Bladder Cancer Center

Question: Does anyone know if the VA has the da Vinci robot? My husband has Pca. VERY low grade. He is 60 tomorrow. He was just dx'd with bladder cancer. I have researched Sloan-Kettering, Johns Hopkins and the University of Maryland Medical Center. They have the da Vinci robot to do surgeries. This will give him a great QOL, and with sparing the nerves. Does anyone know if the VA system has the da Vinci robot that can provide these services? We don't have outside insurance and this is all we have, the VA. I will do anything to save my husband's life and help him to have the best QOL possible. Thanks, Pat

Answer: Pat, If your VA does not have the machine and a local hospital does, it is possible to get the VA to pay for the treatment. The program is called fee basis. Go and check it out at your local VA Hospital.

Question: Menstrual irregularity.... need advice, please help!? I think I may have PCOS or a cyst, or just really messed up hormones due to stress. My last regular period was in early September. It was the usual thing, cramps the day before, heavy the first two days and virtually gone the next two. I normally get my period every 45 days to two months, which is longer than average but it's been consistent and I never saw any real need to go on birth control just to get it every month, or 15 days less between cycles. So I should've been due in late October. Instead, I had spotting on and off for a few weeks in the month of October to early November. Like, one week I'd have very light spotting, and then it would go away, and then come back, and then go away and then come back. No cramping, just a little bit of blood. I haven't spotted in a couple of weeks though, but I haven't had a regular period in quite some time. Come early December, It will be three months since I've had a regular period, not including the spotting which technically is only missing one period since I get it every 45 days to two months. I am not sexually active, no history of cancer in my family in terms of the reproductive tract (Only known cancer in my family is unfortunately my grandpa who suffers from bladder cancer). My mom does have a benign cyst on her ovaries, although I'm not sure cysts are genetic. I smoke, but not heavily, 5-7 a day, although I go through periods where I don't smoke at all. If there's no actual problems with my ovaries, I'm thinking it could be stress related. I have been very stressed out as I am a double major in Biology and Math, and two of my best friends got expelled from school this semester and I cried for about two weeks, amongst other things. I've also been stressed about not getting my period at all. I've also been stressed because everyone in my school is annoying when I try to study. Anywho, I also don't have a roommate this semester, so it could also be that I don't have anyone to sync with. I had a roomie last semester and we got our periods around the same time, although mine was still later. I've had some pelvic pain, right now, it just feels like my uterus is aching or something. Sometimes it's on the right or left side. It's very dull and not typical of my cramps. I hardly notice it unless I think about it. I haven't had the pain on the right or left side in a while, it's mostly centered now. I have had cramps that are typical of my period a couple of times about a week ago. But, I would cramp and then a minute later it would be gone. Sometimes I cramp a few times before I get my period. But, usually there's a time where I would cramp all day until I got it. I get that feeling in the lower back and then I know I'm going to get it. I was actually happy when I felt the cramp, but then it went away like 2 minutes later. Haven't really gotten any cramps since. If it doesn't come soon, I'm going to see a dr. over winter break. In the meantime, does anyone know what could be wrong? Only people who know something about this only, please. Thank you.

