Help,not eating/diagnosis unclear/quick action needed

[Guest guest]

Aside from pancreatitis and gall bladder disease, I suppose that

intestinal blockage or ulcers or some type of gi or abdominal

cancer are possibilities (not fun ones, I know)

Basically, you want to go about things systematically

Begin with your records:

Contact your doctor/doctors and ask for a complete

list of all the tests run so far. Or better yet, tho this may

involve some copying fees, ask for the tests themselves. You are

entitled to your med. records. Keep them all together and organized.

Read thru each of them and from what's reported, characterize each

test as normal, some abnormalities or uninterpretable (to you).

Going thru your records like this will make you a more knowledgable

patient, help you prepare for your next doctor appointment--you

might spot some abnormalities. And if not, then you could ask your

doc/docs... whether this is indeed their interpretation of your

test results. In other words, you are doing a double check at the

same time you are organizing and learning.

Taking a *systematic* approach is the best way to deal with

puzzles like this.

Also, you can ask some questions about how badly you seem to be

doing.

Ask, what is my performance status? (and get it explained

unless the doc rates you at zero, which means no interference

with normal life... and you agree.)

Calculate your weight loss in % terms (starting from the

time you first experienced symptoms). If it is more than 10%,

say 'hey doctor... what can I do to reverse this downward trend? " If

20% or more, be more forceful, ask at what point they plan to begin

TPN? Ask if signs of dehydration were found? (If yes, an immediate

and serious concern.)

Ask about signs of infection? Etc. Etc. If all the lab

tests and phys. exams are within the normal range, ask 'it's possible

I could have be suffering from cancer, yes? So, what is the next

step to take, besides offering me pain relief? "

You probably don't want them to go on a global fishing expedition too

soon (exploratory surgery and whole body CAT scans should not be

undertaken lightly) not until you are unable to function and ther

systematic approaches have failed to yield clues...

If gallbladder surgery is recommended... ask, are most patients

aymptomatic for this disease when you operate on them? And get a

second opinion from a gi specialist at another institution.

You could say, " I'm sure neither one of us wants to overlook something

serious " ...pain and not eating are serious problems... where shall we go

from here? "

Take someone with you to each doc appointment. And esp. if you

are in pain or don't have an advocate with you that day, insist

as forcefully as you can, to be allowed to tape record what's

said, so you can review it later.

Good luck

--

Sally

Sally L. Hobson, Ph. D.

mailto:hobson@...

http://www.adelphi.edu/~hobson