I couldn’t think of a good intro for this month’s case study. Then I remembered an old joke I used in one of my first articles for Doug over five years ago. It is a joke on the different thought processes of four medical specialties
Four doctors were going duck hunting: a psychiatrist, an internist, a surgeon and a pathologist. The doctors were in the duck blind when something flew overhead.
The psychiatrist said, “It looks like a duck, it acts like a duck, but does it think it is a duck? How does it feel?” The opportunity to make the shot was missed.
The internist said, “It looks like a duck. It acts like a duck. But it could be a dove, or a swallow or some other bird. We need to do some tests.” Again, the opportunity was lost.
The surgeon looked up and began shooting like crazy until something fell from the sky. Picking the object up he hands it to the pathologist and says, “Here, tell me if this is a duck.”
The only connection with this month’s case study is that it involves a surgeon, a family practice/internist and a pathologist.
For legal purposes I must give a disclaimer: This case study is for educational purposes only. I am using it to show you how a typical patient presents and the things I consider when I make a diagnosis. The patient’s name has been changed to protect his/her identity. I practice integrative/alternative medicine and my recommendations for treatment are often considered outside traditional practice. It is not my intent to criticize or denounce traditional medicine. I am merely providing an alternative opinion. Most importantly, the information provided here should not be used as a substitute for an examination and/ or treatment by a licensed health care provider.
Presenting illness: Mr. October is a 57 year old male who presented for a consultation eight months ago. Mr. October reported that he had been having some pain in his upper abdomen for the past 2-3 months. He believed that he might need to try prescription anti-fungals.
In March 2004, Mr. October began having symptoms of sinus pressure, ringing in his ears, occasional blurred vision, musky body odor, heart racing and numbness in his toes. He also said that he was experiencing fatigue and mind fog.
He contacted a local health food store who introduced him Know the Cause and Doug Kaufmann. Over the past eight years he had been able to relieve some of his symptoms using natural health products and diet. His sinus congestion “cleared up”.
Past medical history: Unremarkable except for above.
Past surgical history: None
Medications/Vitamins and supplements: Mr. October is taking vitamin D and probiotics.
Allergies: Mr. October has no known drug allergies.
Social History: Mr. October is married with 2 children. He is self-employed. He does not smoke or drink alcohol. He is on the Phase I diet/ Initial Phase diet.
Review of systems: Mr. October has received antibiotics many times in the past for extended periods of time.
Mr. October has had problems with epigastric pain in the past and he was treated for Helicobacter Pylori gastritis for two weeks in 2010. He is also experiencing symptoms of irritable bowel.
Mr. October has a history of kidney stones.
Mr. October’s job includes renovating homes. He has been exposed to mold multiple times and in 2004 he “showered with mold/fungus” while working in an older home. He suffered with sinus pressure for two years and “brown dirt-like material” came out of his nose.
Blood pressure: 121/92 Pulse:88 Height: 5’8” Weight: 172 lbs.
On physical examination Mr. October was noted to have scarring of his ear drums and trace scalloping of his tongue. Mr. October had some mild tenderness in his right upper quadrant but there were no palpable masses and no enlargement of his liver.
Mr. October was noted to have noticeably cooler hands and feet. The soles of his feet were noted to have a yellow discoloration (beta-carotenemia). His fingernails and toenails were found to have vertical ridges.
Based on Mr. October’s history, I felt that he had irritable bowel syndrome (IBS) probably related to chronic fungal overgrowth of the gastrointestinal tract (dysbiosis). It is not unusual for persons with IBS to experience upper abdominal pain, bloating, constipation and or diarrhea. I started him on ketoconazole for two weeks and Nystatin for one month. He was to continue on his daily probiotics and the initial phase diet.
On his physical examination, Mr. October was noted to have multiple physical signs of hypothyroidism. I recommended that he start on a prescription thyroid medication daily.
I also recommended that he start on several vitamins, minerals and supplements, since dysbiosis is often associated with relative vitamin deficiencies.
Mr. October presented for follow-up last month. A few days after his initial consultation with me, he had an episode of severe abdominal pain. He went to the emergency room and was diagnosed with an intestinal obstruction. He underwent colonoscopy which revealed a golf ball size tumor in his colon. Mr. October underwent a partial colectomy (removing approximately 8-10 inches of his colon) to remove the tumor completely.
The pathology report revealed the tumor to be cancerous but the margins of the resected tissue were clean. Mr. October was given the diagnosis of Stage I colon cancer. He did not receive any chemotherapy or radiation treatment.
After recovery from surgery, Mr. October took the anti-fungals that I had prescribed as well as the vitamins and supplements I had recommended. Mr. October is also taking the prescribed thyroid medication. He remains on the Phase I diet.
Exposure to mold and fungi is an occupational hazard for Mr. October. He has recently developed problems with nasal congestion, ringing in his ears and symptoms of prostate enlargement.
Discussion: There are always surprises in medicine. What I initially suspected to be irritable bowel syndrome turned out to be colon cancer. I chose Mr. October’s case this month because it will give us an opportunity to discuss cancer
Cancer is the second leading cau