Answer: couldnt read it too long sry answer mine its they newest one

Question: Identify any areas that are vague or ambiguous.? "By making obesity a disease, government does all Americans—large or not—a disservice." Obesity should not be labeled a disease, Sonia Arrison contends in the following viewpoint. She asserts that while obesity is becoming more prevalent in the United States, treating it as an illness instead of the result of poor dietary choices would unfairly harm healthy Americans. By calling obesity a disease, the condition could be treated using Medicare or Medicaid funds, which come from the taxpayer dollars of all Americans, fat or thin. Arrison concludes that individuals must be aware of the consequence of their overeating and realize that society will not pay for their higher health care costs. Arrison is the director of technology studies at the Pacific Research Institute, a public policy think tank that promotes free-market solutions. [In March 2005] California Governor Arnold Schwarzenegger announced his intentions to support a bill outlawing the sale of junk food in schools. Science shows the governor is right to worry about an obesity crisis, but banning candy in schools is like putting a Band-Aid on a third-degree burn. According to the American Obesity Association, "approximately 127 million adults in the U.S. are overweight, 60 million obese, and 9 million severely obese." That's a huge number of people, and basic medicine predicts that their weight problems will turn into more serious conditions such as type 2 diabetes, hypertension, heart disease, stroke, a number of cancers, gall bladder-disease, osteoarthritis and obstructive sleep apnea. The Economics of Obesity In short, people are eating themselves to death. While consequences are dire for each obese individual, what many don't realize is that their choices also harm the part of America that remains healthy. The most obvious impact is the economic strain. Numbers provided by the Centers for Disease Control and Prevention (CDC) show that obesity costs Americans a ton. For instance, in 1998, medical expenses due to obesity accounted for 9.1 percent of total U.S. medical expenditures and may have been as high as $78.5 billion. That's a lot of cash, but the kicker is that approximately half of these costs were paid by Medicaid and Medicare—in other words, by taxpayers. There's something disturbing about this situation, which could be described as socialized obesity. By sharing the health care costs with obese people, health-conscious Americans lose tax dollars and see health insurance premiums shoot up. [In 2004] Health and Human Services Secretary Tommy Thompson designated obesity as a disease. But much of obesity is caused by poor nutrition and behavioral problems. By making obesity a disease, government does all Americans—large or not—a disservice. Many diseases hit individuals through no fault of their own, but obesity is in a different category. Individual Responsibility To ward off obesity, proper diet and exercise are necessary. Yet the socialization of the costs of the problem only makes it more likely that individuals will carry on with their destructive behavior. It's not rocket science: Whatever is subsidized will grow. And by incentivizing individuals to ignore the consequences of an unhealthy lifestyle, we all suffer a productivity hit when otherwise smart people die early due to obesity-related diseases. Dr. Bruce Ames, the eminent biochemist and inventor of the Ames test for carcinogens, has made longevity and diet one of his key areas of study. His conclusions show that in order to live longer, individuals must maintain a good diet, including the proper amount of vitamins and antioxidants. This advice might seem a no-brainer, but it is easy to ignore in a society where junk food marketing is everywhere and the costs of individual overeating are distributed amongst everyone. The best way to help mitigate the onslaught of obesity is to make sure that individuals are aware that the costs of their behavior will be borne by them. That is, if they choose to eat potato chips and sit in front of the television night after night, instead of eating fruits and vegetables and exercising, then they should not expect society to help them pay the higher costs of health insurance. Perhaps this is a cultural issue as much as a political one, which brings the discussion back to Governor Schwarzenegger's quest to ban junk food in schools. The idea of educating the population about the risks associated with empty calories, such as those found in soda, is a good one. And in a publicly-run system where government is supposed to be responsible for the well being of children, perhaps it makes sense. But there is a larger issue. While schools should educate children about nutrition and a healthy diet, ultimately, kids will have to make their own decisions. So the lesson is also one of individual responsibility. That's how a free and healthy society operates.

Answer: Try taking out the little bits of slang, like "the kicker" and "no-brainer". They stand out too much in a piece that is so factual. Also, you seem to have two arguments here: that obesity should not be treated as a disease in order to avoid financially punishing thinner people, and that children should be taught to make better nutritional choices rather than having those choices made for them. Whatever my opinion on either of those issues, you should either make the tie between them clearer or focus on one or the other.

Question: My upper middle abdomen tender to touch, constipation, nausea, fullness, no acid. Colonoscopy & Endoscopy OK? HIDA scan shows 35%, H Pilori not found. So far only diagnosis is redundant colon, small hiatal hernia. Can gall bladder show all negative results and still be bad if they were to surgically look? Is it normal to have pain when the center, upper abdomen is pressed on? One surgeon told me he was stumped. Gall bladder issues run in family. Maternal grandmother had small intestinal cancer. Anyone have ideas?? Going on 3 months of no relief. Any kind of food can give me nausea 30 minutes to 9 hours after eating. Thank you for your kind responses!!!!! Thank you for your answer. It got worse 9 hours after I ate mac & cheese. It doesn't seem to matter with nausea, though, because it comes & goes with or without eating now.

