Doctor's visit...

I dropped in on Dad before going to work this morning. His sitter was there in the room watching him. No bruising that I could see, however that usually shows up a few days later. While I was there, and this is at 7:00am, the reumatoid specialist comes in. Mom's met him before but I haven't. He asks if I'm his son to which I reply yes. He then asks if Dad's any better than last week. I reply "no, he's basically the same from when he arrived". The doctor says he'd like to speak with the neurologist and perhaps give Dad some medication. I reply to the doctor that if he wants to give Dad some medication then it indicates that they must have some idea of what's the cause. The doctor didn't want to say without consulting the neurologist. He did mention that he wanted to up the dosage of Prednisone. This usually has grave side effects:

"Patients with true GACNS, proven by biopsy, invariably require aggressive therapy with drugs such as high doses of glucocorticoids (a cortisone-like drug such as Prednisone) and a second drug known as cyclophosphamide. These drugs are generally administered for six to twelve months and require meticulous follow-up to assess benefit and avoid side effects.

Possible side effects of high doses of glucocorticoids include abnormalities of blood sugar, blood pressure, weight gain, thinning of the bones, and increased risk of infections.

Cyclosphosphamide also has formidable toxicities including lowering of the white blood cells making individuals more prone to infections, bleeding from the bladder and even bladder cancer. Patients who take cyclophosphamide for more prolonged periods of time have a higher incidence of certain forms of cancer later in life."

This is not to be taken lightly. Dad will either start recovery due to these high dosages or die due to the high dosages.

When the doctor comes to see the patient at 7:00am in the morning, does the doctor really expect a family member to be there?