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Dr. Rick, MD
Dr. Rick, MD, Board Certified MD
Category: Oncology
Satisfied Customers: 10792
Experience:  20+ years as a doctor. Internal Medicine Internship in NYC
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Dear Dr., I had a pelvic exam on Tuesday with my surgeon at

Customer Question

Dear Dr. David, I had a pelvic exam on Tuesday with my surgeon at the Seattle Cancer Care Alliance. She confirmed what I suspected. The fistula has reopened. Because I have only just stopped the Avastin four weeks ago, she advised that we could do nothing
invasive or surgical until the body had a chance to recover from the drug a bit more. So, evidently, she feels that I can wait the extra four weeks, do what I have been doing to help get through the discomfort and to minimize the risks of infections, etc.
and make a decision when I see her again on September 28th. In the meantime, she advised keeping the area clean and dry as much as possible, taking warm baths throughout the day, using a hairdryer after each bath to dry the area. She advised against creams
which trap moisture. She did tell me that Bag Balm may help to heal the abrasive areas, but that because the area is so moist and hard to stay dry, there is really very little to do to help it heal. She also said that the Avastin will slow the healing process,
so until it's out of my system longer, the area is very difficult to heal. She did advise pain meds to help me rest when the irritation becomes worse. As far as diet is concerned, it was her opinion that a less acidic diet may help as well. Do you have any
suggestions on that? I know that the vaginal area is acidic naturally, but food choices may exacerbate the burning. So, that's my update. I am open to any suggestions you have based on your experience about diet, etc. I am desperately trying to avoid sugars
of all kinds. Any suggestions as to the foods I should definitely avoid or suggestions on the alkaline foods which I should be eating to help the situation. I have to live as comfortably as possible for the next few weeks, so any suggestions you have will
be welcome. My doctor told me that the viable options will be TPN to allow the colon to rest, but the recurrence is always a possibility. She also said we can discuss a permanent colostomy. What is your opinion of those options? I am still a bit confused about
the Immodium/Lomotil. Is it better to keep the immodium on a regular basis to slow the motility or does that aggravate the fistula output? I'm taking about 6 caplets a day of immodium now. NO cramping, no pelvic pain, no other issues. Is diarrhea the enemy
of the fistula or is constipation a more aggravating issue. Thank you.
Submitted: 1 year ago.
Category: Oncology
Expert:  Dr. Rick, MD replied 1 year ago.

Hi. My name is***** and I am online and available to help you today. Thank you for your patience.

Question and answer is just one of the services I offer. I can also provide you with additional services, such as live telephone or skype consultation, at a small additional cost. Let me know if you are interested.

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This is not an answer, but an Information Request. I need this information to answer your question. Please reply, so I can answer your question. I look forward to helping you.

Customer: replied 1 year ago.
My question was for Dr. David, as a follow up. According to your profile, your speciality is not appropriate.