Is that just a tension headache or does it signal a brain tumor? Is that low backache caused by poor posture or dos it indicate a fibroid in the uterus? Mild symptoms, which most of us treat dismissively: often they may conceal serious disease. And patients are not the only ones who may be fooled by these great deceivers, says a man of medicines.
A patient came to a doctor complaining of pain in the abdomen since some hours. The doctor, after a cursory examination, told the man not to worry. “It’s only dysentery,” he said. And prescribed three different kinds of pills, to be taken two or three times a day. The pain did not go away and another doctor was called in after a couple of hours. The second doctor did a careful examination and found that the patient had all the signs of peritonitis or inflammation of the membrane surroundings the abdominal organs due o a burst intestine. This was a serious medical emergency and required immediate hospitalization and surgery. In the interim, it was important that the patient not have anything orally, not even a drop of water yet the first doctor had told the patient that there was nothing to worry about and had prescribed so many pills!
The above incident is just one instance of how a patient may experience ‘minor complaints’ which are often ignored or dismissed, not only by himself but by his doctor too, only to realize later, to their combined chagrin that the complaints were an indication of a serious disorder. Nature has favored us with some early warning signals, in the form of symptoms which precede a virulent ailment. Often there may be only one signal, and it may be as innocuous as backache or dizziness.
A 40 year old woman with a previous history of neurosis went to her doctor and said she was experiencing irregular menstrual bleeding, as well as bleeding after intercourse. The doctor thought she was exaggerating her minor complaints in order to draw attention to herself. He told her not to worry and prescribed some tablets to regularize her menstruation. The woman’s problem didn’t go away. In the end she went to a specialist who examined her carefully and found that she was suffering from cancer of the uterine cervix,
Listed below are some complaints that may seem non-alarming in them, but may actually mask a more serious ailment. This does not mean, of course, that if you have any of these complaints you’re bound to be having some virulent disorder. The purpose of this listing is only to underline the need for awareness, so that you don’t ignore or neglect persistent or ominous symptoms. If they are found, upon thorough examination, to be actually innocuous, it will be good for you. If they are, on the other hand, harbingers of other, more virulent disorders, the sooner the ailment is diagnosed and treated, the better for you.
This could be manifestation of:
- A brain tumor
- A chronic sub-dural haematoma
- Brain Hemorrhage.
A Brain tumor may present with a headache only. And the nature of this headache is ‘bursting’ or ‘aching’. It is felt on both sides of the head. One important characteristic of this headache is that it is felt most prominently in the morning and may peter out after an hour or two. It is aggravated by coughing, sneezing or moving the head. However, you can take heart from the fact that a brain tumor presenting only as a headache is extremely rare. It is only when the tumor becomes large, or if it obstructs the movement of the cerebrospinal fluid inside the brain, that the headache starts.
A sub-dural haematoma: Sometimes, several days, weeks, months r even years after a head injury, the victim can develop large haematomas (collection of blood) under the sheath that cover the brain (dura). A haematoma may progressively increase in size, causing a headache. So any patient who has had a head injury should be investigated properly by a doctor if he starts complaining about a headache which is intermittent in nature. The patient may also experience mental confusion, drowsiness and apathy, along with the headache. And all the symptoms (including the headache) may disappear for some time (with the patient becoming completely normal) and then recur. This will go on until the patient is investigated and treated surgically to remove the haematoma.
A brain hemorrhage may occur due to the bursting of an arterial sac inside the brain. The pain of the headache is felt like a violent blow to the back of the head. The patient may also lose consciousness.
Haziness Of Vision
When accompanied by discomfort in the eyeball and halos perceived around lights, haziness of vision could be a sign of impending glaucoma or increased pressure inside the eyeball. If this is followed by sudden, severe pain and redness of the eye, it is an indication that full-blown glaucoma has developed which needs immediate medical attention.
Haziness of vision could also be a sigh of brain tumor and may be one of its earliest manifestations.
This again could also be an early symptom of brain tumor, eg. An acoustic neuroma or cerebellar tumor. The giddiness is in the form of mild, intermittent vertigo that last several weeks to months.
Other deceptively mild pointers to the possibility of a brain tumor include (a) Muscle weakness (b) Double vision.
Personality changes, including irritability, dullness and abnormal behavior: quite often persons with such symptoms are wrongly diagnosed as cases of psychosis. But if such symptoms appear suddenly in old age, it is an almost sure fire sign that the patient has a brain growth or some other organic disorder of the brain.
A Nose Bleed
This could be a harmless origin, such as a reaction to a sudden change in altitude, or it could mean that the person is suffering from purpura – a serious bleeding disorder. Persistent attacks of nose bleeding should therefore be investigated for other possibilities (including, also, hypertension).
Pain In The Shoulder
Some patient of gall bladder colic present only with pain over referred pain, because the pain originates in one place but it referred elsewhere. Any inflammatory lesion near the diaphragm is felt in the shoulder. The left shoulder pain may isolate in the heart attack.