Answer: Is it worse after a meal with a lot of fat in it? Sounds like gall stones to me, especially with the nausea and pain in the central upper abdomen, not to mention, the family history of gall bladder issues. You should get a second opinion, if you haven't already. Good luck!

Question: Does Anyone Else Have This Problem??? When I was a kid my parents never let us have pets. They kept a relatively clean house and always refused to put up with the mess that animals make; also, my brother and I were bad enough. I always complained that I wanted a pet and couldn't understand Mom and Dad's logic against it -- until now. Today, as an adult in a house full of filthy animals, I see my parents' point of view. My wife is a big animal lover and has passed this trait to our nine-year-old daughter. To date we have one dog, three cats, two birds, one hamster, and nine goldfish. At one time we had four birds and twelve hamsters. At the time I started to cohabitate with my wife -- about ten years ago, when I was thirty-two -- she had only two cats and two birds, and I think my stepson had hamsters or mice. Other than the occasional cat hair in the butter dish or skidmarks on my pillowcase, I tolerated the mess. (Being in a new relationship, one doesn't always bitch and complain a lot if one wants to get laid.) I think the first time I lost it was when my wife hung the birdcage from the kitchen ceiling and the birds would flutter around, their feathers, food, and fecal matter leaving the cage and landing wherever... sometimes in the dinner I was ready to eat. But that was nothing compared with my life these days. And it's not only the freaky fecal episodes of the animals that bother me. Growing up, the only time I experienced fecal matter in the house was in the bathroom. Today I experience it everywhere. I'm no angel, and I will admit that living with my gas attacks is no picnic, and that I can destroy a toilet with the best of them; but my wife and my daughter and the all the animals are driving me nuts. The Wife. A lot of women are shy about shitting and farting in front of others, especially their significant other. I once dated a girl for five years and never recall hearing her fart; I don't think she ever dropped a load. I like that sort of woman. Don't get me wrong -- I enjoy a good tale from a female, but I prefer the woman I live with and fuck to be fecal free. Well, after over ten years together, my wife has no shame in ripping massive farts and leaving skid marks on the toilet seat; and believe me, she can stink up a bathroom as good as any man. The Child. A few years back I told P how my wife was always the one on cleanup detail after our daughter dropped a loaf. Our daughter is now nine years old and finally she wipes her own ass; but she will only use wet wipes. Since we don't want a garbage can full of stinky, shit-crusted wipes, we buy the "flushable wipes," and those suckers ain't cheap. This damn wet wipe addiction is forcing my daughter into a life of Shameful Shitting. It seems that nearly every time I pick her up from school she wants to rush home immediately due to the fact that she was been "holding it" all day. She just refuses to use the dry toilet paper at school. I love the child and want her to be happy, but I have certainly survived using dry paper for over forty years... and those flushable wet wipes are expensive... The Dog. Dixie, our four-year-old sheltie, rarely has an accident. I can't remember the last time she shit in the house -- probably not since she was a pup. This dog can really hold a load and has an iron bladder; I've witnessed her go up to eighteen hours without pissing. My problem with the dog is that she shits ALL OVER the yard. Instead of squatting and dropping a pile, Dixie will drop a nugget, move a foot, drop a nugget, move a foot, and continue this up to twenty times per defecation. The dog spends a fair amount of time outside and when she sees a stranger or hears something odd she will run around like a maniac, galloping through her own shit, mud, and whatever else is on the ground. The dog will then come into the house, run on the carpet, and jump on the furniture and the beds with her dookie-covered paws. What burns me is that my wife has the nerve to bitch me out if I walk on the carpet with my shoes on -- even after I wiped them. The only other thing about this dog is that Dixie is a cat shit eater. I have on occasion caught her