occur.

You might suggest to your mom’s physician to run a B12 level, which is also a potential cause of paresthesias.

I will address your brain tumor question in a different post.   Thank you for your question and trust.  God Bless you, God Bless China, God Bless New York, and God Bless New York City.   Stay in touch, and remember, “Always walk in peace.”

Respectfully,

Dr. Roshin








*