Ask the Doctor: October 2021
Q. What is the difference between a sign and a symptom?
A. A symptom is experienced subjectively by a person and may not be easily identified by another person (stomach cramps and headaches, for example). A sign is observable by another person, such as a physician (for example, wincing is a sign of pain). A doctor diagnoses conditions based on observable signs indicative of disease and the subjective description of a person’s symptoms. In general, a symptom tends to be more vague and suggestive, for example a person reports a cough or fatigue, which have many possible underlying causes. A sign typically can be linked to a medical fact/disease, whereas a symptom cannot. Put another way, physicians evaluate symptoms to discern if they are a sign of a specific disease.
Signs of disease are measurable. For example, high blood pressure is measurable and can indicate cardiovascular disease, a stress response, or a medication side effect. To reach a diagnosis, medical professionals ask more questions about symptoms and family history in an effort to discern if it fits a particular disease profile. However, some diseases are asymptomatic, which means a person doesn’t know that damage may be occurring. This can happen with cardiovascular disease, as there may not be any symptoms until the disease has caused more damage. Another example is cancer. At early stages of breast and prostate cancer, people usually don’t have any symptoms until the disease has advanced, which is why screenings are so important. Infections also may be asymptomatic, yet it’s still possible to transmit disease to others. An infection in the incubation period may not produce symptoms but can be infectious, as is the case with the human immunodeficiency virus (HIV), and more recently with COVID- 19. The bottomline is don’t ignore symptoms or physician-recommended tests. Ruling in or out the possibility of disease at its earliest stages offers the best opportunity to treat, better manage, and possibly cure it.
Q. Do all heart attacks lead to heart failure?
A. With more people surviving heart attacks, the incidence of heart failure has increased. But, not all heart attacks automatically lead to heart failure. The risk depends upon how much and how severely the heart muscle was damaged. This, in turn, depends upon how long the heart muscle was deprived of oxygen-rich blood supply. Heart cells start to die as soon as blood flow to the heart is impeded. That’s why time-to-care is so critical when a heart attacked is suspected. Once a person has experienced a heart attack, the risk of a second heart attack increases 15-fold. But there is a lot you can do to reduce the risk of a first and even a second heart attack. The American Heart Association has a good guide called ‘Life’s Simple 7’ (http:// tiny.cc/LifeSimple7). The steps include the need to maintain normal levels of blood pressure, cholesterol, and blood sugar, not smoking, exercising regularly, eating healthfully, and losing excess weight. It’s also vital to reduce stress, take any medications as prescribed, and follow up with your doctor as recommended, especially if you have experienced a heart attack.
Q. How can I get more protein into my diet?
A. Older adults generally require more protein than younger adults to stimulate the same amount of muscle growth. Think about making protein the star of each meal or snack. Make an egg burrito with a whole-grain wrap, build a layered snack-in-a-glass with Greek yogurt, nuts and fruit, or create simple protein-packed patties from black beans or canned salmon. Protein powders also can be an appropriate choice to add to dairy or non-dairy milk for a quick and convenient drinkable meal. Protein needs are estimated based on body weight, height, and activity levels. A registered dietitian can help you identity your ideal protein goals and suggest ways to meet those goals with foods you like.
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