Blue lips, A Deep Voice. The Quirky Ways GPs Spot Your Hidden Health Problems
Trained eye of a GP can pick up on warning signs that might pass you by Billy Connolly discovered he had Parkinson’s disease only after an Australian fan, who happened to be a doctor, spotted his gait What other red-flag symptoms might your GP spot that
You might think you know your own body better than anyone else, but the trained eye of a doctor can pick up on warning signs that might pass you by.
Take, for example, Billy Connolly, who discovered he had Parkinson’s disease only after an Australian fan, who happened to be a doctor, spotted him walking through a hotel lobby. He approached the 73-year-old Scottish comedian and told him to see his GP right away as his gait suggested he was showing early signs of the disease - which tests went on to show he had. So what other red-flag symptoms might your GP spot that you might have missed or not realised their significance? Someone with lips that have a bluish tinge or outline may be suffering from undiagnosed heart problems that are causing poor circulation, says Dr Adam Simon, a GP in Manchester.
It’s a sign that the blood is depleted of oxygen because the heart isn’t functioning properly this changes the blood colour from bright red to darker in colour, which makes the skin and lips look blue, he says. Meanwhile, a flushed face can also be a sign of the heart problem mitral stenosis, where the mitral valve (on the left side of the heart) doesn’t open fully. The face develops pinkish-purple patches because of increased blood pressure throughout the body and reduced oxygen in the blood.
TINY YELLOW LUMP NEAR YOUR EYE
‘If I see a patient in my surgery with a yellow lump next to their eye, I immediately organise a cholesterol test - even if they have come in for something else,’ says Dr Rob Hicks, a GP in London. ‘Many patients won’t realise they have high cholesterol because it has no symptoms.’ The little yellow lumps, known as xanthelasma, are fat deposits caused by high levels of ‘bad’ LDL cholesterol, which are dumped under the skin. Soft and painless, the lumps are more common among people in their 40s and 50s. A Danish study of almost 13,000 people found that those with xanthelasmata, were more likely to have a heart attack or die within ten years. High cholesterol can be treated with medication such as statins as well as changes to diet and lifestyle. The lumps themselves can be removed by a dermatologist.
ROLLING AN IMAGINARY PILL
A rubbing of the thumb and forefinger, known as a pill-rolling hand tremor, is characteristic of Parkinson’s disease. The patient may think this is harmless, but to GPs this would be a warning sign they may well have the condition and so will require more tests, says Shropshire-based GP Dr Roger Henderson.
Parkinson’s, a condition in which part of the brain becomes progressively damaged over many years, affects one in 500 in the UK, most of whom are over 50. The tremor is caused by damage in parts of the brain that control muscles, in particular in the hands. That’s why another characteristic of Parkinson’s disease that GPs sometimes spot is a tremor of the hand when it is relaxed.
A DEEPER VOICE THAN USUAL
‘If a patient comes to see me with an uncharacteristically deep voice, with a slowing of the speech, then it could be a sign of an underactive thyroid, says Dr Henderson. Known as dysphonia - the medical term for disorders of the voice - the change is caused by lack of the hormone thyroxine, which is produced by the thyroid gland.
This leads to the vocal cords thickening, and in turn, lowers the frequency of the voice. Hypothyroidism is thought to be an auto-immune condition, where the immune system attacks the thyroid gland, and is seen mostly in women aged between 40 and 50. An underactive thyroid is usually treated by taking daily hormone replacement tablets. An undetected thyroid cancer can also affect the voice, destroying nerves that can lead to paralysis on one side of the larynx (voice box), so only one vocal cord is able to move. As a result the voice tends to sound more whispery, says Dr Henderson.
AN EYELID THAT SUDDENLY DROOPS
A slightly drooping eyelid - that might be so subtle you may not notice it - is a warning sign to a GP of Horner’s syndrome, a condition where nerves to the eyelid are damaged and which can occur as a result of lung cancer, says Dr Henderson. The symptoms begin when the tumour puts pressure on a group of nerves that affect the eye. The condition tends to affect only one eye.
FANNING YOUR HANDS OVER YOUR CHEST
The way a patient expresses pain can be a sign of heart problems - even if they don’t realise it. ‘If a patient comes to me with a pain high in their chest and fans their fingers out to explain it, rather than pointing to its location, that to me suggests it could be angina - even if they think it is indigestion,’ says Dr Henderson.
‘This spreading of the hand illustrates the spreading feeling of tightness in their chest rather than pointing to one place in the chest or stomach, which would be a truer sign of the stomach acid that they think is their problem.’ Each year, about 20,000 people in the UK develop angina. It happens when the blood supply to the muscles of the heart is partially restricted.
Pain is usually felt in the centre of your chest, but may spread to your shoulders, back, neck, jaw or arm, which is why patients may fan out their hands to describe it. The GP may prescribe glyceryl trinitrate, a medication that works by relaxing and widening the blood vessels that increase the blood supply to the heart.
NOT LOOKING A DOCTOR IN THE EYE
This may tell a doctor that the person has depression - the patient may feel subconsciously that there is a stigma about admitting to depression, so they can find it hard to look their doctor in the eye, says Dr Michael Ingram, a GP in Hertfordshire. Another red flag for depression is when a patient who has made an appointment over a minor health issue either bursts into tears or has a burst of anger or irritability, says Dr Hicks.
‘Depression upsets levels of the so-called “feel good” brain chemical serotonin, making people prone to crying or feeling angry and upset.’
SITTING TO ONE SIDE OF A CHAIR
Just watching how a patient sits in their chair can alert doctors that something may be wrong.
If a patient sits facing to one side with their legs towards the edge of the chair, it can be a warning sign of an undiagnosed brain tumour. ‘Some brain tumours can affect a patient’s visual field - the portion of a person’s surroundings that they can see,’ says Dr Ingram. Brain tumours can affect vision if they impact on the occipital lobe - the back part of the brain that is involved with vision. ‘A patient may subconsciously find themselves readjusting the way they sit and the direction they face when talking to their GP to compensate for that loss of vision,’ adds Dr Ingram.