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Tuesday, November 07, 2006  
Seven Pains You Should Never Ignore

These widespread pains could very well be nothing - or something much worse. And three things that you really do not have to worry about.

In most cases, it is really good that the little Vince Lombardi that sits on our shoulder and tells us to shut up and play through the pain. Otherwise we wouldn't ever get anything done. On the other hand, though, there are several instances in which we are able to talk ourselves out of existence.

Here you can read what happened to NBC reporter David Bloom. While he was covering the war in Iraq from his specially prepared armored vehicle, he suddenly started to feel pain behind his knee. He apparently searched for medical help by means of satellite phone, however he decided not to follow the advice - "Go to a physician". Hem popped several  aspirin tablets, and kept right on going. After three days, Bloom died of a pulmonary embolism resulting from deep-vein thrombosis. He was thirty nine years old.

The pain that Bloom experienced is one of seven pains that should never be ignored by anybody. And this is not negotiable.

1. Sudden Groin Pain

It is not as severe as a shot to the crotch, but pretty close. It may be sometimes accompanied by swelling.

The condition: Odds are something that is known as testicular torsion. Usually, a man's testicles are attached to his body in two different ways: by the spermatic cords, that connect with the abdomen, and by fleshy anchors located close to the scrotum. However sometimes, in a relatively frequent congenital defect, these anchors are missing. This causes that one of the spermatic cords gets twisted, which cuts off the flow of blood to the testicle. "If you have it in four to six hours, usually you are able to save the testicle," claims Jon Pryor, M., an urologist with the University of Minnesota. "But after twelve to twenty four hours, you will probably lose it." Another probable cause of the pain in your pants is an infection of the epididymis, your sperm-storage facility.

The diagnostics possibilities include a physical examination, probably followed by an ultrasound. Antibiotics may stifle an infection.

But what if your testicles are getting twisted? A surgeon will have to straighten the cord, then construct artificial anchors with several stitches close to the scrotum.

2. Severe Back Pain

Alike the kind of agony you would expect if you had just tried to clean-and-jerk an armoire. The usual cures, which means heat, rest, OTC pain relievers, do not provide relief.

The condition: "If it is not associated with exercise, unexpected severe back pain may constitute the symptom of an aneurysm," explains Sigfried Kra, MD, an associate professor at the Yale school of medicine. Predominantly disturbing is the abdominal aneurysm, a perilous weakening of the aorta just above the kidneys. But don't be afraid; finally the pain subsides - right after your body's main artery bursts. A less frightening possibility is that you have a kidney stone. It brings about more pain, but you will only wish you were dead.

The diagnostics: ACT scan that uses intravenous radiopaque dye does as much as possible to reveal the size and shape of an aneurysm. And when its dimensions are determined, it is going to be treated with blood-pressure medicines or surgery to implant a synthetic graft.

3. Persistent Foot or Shin Pain

It is irritating pain in the top of your foot or the front of your shin that worsens while you are training, however it is present even when you rest. It does not disappear even after taking ibuprofen and acetaminophen.

The condition: Most probably it is caused by high level of stress. Similarly to other tissues in your body, bones are constantly regenerating themselves. "However if you are exercising so hard that the bone does not have a chance to heal itself, a stress fracture has the possibility to develop," says Andrew Feldman, MD, the team doctor for the New York Rangers. Eventually, the bone can be enduringly weakened.

The diagnostics: Radioactive dye reveals the fracture in the X-ray, and you will be asked to give up all running until the crack heals. In the worst case, you will be in a cast for several weeks.

4. Sharp Pain in the Abdomen

This condition is also called: knife in the gut, bullet in the belly, skewer in the stomach - except this attack is from within.

The condition: Take your pick. Due to the fact that the area between your ribs and hips is jam-packed with organs, the pain may be one of the signs of either appendicitis, pancreatitis, or an inflamed gallbladder. There is the same cause in all these cases: Something has blocked up the organ in question, leading to a potentially deadly infection. Exploding organs are able to kill a man. Before this takes place- consult your healthcare provider.