with her head in the litter box. We feed the dog well, but I guess kitty poop is a doggie delicacy. Cat One. Max is fourteen years old, blind, and has chronic diarrhea. The vet told my wife four years ago to put Max to sleep and out of his misery; but the wife just won't submit. This cat can really blast ass -- once he shot a watery load all over the side of the dryer about two feet from the ground. This cat shits and pukes everywhere. He tries to make it to the litter box but often he "craps out" or gets confused. About a month ago my wife spent $700 on a new living room chair that has now become Max's favorite spot to sleep. I have witnessed him use the litter box and immediately head for this new chair, his ass hair crusted in liquid poop. The cat also uses the new chair as a scratching post and has already frayed several threads. Cat Two. Ziggy is an outdoor cat. He only has three legs -- he lost a front leg to cancer about four years ago. He can still kill birds and moles and he gets in his share of raccoon fights... he is a tough old bastard. Everyone in the neighborhood feeds him; he will disappear for up to five days at a time and come home happy and well fed. Since the cat is getting older my wife tries to keep Ziggy inside, especially during bad weather, but the cat will let out this fucking annoying cry and scratch at the door. If that doesn't work, Ziggy has a trick that will surely gets us to boot his ass outside: he will shamelessly shit in front of us. Many a time my wife has insisted on keeping Ziggy inside for his own good, like after he gets his ass kicked by a raccoon. This makes the cat rebel and the rotten prick will walk right up to us, perhaps when we are watching the tube, look us dead in the eye, and blatantly drop a steaming pile. Last year when we went on vacation we kept all three cats in the basement for a week. My stepson and parents came over daily to feed the cats. Ziggy shat all over the basement regularly and refused to use the litter box. My stepson told us that one day he stopped over and Ziggy made several attempts to get outside. After the cat gave up he lay down on his side, looked at my stepson, and just squeezed out a monster log. Cat Three. Puss-Puss is only two years old and is still mischievous. My only problem with her is that she will use the litter box after Max paints it with diarrhea, and then she'll sit on the furniture with kitty litter and Max's dung all over her backside. The Birds. As I said earlier, all kinds of crap flies from bird cages. We started out two years ago with one male canary, and that was tolerable. When the thing stopped singing my wife figured it was lonely. We bought an inexpensive companion -- a male finch. The two birds would fight regularly, so my wife bought another cage in order to separate the birds. Now we had two lonely birds. My wife's solution was to go out and buy a female canary and a female finch. We had to keep the cages at the highest point in the house -- on top of our five-foot-high entertainment center -- because Puss Puss desperately wants a bird to chomp on. So the top of the entertainment center, the television, and the DVD player -- not to mention the carpet -- is always littered with bird shit, birdseed, and feathers. Thankfully we managed to get rid of the finches, which cuts down on the mess. The Hamster. The funniest and the grossest display in my house comes courtesy our hamster and his infamous Wheel of Shit. I don't know if anyone is familiar with these newfangled cages in which the hamster exercise wheel is enclosed and on top of the cage. The hamster can climb through a tube to access the wheel, which is sealed except for a few air slits. Hamsters are filthy rodents that drop little turds constantly; needless to say, this wheel is crusted with a trail of smeared crap and the little fucker runs and runs and shits and shits. It is so fucking nasty and, especially at three AM, annoying. I just know fecal matter is flying through those air slits. We keep the hamster cage up next to the birdcage because the Puss Puss also wants that hamster for dinner. I can't believe we haven't caught a weird disease living under these conditions. I panic if I see a fly in the house -- odds are it was just sitting on an animal turd minutes earlier. But I am outnumbered two to one in the household; so I guess I must learn to make all feces my friend, and try and enjoy my household of filth.

