Saturday, January 17, 2009

Your Body's Warning Signs

Usually a headache is just a headache, and heartburn is just a sign that you rang the Taco Bell a few times too many. Except when they're not.

  • Severe head pain
This mother of all headaches makes your bachelorette party hangover seem laughable. If you could laugh.
The culprit Odds are, any jackhammering in your brain is just a migraine. But if it's not accompanied by other migraine symptoms (such as a visual aura), sudden and severe pain--we're talking the absolute worst headache of your life--can signal a brain aneurysm. These arterial bulges occur in up to 5 percent of people, but most of the time they don't cause any trouble--you won't even know you have one unless the weak spot leaks or tears. If that happens, escaping blood can flood the surrounding tissue (causing a violent headache) and cut off the oxygen supply there. Smoking and having a family history of aneurysms increase your odds.
The fix "A burst aneurysm can cause brain damage within minutes, so you need to call 911 immediately," says cardiologist Elsa-Grace Giardina, M.D., director of the Center for Women's Health at NewYork-Presbyterian Hospital/Columbia University Medical Center. Your doctor will take a CT scan to look for bleeding in the space around the brain. If he finds hemorrhaging, you'll head into the OR pronto for surgery to repair the blood vessel.

  • Throbbing tooth
Spooning your way through a pint of Chubby Hubby has become an exercise in torture. When your teeth touch anything frosty, you feel a dull throb or sharp twinge.
The culprit It's likely that the tooth's nerve has become damaged, usually because the surrounding pearly white is cracked or rotting away. Unless you get it patched up quickly, bacteria in your mouth can infect the nerve. And you definitely don't want that breeding colony to spread throughout your body, says Kimberly Harms, D.D.S., a dentist outside St. Paul, Minnesota.
The fix Time for a cavity check! You may just need a filling to cover the exposed nerve. But if it's infected, you're in for a root canal, in which the tooth's bacteria-laden pulp is removed and replaced with plastic caulking material. Antibiotics can clear up any infection that has spread beyond the mouth.


  • Sharp pain in your side
A typical runner's side stitch pales in comparison to this piercing stab, which intensifies over a few hours or days.
The culprits You may just need some Beano. But if you feel as if you're being skewered in your right side and you're also nauseated and running a fever, you could have appendicitis. It occurs when something (like a stray piece of feces) migrates into the space where the appendix empties into the colon, blocking it. Soon the organ becomes dangerously inflamed. Another possibility is an ovarian cyst. Typically these fluid-filled sacs are harmless and disappear on their own. But if one twists or ruptures, it can cause terrible pain.
The fix In both cases, you're looking at emergency surgery. "If you don't remove an inflamed ap­pendix, it can burst," says Lin Chang, M.D., a gastroenterologist and codirector of UCLA's Center for Neurovisceral Scien­ces and Women's Health. This can cause dangerous swelling of the tissue surrounding your organs. A twisted cyst also needs to be removed right away, as it can block bloodflow to your ovary within hours. If that happens, the doctor will need to cut out the entire ovary (and the eggs inside) along with the cyst.


  • Passing chest pain
Periodically, you get what feels like a bad case of heartburn, or a tight squeezing sensation, as if you're being laced into a corset.
The culprit You probably just peppered your pizza with too many chilis. But if you know you're at risk for heart problems, don't blow it off--it could be a heart attack. Every year, about 10,000 women under 45 have one. Symptoms tend to be less severe in women than in men, so "you may just feel pressure, along with fatigue, throat pain, or shortness of breath," Giardina says.
The fix Feel the burn after feasting on chalupas? Normal. Feel as if you're being squeezed to death by a boa constrictor after a hard workout? Not normal. In younger women, a heart attack usually happens when you're working up a sweat. If that's the case, dial 911. Your doc will do an EKG to determine whether your heart has been damaged, then decide on the best treatment, whether it's clot-attacking drugs or surgery to clear your arteries.


  • Abdominal discomfort with gas or bloating
For the past month, you've felt gassy and bloated more days than not, and it takes fewer slices of pizza to fill you up than it used to.
The culprit Who hasn't sometimes felt like an overinflated balloon--especially right before your period? But if it happens often and the problem is new, the worst-case scenario is ovarian cancer. In 2007 the Gynecologic Cancer Foundation released the first national consensus on early symptoms: They include bloating, pelvic or abdominal pain, and difficulty eating. If you start experiencing them almost daily for more than two or three weeks, raise a red flag.
Ovarian cancer isn't as common as breast or lung cancer (about 1 in 70 women will get it during their lives), but your risk is higher if you have a family history of breast or ovarian cancer or if you've never been pregnant.
The fix Book an appointment with your ob-gyn to talk about your symptoms. If she suspects cancer, she'll send you to a gynecologic oncologist for an ultrasound or a CT scan to check for a tumor. The good news: Five-year survival rates for ovarian cancer are 90 percent in women who are diagnosed early.


  • Back pain with tingling toes
No amount of Advil or heating pads can ease this backache. Your feet may also feel numb.
The culprit If you've just helped your cousin move into her new fourth-floor apartment, anti-­inflammatories should banish the pain. But if they don't work, hobble to an orthopedist. "You could have a disc (one of the spongy rings that cushions the bones in your spine) pressing on the spinal nerve," says Letha Griffin, M.D., an orthopedist and sports-­medicine specialist in Atlanta. Without proper attention, you risk permanent nerve damage. And it's hard to do the mambo if you can't feel your feet.
The fix An X-ray or MRI can show whether a disc in your back has slipped or ruptured. As long as the numbness isn't getting worse, your doctor will probably prescribe physical therapy along with oral steroids or NSAIDs to reduce nerve inflammation. But if you're still laid up after a few months, you may need surgery to remove the disc.


  • Leg pain with swelling
Your calf is extremely tender in one location, noticeably swollen, and red or warm to the touch.
The culprit If one of your calves is on fire, you might have deep-vein thrombosis, or DVT, also known as a blood clot. Here's how it usually happens: A flight to Tokyo or a deadline at work keeps you glued to your chair for hours. Blood starts to pool in your lower body and forms a clot. When it gets big enough to act as a stopper in the vein or artery, the area around it will start to hurt and swell. Smokers and women who take the Pill have a higher risk of developing clots.
The fix Resist the urge to massage the area or to walk it off. If the clot breaks free, it can travel through your veins up to your lungs and cut off your oxygen supply. Instead, see your doctor, who will do a CT scan or ultrasound to look for DVT. If you have a clot, you'll need to take blood thinners--sometimes for up to a year--to dissolve it, says Suzanne Steinbaum, M.D., director of women and heart disease at the Heart and Vascular Institute at Lenox Hill Hospital in New York City.

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