Warning pains


IF SYMPTOMS PERSIST

By DR. JOSE PUJALTE JR.

 “To each his sufferings: all are men, Condemned alike to groan…”

– Thomas Gray (1716-1771), English poet

An Ode on a Distant Prospect of Eton College (1747)

Dr. Jose Pujalte Jr. Dr. Jose Pujalte Jr.

To those not familiar with this beloved poem, I’m sure they will still recognize the last two lines – “No more; where ignorance is bliss/‘Tis folly to be wise.”

Now does it ring a bell? It is appropriate for today’s topic because, more often than not, we ignore aches and pains and hope (and pray) these will be gone by the next morning. And since the human body is wonderfully programmed for self-healing, aches and pains do go away. Indeed, for 95% of body complaints, ignorance is bliss.

It’s the other 5% we’re worried about.

Needed: Medical Attention. Health writer Leanna Skamulis of WebMD consulted internists and specialists in cardiology, geriatrics, and psychiatry to find out what body pains must NOT be ignored. She came up with seven. Most of these can be a matter of life or death. They are:

  1. I feel like my head is exploding.” – well maybe it is. The worst headache of your life is classically a brain aneurysm An aneurysm is a weakness in the lining of a blood vessel much like a thinned-out spot in an old tire. If and when the blood vessel finally gives way, it is heralded by a very severe headache. A headache that needs immediate attention may also be coming from a stroke or a brain tumor.
  1. “I feel like a professional wrestler is sitting on my chest.” Okay maybe a midget professional wrestler because the sensation of an impending heart attack is discomfort first before pain. Pain is a late sign. And don’t think that the telenovela actor suffering a heart attack is accurate in just clutching his chest. Other areas of discomfort include the upper chest, throat, jaw, left shoulder or arm, and even the abdomen along with nausea. 
  1. “I can’t walk right because my back hurts. There’s also pain in between my shoulder blades.” While this can be the chronic pain of spine arthritis, this pain description can be the ominous harbinger of a heart attack. In aortic dissection, there is either nagging or sudden pain. Both can signal the tearing of the largest blood vessel of the body and nearest to the heart, the aorta. These emergencies are more likely to occur in those with heart disease, circulation problems, hypertension, and diabetes. Smoking doesn’t help in the profile either.
  2. “I feel like my belly’s about to burst.” Abdominal problems are can be emergencies in cases of appendicitis and peritonitis (inflammation and infection of the appendix and peritoneum, respectively). The peritoneum is the protective covering of the internal organs that can infect if the appendix ruptures, for example. Other abdominal concerns include: stomach and duodenal ulcers, blockage of the intestines, and problems with the gallbladder and pancreas. 
  1. “The back of my leg hurts and I didn’t even hurt it.” That is even more alarming. Muscular tenderness is explainable after a whole day of standing or after a game of badminton. But the calf muscles may hurt, in the absence of trauma, from the presence of a blood clot. It is a condition known as deep vein thrombosis. The danger lies in a blood clot being thrown off to the lungs and eventually causing pulmonary embolism. This blood clot in the lungs could be fatal. Risk factors include cancer, prolonged immobility because of disease or accident, air travel that keeps the passenger sitting down for long periods, pregnancy, and advanced age. 
  1. “I feel that my feet, sometimes legs, are burning.” This should alert the person to diabetes. One of the effects of diabetes is damage to nerves in a condition called peripheral neuropathy. The sensation includes burning and sometimes, “pins and needles” pricking the skin. Numbness and insensate (no sensation) are late signs in diabetes. 
  1. “There’s always some pain here and there and it never goes away.” Chronic aches and pains without a history of trauma or disease could be a presentation of depression. The other differential is fibromyalgia but then there are specific pain areas that hurt or are tender to the touch in this musculo-skeletal condition. In depression, the cause of pain is medically unexplainable.
In the end, a little body awareness is most helpful. We can’t be ignoring

the complaints of the body forever.  The saying “if it ain’t broke, don’t fix it,” shouldn’t be applied to the human body. As a mechanism, it is so intricate that it is not up to ourselves to find out if something has gone awry or not. A better approach is to dignify bodily clues and then get some help from doctors.

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