The hazards of D.I.Y.

The hazards of D.I.Y.

THE neighbourhood hardware shop is stocked with an assortment of D.I.Y. equipment. Speaking from experience, hanging the family portrait on a wrong nail may bring it crashing down, not to mention the hole in the wall as the plaster is sloughed off.

In a similar vein, there is plenty of information regarding health and disease from the media, magazines, books, and the most voluminous of all, cyberspace.

These days, we have Dr Yahoo and Dr Google that offer many seemingly convincing diagnostic algorithms to help the "surfer" find the clue. Alas, quite often, an arrow or two is misdirected, pointing the way to misdiagnosis.

Search engines are great vehicles for information. However, a little knowledge is risky and too much material is a liability, both clouding judgement. We cannot deny the benefits that can be tapped from cyberspace, only if one is discerning enough to differentiate objective information from junk.

Googling a specific symptom brings on an entire list of possible conditions, each apparently describing a situation closely similar to the problem.

Upper abdominal discomfort is a common complaint in many intestinal ailments, ranging from indigestion, gastritis, pancreas inflammation, gallstone or even cancer. Not infrequently, a sinister heart attack can mimic symptoms of gastritis. Like a multiple choice question, the answer is one or all of the above!

Headaches and high blood pressure are commonly associated with one another as the throbbing head discomfort has been described in severe hypertension. However, in general, elevated blood pressure is frequently asymptomatic, thereby lending a false sense of security.

Apart from making the wrong call, attempts at self-diagnosis can create distress.

Hypochondriasis

Hypochondriasis

The state where the concern about a particular symptom becomes disproportionate to the condition, to the extent of causing distress and anxiety, is known as hypochondriasis. Many such personalities believe that the minor irritation that they have picked up is attributed to a serious underlying disease, based on what they have read or heard.

Despite the reassurances of the physician (whom they mistrust in the first place), these poor folks continue searching and will literally spend a significant part of their wealth chasing one imaginary diagnosis after another.

Eventually, some will land in the uncharted territory of quack science, after exhausting doctors and themselves.

Extracting pieces of the jigsaw puzzle from cyberspace and pasting them in an "ad hoc" manner create a distorted impression, often leading to a gravely wrong conclusion. The computer information age has given birth to a new category of sufferers in "dis-ease", namely victims of "cyberchondria" (unfounded anxiety pertaining to health issues after assessing health and medical websites).

A recent encounter with Mr X exemplifies the dangers of why and how too much information in a salad bowl of facts and fancies can clog mental digestion.

He was annoyed by the incessant flatulence and bloating after meals. His "research" brought him to many web addresses, each discussing a disease, with one being more serious than the other. In the end, he was convinced that he had "leaky gut", pituitary disorder, inflammatory bowel disease, and finally, developed insomnia after reading up on colon cancer!

Subsequent investigations confirmed that he was harbouring a stomach bacteria called H. pylori. Treatment would have been a simple and short course of a couple of antibiotics that have been shown to eradicate this bug.

Unfortunately, he "read somewhere" that antibiotics are detrimental and he opted for "natural therapy" instead. Eventually, he chose a fasting regimen (presumably to starve the bacteria) and a herbal extract based on the advice of an internet holistic practitioner.

If Ripley's Believe It Or Not opens its doors to pseudoscience based on fantastic facts and fancies, there will be no standing room. The sad part is people out there readily embrace what they read.

MIssing out on real symptoms

Missing out on real symptoms

There is the case of an old lady in the advanced stage of malignancy, who was given some sort of "fish DNA" to repair the genetic material (which purportedly triggered the cancer in the first place). One may find it amusing, but some people take this seriously!

One of the gravest dangers of self-diagnosis is missing out on red flag symptoms that can be rather subtle. Constipation and piles are common complaints that occur concurrently, with the former innocuously leading to the latter. What may not be so innocent is when the constipation is part of a recent change in bowel habits and the blood is more of staining, mixed with stools, or discoloured rather than squirting like a tap.

