lung discussion with Dr. Shukla

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We met with:

Dr. Shukla
320 superior #240
newport beach, ca
949 548-5111

Talking points: what is mass found on left lung?

Here's the results of our conversations:
Had any lung problems before? May have had pneumonia when young? Has quite a few sinus problems, especially when surfing. Had some allergies previously, but not really bothersome too much now. Currently has a little bit of phlegm, but not too dramatic.
Eye problems? Recently has had some eye problems focusing on small print, but am also now 43 :)
Any joint problems? Have had trouble in left hip and general stretching problems and recent right knee pain.
Any fevers? Did have 101 on 10/6/05
Dr. Shukla showed us the questionable mass in the lung on the scan. He said that it doesn't look like cancer, because it branches out like it is an infection. It has lots of squigglies which is not cancer-like but could be a fungus infection (i.e. valley fever), parasite or some other kind of infection. A PET scan (functional scan that shows up tumors) needs to be done with CT and fusion, if it is positive and verifies that the tumor is there, we need to biopsy, if negative and we don't still see it in the scan,we won't need to biopsy and would just need follow-up (up to 2 years) to make sure it is not growing. Chance of it being bad news is quite small. Looks benign. Possibly something left over from a previous infection/cold. The pulminologist said that there is so much activity in the brain that it is difficult to see specifc tumors in the brain with a full body scan. There are other PET scans specifically for the brain. He said that the brain tumor may or may not show up in the full body scan. Since it is fairly small, it may not show up.
During our visit, we called Dr. Kim and asked if brain thing could possibly be a parasite. Dr. Kim said that it is possible that it could be a worm/parasite in the brain!
Dr. Shukla also told him that physiologically, the lung thing would not be a problem to operate on brain; however, we definitely need to find out the cause of the lung lesion so we can possibly know more about what could be in the brain.


Questions:

What is involved in a biopsy? If we did need to do a biopsy, it would be easy to do based on spot and would be an in/out procedure using a small needle under local anesthesia.

If it is a parasite, are there any nutritional ways to fight it? No, you would need an anti-parasitic drug

What is involved in the PET scan? You must first call insurance, to get pre-approval because it is a $5000 test.
It is an out-patient test.
It is a full body scan, which is good to see if there is anything else
During the test, we will also take cat scan again so we can see if there is any improvement of what was found in the lung previously, which is possible that it could go away.

Whats next?
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get blood test results from 11/1/05 to see if there are any signs of infection, I will also call and ask them to test the blood sample for valley fever
get pre-approval for PET scan
schedule PET scan as soon as possible
11/10/05 tentative meeting with Dr. Shukla to review PET scan @ 5:15pm (may schedule earlier, depends on when we can get PET scan)