Recently, The Doctors took off the scrubs and stepped into the role of being patients. Now, for Dr. Jim and Dr. Ordon, it’s time for the follow-up while Dr. Travis and Dr. Lisa undergo two new tests.
Dr. Travis: Out of Breath
For the past few months, Dr. Travis has had trouble breathing at night following a respiratory infection. After waking up unable to breathe recently, he finally decided to have himself checked out. “I can’t even jog for one minute without starting to cough,” he says. “It hurts to take a deep breath. I literally woke up last week scared because this is not me. It’s not normal. I’m done self-diagnosing.”
Allergist and immunologist Dr. Warner Carr gives Dr. Travis a lung test to check for any serious pulmonary conditions and an allergy skin test. “I wish you would have come and seen me a month ago, two months ago, when you first got sick so you wouldn’t have had to be suffering that whole time,” Dr. Carr tells Dr. Travis.
Dr. Carr explains that tests revealed Dr. Travis has a number of allergies, including an allergy to grass pollens. “As you know, allergies and asthma can go hand in hand,” Dr. Carr says. “The real question is how severe was it. We did lung-function testing on you, we checked for airway narrowing, we checked for airway inflammation and the good news is that I think you’re at the tail end of this. What happened with you, having asthma, this little irritation is like a smoldering fire, and getting that infection is kind of like throwing gasoline or fuel on the fire, and it just blew up.”
To help control his inflammation, Dr. Carr gives Dr. Travis a nasal spray to use every day, as well as a daily controller asthma inhaler and a rescue inhaler. “Just like high blood pressure, you may not feel high blood pressure until you take a test,” Dr. Carr says. “You can be walking around, and it can be really high. It’s the same thing with asthma. You don’t know until you check.”
Dr. Jim: From Blind Spot to Brain Tumor Scare
After ignoring a blind spot in his eye for over a year, Dr. Jim had it checked out on the show. Ophthalmologist Dr. Sanford Chen told Dr. Jim that tests revealed an abnormal optic nerve, that there may have been growths or lesions on his nerve and there was a small chance it was a brain tumor. “It’s not fun walking around for a week or so thinking I might have a brain tumor,” Dr. Jim said.
To follow up on the harrowing news, Dr. Jim goes for a CT scan of his brain. Radiologist Dr. Richard Goldman, who read Dr. Jim’s CT scan, explains the findings while comparing Dr. Jim’s brain scan to that of an abnormal one. “We were concerned that there might have been something growing inside of his head causing increased pressure, which would then be transmitted to his eyes,” Dr. Goldman says. “I’m happy to say that Jim’s scan is completely normal, so everything has turned out fine. There’s no evidence of pressure in your brain. There’s no evidence for any extension to your eye, so that’s a great result!”
“I’m doing the No-Brain-Tumor Dance!” Dr. Jim says with a beaming smile on his face. “It’s good news.”
With the possibility of a brain tumor ruled out, Dr. Chen runs other tests to determine why Dr. Jim has a blind spot. A laser scan through Dr. Jim’s optic nerve reveals the top portion of the nerve is thinner than the bottom portion. “This actually answered why you had your blind spot,” Dr. Chen says. “The eye acts like a camera, and we know that the images are all reversed and upside down. So something affecting the top part of the nerve is actually going to give you an inferior field loss. And that’s exactly what happened.”
Dr. Chen explains that it is just something Dr. Jim was born with, and it will not progress any further.
Dr. Lisa: Bone Density Test
With her mammogram coming back normal and healthy on the previous show, Dr. Lisa takes another test that is vital for all women: a bone density test. The bone density test is done to determine if someone has, or is at risk of, osteoporosis. The DEXA scan, which is the preferred method of testing, uses X-ray technology to measure the bone density at your hip and spine. “This test is just too easy,” Dr. Lisa says. “Of all the tests you can get, it’s just so simple. It takes just minutes, literally.”
Dr. Lisa’s test reveals some startling results. It shows that she has lost 20 to 30 percent of her bone density and has significant osteopenia, which means her bone mineral density is lower than normal, but not low enough to be osteoporosis. If left untreated, this could leave Dr. Lisa at a significantly higher fracture risk within 10 to 20 years. “This gave me a wakeup call that doctors aren’t invincible,” Dr. Lisa says. “We still have to exercise. We still have to get out in the sun even though we’re in an office all day.”
“It’s a good idea for women at around age 40 to start talking to their doctor to say, ‘Am I at risk?’” says Hologic X-ray technologist Deb Burnham. “Go through those risk factors, like, family history is big. Your ethnicity is really big.”
Dr. Ordon: Prostate Follow-Up
Dr. Ordon’s first prostate ultrasound revealed cists and calcification in his prostate. Combined with a history of high prostate-specific antigens (PSA) and prostatitis, urologist Dr. Jennifer Berman encouraged Dr. Ordon to go for a follow-up exam.
The follow-up, which includes a second ultrasound, shows that for the most part, Dr. Ordon’s prostate looks normal. “That’s what I want to hear!” Dr. Ordon says.
He does have a slightly enlarged prostate, which can block the flow of urine, but urologist Dr. S. Adam Ramin explains that it is not cancerous, and he will not perform a biopsy. Photos do show a slight abnormality, which prompts Dr. Ramin to advise Dr. Ordon to have another follow-up in three months, just to make sure everything remains stable. “It’s a big sense of relief,” Dr. Ordon says. “I didn’t have to have the biopsy. I feel much better about the whole thing, and I’ll be back to have a check.”
While prostate cancer is not preventable, knowing if you are at risk is important. Urologist and prostate specialist Dr. Fred Kuyt explains that prostate cancer is hereditary and higher in certain ethnicities. “We urge everybody to have their original PSA screening at age 40 instead of age 50,” Dr. Kuyt says.
“Treatment options depend on the personality of the person who has the cancer,” Dr. Kuyt adds. “Some people immediately say, ‘I need this taken out of me.’ Other people say, ‘Let’s go the least invasive method.’ There are lots of options, lots of good options. And don’t be afraid of the urologist. We’re pretty friendly, and we have small fingers!”
More on Prostate Cancer from Dr. Ramin
• Prostate cancer is a malignancy that originates within the prostate.
• It is the most common cancer in American men. Over 200,000 men are diagnosed with prostate cancer every year in the United States, and about 40,000 men die of prostate cancer per year.
• Risk factors for prostate cancer include a diet rich in fatty foods, family history of prostate or breast cancer and older age. Risk of prostate cancer is lower in Asian countries than in the U.S., presumably due to Asian diets being rich in Bioflavanoids (found in soy beans).
• Screening for prostate cancer includes a blood test called PSA and a digital rectal exam (DRE), whereby the physician palpates the prostate through the patient's rectum. Ultrasonography of the prostate is performed in some situations to look for abnormal areas in the prostate.
• Diagnosis of prostate cancer requires performing a biopsy of the prostate with the guide of an ultrasound probe placed in the rectum.
• Treatment of prostate cancer depends on the physiologic age and health of the patient, the degree of aggressiveness (Gleason Score) of the cancer and the stage of the cancer. Treatment options for prostate cancer include active surveillance, hormone therapy, cyrotherapy, various types of radiation therapy, open prostatectomy, robotic assisted laparoscopic prostatectomy and chemotherapy. Only after a careful evaluation and discussion between a physician specializing in prostate cancer and the patient, should the patient decide on the proper course of therapy for his prostate cancer.