You sense that you’re not well, despite showing no obvious signs or symptoms of illness. You just know something is wrong. After going to your doctor, who orders some basic bloodwork, you get the all clear; tests have turned up nothing wrong. You should be relieved — but you just can’t shake the feeling that something is amiss with your health.
“People are getting subtle messages all the time as to their state of well-being,” says Dr. Larry Burk, a consulting associate professor of radiology at Duke University School of Medicine and musculoskeletal radiologist at Duke University Hospital. Experts say there’s reason not to simply shrug off that nagging hunch. Research indicates that self-reported health — how you say you feel — can reliably predict that someone is going to get sick, including forecasting a person’s long-term health and mortality risk, even when medical tests fall short.
However, because it can be difficult to understand how a vague feeling could indicate a health concern or predict a more serious illness down the road, it often gets ignored. Seeking evidence to better illustrate this link, researchers at Rice University in Houston conducted a study published last month in the journal Psychoneuroendocrinology that found poor self-reported health was associated with higher levels of reactivation of latent herpesviruses (think cold sores) and inflammation. That’s important because higher levels inflammation may be linked with health issues ranging from heart disease and stroke to Alzheimer’s disease.
[See: 10 Seemingly Innocent Symptoms You Shouldn’t Ignore.]
Kyle W. Murdock, a postdoctoral research fellow at Rice University who led the research with Christopher Fagundes, a Rice assistant professor of psychology, compares having high inflammation, which may leave someone feeling like they have a lack of energy and generally fatigued, to feeling a cold coming on — but without obvious outward symptoms. “You can tell something’s going on. But in this case it’s a little bit different, because you don’t have a cough or a runny nose or something like that — those tell-tale signs of sickness,” he says.
While researchers were testing specifically for herpesvirus activity, they noted that given the amount of time testing for this and inflammation take and the difficulty involved, it’s unlikely a primary care provider would check for these issues. Nor do experts advocate that doctors run more tests, as a matter of course, given concerns about overtesting — and the potential harms that can cause. Rather, clinicians say, it’s about striking a balance between taking advantage of advances in modern medicine and paying attention to what the body’s trying to communicate. “Use technology to your best advantage, and trust your hunches,” Burk says.
For some, the moments of clarity come when all the lights are out. Burk published a small pilot study last year in the journal Explore surveying 18 women from around the world who had dreams that they had breast cancer — before they were diagnosed with the disease. “They went into the hospital, got it checked out [and] sure enough they did — and they had no symptoms,” he says. Burk stumbled across the research focus after three of his friends reported they’d had dreams about having breast cancer before it was diagnosed. One of those friends, he says, whose doctor dismissed the dream and didn’t order a mammogram, was later diagnosed with metastatic breast cancer and died from the disease. He adds that some of the women who dreamed they had breast cancer, including another friend who was treated successfully, were able to point out precisely where the tumors were located in their breasts before they’d been biopsied (and without being able to feel a lump).
[See: A Tour of Mammographic Screenings During Your Life.]
Burk says there have also been reports of people having “warning dreams” about other types of cancers, from brain tumors to colon cancer, though he notes there’s only scant information available. As to what might explain the dreams, he theorizes it could be anything from a person being in denial about something that’s wrong with him or her and having that revelation come out in a dream to some sort of physiological signaling or intuitive process that’s not yet understood.
Difficult though dreams or even a gut instinct may be to explain, when a person intuits a problem with his or her health, experts say, it’s important not ignore it.
Dr. Salvatore Mangione, a pulmonologist and associate professor of medicine at Thomas Jefferson University’s Sidney Kimmel Medical College in Philadelphia, says what’s needed is measured collaboration between patient and doctor — starting with the doctor listening intently to the patient. Despite advances in technology, he says the bulk of information used to diagnose patients still comes from what a patient shares, including his or her symptoms and health history, with tests only providing a relative sliver of the picture. “When the patient says something is wrong, they tend to be right,” Mangione says. But he says that the difficult art of making a diagnosis is made harder by the fast pace of medicine and an overreliance on testing. Both can interrupt or shorten the all-important time doctors spend talking with patients. “[A patient’s] interaction with a physician rarely goes beyond 10 minutes in follow-up — a little longer in a primary visit,” he says.
The happy medium, experts agree, is a dialogue in which a physician isn’t dismissive of patient concerns — even when tests don’t bear those out — and patients are, well, patient with the process in pursuing those concerns. In some cases, doctors find themselves in sticky situations, such as when a patient exhibits hypochondria or somatic symptom disorder, characterized by excessive or unrealistic worries about his or her health. More often, though, the dilemma patients and their doctors face is determining how far to go to find out what’s the matter, particularly if it means running lots of tests.
[See: 10 Questions Doctors Wish Their Patients Would Ask.]
That’s all the more reason patients should look for a physician who is a skilled diagnostician, Mangione says, and weigh the risks against the potential benefits for any tests run. Adds Burk: “If you get subtle warning symptoms, if it’s a symptom, if it’s a nagging feeling, if it’s a dream, that is your body’s screening technology, and it’s telling you something that needs to be checked out.”
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Why to Trust Your Hunch You’re Sick — Even if Tests Say Otherwise originally appeared on usnews.com
