Spreedog

I only ask questions when I want your opinions. Other things I can look up myself.

A walk in clinic for teens or other age groups who think they have a malignant disease.

I would not need to pay a nurse. One receptionist is all. No referral needed.

A CBC machine to rule out leukemias. Small office space. Low overhead.

I would just do physical exams and order necessary tests to prove that people

did not have cancer. I wouldn't have to pay for expensive chemotherapy drugs.

If I ever found a real cancer, I could refer the person for treatment.

No night call. No one would die. I would not have to give anyone chemotherapy.

The charge would be $100 which is what I charged when I was in oncology practice.

It would be an out of pocket expense since third party payers probably would not pay.

It's the "Doc in a Box" concept geared to oncology. What do you think ? ?

The regular answerers on the YA Cancer section are all familiar that there are PhD's, doctors, nurses, experienced cancer patients, and other very brilliant medical people, plus adult lay people, and many young teens who may not understand the vocabulary. For which ones do we write ? ? Ages are so often not given. We have to guess by the grammar of the asker. Any, hints, ideas, ways you do it ?

When I wrote my last question (which I do not remember), I was just coming out of brain surgery for evacuation of a subdural right parietal hematoma. It was a close call. I almost joined my Dalmatian - the real Spreedog - who died of cancer two years ago. A simple slip and fall stepping out of the shower. This is the second time I was close to death. I know many cancer survivors who have faced possible death and come through it. I do not put myself in their class.

When I wrote my last question (which I do not remember), I was just coming out of brain surgery for evacuation of a subdural right parietal hematoma. It was a close call. I almost joined my Dalmatian - the real Spreedog - who died of cancer two years ago. A simple slip and fall stepping out of the shower. This is the second time I was close to death. I know many cancer survivors who have faced possible death and come through it. I do not put myself in their class.

When I wrote my last question (which I do not remember), I was just coming out of brain surgery for evacuation of a subdural right parietal hematoma. It was a close call. I almost joined my Dalmatian - the real Spreedog - who died of cancer two years ago. A simple slip and fall stepping out of the shower. This is the second time I was close to death. I know many cancer survivors who have faced possible death and come through it. I do not put myself in their class.

A question posted by Jen Yang of Hollywood CA piqued my interest. Her brother has testicular Ca. I know from observing cancer patients and their families over 20 years that almost all people want to find the cause - something to blame. Her doctors apparently have said that some testicular and ovarian cancers may be linked to excess free copper - possibly from handling quarters. So, if a person works in a bank or on a cash register, may they sue their employer for this ?

My point is that in the U.S. there are 160,000 deaths from lung cancer almost all caused by cigarette smoking. Compare that to 380 deaths from testicular carcinoma each year. Should we be more concerned about warning people to not handle quarters - - or intensify our efforts to get the message out about cigarette smoking. Most testicular carcinomas are cured with existing treatments. Few smoking related cancers can be cured.

Just saw a Cialis commercial saying that men should call their doctors if an erection lasts for over four hours.

' Wondering what a doctor is supposed to do about that over the phone?

I've been on call many a late night for cancer medicine,

but I don't know what I would advise over the phone for a chronic penile erection.

Is there a medication to reverse the effects of drugs like Cialis?

Perhaps an alpha-adrenergic agonist.

I can't imagine a surgical procedure to fix this problem.

Maybe Denisedds will see this - she knows some urology.

I could look up priapism, but I thought it would be fun to float this question on YA.

I have the CD, the box, and code for the Microsoft Office and Student and Teacher Edition 2003 that I bought in 2005. I have a feeling it won't transfer to the new computer.

Also, the new computer cannot read any of the 50 + lectures I have saved from the old broken computer. Any trick for transferring these documents? They are all saved on flash drives and my external hard drive. Thanks !

The current health care reform debate has reminded me of a cardiologist attending I had when in medical training. He told me that only wealthy, productive people should have bypass surgery. He said that poor people did not deserve the expense to prolong their lives. I think it was a rare moment of honesty when he shared his true feelings with a lowly intern. I didn't agree with him then or now. Maybe I am wrong. What do you think? Are only wealthy people worth saving in America?

Not questioning anyone's bravery. The soldiers were unarmed. But this shooter must have reloaded. One pistol was a revolver - relatively slow to reload. 300 soldiers right there. Would not one of them jump this person and wrestle him down while reloading? Was everyone ducking and hiding? Same as the Virgina Tech shooting. People did not attack the attacker. Wonder what I would do? I hope I would have charged during the lull in firing. I guess we never know what we might do.

