Fatigue can be a symptom for a variety of underlying conditions... Lyme disease
- From: "CaliforniaLyme" <CaliforniaLyme@xxxxxx>
- Date: 10 Jun 2005 08:47:00 -0700
http://www.detnews.com/2005/fitness/0505/11/H10-177478.htm
Wednesday, May 11, 2005
Diagnosis: Early symptoms
Some seemingly minor ailments shouldn't be ignored
By Marc Siegel, M.D. / Health and Fitness News Service
When the great jazz musician Bobby Short died recently after a sudden
diagnosis of leukemia, his many fans wondered: Why no warning? Short
reportedly entered a hospital less than a week before his death
thinking that his abdominal symptoms were from diverticulitis, only to
be diagnosed with leukemia. He succumbed to the disease a few days
later. But diverticulitis, an infected wall of the large intestine
caused by an in-pocketing of the bowel lining, is not at all similar to
leukemia. So were there telltale signs of leukemia that were overlooked
in the months before Short's death?
The answer is probably yes and no. Leukemia is a disease that can
provide only vague symptoms for many months. These symptoms include
fatigue, easy bruising, weakness and nighttime fever or sweats. Anyone
noticing these nonspecific symptoms should see a physician. Blood tests
may suggest leukemia; an elevation in white blood count or persistent
anemia warrants further investigation with a bone marrow examination.
A careful physician will pursue these abnormalities and make an earlier
diagnosis than might otherwise be made. With today's medicine, many
cases of leukemia can be cured or at least controlled. However, if
Short had any of these symptoms, he may have dismissed them as not
significant enough to merit a visit to the doctor until they became too
severe to ignore.
Leukemia isn't the only disease that often comes in below the body's
radar. Many diseases have mild symptoms to begin with that could mean
something worse. This is why a person who is feeling a bit "out of
sorts" for a while should contact his or her physician.
Fatigue can be a symptom for a variety of underlying conditions,
including hypothyroidism (especially in women), Lyme disease and
depression. Screening for these problems in a clinic or doctor's office
is a crucial part of health care. All three conditions can be treated
and cured with medications.
Nighttime fevers or sweats can be a sign of infection, most commonly
viral or bacterial, and less commonly the atypical mycobacteria,
tuberculosis. Persistent sweats or cyclical fevers would cause a doctor
to consider an occult cancer, where a growing malignancy is still too
small to manifest overt symptoms. Occult cancers include lymphoma and
leukemia.
Screening for cancer depends upon where in the world you are looking
for it. It's a growing problem everywhere. In fact, estimates suggest
that it could double in the next 20 years. According to the American
Cancer Society, tobacco remains the No. 1 cause of cancer and
preventable death throughout the world, and all smokers everywhere
should be screened for cancer of all kinds.
In the developing world, poor diets and lack of physical exercise are
associated with as many cases of cancer as tobacco. In these places,
cancer of the breast, prostate and colon are on the rise. At the same
time, cancers linked to infectious agents, including cervical
(papillomavirus), stomach (h. pylori bacteria) and liver (hepatitis),
remain a serious threat throughout the developing world.
A doctor considering a patient's symptoms must keep geographic as well
as cultural differences in mind, because these factors relate directly
to risk of disease.
Tests are crucial
An experienced physician does not always expect the symptoms to add up
to a certain illness. Each symptom or finding on examination has its
own response protocol, usually requiring the ordering of a
preconsidered series of tests. The doctor looks smart when the test
reveals a condition that he or she may have been suspecting, but
whether or not this occurs, all bases are covered.
Patients shouldn't think that a test to rule out a serious condition
means that the news is bound to be sinister. In fact, the majority of
the time, a test is ordered to rule out, rather than rule in, a
problem.
In Bobby Short's case, earlier diagnosis might have led to a more
readily treated disease. Leukemia is one of many diseases that respond
better to treatment if caught early.
Recently, I saw a patient with a slight cough and a low-grade fever.
She was only 25, and I suspected she had a mild viral infection. But
when she took a deep breath, she complained of very slight chest
discomfort. I decided to perform a chest X-ray as a precaution,
expecting it to be normal, as so many others under similar
circumstances had been. To my surprise, I discovered a snowball-white
patch of pneumonia in the left lung. She narrowly avoided
hospitalization because she was so young, and she responded well to
antibiotics. Weeks later, she was cured, and the follow-up X-ray was
completely clear.
Now, each time this patient has the slightest cough she worries about
pneumonia. I may never find it again, but we both, doctor and patient,
are wise to be cautious.
.
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