This calls for professional assessment rather than seeking answers from Dr Google!

An obese diabetic may be overwhelmingly pleased with a sudden loss of weight, as that article described correctly that reduced BMI improves sensitivity to insulin, thereby improving blood sugar. Unfortunately, there is bad news hidden in between the lines, as the reverse is true.

As the blood sugar shoots through the ceiling, a state of cellular starvation sets in, with the breakdown of fat and protein. This leads to a state of ketoacidosis and weight loss, which is potentially dangerous, with coma imminent if left untreated.

Anyone who can read would have come across an article or headline rolling the drumbeat of heart disease, diabetes, cancer and many other chronic ailments, which is the pivotal formula to sell the newest snake oil, highest grade supplement, herbs, drugs and health packages.

The mushrooming of private laboratories, pharmacies, hospitals, clinics and naturopathic centres have made health assessment "competitive".

It is an inherent tendency to get "value for money" and it is no different when it comes to undergoing a health screening.

Apart from pricing, the most common query is, "How many tests are included?"

The cost of building a high quality house should not be based on the number of bricks alone, but the quality of the material used! It pays to be austere, but don't sell your health to the lowest bidder.

The trend of today's marketplace is "going direct", bypassing the very important assessment of the physician. In arriving at a diagnostic interpretation, there is more than meets the eye.

Reacting to deviations

How does one react to isolated deviations from the norm? What about the slightly raised lipids, borderline blood sugar, and a hint of liver enzyme disturbances?

There is also the tendency towards denial as those who seek self testing often choose to dismiss certain signs, for example, the slightly raised blood pressure and the expanding waistline. These little derangements are the warning lights of worse things to come, as in all likelihood they are the beginning of the metabolic syndrome (the harbinger of a host of chronic ailments such as hypertension, diabetes, etc).

Failure to recognise this crucial pre-disease state may rob one of optimal health in years to come. However, if appropriate focus is given to these biochemical rumblings in the early stages and the right action instituted, potential disasters can be averted. Unfortunately, the test records often find its home in a remote drawer, blissfully out of sight and out of mind.

With the widespread availability of information and wider acceptance of alternative medicine, many do resort to self-medication or acquiring herbal remedies, occasionally purchasing products online, in the same shopping cart with Victoria's Secret!

With the ever expanding list of over-the-counter drugs, which are medications that can be obtained without a doctor's prescription, many patients do the necessary purchase for simple ailments from the neighborhood pharmacy.

Generally, most trivial illnesses do not need a whole lot of medication in the first place, other than for the relief of symptoms. A common household drug like paracetamol can cause nasty allergies in susceptible individuals or liver damage in accidental overdose.

Self-diagnosis and treatment can run the risk of missing out on a more serious underlying condition. A persistent nasal congestion may be more than the common cold, turning out to be acute sinusitis. That severe "gastric" pain that is not relieved by antacids may be masking a perforated appendix!

Health supplements hit the market in waves. Some are very science-based, high quality and effective, while some are fads, fail to meet required standards, and are of dubious benefit. These products fill up the shelves of pharmacies or the garage of some direct selling distributor.

Due to overhyped sales literature and pressure to sell, there are times that a poorly trained store clerk or product distributor endows oneself with a false sense of empowerment, giving erroneous advice to replace medications with supplements.

This is a dangerous trend as titration of medication falls solely on the shoulders of the doctor.

Information is a double edged sword, as it cuts both ways. Used correctly, it transforms into knowledge that is objective and sound. Conversely, if the wrong kind of information is pieced together, it becomes a potpourri of shaky ideology, leading the seeker from one dark hole to another, ultimately towards an abyss of confusion, much to the detriment of self and others.

Dr C.S. Foo is a medical practitioner. The information provided is for educational and communication purposes only and it should not be construed as personal medical advice.

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