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Author Topic: What makes us "feel unwell"?  (Read 1434 times)

Offline cheryl j

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What makes us "feel unwell"?
« on: 28/04/2013 17:57:50 »
People usually go to the doctor because of specific type of pain (eg sore foot) or an over all sense of feeling unwell. Even though it is the driving force when people seek medical attention, I've never really seen any research about the subjective symptoms of unwellness, and their causes.  When I used to process emerg forms, it was interesting to see how patients described it - "I feel like hell"  "I ache all over" "Everything hurts" "No energy" "Tired all the time, feel like sh1t."

I started thinking about this because a few months ago I got very sick and landed in the hospital for a week. I had an abscess in my abdomen that eventually broke open. I had had this smouldering infection for weeks, possibly a year or more. But unlike, say, pneumonia, which has obvious respiratory symptoms, it was hard to tell what was wrong with me. I just knew I didn't feel well, although the onset was gradual enough, that I think I just adapted to this sense of feeling "yucky" as normal. I attributed the fever and chills to hot flashes, since I'm getting close to menopause age. I attributed achy joints to arthritis which runs in my family, and tiredness to age and the fact that it was winter. I attributed the abdominal pain to cramps, something I ate. But I had an ongoing argument in my head, with one side saying "I don't feel well. Somethings wrong" and another side saying "Nothing's wrong. I'm just getting older." If the pain in my abdomen hadn't gotten a lot worse, I probably would have gone on and on like that, or possibly fallen over dead. Which shows that sometimes severe pain really is your friend.

I once hear an exasperated doctor complain that some of his patients expected to feel not only okay, but "good" all of the time, and would come see him if they didn't. Life just isn't like that, he said. Ups and downs are normal. These patients had very high expectations of normal. Other patients will endure quite a bit of discomfort and dysfunction before getting medical attention. What is responsible for different patients' expectations about what is "normal" or acceptable?

I know a little about the immune system and I believe inflammatory chemicals, cytokines, pyrogens, etc.  are generally responsible for the over all feeling of yukyness - often referred to as "malaise" in textbooks. Because I was cranking out so many white blood cells, my red blood cells were anemic, explaining some of my tiredness. But I don't know if all that fully explains the subjective feeling of unwellness that people experience, and why systemic inflammation is an unpleasant sensation.

I think it might be interesting to study cancer patients or those with other serious illnesses, and ask them when they first started to feel unwell (if at all), and when they first began to think that this illness was different and not just a normal "up and down."

I sometimes wonder if I was 16, and woke up in the body I have right now, if the differences would be extremely apparent. Whether I would immediately notice less agility, coordination, worse eye site, less muscle strength, and a lot less energy. Do we adapt to rather extreme changes over time? Would heart disease be more apparent if the changes occurred in three weeks rather than 30 years?

Finally, other than anemia, I've never read much about the physiological basis of people's perception of "having no energy." It's sometimes, but not always, connected to sleep. Again, it's very common complaint of people who are sick, especially in the earliest stages. But "lack of energy" is also something that characterizes the normal aging process. The funniest thing to watch is an auditorium full of grade school children waiting for an assembly to start. They are an incredibly fidgety, restless, squirmy bunch. Compared to adults,  it is a sea of constant movement and activity even though they are all seated. If you go to the Zoo, the young monkeys are running around chasing each other, and the older ones are sitting quietly under a tree, so I really think it's biological, not cultural.  What are the metabolic processes responsible for these energy levels, or the perception of having more or less energy? Is it thyroid driven or something else?

« Last Edit: 01/05/2013 08:22:37 by chris »


 

Offline Pmb

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Re: The Subjective Feeling of Illness
« Reply #1 on: 29/04/2013 02:57:37 »
I hear ya! Ever since I got Leukemia I've had a stream of health problems. I try to ignore them thinking that its all in my head or I'm worrying too much only to find that I'm extremely ill. Things like gall bladder attack, pancreatitis, detached retina, torn retina, and now perhaps bleeding in my brain. I just don't know how to handle all these things when it seems like its never ending. I'm a statistical anomaly. Iím lost as to what to do about this new thing and Iím tired of going to the ER. This last time they did a spinal tap which was horribly painful. And they found nothing!
 

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Re: The Subjective Feeling of Illness
« Reply #1 on: 29/04/2013 02:57:37 »

 

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