DEAR DR. GOTT: Please explain something for me in terms that I can understand. I have just been diagnosed with renal obstruction. The doctor did not explain to me what causes it, what treatment is necessary — nothing! His nurse said I must have surgery immediately. Needless to say, I am quite upset and would like your opinion ASAP.
    DEAR READER: Renal obstruction is a medical term for any disorder that is marked by blockage of the ureter (the tube that drains urine from each kidney to the bladder). This can be the consequence of a stone, a kink in the tube, a growth, an infection or an injury. The obstruction can be serious because if it is not corrected, over time the urine will build up in the affected kidney, which will then cease functioning.
    Frankly, I am shocked that you were left hanging when what you most needed was more information. While it is possible that immediate surgery is indicated, less drastic therapy, such as sound-wave lithotripsy (to break up stones) is noninvasive and might be appropriate.
    I advise you to be a bit obnoxious. Insist on a meeting with the physician without delay, and if he continues to put you off, tell him you do not wish to change doctors, but if he does not see you to explain the situation completely and answer all your questions, he will be hearing from your lawyer.
    I admit that this approach may be somewhat drastic and is not the way I characteristically deal with my colleagues' misbehavior. However, this situation is so obviously unnecessarily hurtful to you that an aggressive solution seems appropriate.
    Give me a follow-up.

    DEAR DR. GOTT: We have a situation that troubles us. Our son and his wife are raising our granddaughter, now 20 months old, in a fine fashion, except they refuse to have her inoculated. Period. They seem to be basing their decision on information from an outfit called the National Vaccine Information Center.
    We are worried that this lack of protection for her may be troubling or even disastrous in the long run. As a point aside, it would seem that if nobody got vaccinated, then we would regress centuries back in health care and in quality and length of life.
    DEAR READER: I agree. Children need vaccinations, despite the reality that some youngsters have unpleasant side effects from them. I believe that the benefits far outweigh the risks. I encourage your son and daughter-in-law to rethink their objections and discuss this situation with your granddaughter's pediatrician.