Life happens. Things get hectic, the to-do list gets longer, and it gets hard to dole out attention to competing priorities. But when your body talks, you should listen. Lingering colds and recurring headaches might be more than inconveniences. They don’t always go away by themselves, and just because you’ve been to the doctor this year doesn’t mean you’ve got a clean bill of health.[pullquote]“Loss of appetite is a subtle thing, but especially if it’s associated with weight loss, it could mean that something’s going on,”[/pullquote]
“Several studies show that annual exams don’t affect mortality. You can get an annual exam, but if you don’t have any symptoms, there’s really no reason to do it,” says Dr. Laurence Altshuler, director of oncology intake at Tulsa’s Cancer Treatment Centers of America. “It’s not going to help you live longer. It’s up to patients themselves. If they’ve got symptoms, that’s when they need to go in and see the doctor.”
Sometimes there are not signs of illness. However, if we are in tune with our body, we may be able to pick up on symptoms indicating something’s amiss.
We’ve all experienced tummy troubles. Whether it is gas, bloating, diarrhea or heartburn, digestive symptoms are often temporary and will pass. However, it is important to pay attention when issues affecting the digestive system persist.
“Loss of appetite is a subtle thing, but especially if it’s associated with weight loss, it could mean that something’s going on,” says Dr. Frank Hamilton, a family medicine physician at St. John Health System. “I think that another thing would be change in bowel habits. If a person has regular bowel movements, then [develops] constipation or a change in the bowel movement size, that’s a sign that something else is going on.”
Changes in stool color and consistency can also indicate a problem, Hamilton says.
“If a person’s stool turned very dark, that can be a sign that there’s blood loss in the upper part of the GI tract,” he says. “[Stools] almost look black or tarry. A person might notice, but they may not feel all that bad.”
It turns out that this is a somewhat common problem. Hamilton says that black, tarry stools most often indicate gastritis or ulcers.
“Most people think that when you have ulcers, you have pain,” he says. “Some people do, but some don’t.”
Hamilton says that it isn’t always a patient that notices irregularities with his or her digestive system, either. Jaundice, a condition in which the skin takes on a yellow pigmentation, can point to digestive troubles. Though jaundice is often associated with infants or liver failure, Hamilton says that it could point to another problem.
“Others can notice jaundice,” he says. “[Patients’] eyes may start looking a bit yellow, but people look at them and think, ‘Gee your color is really funny.’ That’s a subtle, early finding that could be related to the GI tract.”
Hamilton says the real concern with jaundice is that it could point to pancreatic cancer. A growth could obstruct the bile duct, causing the jaundice.
“Gallstones and hepatitis are not uncommon, and jaundice can also be a marker of that,” he says.
Hamilton encourages everyone over the age of 50 to get screened for colon cancer in order to catch any problems as soon as possible. He also says that to keep the digestive tract in its best shape, drink plenty of fluids to prevent dehydration.
Altshuler says perk up your ears when you get respiratory infections. Your body may be telling you that you’ve got more than just a cold.
“I’ve had patients that say, ‘I had a respiratory infection, and the doctor said I had pneumonia and gave me antibiotics. It helped, but the infection never really cleared up.’ Eventually, they get another test and find out they have lung cancer. I’ve seen that quite often,” says Altshuler.
The problem occurs when patient-doctor communication breaks down. Patients may downplay their symptoms because they don’t want to be seen as complainers. They may also downplay symptoms or fail to disclose them when those symptoms do not impede on day-to-day activities.
Patients with colds, coughs and respiratory infections that don’t clear up with treatment need to tell their doctors. While they may be able to hack and get through the day, they may be on their way to a case of pneumonia that could shut them down for days or weeks.
A small improvement in a cold or cough that’s being aggressively treated isn’t enough. Schedule a follow-up appointment with the doctor soon, and dig into the details with the doctor, providing all the information the physician needs.
Patients should also explore treatment timeframes with their doctors. In most cases, dramatic improvements should be seen within days of starting medication. Very seldom should treatment duration be counted in weeks. When the doctor prescribes, ask how long it will take to see improvement. Start the treatment, and, when time’s up, see the doctor again if the symptoms haven’t disappeared.
Dr. Stephen Travis, an internist and pediatrician at the University of Oklahoma Health Science Center, warns that chest pain always deserves attention. Most of the time these pains are harmless, but he urges patients to err on the side of caution.
[pullquote]‘I’m getting older, and my chest hurts when I walk up a couple of flights of stairs.’ They think it’s a normal part of aging, and it’s not.[/pullquote]
“Most chest pain and discomfort is not from your heart,” he says. “At the same time, there can be disastrous effects if it is your heart and you ignore it. Essentially, if you’re over 40 and get chest pain, it needs to be addressed.”
