Don’t Be Too Quick to Diagnose Yourself


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Learning all you can to manage your health is clearly a good thing. Today we have more at our disposal to learn a huge amount about our health status, how to intervene to avoid a crisis, and optimize our health. But recently, I’ve seen friends make assessments of their health status that were dead wrong. One could have died. Another might have had cancer, but she thought otherwise. Maybe their doctors would have missed the seriousness of these symptoms too, but I have to hope that, in the right hands, they would do better than you and me.

When a Symptom is Thought to Be Part of a Chronic Condition

A close friend of mine who has had MS (multiple sclerosis) for decades has suffered from MS fatigue, a well-known issue for people with MS. To some extent, there is some nihilism about the fatigue in the MS community. According to the National Multiple Sclerosis Society, fatigue occurs in about 80% of people with MS. The Society cautions that outsiders may misread the symptom as “depression or not trying hard enough.” In addition, the MS fact sheet makes it clear that there is no scientifically proven treatment to deal with this symptom. So letting it be may be what people with MS do.

But while my friend was visiting, I watched him make that miscalculation, attributing fatigue to a flare or worsening of his MS. He could have died. Two weeks ago, I met him at Penn Station, for a weekend visit. He looked bushed. I immediately grabbed his suitcase and got no resistance. We went for a meal and he talked about his “MS fatigue.”

We learned the hard way that his fatigue had nothing to do with MS. He reported bouts of dizziness. We stopped to sit down several times when he was walking. Two hours later, he fell down on a NY Subway platform. When EMS got to him, his blood pressure was down to 70/40 and he was rushed to an ICU. There, the doctors spotted a serious electrolyte imbalance. He could not have managed any of this on his own. We are all thankful that he is alive and for the hospital and emergency medical care that he got.

The culprit in the collapse appeared to be a change in his blood pressure medication. Weeks ago, his doctor had added on a second medication because the first medicine didn’t control it. That medication proved ineffective so the doctor substituted another. It brought his blood pressure down too far. After he was stabilized and rested in New York, I accompanied him home, which is out of state. He’s not out of the woods yet. He still has his blood pressure pills to sort out, which he is doing with his doctor on a schedule that the doctor, not him, is arranging. He doesn’t need another health crisis.

What Looks Like Belly Fat Is Not

I also watched a dear friend attribute her bulging abdomen to postmenopausal weight gain. Never mind that she is serious about exercising and eating nutritiously. Are women so hung up about weight that we cannot realize when a change in our bodies is concerning?

What finally got her to a doctor when a friend noticing a far more swollen abdomen after not seeing her for one month.

The result: she had an 18-pound benign ovarian cyst. Here’s a similar story that articulately shows how women are quick to attribute abdominal bulge to weight gain.  Thankfully, both women had the cysts removed. In both cases, the cysts could have masked cancer.

Not Everything is A Thyroid Problem

In my own experience, I have wrongly attributed feeling hot and cold, fuzzy, or confused to my thyroid being out of whack. Like many women, I have hypothyroidism that is corrected with thyroid medicine. I have certainly had to make changes to my  medicine over the years. But this year, I learned that a urinary tract infection was the likely source of the hot-and-cold and fuzziness – and not my thyroid. I’ve seen older women in nursing homes get loopy with a urinary tract infection, with doctors simply guessing it’s dementia. Like fatigue and feeling fat, feeling hot and cold or fuzzy feels nonspecific, vague, and innocuous symptoms – perhaps something to put aside – or something that it is not at all.

Recognizing the Problem

The patient empowerment movement has made great strides in educating people about illnesses and helping us optimize our health and medical decisions. But there are limitations that we need to be cognizant of. If my fatigued friend with MS had not gotten to the hospital in time, he could have died. How long would it have taken my friend to see a doctor about her large, possibly malignant, ovarian cyst? Do we really always have the best medical information to analyze our symptoms? Can we read laboratory results and radiology scans as well as our doctors? Yes, we should have all that information because it is our’s and valuable in disease management, but having information at hand is not tantamount to knowing medicine.

 


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