Answer: Holy crap, that was long! Ok. Firstly sounds like your having some marital issues with the wife. It sounds like you feel that she has somehow tricked you into a relationship that you are now "stuck" in. As a female, I resent some of the wordage you used to describe the act of courtship as trying to get tale etc... She appears to be just being who she has always been, an animal lover. She had pets when she met you after all. It's not like she said she hated animals then, after the I' do's said, "Oh and by the way..." It also sounds like she is unaware that you are having such an issue with her bodily noises and habits. May be you could quietly and calmly with no cursing explain to her that there are some things that are making your life very uncomfortable. We (Ladies) have a right to fart wherever we need to. Most of us try to be discreet. Explain to your wife as lovingly as you can that it really disturbs you that she rips them in front of you. She may not know that she is really bothering you. You can also try to explain that leaving "skid-marks" on the toilet gross you out. As for stinking up the bathroom, sorry- it happens, buy air freshener and move on. The Child, you are enabling her to continue her dependance on wet wipes. STOP BUYING THEM. She will begin wiping using regular old toilet paper when she gets tired of having crusty butt. It's a phase and hopefully will be a short lived one. To me, it would be worth the extra laundry for a few weeks. Besides, holding your bowels for that long is not healthy! The dog- Dixie. Best bet is to put your foot down and demand that she have her paws wiped off before coming inside. A quick wipe with a towel should ease your issues with her. She may not be able to help her deficating methods, it's not like she has a toilet seat to lean on. The best defence against her stepping in it is to scoop it up right away. You can do it yourself (have the child do it) or many communities have a company that will do it for you. Your wife may have never thought to wipe the dog's paws. Max- Explain that the older cat is really not enjoying life anymore, be kind and understand that putting a pet to sleep is a hard choice to make. Point out how his life is no longer enjoyable, the diarrhea being blind/ deaf etc... You can also take him to the groomer and ask for a "sanitary cut" this will shave the long hairs around his nether region and make cleaning him up after an accident MUCH easier. Ziggy- Sounds like you are ok with him as long as he's not on the injured list. When he has to be kept inside "for his own good" you might consider buying a large kennel and placing it in a covered spot outside. Give him a litter box, food and water dishes and a place to get warm (a closed cardboard box with a hole cut into with a towel inside works well.) This way he is outside, so if he does howel, you won't hear him and if he does poo outside the box, its very simple to cleanup. Puss Puss- She cant help if she needs to poo and max has been there first. I would suggest having two boxes out, this will give her the option using a clean box. If max is put to sleep, then that ends that problem. Birds- There is an item called a cage skirt. It wraps around the bottom 1/3rd of a cage and really helps cut down on the stuff that flies out of the cage. You can also, depending on how big the cage is, use an appropriate sized hook and hang the cage from the ceiling. This would enable you place the cage anywhere you deem acceptable. Hamster- Nasty creatures I agree. Your family is probably too attached to get rid of it, so the best you can do is limit the mess. Look for a new cage one that has the wheel inside the cage proper. They do exist, I promise. It sounds as if you are a borderline germaphobe, who is very uncomforatble living with this may animals. I would talk to your wife in as kind and honest a way as you can and explain that while you don't mind the animals, they need to be cleaned up after in a more timely manner. Keep Clorox wipes so that simple cleanups are a snap. Our dogs are not allowed on the bed, unles we invite them "up". It sounds like your dog might do well with a little training refresher, then you an use some of those cues to restrict her unwanted behaviour while in the house. Good grief this took forever! Hope this helped a little!