Diabetics should be especially wary. About 25 percent of patients with diabetes don’t have the advantage of listening to their bodies. Cardiac nerve damage undermines the heart’s pain signals to the brain. In these cases, physicians look for reduced exercise tolerance, shortness of breath and other performance measures that might indicate coronary artery disease, which shows up in diabetics more often than in non-diabetic patients.
“I’ve seen people that thought chest pain was acid reflux or heartburn,” Travis says. “Sometimes people attribute it to aging. They say, ‘I’m getting older, and my chest hurts when I walk up a couple of flights of stairs.’ They think it’s a normal part of aging, and it’s not.”
Some patients, Travis says, are afraid of what chest pain might mean. They tell themselves that it’s temporary and will go away on its own, that no doctor is needed. Most of the time, they’re right. But that’s a call, especially if the pain persists, a doctor should make.
Swollen Lymph Nodes
Another symptom to check is swollen lymph nodes. Altshuler has seen his fair share of cancerous tumors that were initially mistaken for swollen lymph nodes. If lymph nodes grow larger over time or change in texture – from rubbery to rock hard or vice versa – it could be a sign of something serious. If the cause of swollen lymph nodes is an infection, a physician will prescribe antibiotics and schedule a follow-up appointment for two to three weeks down the road. If there’s no improvement within the first few days of taking antibiotics, the patient should see the doctor sooner.
“I recently had a patient that was put on antibiotics for a lump under his jaw. He saw some initial benefit during the first couple of days of taking antibiotics,” says Altshuler. “But after a week, he thought the lump had grown. Instead of going back to the doctor in three weeks, he insisted on coming back sooner. We biopsied the lump, and it was cancer. But he caught it at an early stage, and hopefully he’ll be cured.”
Skin cancer is on the rise, and the only way to get the drop on it is to know your moles.
“If you see a mole change, notice it growing or if it bleeds too easily – those are all kinds of things you should bring to the doctor right away, the earlier the better,” says Altshuler.
We may go through periods of fatigue in which we feel we can barely keep our eyes open, but what about the reverse?
“Sleep problems are really common,” says Hamilton. “In this case, we talk to people about sleep hygiene. It can be as simple as not drinking caffeine into the evening.
Hamilton points out that caffeine can affect the body for up to six hours. Drinking caffeine near bedtime can cause a person to not sleep well.
Partaking in a highly stimulating activity just before bedtime – like watching television, exercising, getting into an argument – may also cause sleep troubles. Hamilton recommends participating in activities that help you wind down before bed, such as reading a book or taking a bath.
And of course, high anxiety and stress levels can also prevent a person from sleeping.
“Anxiety or high stress levels regarding things that are going on in a person’s life, that’s going to effect their sleep,” says Hamilton, “as will depression. One of the hallmark signs is what we call early morning awakening, where a person sleeps and wakes up and can’t go back to sleep. That builds on itself.”
Hamilton says that if a person is struggling with mood issues and it’s causing sleep disruption, it’s time to see a physician. A sleep study can also shed light on sleep troubles as well and can help diagnose sleep apnea or other disorders.
“Typically, you think about sleep apnea associated with people that have excess weight,” says Hamilton, “but even those whose BMI or body weight is appropriate, they can have those problems. See a doctor, especially if they feel like they’re choking or not breathing, tired and sleepy in the daytime.”
Chronic fatigue occurs when the body is fighting illness or disease. Healthy humans don’t get that tired.
“We all get fatigued. We work hard. We’re tired at the end of the day,” says Altshuler. “But there’s a difference between regular fatigue and fatigue caused by a real problem. Most fatigue disappears with rest, and you go out and do the things you want to do. Fatigue from something that’s really a problem doesn’t get better with rest.”
Headaches speak volumes. The occasional headache is no big deal, but persistent headaches usually mean something else is going on. Throwing back Tylenol may take care of the pain, but the ultimate cause needs to be addressed.
“It’s actually pretty rare, but I have seen a couple of episodes where patients complain of the worst headaches of their lives. In the world of medicine, that can be associated with cerebral hemorrhaging or bleeding. But it’s not common,” says Travis.
Patients should worry about headaches when they’re severe, persistent and sudden, with no ramp-up and no history of severe headaches. Dangerous headaches are often accompanied by other symptoms, such as neck stiffness.
Pay attention to the character of the headaches. Not all headaches are created equal, and a change in the character of headaches – a sharp pain instead of a dull, throbbing pain, or a change in the headache’s location, for instance – can indicate that there might be a bigger problem.
“It’s rare, but people that ignore the bad headache can get very sick. If it happens, they should visit the emergency room or get in to see their primary physician as quickly as possible,” says Travis.