DON’T IGNORE THESE SIGNS AND SYPMTPOMS – Part II
If you are diagnosed with a serious disease, the first question that pops into your mind is, “Can this be cured?” Well, the efforts for a cure will have to start with you. The three major barriers for failure of early diagnosis are:
1. Ignorance or unawareness of the importance of a presenting sign, like a black mole that was ignored turning out to be a malignant melanoma, a serious skin cancer that needs early, extensive surgery.
2. Procrastination, as in the case of a woman with significant back pain; she had postponed a doctor visit because of prior personal commitments, but was later diagnosed with metastatic cancer of the spine.
3. Miscellaneous excuses like worry about expenses, inconveniencing others or delay in getting an appointment.
Regardless, one needs to give urgent attention to certain clinical symptoms and signs, the so-called red flags, such as:
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Gastro Intestinal symptoms such as diarrhea with abdominal cramps or any form of GI bleeding - vomiting of blood or bloody (tarry) stools. Untreated peptic ulcer, a whole host of colonic diseases like polyps, cancer, diverticulitis and such can cause these symptoms. Any rectal bleeding should be considered serious.
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Headache: Occasional headaches, especially brought on by stress, alleviated with Tylenol or aspirin, may not be of much concern. But severe, unresolving headaches, with descriptions like, “It started like a thunderclap!” or “The worst headache of my life!” or “My vision suddenly blurred” – portend serious lesions in the brain, especially an aneurysm with or without bleeding or cancer. A small percentage of us could be walking around with an asymptomatic “congenital brain aneurysm or congenital arterio-venous malformation” that can rupture at any time and would need immediate intervention by a neurosurgical team.
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Unexplained weight loss: Day-to-day fluctuations of 1-2 pounds in your body weight are common, but if you lose more than 5 percent of your weight unintentionally, notify your doctor immediately. Weight loss may be the first symptom of diabetes mellitus, some type of cancer or hyperthyroidism.
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Sudden confusional state or personality changes: A recent report in a newspaper said that an elderly man took his car out to go some place but couldn’t get back to his house because he couldn’t remember the directions or the address of his own house. The police tracked down his relatives and got him back to his residence safely. Well, it turned out to be the first sign of Alzheimer’s disease. Such symptoms could also be related to tumors in the brain, stroke, low blood sugar, especially in diabetics on insulin, low blood pressure, etc.
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Loss of consciousness: Even momentary loss of consciousness is a reason for great concern. Fainting in association with chest pain could be from a heart attack, but feeling dizzy or actual fainting could be the presenting symptom of strokes and mini strokes. In older individuals, slow heart rate such as that occurs with heart block, ‘Sick Sinus Syndrome’ (slow and fast heart rates), etc. could be another cause that needs prompt attention.
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High fever or persistent low grade fever: Any fever over 103 degree F has to be looked into promptly as it may be due to serious infections like pneumonia, urinary tract infections, abscesses, etc. Persistent low grade fever can signal ‘endocarditis,’ particularly in those suffering from a valvular heart disease. Some form of cancers like lymphoma and leukemia can present this way too.
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Persistent cough in high-risk individuals such as smokers is a red flag due to the high incidence of lung cancer in them.
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Female issues, particularly vaginal spotting of blood in postmenopausal women could be a harbinger of uterine or cervical malignancy. Breast self-examinations and routine mammograms will lead to early detection and treatment of breast cancer.
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Pediatric illnesses: Look for different presentations in children. High fever with irritability, lethargy and vomiting in infants may signify septicemia, meningitis or encephalitis with dire consequences if not treated expeditiously. Seizures also need to be investigated and treated without delay. Projectile vomiting in early infancy, especially in a male baby, may signify ‘pyloric stenosis’ (tightening of the outlet of the stomach) that calls for surgical treatment.
The health problems which can be handled with patient awareness, early detection and prompt treatment are too numerous to count. In the final analysis, we should all be aware that many serious diseases are curable with several sensitive screening tests available for prompt diagnosis. But everyone should make an effort to visit the doctor on time; physicians can help out by educating their patients and cutting down on the wait time for an office appointment.
This concludes our miniseries.
M.P. Ravindra Nathan, M.D., is a cardiologist and Emeritus Editor of AAPI Journal. His book “Stories from My Heart” was recently released. (www.amazon.com or www.bn.com).
