Re: Help with vasomotor symptoms
From: Joanne Bulley, MD (islesannie@yahoo.com)
Thu Aug 25 21:30:36 2005
Thanks for the review, Art!
I was the one who suspected something fishy after a patient told me
about her multiple trips to the ER with abd pain and bowel symptoms with
flushing that turned out to be carcinoid. With the symptoms she
presented to me and her abdominal exam I got an ASAP CT scan ... and
she had liver disease as well as the primary in the mesentery (?) ...
she is still doing well with the $2500 per shot octreopeptide (or
someting like that in both cost and name) ...
Joanne
At Thu, 25 Aug 2005, art fougner, md wrote:
>
>I'm on it, Joe...
>
>Diagnosis of carcinoid tumors involves urine and blood tests, imaging
>tests (e.g., x-ray, CT scan, MRI scan), and may involve exploratory
>surgery. In some cases, physicians administer a drug (e.g., calcium
>gluconate, pentagastrin, alcohol) to provoke flushing and help in the
>diagnosis. These drugs are administered under careful observation in a
>hospital because they may cause serious side effects.
>
>When a carcinoid is suspected, the levels of serotonin or its
>by-products (usually 5-hydroxyindoleacetic acid [5-HIAA]) in the
>patient's urine are measured over a 24-hour period. High levels of
>other peptides (e.g., neuropeptide, neurotensin, secretin) may indicate
>a carcinoid tumor as well. Blood tests also may be used to measure the
>plasma level of these substances.
>
>Serotonin-rich foods (e.g., bananas, avocados, pineapple, eggplant,
>walnuts) can interfere with the results of this test. Three days prior
>to undergoing the test, the patient should eliminate these foods from
>the diet. Drugs such as guaifenesin (present in cough medicines),
>acetaminophen (e.g., Tylenol®), methocarbamol (muscle relaxant), and
>phenothiazines (tranquilizers) also can interfere with test results and
>should be discontinued prior to testing.
>
>http://www.oncologychannel.com/cancermalignancy/diagnosis.shtml
>
>art
>
>At Thu, 25 Aug 2005, DoctorJoe@aol.com wrote:
>>
>>In a message dated 8/24/05 10:24:36 PM, agfolley@hotmail.com writes:
>>
>>> Consider Carcinoid Syndrome.
>>>
>>I was thinking that. What tests do they do now for Carcinoid? I seem to
>>remember 5-HIAA or something.
>>
>>Joe P.
>>
>>P.S. Yeah, I could google like the rest of us, but I'm still trying to wake
>>up.
>
>--
>art fougner, md
>
> "If you don't know where you are going, you will wind up somewhere else."
>Lawrence Peter Berra
>
--
Joanne Bulley, MD
Keene, NH, USA
"Love is indescribable and unconditional.
I could tell you a thousand things that it is not, but not one that it is."
— Duke Ellington, American jazz artist (1899-1974).