Question: What is wrong with me? Hypothyroidism? Pituitary hypothyroidism? Hashimoto's? Leukemia? ? I'm 19, about 5 feet tall, 116 lbs. African-American. History: Most of the symptoms I have I've had for years, but being raised in a family that pushed me to “just deal with it� whenever I complained about feeling sick Iwas forced to push myself. I'm in a much better situation, but since I've been here my health has consistently been declining and I've developed anxitey which keeps getting worse. Life before this year was pretty close to unbearably stressful including freuqent sporadic bouts of homelessness all throughout my life as well as other traumatic events. I thought maybe it could be ptsd or GAD, but the anxitey just began now that I'm removed from the stressful situation and placed into a stable one, same with my body pretty much breaking down. Through-out my developmental years I abused a variety of pills (Been clean for awhile.) as well as ingesting mass amounts of soy (vegetarian for eight years) and starting birth control at 14. Family has a history of cancer, diabetes, heart disease, high blood pressure, addiction. Possibly a history of hypothyroid, but only one family member is officially diagnosed ,four people total with parallel symptoms though. Symptoms including, but not limited to: Dry, brittle hair & scalp, hair loss, dry skin, several different kinds of recurring headaches (center of head between ears mostly), weight flucuations ,Hirsutism, irregular periods, infertility, acne, visual disturbances (three dots in a triangular formation), bleeding gums, tooth decay, sporadic dizziness, loss of motor control, slurred speech, fevers (past 2 month), menstrual irregularities, infertility, sinuses hurt constantly throughout ears and face, several serious sinus infections over the years, "lump stuck in throat� feeling, swelling under her chin sometimes, heartburn, stabbing chest pains (really painful almost incapacitating), heart palpitations, back & shoulder pain (excruciating, chronic), trouble digesting food, no appetite, possible gall bladder problems, daily nausea, muscle weakness, joint pain, chronic yeast infections over the years (generally very prone to infection), "tingling" in limbs kind of like they fell asleep but more intense of a pins & needles feeling, lack of energy, shortness of breath., lump on her arm about a centimeter or so high, what feels like carpal tunnel, insomnia, serious anxiety. Temperature. is very low in the morning and high at night. She's extremely sensitive to cold, sensitive to light(sometimes it causes her to vomit or pass out) We're worried that the ranges of normality might be off considering she's a pretty tiny person and i guess wouldn't have the same range of normality as someone who is of average height and weight or someone that hasn't been on birth control on and off since they were 14 Theories have been put forth that it could be either depression in general (it absolutely isn't), 1.pituitary or secondary hypothyroid, 2.Adrenal failure originating in the pituitary gland( due to what seems like bouncing between hyperthyroid and hypothyroid) 3. Leukemia (due to her wbc being on the high end and her rbc being on the low end) or some Autoimmune disease (due to her lymphocyte count being on the high end and her monocyte count being on the low end) Doctors are just pretty much refusing to listen to her tell them her symptoms or perform tests, especially if they know her history. Or they tell her it's anxiety or depression because her results are “within range�. Here are a lot of test results, if you can make any sense out of them I'd really appreciate it: BUN/Creatinine Ratio 13 Alkaline Phosphatase, S 48 (IU/L) LDH 115 (IU/L) AST (SGOT) 15 (IU/L) ALT (SGPT) 14 (IU/L) pH 6.0 Free T4 1.28 (ng/dL) TSH 1.051 (uIU/mL) Thyroid Peroxidase (TPO) Ab <10 (IU/mL) free t3 3.3 (pg/mL) antithyroglobulin ab siemens (DPC) ICMA Method <20 IU/ML --40 WBC 8.6 (x10E3/uL) RBC 4.13 (x10E6/uL) Hemoglobin 12.3 (g/dL) Hematocrit 36.2 (%) RDW 12.7 (%) Platelets 344 (x10E3/uL) Neutrophils 46 (%) Lymphs 49 (%) Monocytes 4 (%) Eos 1 (%) Basos 0 (%) Neutrophils (Absolute) 4.0 (x10E3/uL) Lymphs (Absolute) 4.2 (x10E3/uL) Monocytes (Absolute) 0.3 (x10E3/uL) Eos (Absolute) 0.1 (x10E3/uL) Baso (Absolute) 0.0 I forgot to clarify a few things. The tooth decay is recent, most of the enamel on my teeth is gone. I don't have insurance at all. I can't work and I can't go to school. And I'm no longer a vegetarian as of one year ago. Also, I've been all over the vitamins situation. All kinds of D, B, B12, A and some other multi as well as iron supplements.

