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Dr. Andrew Rynne

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Exp 50 years

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Suggest treatment for dizziness, lack of appetite and nausea

My family friend is Mary, and she lives in San Jose, California. She is about 60 years old, Asian, over 5 9 , originally weighed 160+ pounds. At the beginning of this year, Mary experienced extreme dizziness, lack of appetite, and vomiting. She checked into Santa Clara Valley Medical Center. I am not sure of what tests were ran on her but they could find nothing wrong with her. Mary then tried acupuncture which temporarily relieved her pain. Then she collapsed and she was taken to the Stanford Hospital, where they did a scan on her chest and they said that her lung is of interest. However, they could not find what was causing her lack of appetite. She was again checked into Santa Clara Valley Medical Center. She has been diagnosed with lung cancer; however, the doctors believe that is not causing her lack of appetite and vomiting. At the beginning of the year, she was 160+ pounds. As of this week, she is 110 pounds. Sometime in this year, she had a seizure as well. She has gone through many doctors without any luck as to what is causing this major lack of appetite and vomiting of any food she puts down in her stomach. They brought in an infections specialist and he could not pin anything down. Their family member found on the Internet that tuberculosis was a close fit to her symptoms but they got a brain culture and they found it to be negative. From the looks of it, she has lung cancer and something else mysterious causing her to vomit and not eat. She has started some chemo sessions for lung cancer but at this pace, it s not the lung cancer that is killing her, it s this starvation. The doctors seemed to have focused a great deal on her brain and head, but I wanted to get your opinion on what it could be in her digestive system. They ve tried some various IV fluids but some reacted badly to her liver and even damaged her liver a bit. A nutritionist was brought in yesterday to discuss what she can have, but she just seems to be vomiting everything and even when she only has water in her stomach! I m sorry I don t have the exact details like family history for now but I can get them for you if necessary. If you don t think it involves the digestive system, could you tell me what part of the body you think it could be? Could it be the lung cancer or something really in her head?
Tue, 27 Nov 2018
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General Surgeon 's  Response
Hi,

I have reviewed your query and here is my advise.

As per my surgical experience, the issue of vomiting can be from multiple etiologies as
- basic pathology of cancer affecting vomiting center of the brain
- ulcer stomach or duodenum (stress, chemotherapy induced or else)
- chronic gastritis or duodenitis
- pancreas or liver problems
- psychologic
- others.

I would like to know the current status of any GI evaluation done in terms of upper GI endoscopy or so forth, on the basis of which we can figure out the future course of action.

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

Regards,
Dr. Bhagyesh V. Patel,
General Surgeon
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