What was your favourite movie growing up? Mine was Titanic- the romance,the grandeur and particularly Dicaprio!!I would have watched this movie upwards of 20 times and knew all the lines by heart. The main villain in the movie later turned out to be a very significant presence in my own life. No I’m not talking about Billy Zane the actor, I am in fact talking about the iceberg. None of this would have mattered if the iceberg were’nt there that fateful night. Years later in med school I’m introduced about the Iceberg concept- that nothing is as it seems on the surface. There is something big waiting beneath the calm exterior like the iceberg phenomenon. This holds good for many things in life but today I would want to focus on our body and of course our health.
Every day we meet patients who come to us sick. We meet them, we treat them and hopefully they do not return back. Every once in awhile we hear about a young person meeting a tragic fate in the emergency department. Maybe a heart attack might be stroke. Very recently in India we had a popular singer who had captured our hearts pass on due at an untimely heart attack right after his concert performance. The country mourned his loss and wondered what went wrong? We contemplate on it, we empathise with the family and again life goes on. We all walk around with the belief that nothing bad will ever happen to us. But do you know that there might be something lurking beneath the seemingly calm surface of your existence and that this same thing might literally be the cause of your doom?
Our body is like a well oiled machine. It is our only true companion for the rest of our lives. Not even our spouses may be with us during ‘sickness and health’ but our body endures all. The cigarettes you smoke out of desperation and need to ‘relieve stress’, the junk food that you gorge on every time there is a party, the alcohol that you gulp down on the weekends, binge watching all seasons of the latest series a single day forgoing sleep and food, the long periods of inactivity and the waves of emotional and psychological stress- it endures it all! But, there are times when your body tells you – hang on I can’t do it anymore. Why don’t we listen to these subtle signs of our body telling us to change and do something to recover.
Iceberg Phenomenon : What are the signs of ill Health in our body?
Even seemingly simple signs actually might be a cry for help from our body. Here I have listed a few below pointers that could be signs of ill health:
- Hair– our crowning glory, the cause of pride for some, source of worry for others. Did you know that the condition of your hair mirrors your inner health? Hair loss might not be just due to ageing or ‘change in weather, change in water’ as your grand mom might say. Hair loss and premature greying can be due to a long standing diet which is deficient in nutrients. You might be anaemic with low blood haemoglobin values, or you might have an underlying thyroid condition. On the contrary for women, excess hair growth in all the unwanted places like the face and forearms might be due to the hormonal condition called PCOD- polycystic ovarian disease.
- Skin– don’t we all crave for the blemish free bright and clear skin of our youth? Our media is fraught with models strutting across with “glass skin” and tutorials galore on how to achieve it. But what you need is not how to improve your complexion but how to maintain a healthy looking skin. PCOD can lead to darkening and thickening of the skin around the folds of the neck or the elbow region. Dryness of skin might be an indicator of excess stress and lack of sleep.
- Oral health– do you suffer from mouth ulcers on a regular basis? Notice how these ulcers erupt especially during times of excess stress and lack of sleep? They can also be seen following a bout of illness probably after taking too many painkillers.
- Digestion matters– notice how your digestion comes to a standstill as if on a holiday every time you go on a holiday? The worry about being unable to ‘do the deed’ elsewhere is a major concern for many when packing for holidays. A good digestion is synonymous with a balanced life. Focus on your digestive health every once in a while. I have had several people who present just with a recent change in their bowel habits such as constipation and gastritis and were later diagnosed to have end stage stomach or intestinal cancers!
- Headache– not all headaches are migraines or sinusitis. A computer professionals best friend and a students exam companion, a party popper and often accompanied by its close cousin nausea, repeated headaches are not to be taken lightly. Everything from high blood pressure and defective vision to even brain tumours begin with a headache. But don’t be alarmed yours might just be sinusitis after all but only getting it checked can ‘relieve this headache’.
- Chest pain– can closely resemble pain due to gastritis and is often ignored until it is too late. Any chest pain needs to be checked out. Similarly the feeling of your heart pounding on your chest like the times it would when your crush walks by is actually not so romantic after all!
- Weighty issues– our weight gain or loss always is the hot conversational topic at any gathering. Many diseases right from diabetes and tuberculosis to even cancers can just begin with weight loss. Similarly if you have been packing on the pounds without any reason look at the thyroid gland, PCOD, or any other hormonal imbalance for its cause.
