Know your body: subtle signs of disease
published in Reader's Digest,
24 February 2023
Spotting subtle signs of disease in your body can be done with a simple body scan.
In 1873, Sir William Gull, doctor to Queen Victoria, described seeing bodily changes “going on from year to year” in some women, often around the time of menopause.
Noting that the women became “insensibly more and more languid, with general increase in bulk…with faces altering from oval to round—like the full moon at rising—the voice guttural and the hands peculiarly broad and thick,” he was the first to identify an underactive thyroid as the cause.
Spotting external signs and symptoms can speed up diagnosis of disease within and aid recovery.
The body scan
In mindfulness meditation, you mentally scan your body from head to toe, learning to focus on sensations (before letting them go) and become fully present in your life. In a similar way, it can be a good idea, every now and then, to scan your body for signs and symptoms of disease, tuning into your body in a way that allows curiosity and kind concern—but which avoids hang-ups, health anxiety or hypochondria.
It took a brightly illuminated bathroom in Beijing, with multiple mirrors, for Clare Wise, sister of actor Greg, to spot a breast lump which turned out to be cancer. Writing in her biography, Clare marvels at women who are “so in tune with their bodies that they can tell when they are ovulating or growing a nail.”
She, on the other hand, admits to having had a less close relationship with her body, seeing it more like “a third cousin several times removed”. Being somewhere between these two extremes is probably best: here are some starters for the scan.
It’s normal for the pupils in your eyes to enlarge in response to emotion, whether it’s anger, anxiety or arousal, and concentration. They also widen to aid illumination in a darkened room. But when one or both pupils are fixed and dilated, not returning to their usual size, it’s a medical concern and could signal something serious.
"When one or both pupils are fixed and dilated…it’s a medical concern"
So-called “blown pupils” can indicate increased pressure in the brain, through head injury, tumour or stroke; or damage to the nerves controlling the eye, through infection, injury, diabetes, or multiple sclerosis. For some people with spinal cord injury, dilated pupils may be a sign of medical emergency, when the nervous system overreacts to something such as a full bladder, sending blood pressure soaring.
Overdose of adrenaline (through tumours of the adrenal glands, which sit above the kidneys), or intake of recreational drugs including cocaine, LSD, ecstasy and amphetamines, or drugs prescribed for your muscles or your mood, may also dilate the pupil. If pupil enlargement is particularly pronounced when taking a mental test, it could be an early warning sign for dementia, according to recent research at the University of California.
The FAST test can help you spot signs of a stroke—with F standing for facial weakness, since a droopy mouth (or eye) is one of the most common symptoms.
If the one-sided smile has a less sudden onset, it could be Bell’s palsy. First described by, and named after, Scottish surgeon Sir Charles Bell in a lecture at the Royal Society of London in 1821, the palsy remains a mystery in many cases. It’s possible that a virus, including the one that causes cold sores, damages the facial nerve—but usually the origin is unknown. Most people get better within months.
"The FAST test can help you spot signs of a stroke, with F standing for facial weakness"
Other viruses, including HIV, mumps and influenza, can also make your mouth droop, through effects on the facial nerve. When the chickenpox/shingles virus is the cause, so-called “Ramsay-Hunt” syndrome develops, seen recently in singer Justin Bieber.
Tick bites (in Lyme disease), tumours, and trauma during dental surgery can also damage the facial nerve, while some rare conditions, including myasthenia gravis and Moebius syndrome, cause muscle weakness around the mouth, making it a struggle to smile.
Deathly white hands
In Raynaud’s phenomenon, the response of your circulation to the cold is excessive. Blood supply is completely cut off to the fingers when the blood vessels suddenly spasm. The thumb, interestingly, is often spared, whilst the fingers can turn white then blue then red—the colours of the French Tricolour, and rather appropriate since the syndrome is named after Maurice Raynaud, the French physician who first described the condition in 1862.
The deathly white fingers of Raynaud’s are because they’re bloodless; the bluish tinge represents reduced blood flow returning to the skin; and the fingers turn a bright red when blood flow is restored. Sometimes Raynaud’s is the result of an underlying health condition such as lupus, scleroderma or rheumatoid arthritis.
If your hands have raised yellow lesions, high cholesterol could be the cause; bony knobs on finger joints are associated with arthritis. Clubbed fingers, enlarged at the tips, can help diagnose disease of the heart and lung. Shaking hands may be a sign of Parkinson’s disease, multiple sclerosis, or essential tremor, a sign of alcohol intake, or a side-effect of some medications.
Red legs pose a diagnostic dilemma for doctors: it’s not always cellulitis, and antibiotics can be over-prescribed. When both legs are red, and not warmer than other body parts, it could instead be varicose eczema, a long-term leg condition caused by increased pressure in the leg veins. Obesity, ageing, pregnancy and immobility are risk factors; moisturisers, steroids and stockings can help.
"Looking at the legs when someone is dying can signal that death is near"
Changes to blood flow in the legs, through furred up arteries, weakened veins, or a blood clot, can also discolour the skin, as can infected joints, leg ulcers and dermatitis. When bad circulation is to blame, it could be a sign that arteries elsewhere in the body are in trouble. Heart attacks and strokes are both diseases of the blood vessels and they are up to three times more likely in people with peripheral arterial disease.
Looking at the legs when someone is dying can signal that death is near. Blotchy, purplish marbling of the skin is a sign that the heart is no longer able to beat strongly—and the feet and legs, being furthest from the heart, are the first to manifest this mottling.
Different bowel habits
Temporary constipation or diarrhoea may be triggered by your diet, medication or infection. Persistent and unexplained changes in bowel habits might signal a more serious underlying problem, so seek medical advice.
When it comes to bleeding from your back passage, the British Medical Journal have just released a booklet summarising likely causes, including haemorrhoids, polyps, ulcers, Crohn’s and colitis, and cancer.
The best advice comes from Dame Deborah James, previous patron of Bowel Cancer UK who died from the disease in 2022. In her final message, she said, “Find a life worth enjoying; take risks; love deeply; have no regrets; and always, always have rebellious hope. And finally, check your poo—it could just save your life.”