Oftentimes, patients come in asking for a 'general check-up' and on further query all they really wanted is a request for ancillary procedures to see if they have existing diseases or if they are at risk for developing chronic illnesses.
One day, a seemingly worried lady in her late 30's came in because of weakness of her legs. She asked for a 'general check up'. She is single,never been married nor bore a child. On physical examination everything was normal except for a blood pressure of 130/90 which is pre-hypertensive. She looked so worried and tensed asking me to allow her to stay in my clinic to rest for a while. She said that the day before, she went to an emergency room because she had difficulty getting up from bed. Her electrolytes were taken and showed a slightly low potassium levels.
I started exploring where her tension is coming from. As a family physician, I make sure I was able to check on prevailing issues which could have affected her perception of the illness that she might have. She started to cry. She said that she has been worried for the past weeks. Her boyfriend left her for another woman at a time when they were already considering marriage. She claimed though that it doesn't bother her anymore and what really worried her most is the fact that an office- mate has been diagnosed to have cancer who complained of easy fatigability for just a short time. She is afraid that her weakness might be a sign of cancer.
Many times, to satisfy a patient, you need to request a battery of test which can help in explaining what she is going through. A simple routine exam appropriate for her age may be necessary like a CBC, urinalysis, Chest X-ray, and a lipid profile perhaps. In this patient, everything came out normal.
I explained to her that her blood exams were normal. I didn't stop at that. I went back to her problems and tried to address her issues. When she realized she has been feeling depressed not just because she's worried about her health but because of the break-up, she started to open up. Aside from the potassium supplement and advice to eat bananas, I made sure she updates me on her critical issues everytime she follows up.
After 4 visits, she felt better, weakness of the legs were gone and she didn't look tensed anymore as compared to the first time I saw her.
When illness is viewed just as physical illness, we miss the chance of knowing where the perceived illness really comes from. Personal anxieties exaggerate physical experience of a disease. When we're sick and we worry a lot, sometimes the disease is magnified. Therefore, when we visit our doctors, we tell them what we really feel, physically and emotionally too.
One day, a seemingly worried lady in her late 30's came in because of weakness of her legs. She asked for a 'general check up'. She is single,never been married nor bore a child. On physical examination everything was normal except for a blood pressure of 130/90 which is pre-hypertensive. She looked so worried and tensed asking me to allow her to stay in my clinic to rest for a while. She said that the day before, she went to an emergency room because she had difficulty getting up from bed. Her electrolytes were taken and showed a slightly low potassium levels.
I started exploring where her tension is coming from. As a family physician, I make sure I was able to check on prevailing issues which could have affected her perception of the illness that she might have. She started to cry. She said that she has been worried for the past weeks. Her boyfriend left her for another woman at a time when they were already considering marriage. She claimed though that it doesn't bother her anymore and what really worried her most is the fact that an office- mate has been diagnosed to have cancer who complained of easy fatigability for just a short time. She is afraid that her weakness might be a sign of cancer.
Many times, to satisfy a patient, you need to request a battery of test which can help in explaining what she is going through. A simple routine exam appropriate for her age may be necessary like a CBC, urinalysis, Chest X-ray, and a lipid profile perhaps. In this patient, everything came out normal.
I explained to her that her blood exams were normal. I didn't stop at that. I went back to her problems and tried to address her issues. When she realized she has been feeling depressed not just because she's worried about her health but because of the break-up, she started to open up. Aside from the potassium supplement and advice to eat bananas, I made sure she updates me on her critical issues everytime she follows up.
After 4 visits, she felt better, weakness of the legs were gone and she didn't look tensed anymore as compared to the first time I saw her.
When illness is viewed just as physical illness, we miss the chance of knowing where the perceived illness really comes from. Personal anxieties exaggerate physical experience of a disease. When we're sick and we worry a lot, sometimes the disease is magnified. Therefore, when we visit our doctors, we tell them what we really feel, physically and emotionally too.
1 comment:
My mum is extra stressed, has had an operation (benign hypothalamic tumor) and has low potassium levels. Can the latter be the consequence of stress? She is also pessimistic and apathetic, quite contrary to her normal self - can this be a consequence of hypokalemia?
Thank you.
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