Spreedog - my Dalmatian age 13 - is wasting away with what appears to be a widespread lymphoma. She has 8 hen egg sized lymph node masses in the cervical and supraclavicular areas plus axillary and inguinal lymphadenopathy along with two pelvic masses. She is down to skin and bones but not in pain. She can still walk - but barely. She will not eat. Trying to figure out the humane way to end this. Don't want to play God and put her down for my convenience. Never had these options with human cancer patients. Inclination is to let nature run its course and keep her as comfortable as possible as we do with people who have end stage malignancies.

No one who graduated in my medical school class took this oath in 1977, but it seems to be the general impression of many people that doctors actually take this oath. I'd be surprised if any doctors on this site have taken the original oath. To do so you would have to swear by Apollo and other pagan gods. You would swear to never perform surgery that would involve cutting with a knife. You would swear to never perform an abortion.

That oath dates back to pre-Christian times. I'll be fascinated if any modern doctors have actually taken that oath.

Risking some angry responses here. I heard this quite often as an oncologist - "We want everything done.". But these days there are so many more things that can be done and many treatments are very expensive with no chance of cure. I specifically recall the family of a 96 year old woman with widespread incurable gastric carcinoma. They wanted "everything done." The patient could not speak for herself. With health care reform focusing on cost containment, who will tell doctors and patients/families that it is not cost effective to do everything possible? Insured Americans - third party & Medicare - are often accustomed to having "everything done" regardless of costs. In the 1980's and 1990's, Medicare did not tell us we couldn't try aggressive chemotherapy in 96 year old patients. Who should make these decisions - doctors, distraught families, or the government?

The trouble is that some (not all) oncologists will treat everyone rather than explain why treatment is not advisable. Some because that's how they make money, and some because it's easier to treat than to spend the time explaining. The good news is that we have many more new treatments for cancers. The bad news is that they are incredibly expensive. Who will limit care rationally in these emotional situations?

While I am actively checking e-mails, I repeatedly have the Yahoo mail system close saying it shut down unexpectedly. Is this my computer or the server or Yahoo mail itself? Thanks.

I was looking up TARCEVA (erlotinib) which is a pill used for advanced pancreatic and non-small cell lung cancer patients. It may add some months of survival time in a minority of people with these very serious malignancies. It seems difficult to find out how much a month of treatment costs. I'm sure it varies, but in this age of health care cost consciousness, this information should be readily accessible. Perhaps I'm not search correctly for this information.

I realize the thinking that "no cost is too great to buy some time," but this is the attitude that may allow pharmaceutical companies to charge excessively without some measure of profit control - greed seeming to be epidemic these days.

This story appeared today http://news.yahoo.com/s/ap/20090401/ap_on_re_us/fr...

My experience working in a free clinic was that average Americans tended to come in frequently for even minor complaints and demand prescription medicines because it was all free. The 9 people who racked up 2700 ER visits over six years in Texas never paid - but the hospital had to charge others to cover their costs. These people all had mental disorders. But what of average Americans given access to free care and free medications as in Canada or Britain? Might some - or many - overtax the system? I suspect it might lead to overcrowding and longer waits for the very sick to be seen unless triage were handled very carefully. It looks like we are headed towards a national health care system in the U.S. I see good and bad consequences. Your thoughts?

My mother has reported to me that her unread Email messages erase when she reads one and then clicks back to the Inbox. She is on Verizon in New Jersey. She has tried communicating with Verizon troubleshooters - 90 minutes worth - to no avail. Ideas?

I have a guess of my own, but I'd like to hear your opinions. The English claimed to be Anglo-Saxon, but the Angles and Saxons were both Germanic tribes who came to England in the 400's AD. The French were in part derived from the Franks who were another Germanic tribe from northwest Europe who became the Merovingian rulers of France in the early 500's. The Germans were not ethnically related to the notorious Huns of Attila in the 434 to 453 AD era. The Huns were more likely a Turkish people. That's all I'll insert regarding my guess. Maybe someone really knows.

I've noticed that lawyers charge me for fractions of an hour if I call with questions. I returned many calls from patients with questions during my 20 years as a physician, and we had no charge for this. I just wonder if this has changed in the few years since I retired?

It would often take me one to two hours to return all the calls at the end of the day. Most of these were not emergencies and came in after hours through the on call operator. I wonder if people realize the hours that doctors put in without pay?

I do suspect this question will provoke the anger of so many who think that all doctors are overpaid already. There are a surprising number of people who do not realize that many doctors in tough specialties like pediatrics and family medicine are not making a great deal of money.