Health News

Description and Possible Medical Problems

Gradual hair loss is a normal sign of aging. But if your hair begins to fall out in clumps, a serious health condition is probably causing it and you need to seek medical attention immediately.

Frequently, during an illness that is serious enough to require hospitalization, hair growth will cease altogether for a few months. After the initial onset of the illness, the hair will fall out and then begin to grow back when the illness has disappeared. Though everything from emotional stress to surgery can cause this type of baldness, called telogen efuvium, the hair loss is temporary. Some diseases that can cause telogen efuvium include kidney disease, diabetes, and certain skin diseases. And a low-calorie diet can cause temporary hair loss. In rare instances, when the illness is particularly severe, a person can lose all the hair on her body, including the eyebrows and eyelashes and even the pubic hair.

Chemotherapy for cancer will often cause a person to lose all of her hair over the course of several days. Then, when the therapy is over, the hair will usually begin to grow back.

Alopecia areata is the term for when hair falls out in clumps all over the head. It is frequently used to refer to women who have a severe, sudden hair loss that is due to a serious illness and for which there is no other apparent cause.

Treatment

Hair loss due to aging is basically irreversible, hair loss caused by a disease is almost always temporary. Though this is the good news, the bad news is that you need to treat the underlying disease before your hair can grow back. Since one of the causes, kidney disease is life-threatening without proper treatment, if your hair is suddenly falling out in clumps, you need to see your doctor to determine the cause right away.

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Description and Possible Medical Problems

If you have a headache, feel nauseous, and are vomiting and your eyes are sensitive to light, you should see your doctor. Headaches with these three additional symptoms fall into migraine territory, and at times the pain can be quite severe, almost incapacitating.

In some people, migraines make their first appearance in childhood. For others, often women in their 30s, migraines make their debut in midlife and continue for ten years or more, usually disappearing at the onset of menopause.

Treatment

If you think you have a migraine headache, you need to be evaluated by your doctor. He will take your medical history, do a physical exam, and run some lab tests, including a blood test. He might also order a GAT scan to rule out the possibility of a brain tumor, but in my experience I’ve found that most worry about tumors of the brain is needless, since they are so rare.

The first step in treating migraines is to eliminate certain foods that may be causing the headaches, commonly cheese, chocolate, and dairy products. Over-the-counter medications for pain work well for some

people, but others will need to use a strong prescription medication such as Fiorinal three or four times a day from the time the migraine starts until it clears up. Antidepressant medications such as Elavil and beta-blockers such as Inderal have also been used with some success to treat migraines, as has biofeedback.

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Description and Possible Medical Problems

Depression is probably the most underdiagnosed and misdiagnosed disease in America today. As a result, it is vastly undertreated. Part of the problem stems from the stigma against mental illness that exists in all segments of society. Particularly among the elderly, depression is extremely common and many times goes unrecognized. Depression is also a side effect of many chronic diseases, and it frequently develops after a person is hospitalized for a heart attack, small stroke, or another illness.

If you answer yes to one or more of the following questions about yourself or a loved one, chances are that depression is the cause.

1. Have you noticed a change in your sleeping habits? Are you sleeping more or less lately?

2. Do you lack motivation and energy?

3. Do you have difficulty concentrating for long periods of time?

4. Are you eating more than usual? Or have you lost your appetite?

5. Have you felt suicidal lately?

Depression is often the result of lifestyle changes that we are ill prepared to accept. For example, it’s very common for a man to become depressed after he retires, since his role as employee as well as his status within the company probably served as his primary identity for many years. Once that position is taken away, many people have an identity crisis and can become very depressed.

In younger people in their late 40s or early 50s, a midlife crisis can spark a lengthy depression; premenopausal women who are leaving their childbearjng years behind are also at risk for depression.

In my practice, I once saw a police captain who had retired after many years of service. He had taken a job as a security guard so he’d have something to do. However, he had become very depressed over the change in status in his life and job, and he had attempted suicide. After he failed, he sought help and learned that the change in his life hadn’t changed who he was as a person. As a result, he began to enjoy life again.

Occasionally, depression can be a sign of a serious illness that has not yet manifested itself. This is especially true in any cancer of the gastrointestinal system, such as pancreatic or colon cancer. Though we don’t know the exact reason for this, some speculate that it may be a result of the body’s inability to process food and nutrients properly once the cancer begins to grow. And in elderly people, depression is a major cause of suicide.

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In many cases, patients would pick and choose which tests they wanted to take, as recommended by their doctors. Frequently, patients would have every test performed, even the same one several times. In this way, they would feel they were benefiting from the latest in medical technology, in addition to knowing that they were participating in something really new and different. And doctors would suggest a whole battery of tests not only because they stood to benefit from them financially but also because they feared making a misdiagnosis, which might result in a malpractice lawsuit. Therefore, most physicians preferred to perform tests sooner, rather than later, to cover all the bases.

Everyone was thrilled with this arrangement: doctors received their fees, the patients were reimbursed by their insurance companies. Everyone, that is, except the insurance industry.

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I remember the conversation quite clearly. A woman in her early 50s, who was a regular patient, called my office to make an appointment, and she insisted on speaking to me. The receptionist offered to have me return her call later that day, but no, she said, she had to talk to me right now.

My receptionist pulled me out of an examination room where I was with a patient and told me about the situation. To my knowledge, this patient hadn’t had any serious health problems before, and I felt she wouldn’t be so insistent if it was something minor. So I picked up the phone and braced myself for the worst.

Here’s how the conversation went:

“Oh, Doctor Lowell, I don’t feel so good,” she said in a voice verging on panic. “And I don’t know why!”

I asked her to describe her symptoms.

“I just feel weak, Doctor, I don’t feel like myself and I’m belching a lot—”

I interrupted her. “Do you have a headache, or has your stomach been upset lately?” “No.”

I kept going. “Have you been tired lately? Do you feel short of breath?”

“Yes, and I have no energy. And this morning I started to sweat heavily when I tried to clean up the house.”

I then proceeded to run down a list of general symptoms. When some of them appear together, they make for an easy diagnosis, while others point to the need for further testing to narrow down the possible causes. Her negative replies to most symptoms became more frenzied with each answer. I started to become concerned as well.

“Well, then, exactly what is it that doesn’t feel well?”

“I just don’t know,” she blurted out. “I hate to say it, Doctor Lowell, but I think I’m going to die. Please help me.”

I tried to calm her down and focused more on her belching and upset stomach. I asked her if she was taking aspirin or eating spicy foods; she said no. She had said that the belching had appeared suddenly that morning and that she couldn’t stop. Since she had also said that she was sweating heavily and lacked energy, I asked her what she had eaten recently, and she replied that she had eaten her usual dinner. Though she told me she did not have any chest pains or palpitations, I told her to call 911 immediately and go to tne emergency room. She became a little panicked, but she said she would meet me there.

When she described all of her symptoms, I knew she was having a heart attack, since belching and sweating are typical symptoms of a heart attack in a woman who’s 50 years or older. The symptoms of a heart attack aren’t always chest pain and pain down the left arm. The doctor inside her told her that her life was in jeopardy, even though she wasn’t sure what was wrong. This is what had prompted her to make that very important phone call to me. The doctor inside her was telling this woman, who usually doesn’t call physicians, that she had to contact me immediately. Listening to the doctor inside her saved her life.

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