Blood In The Phlegm
Blood in the phlegm may be the only initial symptom in Pulmonary Tuberculosis or in Bronchogenic Carcinoma (a cancerous condition). It may sometimes be accompanied by coughing or breathlessness.
Blood From The Stomach
The blood is dark colored, coffee ground, in contract to the blood from the lungs which is bright red. Bleeding from the mouth may occur in case of carcinoma of the stomach. It may be mistaken for bleeding from the gums.
This could be due to simple emotional stress or it could be a heart attack. It need not be severe to be a heart attack, and if you are in the high risk group i.e above 40, obese, sedentary, aggressive and hot tempered (type A personality), and eat high fat, high cholesterol diet, even a mild attack of chest pain should be reported to a doctor and an ECG done.
Apart from the pain in the chest, heart attack pain may be felt in the jaw, in the upper abdomen or only in the left arm. It may be aggravated by exercise or after a meal and relieved by rest, especially if the pain is due to angina.
Chest pain could also be a sign of pleurisy of the lungs, which also reckon as tubercular in origin. In this condition, the pain increases on deep breathing or coughing. Chest pain also occurs in pneumonia.
Pain In The Abdomen
A peptic ulcer or a stomach cancer may be felt right in the middle of the upper abdomen. This pain is usually relieved by taking meals or by vomiting. Sometimes there may even be no pain at all, only a slight discomfort. The pain or discomfort may be felt also in corresponding area of the back. An endoscope examination can confirm the diagnosis.
Pain in the lower abdomen could signal appendicitis if it is felt initially around the umbilicus (the naval area) and then shifts to the right lower abdomen. Vomiting and fever accompany the pain. The pain of kidney and ureter stones is sometimes from back to front, with radiation of the pain to the groin, a burning sensation while urination or vomiting.
Intestinal obstruction, which could be a surgical emergency, may manifest as pain in the abdomen, with vomiting and constipation. Tumors or inflammation of the ovaries or fallopian tubes, as also tuberculosis, may also cause pain in the lower abdomen and no other symptoms and this pain may be mistaken for something as innocent as dysentery cramps.
The pain that accompanies perforation of the intestines and peritonitis is felt all over the abdomen, which becomes tight and rigid. Immediate surgical intervention is required.
Localized lower backache should be a symptom of cancer usually as a resold of secondary spends from a malignancy of the lung, breast or stomach and in me also of the prostate gland.
Sometimes, a fibroid of the uterus may present only as backache. A large fibroid filling the pelvis may cause pressure symptoms. IF the pressure is on the rectum, backache and constipation may result. If it presses upon the bladder, the presenting symptoms may be frequency of urination and discomfort in the lower abdomen.
Backache may also be caused by a tumor such as a simple neurofibroma of the spinal cord.
Often a patient of depression may also complain only of backache and a course of anti depressants generally cures the pain.
Irregular bleeding may be a sign of malignancy of the uterus or cervix. Vaginal bleeding needs to be even more carefully investigated if it occurs after menopause. In cervical carcinoma there is bleeding after intercourse, along with a pink discharge. All these symptoms may be mistaken for minor menstrual irregularity. Pain is a late manifestation in both kinds of malignancies.
Bleeding From The Anus
This may not be ‘just a touch of piles’; it could mean cancer of the colon or ulcerative colitis.
Faulty nutrition or an indolent lifestyle can result in constipation but this symptom could also be due to malignancy of the intestines (especially if it alternates with diarrhea); or it could signal intestinal obstruction which as mentioned, could be an emergency requiring urgent surgery.
A feeling of listlessness, early exhaustion and weight loss could be simple anemia or the beginning of leukemia. In chronic myeloid leukemia, in addition to these symptoms there could be hemorrhages from various parts of the body.
This could be result of poor dental hygiene or it may signify a lung abscess or sinusitis.
Sometimes an astute physician can diagnose cancer of the uterine cervix from the fishy odor surrounding many a patients of this condition.
- Spider shaped reddish streaks over the abdomen in a man indicate serious liver disease or malnutrition.
- A change in a mole, specially a non hairy one, could be a sigh of skin cancer.
- Alopecia (bald patches on the head) is often a manifestation of syphilis
- Itching of the anal or vaginal areas may be a factor of diabetes thread worms or virginities.
- Bluish discoloration of the lips or mouth indicates cyanosis or oxygen deficiency in the blood due to congenital heart disease or respiratory illnesses.
- Swelling over the face cold mean myxoedema, or thyroid deficiency. The swelling, which is more marked in the area around the eyes, is due to fluid deposition. Facial swelling can sometimes also indicate vitamin deficiencies or anemia.
- On the other hand, bulging of the eyeballs, excessive sweating and hand tremors point to the possibility of an overactive thyroid.
- Swelling of the feet (edema) may often be one of the first signs in serious heart or kidney disease, or in malignancies of the pelvis. It is also seen in severe anemia and hypoproteinaemia.
- Discoloration of the eyes/urine may be the case of severe hepatitis, or evening malignancy of the liver, one of the first signs is a yellowish discoloration of the eyes and deep yellow urine.
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