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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" 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








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           "PHILIPPINE MAN HAS PSA TEST DONE.  DOES HE HAVE CANCER?"

“Hello! Doc, busy? My husband Doc. on this coming tuesday he has a check up again. Can I send you a result of his ultra sound? He feel that he has a frostate enlargement but I said to him you need to go to the doctor to make medical check up, then he noticed that he has a milk calcium syst in the left kedney!” (Ms.DD, Philippines)

Dear Ms. DD,

The last time we visited, you had sent your husband’s sonogram report which confirmed a benign, renal milk calcium cyst.  In addition, I mentioned the following statement to you and your husband (Pepe), “since your husband “feel he has frostate enlargement,” I suggest that your husband ask his doctor to perform a digital rectal exam and run a PSA test (prostate specific antigen) test.  The PSA test results provide a snap shot of potential prostate conditions including benign prostatic hypertrophy, and along with a digital rectal exam, this test will help rule out prostate cancer.  We should make sure that the prostate is not evolving into a future, serious problem.”

Subsequent to our discussion three weeks ago, your husband had a PSA test completed, and you forwarded a scanned picture of the result.  Your husband’s PSA result was a 0.435 ng/ml, a value well within the normal range of 4.40 ng/ml.  Since this is your husband’s first prostate blood test completed, we have no previous reference number to gauge whether Pepe’s symptoms mirror the test result found.  However, he should rest peacefully tonight knowing that the 0.435 result, at face value, does not appear to reflect any pathology or condition of his prostate gland.  My recommendation, is to ask that your husband repeat a PSA test one year from today.  When that result is in hand, please contact me, as a means to guide further treatment if needed.

However, if your husband experiences worsening symptoms including 1) frequent urination at night, 2) urgent need to urinate, 3) difficulty urinating, 4) weak urine stream, 5) a urine stream that repeatedly starts and stops, 6) blood in the urine and or 7) the inability to completely empty the bladder during urination, your husband should have the PSA redone in six months with urgent consultation with his doctor or a urologist to include a prompt digital rectal exam.  The symptoms mentioned above could reflect a worsening prostate condition even though today’s PSA blood test result indicates otherwise.

I am deeply humbled by your trust in me.  Although we are miles apart, do know that I care about the health and well-being of all people who inquire medical assistance.  You all are, in essence, my patients; however, my advice is never a substitute for seeking professional medical services from a doctor or health personnel within your locale.

God Bless you, God Bless Pepe, and God Bless the Philippines.

“Always, walk in peace.”

Respectfully,

Dr. Roshin

* "ARE SWEET POTATOES A TREATMENT FOR RHEUMATOID ARTHRITIS?"

“Is it true sweet potatoes helps rheumatoid arthritis pain?” (Ms. J, New Jersey)

Dear Ms. J,

I have to admit, medical school trained me in a western philosophy medicine thought process; thus, your question required in depth research. After reading eastern philosophy medicine textbook(s) and conversing with an herbal specialist; the following information was discerned. Put simply, sweet potatoes, typically called yams (Convolvulacea family), are different from wild yams (Dioscorea villosa family). The wild yams, and their extracts, due to anti-inflammatory and antispasmodic properties, are considered by many alternative and herbal specialists, to contain many health benefits with disease treatment value.

Wild yams, are often used, but not limited to the following conditions:

1) rheumatoid arthritis 

2) menopause symptoms 

3) vaginal dryness 

4) nausea/ vomiting 

5) stomach cramps 

6) gall bladder pains 

7) diverticulitis pain 

8) hiccups 

9) menstrual cramps

Before self medicating or self treating yourself, always consult your doctor and move forward together to gauge both alternative and general medicine treatment success. With that in mind, thank you for your question and trust.

“Always, walk in peace.”

Respectfully,

Dr. Roshin

Philippine Man Has Kidney Milk of Calcium Cyst & Family Asks If Harmful

“Hello! Doc, busy? My husband Doc. on this coming tuesday he has a check up again. Can I send you a result of his ultra sound? He feel that he has a frostate enlargement but I said to him you need to go to the doctor to make medical check up, then he noticed that he has a milk calcium syst in the left kedney!” (Ms.DD, Philippines)

Hello Ms. DD,

Thank you for sending your husband’s kidney sonographic report on Facebook.  After viewing the ultrasound report, the radiologist documented “the kidneys are normal in size,” and the “rest of the bilateral renal parenchyma are homogenous.”  Put simply, your forty-seven year old husband, Pepe, has functioning, normal kidneys.   However, “a 1.3 cm cortical cyst with milk of calcium is seen in the left kidney” was also reported by his physician. 

Similar to kidney stones, milk of calcium cysts are composed of precipitated, calcium salts (oxalate, calcium, and phosphate).  These cysts form due to stasis of urine in urinary tract cavities with suboptimal drainage.  You mentioning that “He feel that he has a frostate enlargement” is a potential cause of decreased urine flow; however, kidney stones have serious symptoms not limited to blood in the urine, nausea, vomiting, pain on urination, urinating small amounts of urine, fever, chills, and pain that spreads to the groin.   When I asked you if your husband had any symptoms, you said no major complaints. 

Thus, the renal milk of calcium cyst appears to be an incidental finding on your husband’s ultrasound exam, and to answer your question “You know what is the milk calcium syst? In left kedney? It is need a surgery doc?” my reply is no surgery is needed. 

I am deeply humbled that you contacted me, and I value your trust in my opinion.  Thus, since your husband “feel he has frostate enlargement,” I suggest that your husband ask his doctor to perform a digital rectal exam and run a PSA test (prostate specific antigen) test.  The PSA test results provide a snap shot of potential prostate conditions including benign prostatic hypertrophy, and along with a digital rectal exam, this test will help rule out prostate cancer.  We should make sure that the prostate is not evolving into a future, serious problem.  Thank you for your question and faith in me.  God Bless you, God Bless Pepe, and God Bless the Philippines.

Respectfully,

Dr. Roshin