4.2 Info from Dr.Roberts visit

This is from an email that I sent to Mom on Tuesday.

Dr. Roberts came in yesterday and said that he believes that Dad has either a Carcinoid Tumor or Ischemia of the Bowel.

The 24 hour urine test should show if there is a carcinoid tumor. The Doctor said that if it is the carcinoid, the reason that Dad gets sick every time he eats (which usually isn't the case with carcinoid) is maybe the tumor is around or surrounded by muscle which squeezes the tumor when the muscle is working on Dad's food, which then causes the carcinoid to secrete hormones, and that causes Dad to get sick. The test results should be back in a few days since they had to send it somewhere to get tested. Now the tumors are slow growing and small. Dr. Roberts said that he has been involved in cases where they have diagnosed carcinoid tumors but hadn't been able to find them for a while, until they grew larger to see. He said that is pretty rare, but to be aware of it. It could be one tumor or a few they aren't sure. And since they are slow growing and small that would account for the carcinoid not being seen in the CT scans that Dad has had done.

Speaking of CT Scan, the one that he had done ion the 26th wasn't done to the specification that Dr. Roberts ordered. He seemed pretty angry about this, but didn't seem as though he wanted Dad to do it over again. They didn't do some of the cross sections that he had ordered.

They have been taking blood from an artery when Dad has these episodes and they've found an increase of lactic acid and white blood cells. Lactic acid is produced when a muscle isn't getting enough oxygen. That would lead them to go with the escarpic bowel, but it's not a very high amount of lactic acid. Escarpic bowel is when the blood vessels to a certain part of the bowel aren't supplying it correctly. An angoigram would give them a better idea if this is the cause of Dad's episodes. Dr. Roberts seemed to want to have done this from the beginning, but the team and radiology have been against it as an initial test because of the invasive nature of the test. Dr. Roberts said to Dad yesterday that he is pushing for them to do the angoigram even before they get the results from the urine test. But then another doctor came up a few hours later and said they aren't going to do it yet. If it is this escarpic bowel, that doesn't account for the flushing and sweating that Dad keeps having. The treatment for the escarpic bowel is to remove that section of bowel.

Dr. Roberts said that they aren't 100% sure that either one of these are what Dad is suffering from. And if he had to pick he would want it to be the escarpic bowel, and not the carcinoid tumor.

-Paige