Redbook, July 1997
Your doctor says you’re just run down. But could you have one of these seven illnesses? They’re tough to diagnose – and may be very serious if not caught in time.
You’re tired, dizzy, achy, or you have weird burning sensations or heart palpitations . . . Sound serious? Probably not to your doctor. Chances are, he’ll simply tell you that you’re just pushing yourself too hard. But before you, too, begin to believe that your symptoms are all in your head, keep in mind that there are a number of diseases common in young women that many doctor are still unfamiliar with or don’t think to look for. And with virtually all of these, you look fine and your symptoms seem to mimic those caused by stress.
It’s bad enough being diagnosed as a hypochondriac. In some cases, a delay in diagnosis may lead to more serious problems. That’s why, when your doctor can’t find anything wrong, you need to know about these diseases – and the best ways to sleuth them out.
1. Mitral Valve Prolapse Syndrome
With no forewarning, your heart starts racing, you break into a sweat, and you’re overcome by a feeling of panic. MVPS is different from true mitral valve prolapse, which is a structural defect in the heart valve. MVPs isn’t really a heart problem but a malfunction in the autonomic nervous system, explains Dr. Phillip Watkins, M.D., medical director of the Mitral Valve Prolapse Center in Birmingham, Alabama. Your mitral valve – a flap of tissue that regulates blood flow between two of the heart’s chambers – tends to slip because of faulty regulation of blood volume by the autonomic nervous system. This keeps the heart chamber below capacity, making your heart race and upping adrenaline, which produces those panicky feelings.
How do you know if you have it?
If your symptoms worsen when you lie down on your left side, you can be pretty sure it’s MVPs, according to Dr. Watkins. Your doctor should listen for a clicking sound or murmur in your heart (a key sign). He may also order an echocardiogram.
What helps?
Small doses of medications that raise or stabilize blood pressure usually offer relief. It’s also important to eliminate caffeine, increase your fluid intake, and exercise regularly.
2. Interstitial Cystitis
Although an estimated 5000,000 women have this inflammatory disease of the bladder wall, getting correctly diagnosed still takes an average of two to four and a half years. "Many doctors don’t even know that IC exists," says Kristene E. Whitmore, MD, clinical associate of urology at the University of Pennsylvania. They dismiss the symptoms – searing pelvic pain and the constant urge to urinate (up to 50 times per day) – as signs of a common urinary tract infection.
How do you know if you have it?
Only a cystoscopy can tell for sure. While you’re under anesthesia, the doctor inserts a probe through your urethra to examine the inner walls of your bladder.
What helps?
There’s no cure, but recently the FDA approved Elmiron, a drug that seems to work by forming a protective bladder lining. Another common treatment is to "rinse" the bladder with dimethyl sulfoxide. Bladder "retraining" (by increasing time in between each urination) and avoiding chocolate, alcohol, and spicy foods help, too.
3. Thyroid Disease
As many as 20 million Americans have a disease of the thyroid, a gland that produces metabolism-regulating hormones. How can something so common be so commonly over looked? "The symptoms are often identical to those you have if your life is hectic or that occur normally as you get older," explains Sheldon Rubenfield, MD medical director of the Thyroid Society for Education and Research in Houston.
If your thyroid gland overproduces hormone (a condition known as hyperthyroidism), your symptoms may include trembling hands, nervousness, fast heart rate, increased frequency of bowel movements, and menstrual irregularities. Fatigue, dry skin, infertility, and sensitivity to cold are all signs of hypothyroidism, or too little hormone.
How do you know if you have it?
A simple blood test can determine if levels are abnormally high or low.
What helps?
Hyperthyroidism is usually corrected with a dose of radioactive iodine, which shrinks the thyroid gland: daily thyroid pills work for an underactive gland.
4. Vulvodynia
It feels like a wicked yeast infection – only worse. In fact, some women suffering from vulvodynia find that the burning, itching, and pain they experience in the skin at the vaginal entryway (or sometimes the labia or clitoris) can be so intense they have difficulty even wearing underwear. "Yet most doctors can’t detect much upon a physical exam," says John J. Willens, MD, head of obstetrics and gynecology at Scripps Clinic in La Jolla, California, "so it’s not unusual for them to think a patient is exaggerating."
How do you know you have it?
With no definitive test, vulvodynia is diagnosed largely by ruling out the other possible causes for vulvar pain: vaginal infections, diabetes, and vitamin B12 deficiency.
What helps?
A combination of topical estrogen cream, calcium citrate supplements, and dietary changes (avoiding foods high in oxalate, such as tea, peanuts, spinach, and chocolate).
5. Lyme Disease
Although this tick-borne illness has now been reported in up to 47 states, some 80 percent of the cases occur in southern New England and the mid-Atlantic states. As a result, doctors practicing in other regions often don’t think to look for Lyme, says Alan Barbour, MD, professor of medicine and microbiology at the University of California at Irvine.
In its initial stages, Lyme Disease mimics the flu, although if often also causes a bull’s eye or large rash. If undetected, the disease may progress, triggering joint pain and swelling.
How do you know you have it?
A blood test can detect Lyme, but only after about a month.
What helps?
Oral antibiotics are the primary treatment. But, if the diseases has progressed, you may need intravenous antibiotics.
6. Multiple Sclerosis
Even the best of doctors can miss the initial signs of this central nervous system disease – transitory blurred vision, muscle weakness, "pins and needles" sensations on your skin – because they’re non-specific. What’s more, in about 70 percent of early-stage cases, symptoms completely disappear for long periods of time.
How do you know you have it?
The diagnosis can usually be shored up with a combination of tests including an MRI.
What helps?
Many new medications reduce the number and severity of attacks; some may actually slow the courses of the disease.
7. Lupus
In this disease, something goes wrong with your immune system, so that it produces antibodies that attack and destroy your body’s own cells and tissues, especially in the joints, skin, kidneys, and lungs, explains Daniel J. Wallace, MD, clinical chief of rheumatology at Cedars-Sinai Medical Center in Los Angeles. Symptoms vary but may include swollen joints, fevers, chest pain, anemia, sun sensitivity, and/or a butterfly-shaped rash across the nose and cheeks.
How do you know if you have it?
The cornerstone of a lupus diagnosis is an antinuclear antibody (ANA) blood screen. If this is positive, it’s important to consult a rheumatologist.
What helps?
If symptoms are mild, patients often manage with ibuprofen or naproxen and antimalarials; other patients, however, may require steroids or chemotherapy to halt the progress of the disease.
|
