Not every symptom points to a single organ. Dr Jonathen Venkatachalam, who practises general medicine alongside respiratory and critical care medicine at Aeden Health, explains common problems that need a doctor to look at the whole picture, from choosing the right health screening to unexplained weight loss, prolonged fever and heart failure.
Health Screening: More Tests Are Not Always Better
Screening chosen for you
More tests are not always better. The right health screening is the one chosen for you, based on your age, family history and lifestyle.
A good start for most adults
Checking blood pressure, blood sugar and cholesterol is a good start for most adults.
Cancer screening
Screening for breast, cervical and bowel cancer saves lives, and lung cancer screening may be right for some.
The problem with blanket packages
Blanket packages of tests can lead to findings that are harmless but cause anxiety and further tests. We will help you decide what is worth doing, and what is not, so that your screening is as useful as possible.
Unexplained Weight Loss
When weight loss needs looking into
Losing weight without trying is a symptom that should be looked into, particularly if it is more than five percent of your body weight over six months.
What causes unexplained weight loss?
The causes are wide ranging. They include an overactive thyroid, diabetes, infections such as TB, bowel conditions, depression, medications and cancer.
How it is investigated
We take a careful history, examine you, and arrange blood tests and scans as needed. Many causes are treatable.
Don't wait and see
Please do not wait to see if it settles, as an early answer, whatever it is, is better than a late one.
Prolonged Fever
A fever that lasts for weeks
A fever that lasts for weeks without an obvious cause can be frustrating for patients and doctors alike.
What causes a prolonged fever?
The causes include hidden infections such as TB, inflammatory and autoimmune conditions, cancers and reactions to medicines.
How it is investigated
We work through the possibilities in a systematic way, with a careful history, blood tests and imaging, and sometimes a PET scan or biopsy.
Why antibiotics are not the first step
Giving antibiotics without a clear reason can mask the picture and delay the diagnosis.
Finding the answer
It takes patience, but in most cases we find the answer, and in others the fever settles on its own.
Deep Vein Thrombosis (DVT)
What is a deep vein thrombosis?
A deep vein thrombosis is a blood clot in a deep vein, usually in the leg.
Symptoms
It can cause pain, swelling, warmth and redness, but some are silent.
Who is at risk?
The risk rises after surgery, long periods of immobility, long journeys, pregnancy, hormone treatment and cancer.
Diagnosis and treatment
An ultrasound makes the diagnosis. Treatment with blood thinners prevents the clot from growing and from travelling to the lungs, which is the real danger.
After a DVT
Some patients develop long term leg swelling, and compression stockings and exercise can help. How long to continue treatment depends on why the clot formed, and it is a decision we make together.
Electrolyte Abnormalities
Why electrolytes matter
Sodium, potassium, calcium and magnesium are essential for the nerves, muscles and heart.
Symptoms of an electrolyte abnormality
Abnormal levels are often found on routine blood tests. Mild changes may cause no symptoms, while more severe ones can cause tiredness, cramps, confusion, palpitations or fits.
Common causes
Common causes include medications such as water tablets, kidney and hormone problems, vomiting, diarrhoea and diet. The cause matters as much as the number.
Why not to correct it yourself
Some abnormalities need to be corrected slowly and carefully in hospital, and correcting too quickly can be harmful. Please do not try to correct these on your own.
Diabetic Ketoacidosis (DKA) and Gastrointestinal Bleeding
Diabetic ketoacidosis (DKA)
Some medical problems cannot wait. Diabetic ketoacidosis, or DKA, occurs when the body, lacking insulin, begins to produce harmful acids.
It causes thirst, vomiting, abdominal pain and drowsiness, and can occur even when sugar levels are not very high in patients taking certain diabetes medicines.
DKA is a medical emergency, treated with fluids, close monitoring and insulin.
Gastrointestinal bleeding
A gastrointestinal bleed may present as black stools or vomiting blood.
A gastrointestinal bleed is a medical emergency, treated with fluids, close monitoring and an endoscopy to find and treat the source.
Early attention makes a big difference, and most patients make a full recovery.
Heart Failure
What heart failure means
Heart failure does not mean the heart has stopped. It means the heart is not pumping or relaxing as well as it should, leading to breathlessness, tiredness and swollen legs.
How treatment has changed
We have made great strides in treatment. A combination of four types of medication, now regarded as the foundation of care, can help people feel better, stay out of hospital and live longer. Some patients also benefit from devices.
Living with heart failure
Understanding your fluid and salt intake, monitoring your weight and having a team that works together makes living with heart failure more manageable. A diagnosis of heart failure is not the end of an active life.
Next steps
Dr Venkatachalam consults at Aeden Health. To arrange a consultation, book an appointment or read more about The Aeden Physicians.
Related guides: Lung and Respiratory Conditions: A Patient Guide · Intensive Care: A Guide for Families
Frequently Asked Questions
Are more health screening tests better?
More tests are not always better. The right health screening is the one chosen for you, based on your age, family history and lifestyle.
When is unexplained weight loss a concern?
Losing weight without trying is a symptom that should be looked into, particularly if it is more than five percent of your body weight over six months.
What causes a fever that lasts for weeks?
The causes include hidden infections such as TB, inflammatory and autoimmune conditions, cancers and reactions to medicines.
What are the symptoms of DVT?
A deep vein thrombosis is a blood clot in a deep vein, usually in the leg. It can cause pain, swelling, warmth and redness, but some are silent.
Can I correct my electrolytes on my own?
Some abnormalities need to be corrected slowly and carefully in hospital, and correcting too quickly can be harmful. Please do not try to correct these on your own.
What are the symptoms of DKA?
It causes thirst, vomiting, abdominal pain and drowsiness, and can occur even when sugar levels are not very high in patients taking certain diabetes medicines.
What are the signs of a gastrointestinal bleed?
A gastrointestinal bleed may present as black stools or vomiting blood.
What is heart failure?
Heart failure does not mean the heart has stopped. It means the heart is not pumping or relaxing as well as it should, leading to breathlessness, tiredness and swollen legs.