- Sleep– how we sleep and how much we sleep matters a lot and this varies from person to person. While some of us love to snooze at any given opportunity there are others who are power rangers and can go on with just 4 hours of sleep. If however you have been experiencing trouble falling asleep or staying asleep don’t take it lightly. It can be an indicator of extreme stress or depression. Please click here to read my blog about sleep hygiene and some tips to sleep better
Many of us pride about never having to ever meet with the doctor. ‘An apple a day to keep the doctor away’ goes the popular saying but why not seek timely help when required? Remember even our vehicles need periodic servicing to keep it running in top shape. So why not our bodies? Just like the iceberg phenomenon which apparently has more than 80% of its body mass below the surface of water and only 20% above. We also encounter only 20% of people who are sick in the hospitals.This is the key characteristic of the iceberg phenomenon. The vast majority of unhealthy people are actually hidden in the community walking oblivious to everything around. As a public health physician it has become my life’s motto to identify and treat these people under the iceberg. For if they are left alone, they will ultimately land up with complications or heavens forbid a worser fate.Hence it is important to identify the signs of ill health early as possible like the hidden portions ice in the iceberg phenomenon.
Iceberg Phenomenon: Few things you can and must do for your body today:
1.Health check up- take your health in your own hands. Visit the doctor for a thorough health check up at least once every year. Since most of us are working in the private sector we are mandated by our organisation to do a yearly health checkup. But what about our parents and spouses who are working at home? It would be a good idea to convince your parents to do the same as many are not receptive to this idea.Please read the blog here to learn about health checkup packages and how to choose the right one for you
2.Follow up is key- I once visited a factory as part of an audit where all the workers had undergone routine tests. Everything seemed wonderful on the surface but on close scrutiny we found many of workers had hearing loss and some of them were severely anaemic. They continued working in these same noisy environments despite the report well on their way to becoming completely hearing impaired in a few years. The anaemic individuals received no iron supplementation or nutritional intervention. Mere testing is pointless if not followed up by consultation with doctors.
3.Women especially need to be mindful of their reproductive health. A monthly self breast examination can help detect any small lumps or changes in the breast and any cancer detected early has wonderful outcomes. It’s a good idea to undergo a Pap smear test every three years to screen for cervical cancer. Recently, I recently came to know of a woman who had done a Chest X-ray as a preliminary requirement to get her overseas visa. That technicality ended up saving her life as she was detected to have early stage lung cancer and she is now on chemotherapy.
4.Are you over 30 years of age? It would be a good idea to check your blood sugar, cholesterol and blood pressure values at least annually then. Such lifestyle diseases are now creeping in early and if detected soon while they are hidden like the iceberg phenomenon can be managed even without medications.Even if you feel you are some sort of a super human it’s good to get that validated.
5.Do you suffer from lack of sleep, low mood/ mood swings or anxiety and have been brushing it aside for far too long? There should be no shame in acknowledging your mental health issues. Just like a fever or cold needs a visit to the doctor our mind also needs periodic upkeep. An occasional visit to the psychiatrist/ counsellor to discuss things troubling you will help give you a clearer perspective of life. And no, psychiatric medicines are not addictive nor are they sedative so stop giving lame excuses.
6.Many of our parents are diabetic and hypertensive but how many of them are meeting up with their care providers on a regular basis and keeping their sugars under control? I’ve had patients who had never met their doctors after being diagnosed with diabetes, they continued to take the same medicines prescribed years ago from the local pharmacy and then wonder why they developed gangrene of the feet! The cost of such neglect is phenomenal, so next time do accompany your parents to the doctor at least once every couple of months.I have mentioned some scenarios which I encountered in some of my rural patients in this blog about diabetes a rural paradox.
7.Do not self medicate- while its good for us to have common medicines at home not every medical emergency can be solved by asking the nearby pharmacist. Half knowledge is dangerous and even a call/ text to your doctor friend is insufficient. Detailed history taking and physical examination is crucial before diagnosis so take the effort to meet your physician.
8.Everything organic or plant based is not necessarily healthy. Some of them even contain trace amounts of heavy metals like lead and arsenic which can cause immense harm. So do your research before gulping down every new ‘immunity booster’ out there.
9.Insurance- we have insurance for our vehicles(pardon my frequent reference to vehicles, I’m just back from servicing my car!), insurance for our houses and life but do we have a good health insurance? Many people are pushed to poverty when there is a health emergency. We call it a ‘catastrophic health event’. Even well to do families find the cost of healthcare pricy. Health care costs are escalating day by day so it would be prudent to get yourself and family insured to avoid the dizzy spells when you get the hefty bill!
Ultimately we are responsible for our health and we need to proactively identify signs of ill health which are hidden as I mentioned in the iceberg phenomenon . Blaming the doctors at the hospital once things go down hill can get you nowhere. There is only so much we can do. As the popular adage goes ‘prevention is truly better than cure’. So the next time your body cries for help- stop and listen!