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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Lack Of Appetite In An Elderly Person While On Megace And Marinol?

My name is Michael. My grandmother is 72 years old with diabetes and is currently on dialysis.. The way I understand it she will be dead within 6-12 months. The problem is my mom has no appetite. For example yesterday she barely at a single jello serving yesterday. From my understanding Marinol and Megace are the only effective drugs that actually increase appetite. With the drugs side by side, The side effects of Megace are horrible compared to Marinol. https://druginformer.com/search/side_effect/megestrol+acetate https://druginformer.com/search/side_effect/marinol Apparently though Marinol is not covered by medicare and can cost upwards of $300 for the generic a month, This would not be a problem though because my family will make sure she gets what she needs. My question is why are doctors so hesitate to prescribe Marinol? I do understand it s a schedule 3 drug and derivative of marijuana, but she s already on the powerful painkiller schedule 2 drug hydrocodone. I m looking for a doctor that is open to prescribing the drug in this dire situation and would do at-least consult with my grand parents about this particular medication. All I want is my grand mother to be able to get some food in her for she can be here as long as possible and have at least a little bit of quality of life before she s dead.
Wed, 31 Jul 2019
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General & Family Physician 's  Response
Hello,

First of all the cases of thyroid requires thoroughly clinical examinations, thyroid function tests (which are the blood investigations for thyroid), based on these findings further evaluation are continued. In your case the USG indicates:

1) Normal-sized thyroid gland -which is normal
2) Bilateral vague nodularities :::::: which implies there are nodularities over both lobes of the thyroid gland
3) Discrete swelling in the left lobe as mentioned:: a discrete swelling also called isolated or solitary nodule is the swelling in an otherwise impalpable gland (these are common in 3-4 % of the population of west and more in women).
4) No demonstrable or enlarged lymph nodes:: enlarged or suspicious lymph nodes are usually a sign of malignancy in your case those are absent, therefore chances of malignancy are less. TO CONCLUDE :

1) Get your thyroid function test done
2) For the discrete module on left lobe it is better to have an FNAC (fine needle aspiration) to be done as it is best investigation of choice.

Hope I have answered your query. Let me know if I can assist you further.

Take care

Regards,
Dr ASIF, General & Family Physician
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What Causes Lack Of Appetite In An Elderly Person While On Megace And Marinol?

Hello, First of all the cases of thyroid requires thoroughly clinical examinations, thyroid function tests (which are the blood investigations for thyroid), based on these findings further evaluation are continued. In your case the USG indicates: 1) Normal-sized thyroid gland -which is normal 2) Bilateral vague nodularities :::::: which implies there are nodularities over both lobes of the thyroid gland 3) Discrete swelling in the left lobe as mentioned:: a discrete swelling also called isolated or solitary nodule is the swelling in an otherwise impalpable gland (these are common in 3-4 % of the population of west and more in women). 4) No demonstrable or enlarged lymph nodes:: enlarged or suspicious lymph nodes are usually a sign of malignancy in your case those are absent, therefore chances of malignancy are less. TO CONCLUDE : 1) Get your thyroid function test done 2) For the discrete module on left lobe it is better to have an FNAC (fine needle aspiration) to be done as it is best investigation of choice. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr ASIF, General & Family Physician