Medical advice

[PeteH*]

Hi James.
I'm an anaesthetic/intensive care doctor, so not at all a specialist in this area, and also in ICU we tend to see the worst-case scenarios rather than more common outcomes/presentations, so my view on things may be somewhat skewed.

It sounds like you and your step-mum have taken some really sensible steps in persuading him to push for further investigations, and I do think that the 2-week referral is appropriate at this stage.

For what it's worth, 8 weeks is not that long in terms of your body's recovery from a nasty bout of anything... Depending on the nature of his initial illness it may have been reasonable for the GP to give it a bit longer to see if it settled. (For example, after severe gastroenteritis it is not uncommon to get a degree of malabsorption for a few weeks which can give similar symptoms to what your dad has had.) Having said that, 8-12 weeks is definitely a bit of a turning point for symptoms being defined as "chronic" (ie longer lasting), and it's harder to put continued weight loss down to something that happened a couple of months ago.

I don't wish to alarm you, and the combination of symptoms your dad has could be due to any of a very long list of diseases, but the reason he's been referred within a 2-week window is because some of his symptoms can be signs of cancer. In fact - and this is for everyone else - given that one in three of us will get cancer at some point in our lives, if anyone over 60 develops new/unusual symptoms which last more than 4-6 weeks, cancer will almost often be somewhere near the top of the list of possibilities. I've just turned 40 and am increasingly considering myself as an "older adult" from this point of view, not least because my cousin recently got diagnosed (and successfully treated) with kidney cancer after a single episode of blood in his urine, having never in his life had that before, and being fit as a fiddle.

Cancer is a scary word, but that shouldn't prevent us from talking about it and raising awareness, because awareness genuinely saves lives.

I really hope your dad gets the answers and treatment he needs. Good luck and well done for advocating for him.

 

[slab_happy]

She managed to persuade him to book into the GP sooner and has managed to get an urgent (within 2 weeks) referral for a gastrointestinal specialist appointment.

Brilliant, that's great to hear! Hopefully he gets a diagnosis soon and it's something easily fixable -- and if not, I hope it's at least something manageable.

I've got a friend who's had ulcerative colitis (one of the cluster of GI nasties like IBS and Crohn's and so forth) for many years, and it's not a bundle of laughs to have, but it can be treated and managed and he can get on with his life fine.

 

[James Malloch]

Hi James.
I'm an anaesthetic/intensive care doctor, so not at all a specialist in this area, and also in ICU we tend to see the worst-case scenarios rather than more common outcomes/presentations, so my view on things may be somewhat skewed.

It sounds like you and your step-mum have taken some really sensible steps in persuading him to push for further investigations, and I do think that the 2-week referral is appropriate at this stage.

For what it's worth, 8 weeks is not that long in terms of your body's recovery from a nasty bout of anything... Depending on the nature of his initial illness it may have been reasonable for the GP to give it a bit longer to see if it settled. (For example, after severe gastroenteritis it is not uncommon to get a degree of malabsorption for a few weeks which can give similar symptoms to what your dad has had.) Having said that, 8-12 weeks is definitely a bit of a turning point for symptoms being defined as "chronic" (ie longer lasting), and it's harder to put continued weight loss down to something that happened a couple of months ago.

I don't wish to alarm you, and the combination of symptoms your dad has could be due to any of a very long list of diseases, but the reason he's been referred within a 2-week window is because some of his symptoms can be signs of cancer. In fact - and this is for everyone else - given that one in three of us will get cancer at some point in our lives, if anyone over 60 develops new/unusual symptoms which last more than 4-6 weeks, cancer will almost often be somewhere near the top of the list of possibilities. I've just turned 40 and am increasingly considering myself as an "older adult" from this point of view, not least because my cousin recently got diagnosed (and successfully treated) with kidney cancer after a single episode of blood in his urine, having never in his life had that before, and being fit as a fiddle.

Cancer is a scary word, but that shouldn't prevent us from talking about it and raising awareness, because awareness genuinely saves lives.

I really hope your dad gets the answers and treatment he needs. Good luck and well done for advocating for him.

Thanks for the post, Pete.

My dad mentioned it was a cancer referral after i posted, i hadn’t thought about that as an option before then (I’m a massive optimist and probably a bit head in the sand). You’re right that it’s good to talk about it though - and it was useful reading your post for more context.

Just had a good cry and I’ll call him tomorrow. Hopefully it’s nothing that serious…

 

[SA Chris]

I don't wish to alarm you, and the combination of symptoms your dad has could be due to any of a very long list of diseases, but the reason he's been referred within a 2-week window is because some of his symptoms can be signs of cancer. In fact - and this is for everyone else - given that one in three of us will get cancer at some point in our lives, if anyone over 60 develops new/unusual symptoms which last more than 4-6 weeks, cancer will almost often be somewhere near the top of the list of possibilities. I've just turned 40 and am increasingly considering myself as an "older adult" from this point of view, not least because my cousin recently got diagnosed (and successfully treated) with kidney cancer after a single episode of blood in his urine, having never in his life had that before, and being fit as a fiddle.

Cancer is a scary word, but that shouldn't prevent us from talking about it and raising awareness, because awareness genuinely saves lives.

A timely post. As per the "one for the runners" post a while back about my sudden weight loss, looks like it might not be the gastroparesis the doc initially though. Had a CT scan which has shown a small lesion on my pancreas. Awaiting further appointments to see what the next steps are. Can confirm the advocacy bit - I had to push for the scan and if my brother hadn't died of cancer in his GI system I might not have got one. Anything unusual - get yourself checked. And do your poo on a stick test when it arrives. I'm nearly 55.

Anyone with any knowledge on what to expect, be great to hear.

(Apologies for the hijack James, but it is kind of relevant, good your dad is getting the attention he needs).

