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Archive for April 9th, 2009

BOW SIGNAL ALERT: VARICOSE VEIN THAT BECOMES TENDER ANP PAINFUL

Description and Possible Medical Problems

If you have surface varicose veins that become tender and painful, you probably have a condition known as superficial phlebitis, more commonly known as phlebitis. Phlebitis may occur because of a vein in the leg becoming inflamed due to injury or a clot, being inactive for more than several weeks, sitting in an airplane seat for hours, or taking estrogen.

In addition to the pain and tenderness, the entire length of the vein may become hard and the skin around the vein may be itchy.

Treatment

Many people confuse superficial phlebitis with deep-vein thrombosis. The truth is that superficial phlebitis usually appears in a vein near the surface of the skin, while deep-vein thrombosis occurs in veins deep in the legs or abdomen and is a potentially life-threatening illness in which a blood clot forms within a blood vessel.

There are several things you can do to treat the pain of phlebitrs. Taking aspirin or Advil will help relieve the pain and reduce the swelling. You should also try to elevate your legs whenever you’re sitting or lying down. Some people find that applying moist heat to the legs or soaking in a warm tub helps.

A mild case of phlebitis will usually disappear within a week. However, you should see your doctor to rule out deep-vein thrombosis.

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VAGINAL BLEEDING, PREMENOPAUSAL: DESCRIPTION AND POSSIBLE MEDICAL PROBLEMS

If you are in the second stage of your reproductive cycle, also known as the premenopausal stage, you may notice that your periods have become less regular with different amounts of bleeding.

If you ate premenopausal and experiencing a change in pattern of bleeding or time of periods, ask yourself the following questions:

1. When did my periods start to change?

2. Are my periods more or less frequent than they used to be?

3. Do I have a smaller or larger amount of bleeding than usual? For instance, how many pads or tampons am I using?

4. Have I started to take a new medication or stopped taking one?

5. Do I have vaginal bleeding during or after intercourse?

Vaginal bleeding during the premenopausal stage can range from mild spotting to a flow that approaches what you experienced during the heavy days of your period. It’s important that you see your doctor if you’re spotting and head for the emergency room if the bleeding is heavy. It’s not certain what causes premenopausal bleeding, but it’s likely that it’s related to the sudden and extreme hormonal changes that occur as the body prepares for menopause.

In some cases, usually in younger women who are sexually active, polyps and/or cervical lesions may be the reason for vaginal bleeding. Even though they are still menstruating, they may confuse the bleeding with the spotting that sometimes occurs between periods and delay seeking medical treatment because they don’t think anything is wrong.

Fibroid tumors, which are growths on the uterine wall, are another common cause of irregular bleeding episodes in premenopausal women. They can be responsible for pain during intercourse, a sensation of abdominal fullness, and overall discomfort. In my practice, I have seen women with fibroid tumors who looked as though they were four months pregnant.

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BODY SIGNAL ALERT: ABDOMEN, LUMPS OR MASSES IN

Description and Possible Medical Problems

Anytime you notice a lump or other mass in your abdomen that wasn’t there before, you should consult your doctor. First, ask yourself these questions:

1. Does the mass disappear with a bowel movement? Does it appear after a meal?

2. When I change position, does the mass change as well?

3. Have I noticed any change in my urination habits lately?

4. Is the mass painful?

A new lump or mass in the abdomen could actually be an enlarged internal organ. If it appears under your left rib cage and feels smooth, it may be an enlargement of your spleen. If you notice a painful mass that is either smooth or bumpy under your right rib cage, your liver may be enlarged.

The most common cause of a lump or mass that appears suddenly, however, is a stool that stays in the bowel longer than usual due to constipation; it will feel like a sausagelike mass. You’ll also be gassy. In older men who have prostate problems, the bladder can enlarge and become distended if an enlarged prostate makes it difficult to urinate.

In women, a mass that appears below the navel may be fibroid masses in the uterus. In some cases, a mass can actually be a harmless lipoma, or mass of fat, in the belly that might be present for years.

Treatment

If you detect a mass in your intestine, either by feeling it physically or by noticing that your abdomen is distended, if the mass does not go away after a bowel movement or if it has been present for more than a few days, you should see your doctor. He will conduct a physical exam and health history to help him determine the cause. Your descriptions of other Body Signals, whether a recent fever or cold or prostate problems, will help him make the diagnosis and determine treatment.

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COUGH, NONPRODUCTIVE, PERSISTENT, BROUGHT ON BY PHYSICAL ACTIVITY

Description and Possible Medical Problems

You consider yourself to be quite active, but more often than not you find you start to cough whenever your heart rate gets above 80 during exercise. You may also find it hard to breathe and be short of breath at other times of the day.

Exercise-induced asthma occurs mainly in children and adults from their 20s through their 40s; I’ve rarely seen new onset exercise-induced asthma in people over the age of 30. The cough may be persistent and may last as long as you exercise or continue after the exercise session is over.

In people over 50, when a nonproductive cough is brought on by a short walk, it can be a sign of an underlying heart problem such as angina pectoris, in which narrowed vessels make it difficult for sufficient blood and oxygen to reach the heart.

Treatment

Even if a person has exercise-induced asthma, I’ll almost never recommend that she stop exercising, since regular physical activity is so beneficial for your body and your general health. If you begin to cough and have trouble breathing during exercise, your doctor may recommend you carry a’ handheld inhaler such as Ventolin and take two puffs as needed. If you’re over 50 and have exercise-induced asthma, I’ll usually recommend that you undergo a complete cardiac work-up, including a stress test, to make sure that the condition is not an early sign of heart failure or angina.

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BODY SIGNAL ALERT LESION, SCALY AND HARD

Description and Possible Medical Problems

As you’ve read elsewhere in this chapter, if you spent your youth and early adult years baking or working in the sun, you’re more apt to get skin cancer than a person who has stayed in the shade.

If you begin to notice that the part of your skin that’s been exposed to the sun begins to look scaly and feels as though it’s hardened, you may have squamous cell carcinoma, a form of skin cancer.

Squamous cell carcinoma frequently appears on the lips, hands, or ears; people 50 and over are most likely to have squamous cell carcinoma.

In addition to the hardened scaliness, you may also notice that a small growth has appeared below the rough skin. This growth may resemble a wart or an ulcer, but if it doesn’t clear up completely, you’ll know it’s squamous cell cancer.

Treatment

If you notice a growth that may be a squamous cell carcinoma, see your doctor right away. Squamous cell carcinoma can eventually spread to other parts of the body, making it harder to treat.

Your physician will probably take a biopsy of the tumor in order to determine proper treatment, which will probably include surgical removal of the tumor. Treatments in addition to surgery may include chemotherapy, cryotherapy, and radiation (see pp. 196-197 for more information). When a squamous cell tumor is detected and treated early, the survival rate is close to 100%. After treatment, you will need to see your doctor regularly to guard against other growths.

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