Q: I'm hoping you can ease my mind somehow. Last year, my father was diagnosed with colon cancer. He had surgery. Recently, they found a spot that's inoperable on his liver, and they've changed the dose of his chemo to try anddissolve this spot.

Ever since his surgery last year, my father has been in horrible pain, which is located in the colon area. However, the CT scan shows nothing in the colon area as far as tumors. I tried calling my father's doctors to voice my worries and concern, but none of them will talk to me. I cry and stay awake at night, because I'm so worried I'm going to lose my father. I'm also concerned the doctors may have made a mistake during surgery and cut nerves that weren't supposed to be cut.

I've never seen my father in so much pain in my life; it hurts us all to see him this way. Please let me know what you think my father should do, and if there's any support for me locally here. Thank you so much for your time. — Karen

A: I am also very concerned about your father. In my opinion, no one deserves to be in pain — ever. I am also puzzled by the fact that you are unable to communicate with your father's doctors. The Patient Privacy Act (also known as HIPPA) requires that the doctor has the permission of the patient to speak with his or her family. As long as your dad has made it clear to his physicians that you need be kept informed, there is no reason why they should not be willing to talk to you. Yes, doctors are busy. Most of

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us will return calls only after patient hours, which is sometimes between 6 and 8 p.m. We will also ask to identify a spokesperson for the family if there is more than one person calling. Since you are not a "local" person (in your letter you indicated that your dad lives out of state), I wonder if doctors have already communicated with your mom or your siblings. If that is the case, you may have to go through them to get the information. At any rate here is what needs to happen:

First, talk with your dad. Find out who is the main doctor he deals with. It may actually be his cancer doctor rather than his internist. There needs to be, however, one physician in charge of your father's care.

Second, get well-informed about your father's cancer history. Has he received radiation? How much does he know about his prognosis? How comfortable does he feel with his doctors? Has he been insisting on the pain treatment? Sometimes doctors do not realize how bad someone's complaint really is, especially if the patient is rather "stoic" and not very forthcoming about it. If medications were tried to help with the pain, what were they and how long were they used?

Third, provided that you are chosen to be the family spokesperson, state your concerns clearly to your dad's doctor by calling, sending e-mail or a letter. Make sure that your dad informs the main doctor about your questions.

Finally, you may need help, as well. Your father is fighting a tough battle. He will need you by his side — strong and optimistic. I know how hard it is to be far away from your parents. There will always be things you may not know or find out about soon enough. Only by being well-informed, realistic about the future and constructive about your emotions will you be helpful to your dad. You need to be there as his advocate and voice of caring and love. Do whatever it takes to stay strong. Regular exercise, therapy, a short course of medication or talking with a trusted friend may all be helpful for you. My heart goes out to you both. Dr. Beata Skudlarska is a Bridgeport geriatrician. Send questions to Bridgeport Hospital Center for Geriatrics, 95 Armory Road, Stratford CT 06614 or geriatricmd@aol.com.