The diagnostics: If you experience the pain in your lower-right abdomen and your white-blood-cell count is up, explains Dr. Kra, most probably it is appendicitis (out comes the appendix). If the ache appears in your upper abdomen with high white blood cells normally spells an inflamed gallbladder (goodbye, gallbladder). And if you feel the pain below your breastbone and some enzymes in the blood are increased, then pancreatitis is probably responsible. (The pancreas remains, but a gallstone can be blocking things up. If so, the stone and the gallbladder may have to be removed.)

5. Transient Chest Pain

Not a type of ache that strikes only the homeless, but a severe pain that comes on unexpectedly and then disappears just as fast as it came. Otherwise, you feel all right.

The condition: It is very likely that it is indigestion. It could be a heart attack as well. "Even if the duration of this condition is very short, it can be a symptom of something serious," explains John Stamatos, MD, medical director of North Shore Pain Services in Long Island and author of Painbuster. Here's how serious: A blood clot may have lodged in a narrowed section of a coronary artery, entirely cutting off the flow of blood to one section of your heart. How much wait-and-see time do you have? Actually, you have no time. Fifty per cent of deaths from heart attacks happen within three to four hours after experiencing the first symptoms. You are literally living on borrowed time.

The diagnostics: Take blood tests to check for markers of damaged heart tissue. Treatment: angioplasty or bypass is recommended.

6. Leg Pain with Swelling

In particular, one of your calves is really killing you. It's swollen and tender to the touch. You may have the impression that it is warm, as if it's being slow-roasted from the inside out.

The condition: You should just sit in one place for six hours or even more straight and wait for the blood that pools in your lower legs to form a clot (a.k.a. deep-vein thrombosis, or DVT). Next thing you know, that clot will be large enough to block a vein in your calf, enhancing pain and swelling. Unluckily, the first thing you will probably be willing to do - rub your leg - is also the worst thing you can do. "It can send a big clot running up to your lung, which may kill you," warns Dr. Stamatos.

The diagnostics: A venogram is recommended, in which dye is injected into the vein and then X-rayed, is the perfect way to diagnose DVT. The doctors will try to dissolve the clot with medications, or outfit weak veins with filters to stop a clot before it stops you.

7. Painful Urination

Relieving yourself has become an exercise in expletives. Furthermore, you could swear (and you do) that your yellow stream has a rusty tint.

The condition: According to Joseph A. Smith, M.D., the president of the department of urologic surgery at Vanderbilt University, in the worst case it may result in bladder cancer. The ache and the blood in your urine are signs of this, the fourth most common cancer among men. Smoking cigarettes is the greatest risk factor. Catch the illness early, and there is a 90 per cent likelihood of fixing it. Bladder infections share similar symptoms.

The diagnostics: It sounds as a sick joke, but nevertheless it is true: They will diagnose you by process of elimination. The first thing is urinalysis, to rule out bugs, followed by inserting a scope to look inside the bladder. A tumor will be treated with surgery, radiation, or chemotherapy.

Three Health Scares You Can Ignore

We add a dose of perspective to the panic.

West Nile virus – Despite the fact that it is true that West Nile virus killed 284 people in 2002, the likelihood of its taking out a healthy young or middle-aged man is really little. "The healthier a person is, the less probable he is to become seriously ill if he's infected," explains Stephen Zinner, MD, a professor of medicine at Harvard medical school. Actually, of persons bitten by virus-carrying mosquitoes, no more than 15 per cent will develop symptoms, and following death happens even more seldom. Therefore, just do what you have always done: Use bug spray, and try to relax.

Mercury in dental fillings - When the American Dental Association (ADA) interviewed adults about whether they believed that dental amalgams (silver-colored fillings) led to illness, almost fifty per cent replied 'yes'. They are wrong. "Mercury vapor may be leaked, however it is very small and causes no harm," explains Richard Price, DMD, a consumer advisor for the ADA. "An amalgam's only downside is that it looks ugly." The FDA and the World Health Organization agree that there is no health risk.

SARS - Toss the surgical mask. "A 35-year-old American male citizen's likelihood of ever being exposed to this virus in the United States are so little that he ought to be more afraid of walking across the street," claims Stanley Deresinski, MD, a clinical professor of medicine at Stanford University and editor of Infectious Disease Alert. However, let's say that you somehow have contact with SARS instead of an SUV. The same as with West Nile virus, the chances that a healthy man will succumb to the virus are low, about 5 per cent only, Dr. Deresinski explains.

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