Roach: Elder hospitalized due to hypercalcemia

In a “Dear Dr. Roach” column, the doctor explains that hypercalcemia simply means a high calcium level and that many causes exist, including some cancers. A reported calcium level of 14 mg/dL is described as very high, but Roach notes that extensive testing with normal results afterward makes a serious cause unlikely. He suggests primary hyperparathyroidism should typically be among early tests, and he suspects pseudohypercalcemia—an apparently high reading caused by abnormal calcium binding to proteins. He cites examples such as abnormal albumin from dehydration or abnormal immunoglobulins in multiple myeloma, and mentions confirming with ionized calcium. In a second question, Roach says pseudomonas is difficult to treat and that ciprofloxacin is generally the only reliable oral option.