Wednesday, February 24, 2010

Pains Men Should Not Try to Macho Through

When the going get tough, guys should go to the doctor.
By Scott McCredie for MSN Health & Fitness

You’re a guy’s guy, tough as nails and hard as rock, right? Able to soldier on despite hardships or injuries? Because everyone knows that hardship builds character, and pain is all in your mind. And, oh, don’t forget: no pain, no gain.

Well, that’s the traditional view, anyway. Modern males are supposed to dance to a different tune. We’re advised that a healthier philosophy is to listen to our bodies and heed the language of pain, the body’s way of telling us that something is wrong and needs our attention. Men who fail to heed the message often meet disaster.

“Men tend to ignore pain more than women, but they also tend to seek medical attention less than their women counterparts for any ailment or symptom,” says Dr. Camelia Davtyan, associate professor of general internal medicine and health services research at the David Geffen School of Medicine at UCLA.

My brother, Tim, is a good example.

A 25-year-old law intern living in Portland, Ore., Tim woke up one morning with severe stomach pain. He thought the culprits were the guacamole, chips and beer he’d had the night before. “It was the stomachache from hell,” he remembers. “I thought I could endure the pain and hoped it would go away.”

A few days went by and the pain continued. He went to a doctor who examined him but could find nothing amiss. A couple more days passed and he broke out into a feverish sweat that scared him into a hospital, where a doctor immediately sent him to the surgical ward. Tim’s appendix had burst, a life-threatening situation. Fortunately, he was young enough to withstand the bacterial onslaught this caused, and after the emergency appendectomy he recovered fully.

Here’s a list of potent pains that you ignore at your peril:

1. Severe headache

“If you were to say, ‘that’s the worst headache of my life,’ it could be related to a brain aneurysm rupture, which can be quickly fatal,” says Davtyan.

A brain aneurysm is a swelling of an artery due to a weakness in its wall. Anyone, at any age, can have them, but they’re most common in adults between the ages of 30 and 60. If an aneurysm should burst and bleed into the brain, it can cause “hemorrhagic stroke, permanent nerve damage and death,” according to the National Institutes of Health (NIH).

In the U.S., some 27,000 people a year report ruptured aneurysms. In addition to the headache, other symptoms may include nausea, vomiting, a drooping eyelid, light sensitivity and a change in mental awareness.

If you experience the “worst headache of your life,” especially combined with any of the other symptoms, you should go immediately to the ER.

2. Chest pain

Davtyan explains that if you ever have the sense of “having an elephant on your chest"—intense chest pressure, pain or squeezing sensation—you could be having a heart attack, which can also be quickly fatal.

The NIH describes the feeling as “uncomfortable pressure, squeezing, fullness, or pain” in the center of the chest that lasts for more than a few minutes, or goes away and comes back. Other parts of your body can be affected too, including pain in one or both arms, the back, neck, jaw or stomach. You may also feel short of breath, lightheaded, nauseous or break out in a cold sweat.

3. Other chest pains

“Sharp, stabbing chest pain of sudden onset, with or without shortness of breath, could be pneumothorax [a collection of air or gas in the space surrounding the lungs] or a blood clot in the lung,” Davtyan asserts.

The latter condition is called a pulmonary embolism, a sudden blockage in a lung artery, usually from a blood clot that traveled to the lung from the leg. The National Heart Lung and Blood Institute says more than 600,000 Americans experience a pulmonary embolism each year, and about 10 percent of them die from it. Fatalities usually occur within an hour after the symptoms begin, so time is of the essence.

Pulmonary embolism, according to the institute, is one of the leading causes of death among people who must remain in hospital beds for long periods of time—and it also can crop up in people who must sit (say in an airplane or office) for many hours without interruption. (Say, don’t you feel the sudden urge to get up now and walk around a bit?)

4. Severe back pain

It seems that nearly everyone, at one time or another, experiences back pain. It’s the cost of being a biped equipped with a spine designed for four-legged travel. But if you should ever suffer from low back pain combined with either weakness in the legs, pain radiating down one leg, trouble controlling your bladder or bowels, or pain when coughing, it could mean something sinister is going on with your spinal cord. This might be caused by a bulging (herniated) disc, the cartilage that cushions each vertebra, which could be pinching nerves.

In this case you should contact a doctor immediately to prevent permanent damage.

5. Abdominal pain

Pain emanating from the lower right side of the abdomen, with or without fever or nausea/vomiting, could be appendicitis, says Davtyan. As Tim discovered, you shouldn’t delay if you experience prolonged pain in this area. Some of the other classic symptoms of appendicitis are nausea, vomiting, constipation or diarrhea, an inability to pass gas, loss of appetite, a low-grade fever, and abdominal swelling, according to the NIH. But not everyone experiences all the symptoms.

The most serious complication of appendicitis is rupture. Infants, young children and older adults are at highest risk. When bacteria-laden fecal matter from the intestines enters the body cavity, bad things can happen—including death.

6. Joint and muscle pain

The burden of the weekend warrior and aging jock is the duo of sprains and strains. But when should you pay them any mind?

“A lot of people think they can play through the injury and it will be OK,” says Dr. Ed Laskowski, co-director of the Mayo Clinic Sports Medicine Center in Rochester, Minn. “But it’s not OK.” If you don’t get certain injuries treated early by a physician, you could be looking at the prospect of causing further damage or longer recovery times.

Signs to watch for, he says, are pains associated with joint swelling, which usually are the result of inflammation or tearing. If an injury leads to limping or causes your stride length to change, you should get it checked out. Also, instability of a joint could indicate a ligament tear, and should be looked at immediately to prevent further damage.

If pain is combined with a restricted range of motion, that’s another cause for seeking medical attention. “Persistent or worsening pain—and I mean pain beyond normal soreness—is something to watch out for,” Laskowski says. “The earlier you come in, the better you will respond to treatment. I’d say any pain that lasts beyond a few days is something to be concerned about.”

Denial? Not me

So why do many men postpone getting treatment when they feel unusual pain? That turns out to be a complicated question. For his part, my brother had a long list of reasons. “I was in denial about the pain,” Tim says. “I didn’t want to believe that I had to have surgery and take time off work, and it was all going to cost a lot of money.”

“People use a variety of excuses for not promptly addressing a serious pain,” Davtyan says. ”They’re too busy, there’s nobody else to take care of the kids, or ‘I'll take some Tylenol and it will go away.’ ” A lack of medical insurance is another popular reason, she adds.

But whatever the cause, none of them is wise. You may ignore your boss, your wife, your kids, your job and maybe even the dog, but certain kinds of pain should always get your full and thoughtful attention. Or else.

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