Patient didn’t get doc’s answers

April 12, 2012 By

DEAR DR. GOTT: My doctor says I have appropriate age-related changes in my brain (message relayed by his nurse). What would those be – a smaller brain, bigger, or what? I’m 76 and female.

DEAR READER: It’s sometimes difficult to formulate all the questions we should have asked when a situation such as yours occurs. My guess is that you received a phone call, thanked the nurse for calling and hung up the phone. In this instance, that wasn’t sufficient. You may have been overwhelmed and confused by her words and had to mull everything over afterward in an attempt to understand what she said (or in this instance didn’t say); however, you should have asked questions and she should have either been able to answer those questions or should have had your physician respond.
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Patient’s size prohibits testing

March 12, 2012 By

DEAR DR. GOTT: My family doctor recently sent me to have an MRI done on my head to look for possible signs of an impending aneurysm. There is a family history of this problem on my father’s side. My problem is that my shoulders are too wide and with the slightest brush, the machine reverses me out. Do these units come in larger sizes? I have still not had the test. What is available to a larger person such as myself? Any advice or suggestions you may have would be most helpful as my family GP could not provide me an alternative. Thank you.

DEAR READER: Frankly, I’m astonished, and a bit dismayed, that your physician, the technicians/radiologists and/or hospital couldn’t provide you with an answer. For individuals who don’t fit into a conventional MRI unit or have extreme fear of enclosed spaces, an open or short-bore MRI may be considered. [Read more...]

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Sunday Column

July 27, 2008 By

DEAR DR. GOTT:
I recently read your article about a lady who had disc problems. I had similar problems with pain and following an MRI was told I had vertebral compression fractures. I immediately saw a chiropractor who told me I was a good candidate for a procedure called “Balloon Kyphoplasty”. After the surgery I had immediate pain relief and I feel so much better. My life is back to normal. I highly recommend this to anyone else suffering from these fractures.

By the way, I am an 80-year-old female.

DEAR READER:
Balloon kyphoplasty is a relatively new procedure used to correct painful compression fractures of the vertebrae. These fractures are often the result of osteoporosis.

The procedure is done through a small incision near the vertebrae. A small, deflated orthopedic balloon is then guided into the fracture site where it is then inflated. [Read more...]

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Daily Column

April 25, 2008 By

DEAR DR. GOTT:
I am a 79-year-old male in reasonably good health for my age.

Many years ago I was diagnosed with mitral valve prolapse. It does not give me any trouble, unless it is somehow connected with my other problem. I have been diagnosed with air hunger.

Occasionally I have the sensation of a shortage of air in my lungs. This causes me to cough suddenly and take several deep breaths to relieve the feeling. I have never smoked and over the years have had several normal chest X-rays. A stress test also showed no abnormalities.

My doctor has prescribed Ativan and Buspirone daily. These seem to help somewhat but are not a cure. The problem intensifies when I have a cold and at other times for no apparent reason. This has been occurring for many years.

DEAR READER:
Air hunger is a respiratory distress condition. It is marked by labored breathing, difficulty breathing and/or the feeling of not getting enough air into the lungs. It can be very disturbing when it occurs. It is not related to mitral valve prolapse.

Your physician appears to have taken appropriate first steps in testing. I believe the next step should be a CT scan or MRI which shows more detail and may pick up an abnormality previously missed. Lung masses, cancer and other conditions need to be ruled out before you can be definitively diagnosed with a benign condition.

I would like to mention that since you appear to be responding favorably to Ativan (an anti-anxiety drug) and Buspirone (a tranquilizer), your air hunger may simply be a manifestation of a panic disorder. Perhaps a psychiatrist or therapist would be the appropriate next step to take.

To give you related information, I am sending you a copy of my Health Report “Pulmonary Disease”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure mention the title.

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Daily Column

April 23, 2008 By

DEAR DR. GOTT:
I have lower back pain and would like your opinion about what I should do. I had an epidural injection in April 2006 but still have pain. I also saw a chiropractor but couldn’t afford to keep going. I have enclosed the results of an MRI of my lower back I had done in September 2006.

I am a 57-year-old female.

DEAR READER:
According to the report you sent me, the MRI impression was “multi-level degenerative disc changes”. Taking a closer look at the findings, I note that most of your lower back appears normal. Two of the discs show mild narrowing and mild to moderate desiccation (drying). One disc also shows a “small subligamentous central disc protrusion with slight effacement of the thecal sac”. This lovely little gem of “medicalese” simply means that one of your discs has been squashed causing the soft inner part to “bulge” which has thinned an area of the membrane that covers the spinal cord and contains the spinal fluid.

All in all, your MRI is not bad. I am, however, concerned about the disc protrusion that has caused thinning of the thecal sac. Without treatment this could worsen and lead to a hole in the membrane causing the spinal cord to be exposed allowing it to be easily damaged.

You are experiencing pain which has been ongoing for more than two years. In my opinion, you need to make an appointment with the physician who ordered the MRI. He or she should then order a follow-up MRI to see if there is new damage and to asses the extent of the existing damage. At this point you should also ask what treatment options he recommends.

Don’t let your lack of funds prevent you from seeking appropriate medical treatment. If you let this go, there is a chance of permanent damage and disability. If your physician is unwilling to make payment arrangements and/or lower his fees, find someone who will. You may also wish to try to get temporary medical assistance through your local department of social services.

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Daily Column

April 7, 2008 By

DEAR DR. GOTT:
I’m 73 years old and have been told by two doctors (after having two lung X-rays one month apart) that I have a small spot on my lung. The last doctor said it is probably scar tissue. I have never smoked, had pneumonia or any other disease or illness that might have caused this. The doctors just attribute it to age. The latest advice was to wait six months and have another X-ray to see if the spot has enlarged.

Can you shed any light on this? Do you think it’s advisable to wait six months or should I go to a pulmonary doctor?

DEAR READER:
I advise you not to wait. Were I in your shoes, I would opt to discover what the “spot” is now, not later.

You need to have proof that the “small spot” is benign and not an early lung cancer. In my opinion, you should be referred to a pulmonary specialist who may choose to obtain a CT scan or MRI possibly followed by a biopsy of the lesion. Depending on the outcome of the tests, the specialist can then advise whether treatment is necessary, and if so, can provide you with appropriate options.

While I may be over-reacting, I would hate to miss diagnosing an early lung malignancy that could be cured if addressed early in the course of the disease. Let me know how this turns out.

To give you related information, I am sending you copies of my Health Reports “Pulmonary Disease” and “Medical Specialists”. Other readers who would like copies should send a self-addressed, stamped number 10 envelope and $2 (per report) to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title(s).

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