Patient History and Physical Examination can be Physician’s tool to Prevent Diseases

Patient History and Physical Examination can be Physician’s tool to Prevent Diseases

One patient who experienced a slight change in urination-dribbling a little during the night- passed it off as a joke, kidding with his wife that somehow, though he was still a young and vigorous man, he had entered second childhood. He had actually developed an enlargement of the prostate gland. A year of delay made the operation he needed more difficult and led to a complication, kidney infection, caused by backing up of urine. In reporting symptoms to the doctor, don't grope for medical words; use simple English. Many diseases have strong psychological aspects, and symptoms may recede the moment you are in the doctor's office. Still, tell the doctor you have the symptoms even though it may seem silly to talk about them when they are not immediately present. You can be certain the doctor will understand the phenomenon.

THE PHYSICAL EXAMINATION 'Even as he shakes hands with you, an alert physician may pick up some clues. Are your hands warm and moist, with a fine tremor? These characteristics may suggest over activity of the thyroidgland. If the hands are cold and the skin is coarse and puffy, the thyroid could be under- active. Red fingertips may signal some abnormal flow of blood in the heart; flushing of the nail beds in time with the heartbeat may indicate another type of heart problem called aortic regurgitation. As he observes the body, the physician can learn a great deal. The color of lips and ears may indicate possible anemia.

The Promise and Nature of Preventive Medicine

 One leg is slightly shorter than the other-enough in some cases to account for a backache problem. He may note leg swellings traceable to a heart problem, and any enlarged glands, tumors, or abnormal pigmentation resulting from internal disease. In his examination, the physician will be looking to see if the body is symmetrical. Lack of symmetry is almost always a sign of some dis- ability or disease. If the left side of the neck looks different from the right, it may be because of a tumor which is pushing out on that side. If the thyroid is not symmetrical, it may be because of a benign tumor which has enlarged one lobe ofthe gland. In the retina at the back of the eyes, small blood vessels-arteries and veins-lie are almost naked, devoid of covering material.

And there, very quickly, with an instrument called the Ophthal-mo-scope, the physician by looking through the pupil of the eye can detect any blood vessel changes which may provide clues to diabetes or kidneydisease. Women need a breast examination for any tenderness, abnormal lump, or nipple discharge. During a vaginal examination, a smear of cells for the "Pap" test is usually taken; this is a test to detect early cancer in the area. Both men and women should have a rectal examination to detect any local disturbances. With an instrument, the Sigmoido-Scope, the physician can see and check the lower portion of the colon for any growths.

As a patient, you can help greatly by insisting that the physician do a thorough inspection, by reassuring him that you have no squeamishness. Some doctors feel that patients’ are resistant to rectal andgenital examination and omit these vitally important checks.