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Six Critical Symptoms Patients Overlook by Judith Newman
It was silly, really. Just a bit of gum bleeding--well, a lot. But didn't most people's gums bleed sometimes? Keitha Clements, 42, was not the kind of willing to worry over every little thing or it a mother of 5 and restaurant manager in the tiny lumber town of Scotia, California, Clements was a busy woman. In the winter of 1994 -- 95 she'd been nursing a nasty cold and the bladder infection, and had been unusually tired. But she charted up to a tough winter. A doctor prescribe medication for the infection, and she felt better. Sort of.
But a few weeks the gum pain and bleeding were even worse. Clements knew she had impacted wisdom teeth. Maybe that was the problem? So she went to an oral surgeon, to remove the teeth. Suspecting a problem, he took a gum biopsy and set her to a doctor for additional blood tests. The doctor called the next day. "I want you to see a specialist, "he said. "Today!" The tests showed that Clements had acute myeloid leukemia, the most deadly form of the disease. Some people run to the doctor every time they get a little head cold, the more common for those who noticed that ignore symptoms out of ignorance, embarrassment or fear. Bleeding gums that signal leukemia may be rare, but other signs are not so unusual, and people tend to dismiss them. Here are important ones to look out for:
Pains in the Chest "It'll go away" can be the most dangerous words of patients vocabulary. The national center for health statistics reports that heart disease is responsible for some 725,000 deaths annually in United States -- more than all forms of cancer combined. Yet a 2000 study of people age 65 and over published in the journal of the American College of cardiology found that one in five attacks had gone undiagnosed. "People often think they have indigestion, particularly if symptoms, come on during exercise," says Monika Safford, an internist at New Jersey medical school. Heart attack symptoms are often described as uncomfortable pressure, fullness, squeezing or pain in the chest, which sometimes radiates to the job, neck, back or arms. It may also be accompanied by shortness of breath, sweating or nausea. you may think the pain is minor, and often it is, but you shouldn't take chances -- especially if you are overweight, have high blood pressure, high cholesterol for diabetes. The time to act is when you first feel it, Safford says. If your symptoms last longer than just a few minutes, do not wait to contact your doctor, the call 911 immediately for an ambulance. Don't try to drive yourself to the hospital or it.
Sexual Dysfunction In a rush to complete a physical exam, questions about sex can easily be missed. Doctors observe that patients are often reluctant to discuss sexual difficulties -- even though there are common side effect of widely prescribed drugs like antidepressants and blood pressure medication. "There are many medical conditions that can show themselves as decreased libido," says Dr. Steven Weinreb, and internist at Hartford Hospital in Hartford, Connecticut. "Lack of libido Indian or women and difficulty with erection in men can be an early sign of diabetes, thyroid problems, depression or tumors." In fact, recent studies show that one of the best early predictors of heart disease may be erectile dysfunction.
Changes in Sleep Habits Many people figure insomnia or sleeping too much are just liabilities of a busy life. But a change in sleep habits may be assigned of an underlying psychiatric issue, says Rosemarie Conigliaro, an internist at the University of Pittsburgh Medical Center. According to the National Institute of Mental Health, some 19 million adults suffer from depressive illness. Yet as many as two-thirds don't receive treatment. Depression can be a self cloaking disease, leading to passivity and denial, yet it has serious consequences-- family and career disruptions, alcohol and substance abuse, heart disease and even suicide. "I always ask about sleep, because even a patient who wouldn't admit being depressed sees sleep as in April issue," says Conigliaro. "I find out about a lot of depression and anxiety this way." Problems sleeping can be due to things as simple as stress, alcohol or too much caffeine, that can also be a sign of disease. Certain sleep problems may signal a breathing disorder, kidney disease for diabetes. A surprising sleep-related sign of trouble is the need for extra fellows. People who must elevate their heads the sleep may have heart disease. Raising the head allows blood pool in the feet, taking strain off the heart.
