As a patient, do you have the audacity to suggest you have one of these ailments that will shock your doctor?
Physicians can be very good at connecting the dots. If symptoms A and B then C. Expressions that concern many doctors are “autoimmune disorder,” “systemic,” and “metastasize.” The reason is there is little they can do to cure either condition. (There are promising new drugs that slow progression of some types of metastatic cancers.) Another reason is that many diseases in these categories are rare—seldom coming up in clinical practice.
1. Autoimmune disorder. The immune system makes up a powerful defensive team. When functioning well, it fights off foreign invaders. Some vitamins and medicines strengthen the immune system. When it switches to the offensive side, the immune system exploits weaknesses and begins attacking healthy tissue. Lupus and Sjögren’s disease are two examples of an immune system going haywire, resulting in autoimmune disorder.
2. Systemic illness. Eleven bodily systems symbolically work together, allowing us to function regularly. The largest is the integumentary system, providing an external and internal protective barrier against wounds and staph infections. It is estimated that there are an estimated 3.72 x 713 human cells in our bodies. The vascular system supplies oxygen and nutrients to each one, every second. Bone, ligaments, nerves are all fair game. A battle against a bodily system is unpredictable at best or certain defeat at worst. Diabetes and arthritis are common systemic diseases.
3. Metastasize. The lymphatic system is like a superhighway with free access to vital organs. It is the favorite path for cancers to spread throughout the body. This is what we call metastasis or stage IV cancer. Lymphoma is a cancer of the lymph nodes.
Relentless difficult-to-trace attacks are tabu exam-room discussions. A patient tells a doctor, “I feel like there is something systemic going wrong.” If the response to such a negative affirmation is not either condescending or dismissive, there is a referral to a specialist—perhaps for psychiatric evaluation.
Unraveling Systemic Illness
Now suppose for a moment is is true. As a patient, you are in serious trouble, seeking help from someone you expect to slow the internal attack or at least manage the symptoms. In addition to the internal onslaught, you now must deal with an external attack on the credibility of your admission.
Bizarre, itchy non-healing plaques are dismissed as eczema. Combined with headaches and vertigo, you ask your primary physician if these symptoms suggest a systemic cause. Different specialists unsuccessfully treat symptoms in isolation—eczema (dermatologist), migraines (neurologist), benign positional proximal vertigo (otolaryngologists), depression (psychologist)—all incorrect.
The first substantive clue comes from an allergy test revealing a severe mold and mildew allergy. The immunologist cannot elaborate on the manifestation. After more years, you stumble upon a medical connection. Repairing a water leak in the crawl space eliminates symptoms. Environmental issues can trigger systemic manifestations.
Systemic diseases manifesting ocularly
- Diabetic retinopathy and macular edema
- Herpes zoster ophthalmicus
- Molluscum contagiosum
- Kaposi’s sarcoma
- Cryptococcal meningitis
Many other systemic diseases are manifest through the skin. It is as though it is trying to warn hall monitors that a fight is taking place in the school cafeteria. Seborrheic dermatitis may be associated with systemic disease, such as Parkinson’s disease and human immunodeficiency virus (HIV) infection. Seborrheic keratoses rarely indicates an underlying adenocarcinoma of the gastrointestinal tract, when appearing suddenly in great numbers. Paget’s disease, erythema nodosum, and Ehlers-Danlos syndrome are a few others.
Among all the fear-inspiring medical conditions, good doctors can ease symptoms. With research, they can even find a cure to help us feel better.
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