Garth Rattray | Don’t just ‘watch’ your health problems

Someone that I know is diabetic … it even landed him in the hospital several years ago. He recently stepped on a rusty nail. It penetrated his footwear and went into the sole of his foot. He ‘watched it’ for two weeks. His foot became swollen, painful, and black. It was almost amputated. If he had acted by seeing a doctor as soon as he stepped on the nail, the threat to his foot would have been eliminated. He should have exercised a lot more caution, especially because he is a diabetic. He was very lucky.

Unfortunately, many patients choose to watch their health problems, sometimes to their detriment. For example, many people tend to watch a cough; however, any cough that goes on for more than three weeks is a chronic cough. That person needs to see a doctor. Many people think that ‘chronic’ means ‘bad’. But chronic is derived from the Greek word for time, ‘ chronos’.

Chronic means that something has been going on for a long time. A chronic cough needs to be investigated. Although it may be due to post-nasal drainage, it can also be due to gastro-oesophageal reflux, inhaling irritants, mould, reaction to a medication, asthma, chronic obstructive pulmonary disease, a chronic infection, or even lung cancer.

I cannot count the number of times that patients tell me that they were ‘watching’ a medical problem. Sometimes the thing that they were watching is alarming. Some watch bleeding from the rectum for weeks or months! It is true that rectal bleeding may be caused by haemorrhoids (piles), but it can also be caused by an inflammatory condition of the colon, polyps, diverticulosis, or a cancer.

Sometimes people tell me that they were watching a headache for months. Some say that it is because they are hypertensive and that their blood pressure is elevated. However, contrary to popular belief, an elevated blood pressure is not a common cause of headaches. Hypertension is also called the ‘silent killer’ for good reason; it is extremely sneaky. It gives no hint of its presence unless and until it is extremely high or chronically elevated and causes damage somewhere.

SELF-DIAGNOSE

Some patients self-diagnose their headaches as migraine headaches or sometimes as sinus headaches. However, before such diagnoses are made, people should see a physician and [probably] be investigated. There are many reasons that people get headaches. Some of them are fatigue, the carbon dioxide headache caused by sleep disordered breathing, medications, pinched nerves in the neck, tight muscles, eye problems, dental problems, toxins, chemical exposure, sinusitis, very severe hypertension, stress, increased pressure inside the head, and tumours, among other causes.

Some pains should not be watched. I had a patient who accompanied her husband when he was seeing me. I noticed that she stood up and rubbed her belly as she paced behind him. When I asked what was up, she explained that she had gas pains and that it had been going on for a while. Of course, red flags went up inside my head, and I asked her to do a CT scan. The report came back that she had a large colonic mass that had spread to her lymph nodes and abdominal wall.

Which brings me to the topic of gas pains. Gas can only occupy the bowel. It cannot cause pain in the head, chest, or limbs. If gas is temporarily trapped inside the bowel, it cannot compress the gas. Instead, the presence of gas puts pressure on the walls of the bowel and results in spasms, which cause pain (gripes, colic). But this pain is always somewhere in the abdomen. Everybody experiences gripes occasionally, but if they are frequent or persistent, it needs to be checked out.

GAS IS TRAPPED

Some folks explain that when they massage a painful area on their back or limbs, for example, they burp. This is why it is believed that gas is trapped where they massaged. But that belch is not from the stomach. It is from the oesophagus (gullet) and is caused by the person swallowing air, often subconsciously. That is called aerophagia.

People also have a habit of ‘watching’ weight loss even when they are making no effort to lose weight. Weight loss may be a sign of something serious. Diabetes, thyroid problems, depression, eating disorders, problems of the gastrointestinal tract, chronic lung problems, central nervous system disorders, AIDS, chronic infections, and cancers can cause weight loss. Because most of them are amenable to treatment, especially if caught early, do not simply watch weight loss, get it checked out ASAP.

Men believe in the inevitability of urinary problems due to prostatic enlargement with age. They should not assume anything and end up condemning themselves to a life of extreme discomfort and inconveniences. Aside from the established prostate cancer screening, beginning at the age of 40 for most men, any symptom of urinary problems must be explored and treated. Nowadays, there are medications to relieve the symptoms of an enlarged prostate and treatments to shrink the gland to some extent … if begun early.

People also tend to ‘watch’ and downplay mental-health maladies. They find all kinds of excuses and explanations for them. It is particularly dangerous to ignore symptoms of depression as they could lead to suicide. Nobody, including medical doctors and nurses, likes going to the doctor. But if people stopped ‘watching’ their health problems until they become serious, we would have a far healthier society.

Garth A. Rattray is a medical doctor with a family practice. Send feedback to columns@gleanerjm.com and garthrattray@gmail.com.