Drug Reactions Headaches, knowledge and, dizziness, rashes, trouble breathing -- the symptoms can be indicators of a variety of diseases. The people sometimes overlooked the obvious: they can also be reactions to medication. In April 1998 study in the journal of the American Medical Association estimated that some 43,000 Americans were hospitalized and died from adverse reactions and over-the-counter drugs in 1994 alone. If you have recently started a new medicine and are experiencing symptoms, call your doctor and described them. And when you visit your doctor, bring a list of all the drugs and herbal remedies you're taking.
Changes in Bowel Habits "It's not so much the nature of the habit-- some people have any bowel movement once a day, some more, some less, which may all be perfectly normal," says internist Conigliaro. "It's a change in habits that could be important. A change is one of the warning signs of colon cancer, as is leading the stool and stomach pain." Changes in bowel habits are sometimes associated with certain psychiatric disturbances such as depression and anxiety disorders. "A patient I saw had a lot of gastrointestinal symptoms -- diarrhea, abdominal pain," says Eileen Reynolds, an internist at Beth Israel Deaconess medical Center in Boston. "The symptoms were consistent with irritable bowel syndrome-- and that can correlate with psychiatric disease."
Changes in Skin Another patient came into Reynolds office worried about a lump on his leg. It turned out to be a cyst. But the patient had had melanoma before, so she wanted to check him further. "He was reluctant to take his close off," Reynolds remembers. "Luckily, I convinced him." Reynolds found a brown flaky growth with uneven borders on the shoulder, which he had seen it not recognized as problematic. So she did a biopsy. Skin cancer is the most common of all cancers, and melanoma accounts for only about 4 percent of all cases, but about 80 percent of skin cancer deaths. And the incidence of new melanoma is diagnosed yearly between 1973 and 1997 has more than doubled. Melanoma is often curable in its early stages -- but it must be caught before it spreads to other parts of the body. Fortunately, the Cancer Reynolds spotted turned out to be less dangerous that melanoma. The point, she says, is to check yourself regularly and tell your doctor of any suspicious growths or changes in moles or freckles. And, because you're not an expert, once a year ask the doctor to do a complete skin exam.
Summary Embarrassment for fear can be as bigger problem as ignorance of symptoms. Fear of doctors or fear of knowing the truth keeps many from getting the treatment they need. Doctors see this year in many ways. They even have a name for it. "We call it hand on the doorknob reflex," says Beth Israel's Reynolds. "It's when the patient is heading out the door and says, "oh, one more thing..."" That one more thing often turns out to be a crucial symptom. Why is this pattern so common? "Patients exhibit that reflex out of anxiety, nervousness and fear of the symptom really means," says Mark Graff, a psychiatrist at Kaiser Permanente in Reseda CA. Patients frequently develop their own theories, but usually their worst fears are not realized. Besides, says Graff, "many illnesses are much more treatable than they were even a decade ago." And the earlier the treatment, the more likely a successful outcome. Speak up the visit the doctor. Don't be rushed for distracted. "We live in the realities of managed care," says Reynolds. The average time a doctor and patient spent together is 23.4 minutes, according to the national center for health statistics. "So make a list of everything you need to discuss with us," Reynolds adds, "and put your most important concerns at the top." Doctors agree that no symptom is too insignificant to mention. "The bias of our society is to downplay medical problems," says New Jersey medical schools Safford. "But with symptoms, you don't have the judgment to decide what's important and what's not." This doesn't mean that you get one nosebleed and assume you got the Ebola virus. It does mean that if your noting changes in your body over the course of a few weeks, don't wait until it's time for your physical to get the symptoms investigated.
Getting a harmless symptom like bleeding gums checked out saved Keitha Clements life. Six years in one bone marrow transplant later, she is among the 20 to 30 percent of adults with acute leukemia have experienced long-term remission. Clements is deeply grateful she had a doctor he didn't treat her symptoms as lightly she did. "I'm still not a big worrier," Clements says, "but now I don't ignore what's right in front of my face." reprinted from Readers Digest, June 2001.
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This site courtesy of: Dennis Wiltfong, RN, BSN, CNOR, CRNFA Mercy Health Center |