Answer: Hello...your test results mean nothing to us if you don't include the lab ranges. Thats because every lab has a different method of testing and have different ranges. So I am unsure what is low or high. I have a pituitary condition AND Hashimotos. Before I was able to find a Dr. that would listen, I had many of the symptoms you describe and was told I was just depressed. I found a good Dr. that realized I might have the 2 conditions and combined they were making some of the lab results look normal (one condition was pulling them down, the other up). And he said "OF course your depressed, your very sick!" Why isn't IGF 1 including in your test results? Thats a very important test to determine pituitary functioning. All your symptoms point to a pituitary problem. You need to find a good Endocrinologist who specializes in pituitary disorders. Go to www.pituitary.org and look through Dr. listings. I'm not sure what you should do about the financial issue but maybe someone can help you out.

Question: Chemo & Radiation...Yes or No? Mid March I recv'd a phone call that my Father who lives out of state. Had been hospitalized and was not expected to make it. My brother and I arrived at the hospital within 24 hrs and was met by his Dr who immediately told us he had pneumonia and because of his dementia and alcoholism was going to call in the state to take custody of him if we didn't want to. Please keep in mind we were unaware of any health issues with him. The next day we hired an attorney, day after that appeared before a judge and gained guardianship. After 1 week in the hospital and 4 weeks in a skilled nursing facility we prepared him for the move back to California with us. Over a 6 week time frame I made 3 trips to Oklahoma. I contacted UC Irvine Research Center for Aging and Demential before we moved him. Scheduled his appts for the week after the move. Obtained a new primary care Dr. The week following the move he saw his new Dr-she ordered a Brain CT, did a chest X-Ray and blood work. (Did I mention he has diabetes?) His tests came back as follows: CT-revealed moderate dementia and a previous stroke. Blood work showed 3rd stage kidney failure. Chest X-Ray showed a 2.7 x 2.0 mass causing concern for maliginacy. She referred him to a lung specialist who saw him 3 days later who ordered a Pet Scan. The next week the Pet Scan came back indicating multiple tumors in left lung. Colon, bladder, bowel, 3 ribs, 1 vertebre, invasion of the chest wall and his tonsils. The next week a biopsey was done and 8 days ago I was told that he has extended small cell lung cancer undifferentiated. His primary Dr said she personally would not put a loved one through chemo and radiation that was in his condition. She did however move forward with referrals to the oncologists. After my brother and I received the news and knew the appts had been made for July 6. We booked a 75' houseboat on Lake Powell for the entire family to spend a vacation together. We have camped and fished Lake Powell many years as a family and want to do this for my Dad and for us while he is still functional to do so. The problem is....telling him. Yes, we will have his primary care Dr do that but the decision for Chemo and Radiation is all together another issue. At best it will be pallitive for him. We don't know if the chemo oncologist will even determine if he will be able to tolerate chemo given all his health issues but won't discuss it with me until he see's my Father. There is a part of me that does not want to tell him that he has 2-4 months without any radiation or chemo. There's a part of me that feels like he would want to fight the fight. Then there's the part that just wants my Dad to enjoy as much of the time he has left doing what he loves and that is being with his family and fishing. Any insight or recommendation of treatment or lack of would be greatly appreciated. I am just at a loss...

Answer: Having nursed a parent with cancer, a parent in law with dementia and been through cancer treatment myself I would not recommend chemo for your father. Chemo makes you feel ill, and lowers your immunity, leaving you open to more opportunistic infections. Dementia patients deteriorate rapidly when ill or fighting infection. Chemotherapy will accelerate the dementia. Without the chemotherapy, the cancer will probably kill him before the dementia advances, he will still be himself. With the chemo you will keep him alive longer but the dementia will advance faster so you will have a breathing someone who is no longer your father. I would take cancer over dementia any day.