 

[mrjonathanr]

I hope this comes back with less worrying results.
Good luck both.

 

[James Malloch]

I don't wish to alarm you, and the combination of symptoms your dad has could be due to any of a very long list of diseases, but the reason he's been referred within a 2-week window is because some of his symptoms can be signs of cancer. In fact - and this is for everyone else - given that one in three of us will get cancer at some point in our lives, if anyone over 60 develops new/unusual symptoms which last more than 4-6 weeks, cancer will almost often be somewhere near the top of the list of possibilities. I've just turned 40 and am increasingly considering myself as an "older adult" from this point of view, not least because my cousin recently got diagnosed (and successfully treated) with kidney cancer after a single episode of blood in his urine, having never in his life had that before, and being fit as a fiddle.

Cancer is a scary word, but that shouldn't prevent us from talking about it and raising awareness, because awareness genuinely saves lives.

A timely post. As per the "one for the runners" post a while back about my sudden weight loss, looks like it might not be the gastroparesis the doc initially though. Had a CT scan which has shown a small lesion on my pancreas. Awaiting further appointments to see what the next steps are. Can confirm the advocacy bit - I had to push for the scan and if my brother hadn't died of cancer in his GI system I might not have got one. Anything unusual - get yourself checked. And do your poo on a stick test when it arrives. I'm nearly 55.

Anyone with any knowledge on what to expect, be great to hear.

(Apologies for the hijack James, but it is kind of relevant, good your dad is getting the attention he needs).

Hope all the results are favourable, Chris.

And hijack away - it would be good for me to read as well as I’m going over worst case scenarios in my head without any knowledge of what actually happens.

 

[Wellsy]

Remember, a doctor isn’t just for treating ill health, but also for perpetuating existing systems of social inequality and hierarchy!

what?

General poorer outcomes for women, ethnic minorities, lower income people. Diseases which mostly affect women get much worse treatment (I know, I have one!). Women’s pain getting taken less seriously or symptoms being psychologised rather than treated. Sometimes presenting a doctor with a thing they don’t understand is dangerous for the patient, as it upsets the authority and hence social standing of the doctor.

If this sounds weird or extreme then you are lucky, bask in it.

Whilst it is true that medical and social care has inherent biases in it, that is more a reflection of wider society than it is a reflection of the efforts of medical professionals, many of whom actively work against those biases. I think saying doctors are there to perpetuate those biases is rather misguided. Doctors are often trying to correct those biases. I worked in the area of healthcare feedback and development so I saw both some pretty awful and also some pretty incredible outcomes of patient experience but almost every NHS Trust I ever dealt with were all aware of the biases and trying to do something about them.

 

[Hoseyb]

Another tangent. I was reflecting this thread perfectly demonstrates what an amazing cross section of people use this forum, and how open and supportive they are. On the climbing community as a whole I wonder if the same rings true about climbers as a whole, and whether it always will?

 

[SA Chris]

Have you ever been on UKC or the Supertopo forum? Agree the support on here is great.

 

[seankenny]

I’m perfectly happy to discuss long covid on here, on UKC it’s usually not worth the effort.

Also, James - good luck with your dad’s care. My mum had cancer and obviously at the time it was very distressing but she made a full recovery and had many good years after her treatment.

 

[Hoseyb]

Have you ever been on UKC or the Supertopo forum? Agree the support on here is great.

If you remember, I used to be pretty active on UKC back when you were, it was ok back then, but I wouldn't touch it now. Maybe that's the changing face of UK climbing. It does feel most people on here are older school.

My only experience of US climbing culture is through Widefetish.com. also old school, but definitely more self focused

 

[SA Chris]

I remember. It was a fun and new experience.

 

[SA Chris]

Had a CT scan which has shown a small lesion on my pancreas. Awaiting further appointments to see what the next steps are.

Update if anyone is interested. Consultant sent a letter saying it's just a small cyst / IPMN and no cause for concern. Which is obviously a relief, and good news as it's not serious, but something is still up with my digestive system and I don't know what.

Hope your dad is doing OK James.

 

[Duma]

Great to hear Chris.

Hope you manage to bottom out (sorry couldn't resist) the gut issues

 

[SA Chris]

Had all the jokes already! Next step is back to doc I guess. In spite of eating as usual by weight is still dropping. Not as fast as it was, but still falling off.

 

[stone]

Great to hear the spooky CT pancreas thing turned out OK.

And best wishes with sorting your gut out.

 

[SA Chris]

Thanks

 

[James Malloch]

Had a CT scan which has shown a small lesion on my pancreas. Awaiting further appointments to see what the next steps are.

Update if anyone is interested. Consultant sent a letter saying it's just a small cyst / IPMN and no cause for concern. Which is obviously a relief, and good news as it's not serious, but something is still up with my digestive system and I don't know what.

Hope your dad is doing OK James.

Hope that you get your issues sorted, Chris. But good to know that something has been ruled out at least!

My dad is still losing weight, but saw a Gastroenterologist a week or so ago. He then had a CT scan on Monday and has an Endoscopy tomorrow. Hopefully the CT results will come back next week and tomorrow’s should be instant.

The gastroenterologist also noticed he had bad Thrush, which when serious enough can apparently have similar symptoms to what he has been having. He is being treated for that and after 4 days of having a bad reaction to the medication, he had a pain free night. So maybe that’s something…

Hopefully everything will be more clear in the coming week. Or at least some things may be ruled out…

 

[SA Chris]

Sounds potentially positive at least.

 

[James Malloch]

Sounds potentially positive at least.

Hope was shattered today by a stage 4 pancreatic cancer diagnosis. Thanks for all of the advice on this thread. It’s weird how a load strangers can be so important for support! Time to go and spend some time with my dad…