Six serious medical symptoms

Your body flashes signals – symptoms and signs – that warn you of potential problems.

Fortunately, many symptoms turn out not to be serious. For instance, the majority of headaches stem from stress, eyestrain, lack of sleep, dehydration, caffeine withdrawal, and other mundane causes.

But a sudden agonizing “thunderclap” headache – the worst of your life – could mean bleeding in the brain. Being able to recognize this serious symptom and calling the ambulance may save your life.

Here are six very important signals.

1.    Paralysis of the arms or legs, tingling, numbness, confusion, dizziness, double vision, slurred speech, trouble finding words, or weakness, especially on one side of the face or body.

These are signs of stroke – or a “brain attack” – when arteries that supply oxygen to the brain become blocked or rupture, causing brain tissue to die.

Symptoms depend on which area of the brain is involved. If a large blood vessel is blocked or ruptures, a wide area may be affected, so a person may have paralysis on one side of the body and lose other functions, such as speech and understanding. If a smaller vessel is blocked, paralysis may remain limited to an arm or leg.

If you have symptoms get to an emergency room right away. If it is a blood vessel in the brain that’s blocked, clot-busting therapy is best started in the first three hours, although newer treatments work within a longer time frame. But timing is urgent. In these parts, a stroke usually occurs because of a ruptured blood vessel due to uncontrolled hypertension. Hypertensives, beware.

2.    Chest pain or discomfort; pain in the arm, jaw, or neck; breaking  out in a cold sweat, extreme weakness, nausea, vomiting, feeling faint; or being short of breath.

These are signs of a heart attack. If you get some of these symptoms, call the ambulance and get to the emergency room. A recommendation is to chew one regular, full-strength aspirin (unless you’re allergic to it) to help prevent damage to the heart muscle during a heart attack.

Not everyone who has a heart attack feels chest pain or pressure or a sense of indigestion. Some people, especially women, the elderly, and people with diabetes, get “painless” or “silent” heart attacks. Being aware of “silent” heart attack signals is crucial; a very weak feeling, sudden dizziness, a pounding heart, shortness of breath, heavy sweating, a feeling of impending doom, nausea, and vomiting are signs and symptoms for serious concern.

It’s important to learn heart attack signs and understand them in context. Everybody who has jaw pain shouldn’t immediately run and say, “I’ve got a heart attack.” But if they’re also sweating and have some of these other symptoms, then that should be a tip-off that something more serious is happening.

3.    Tenderness and pain in the back of your lower leg, chest pain, shortness of breath, or coughing up blood.

These may be symptoms of a potentially dangerous clot in your leg, especially if they come after you’ve been sitting for a long time, such as on an airplane. These signs can also surface if you’ve been bedridden after surgery, are obese, have cancer, and certain intrinsic diseases of the blood vessels.

Blood is more likely to pool in your legs when you’re sitting or lying down for long periods of time, as opposed to standing and walking. If a blood clot forms in your leg as a result, your calf can be warm, swollen, painful, and tender to the touch; you should be evaluated. If you get sudden chest pain or shortness of breath, a piece of the blood clot may have broken off and traveled through the blood stream to your lungs.  This is called a pulmonary embolism and can be life- threatening; get to the doctor or emergency room.

4.    Blood in the urine without accompanying pain.

Anytime you see blood in your urine, call your doctor or go see him promptly, even if you have no pain.

Kidney stones or a bladder or prostate infection are common causes of blood in the urine. But these problems are uncomfortable, which sends people to the doctor promptly.

On the other hand, when people see blood in their urine but feel no pain, some take a “wait and see” approach, especially if they just have one episode. This may be ill-advised because lack of pain doesn’t necessarily mean lack of seriousness.

Cancer of the kidneys, ureter, bladder, or prostate can cause bleeding into the urinary tract; when these cancers are small enough to be curable, they many not cause pain. So don’t dismiss this important sign because blood in the urine may be the only clue for an early diagnosis.

5.    Asthma symptoms that don’t improve or get worse.

Asthma attacks are marked by wheezing or difficulty breathing. When an attack doesn’t improve or worsens, a patient should get emergency care.

If an asthma attack is left untreated, it can lead to sever chest muscle fatigue and death. Some people with persistent asthma hesitate to go to the emergency room because they’ve gone so many times before, or they need someone to drive them because they’re too short of breath. So instead of seeking care, they try to “hang in there” even if they need higher doses of inhalants or have decreasing lung function.

Because asthma makes breathing difficult, the muscles for breathing may tire and the volume of air exchanged by the lungs will decrease. So a person’s oxygen level drops while blood levels of carbon dioxide rise. A carbon dioxide buildup in the blood has a sedating effect on the brain, which may cause you to feel even drowsier. You may lose the motivation or energy to breathe.

A person with asthma who seems to be relaxing more, who seems not to be struggling for breath anymore – even though they’ve been at it for six or eight hours – may actually be worse. It could be a sign of respiratory fatigue and eventually the person could stop breathing. Patients are in a danger zone here. They believe they’re getting better when they’re actually getting worse. They become sedated and seem to be peaceful when actually, they’re dying.

One of the most important considerations is how long an attack lasts. If you’ve been having labored respirations with the asthma not relenting after a period of several hours, even though you may be apparently doing ok, don’t let it go any longer. Go to the emergency room.

6.    Depression (and suicidal thoughts)

I won’t say too much about this, but rather leave it for the psychiatrists.

Few people would put up with crushing chest pain or extreme shortness of breath, but many endure depression, even though at its extreme it can be life-threatening.

Depression can be a very serious problem because people can commit suicide. Some don’t seek care when they’re depressed because they think they’ll be perceived as being crazy or not strong or not manly, and they have to understand that there is a chemical imbalance going on in their brain. It is a disease just like any other disease.

Symptoms of depression include sadness, fatigue, apathy, anxiety, changes in sleep habits, and loss of appetite and libido as well as a sense of guilt, helplessness, and hopelessness. Depression can be treated with medications and psychotherapy, this latter by psychiatrists and psychologists.

If you have thoughts of suicide, speak to someone qualified, such as personnel at the psychiatric hospital or any hotline that’s established.

See you next week.

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5 Comments

  1. CUFFY
    July 7, 2011

    GOOD VIBE DOCTOR!

  2. embadoc
    July 6, 2011

    Great article. Thanks for enlightening us. I really appreciate the segment on stroke….few peoplĂ© are aware of the signs.

  3. MARIGOT
    July 6, 2011

    THANK YOU DOC

  4. Anonymous
    July 6, 2011

    Great column Doc. keep them coming. Interesting reading.

  5. lady
    July 6, 2011

    Hi sir could you do a column on spotting? That is when you spot blood a week before your period comes, this have happen to me once in the past, some explanation and insight would be appreciated

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