Question: What is wrong with me? Hypothyroidism, Pituitary hypothyroidism, Hashimoto's? Added ranges for results.? I'm 19, about 5 feet tall, 116 lbs. African-American. History: Most of the symptoms I have I've had for years, but being raised in a family that pushed me to “just deal with it� whenever I complained about feeling sick I was forced to push myself. I'm in a much better situation, but since I've been here my health has consistently been declining and I've developed anxiety which keeps getting worse. Life before this year was pretty close to unbearably stressful including frequent sporadic bouts of homelessness all throughout my life as well as other traumatic events. I thought maybe it could be ptsd or GAD, but the anxiety just began now that I'm removed from the stressful situation and placed into a stable one, same with my body pretty much breaking down. Through-out my developmental years I abused a variety of pills (Been clean for awhile.) as well as ingesting mass amounts of soy (vegetarian for eight years) and starting birth control at 14. Family has a history of cancer, diabetes, heart disease, high blood pressure, addiction. Possibly a history of hypothyroid, but only one family member is officially diagnosed ,four people total with parallel symptoms though. Symptoms including, but not limited to: Dry, brittle hair & scalp, hair loss, dry skin, several different kinds of recurring headaches (center of head between ears mostly), weight fluctuationss ,Hirsutism, irregular periods, infertility, acne, visual disturbances (three dots in a triangular formation), bleeding gums, tooth decay, sporadic dizziness, loss of motor control, slurred speech, fevers (past 2 month), menstrual irregularities, infertility, sinuses hurt constantly throughout ears and face, several serious sinus infections over the years, "lump stuck in throat� feeling, swelling under her chin sometimes, heartburn, stabbing chest pains (really painful almost incapacitating), heart palpitations, back & shoulder pain (excruciating, chronic), trouble digesting food, no appetite, possible gall bladder problems, daily nausea, muscle weakness, joint pain, chronic yeast infections over the years (generally very prone to infection), "tingling" in limbs kind of like they fell asleep but more intense of a pins & needles feeling, lack of energy, shortness of breath., lump on her arm about a centimeter or so high, what feels like carpal tunnel, insomnia, serious anxiety. Temperature. is very low in the morning and high at night. She's extremely sensitive to cold, sensitive to light(sometimes it causes her to vomit or pass out) We're worried that the ranges of normality might be off considering she's a pretty tiny person and i guess wouldn't have the same range of normality as someone who is of average height and weight or someone that hasn't been on birth control on and off since they were 14 Theories have been put forth that it could be either depression in general (it absolutely isn't), 1.pituitary or secondary hypothyroid, 2.Adrenal failure originating in the pituitary gland( due to what seems like bouncing between hyperthyroid and hypothyroid) 3. Leukemia (due to my wbc being on the high end and my rbc being on the low end) or some Autoimmune disease (due to my lymphocyte count being on the high end and my monocyte count being on the low end) Doctors are just pretty much refusing to listen to her tell them her symptoms or perform tests, especially if they know her history. Or they tell her it's anxiety or depression because her results are “within range�. Here are a lot of test results, if you can make any sense out of them I'd really appreciate it: BUN/Creatinine Ratio 13 mmol/L Range - 8-27 Alkaline Phosphatase, S 48 (IU/L) 60-400 LDH 115 (IU/L) 100-250 AST (SGOT) 15 (IU/L) 0-40 ALT (SGPT) 14 (IU/L) 0-55 pH 6.0 Free T4 1.28 (ng/dL) 0.61-1.76 TSH 1.051 (uIU/mL) 0.450-4.500 Thyroid Peroxidase (TPO) Ab <10 (IU/mL) 0-34 free t3 3.3 (pg/mL) 2.3-4.2 antithyroglobulin ab siemens (DPC) ICMA Method <20 IU/ML 0-40 WBC 8.6 (x10E3/uL) 4.0-10.5 RBC 4.13 (x10E6/uL) 4.10-5.60 Hemoglobin 12.3 (g/dL) 12.5-17.0 Hematocrit 36.2 (%) 36.0-50.0 RDW 12.7 (%) 11.7-15.0 Platelets 344 (x10E3/uL) 140-415 Neutrophils 46 (%) 40-74 Lymphs 49 (%)14-46 Monocytes 4 (%) 4-13 Eos 1 (%) 0-7 Basos 0 (%) 0-3 Neutrophils (Absolute) 4.0 (x10E3/uL) 1.8-7.8 Lymphs (Absolute) 4.2 (x10E3/uL) 0.7-4.5 Monocytes (Absolute) 0.3 (x10E3/uL) 0.1-1.0 Eos (Absolute) 0.1 (x10E3/uL) 0.0-02 Baso (Absolute) 0.0 0.0-0.4 Additional Details I forgot to clarify a few things. The tooth decay is recent, most of the enamel on my teeth is gone. I don't have insurance at all. I can't work and I can't go to school. And I'm no longer a vegetarian as of one year ago. Also, I've been all over the vitamins situation. All kinds of D, B, B12, A and some other multi as well as iron supplements. Not diabetic. Been having trouble feeling my peehole and trouble peeing.

Answer: I would ask for a serum ferritin test. Anemia often shows up in the ferritin (storage iron) before it is apparent in other iron tests. With your hemoglobin slightly below range, your hematocrit at the bottom of its range, and your history of vegetarianism, I would suspect that many of your symptoms are due to anemia. If you were a vegetarian for very long, you may have lost your ability to digest meat. I would add that soy binds thyroid hormone and prevents it from being absorbed into your cells. If you still eat any soy at all, you can be hypothyroid on the tissue level, even though your blood levels look OK. The lump in the throat might be a thyroid nodule, which should be watched with ultrasound imaging.