Early health warnings you shouldn’t ignore

First things first – what symptoms should you never ignore?

Heart attack and stroke are medical emergencies and warrant calling 999 immediately. Delaying can have negative outcomes.

See below, an Irish Heart Foundation poster reminding us of the symptoms of heart attack in men. However there are different more vague symptoms to look out for when dealing with a heart attack in women.

Heart attack in women

Dr Angie Brown, medical director of the Irish Heart Foundation (IHF) points out that heart attacks can present differently in women:

“Rather than the classic version of a heart attack where someone is seen clutching their chest, the symptoms of a heart attack in women can be quite vague, making it hard to diagnose,” she says, “but one of the most important messages is to advise women, who are experiencing the symptoms (listed below), not to delay – call 999 for an ambulance and get to the emergency department immediately. Irish research shows that one of the reasons many women die from heart attack is that they delay in getting to the emergency department.”

Symptoms of heart attack in women:

Not all these symptoms are always present. If only some are present, don’t wait. If you think you are having a heart attack, get help quickly and dial 999.

Other symptoms

As well as the emergency symptoms for heart attack or stroke outlined in the poster, the following is a list of symptoms that should warrant a GP consultation, even during a pandemic:

1 New lumps or growths on your skin.

2 A sore or bruise that doesn’t heal.

3 A mole that changes in shape, size or colour or bleeds.

4 An ongoing cough or hoarseness for more than three weeks.

5 Indigestion or difficulty in swallowing.

6 A change in bowel or bladder habits for no good reason.

7 Shortness of breath.

8 Loss of appetite.

9 Unexplained weight loss or tiredness.

10 Blood anywhere it normally should not be – in urine, bowel motions or from spitting.

One in two people worried about visiting GP or hospital

Looking for proof that people aren’t going to their GP or to hospital because of COVID-19 fears? Research* from Pfizer, for example, carried out in July this year found that one in two people were worried about visiting their GP or hospital and one in three people say that the COVID-19 lockdown has had a negative impact on their health.

Those who were asked about the impact of the pandemic on their health listed their concerns as lack of access to a doctor, treatment delays, lack of access to diagnostics or tests and diagnosis delays. Twelve per cent of the adults surveyed did not seek treatment during the lockdown despite feeling unwell.

Early diagnosis of a medical condition such as cancer or stroke is often critical to ensure a good outcome

Many health-related organisations are now highlighting this and asking people to please seek medical advice if unwell.

Paul Reid, managing director of Pfizer Healthcare Ireland (which is at phase 2/3 stage of developing a vaccine for COVID-19 with BioNTech), advises people not to ignore serious symptoms, for example.

“One of the worrying aspects of the pandemic has been the impact on non-COVID-19 related healthcare with patients not presenting to doctors and hospitals in the same manner that they normally would,” he says.

“This is a major concern as early diagnosis of a medical condition such as cancer or stroke is often critical to ensure a good outcome. We will be living with some level of restrictions for some time and I would encourage all people to seek medical care promptly when required.”

‘vital to go to doctor’ – Irish Cancer Society

The Irish Cancer Society is appealing to people to attend for medical advice also.

“Cancer patients need to be diagnosed and treated at the earliest opportunity, so they stand the best chance of survival and having a good quality of life,” says Rachel Morrogh, director of advocacy at the Irish Cancer Society.

“Pfizer’s research supports the data from the HSE that shows fewer people accessed diagnostic services during the heightened phases of the pandemic. Thankfully, the number of people being referred to cancer rapid access clinics is increasing but our message remains the same – when it comes to cancer, early detection is key and can be the difference between life or death in some cases.

That’s why it’s so important people contact their GP immediately if they notice potential cancer symptoms like a lump, bleeding, weight loss or fatigue. There are still people out there who are suffering with symptoms in silence and it’s vital that they seek help and call their GP today.”

Don’t ignore chest pain or stroke

The IHF agrees with the sentiments of the Irish Cancer Society.

“With check-ups and appointments being cancelled and people reluctant to seek medical attention during lockdown, we will likely be seeing the long-term impact of this over time,” says Chris Macey, head of advocacy and patient support.

“We are urging the public to seek immediate medical care if they experience heart issues or symptoms of stroke. Any delay in seeking urgent medical care could have fatal consequences.”

Help is there via online/telephone consultation

The research shows that while incidence of online health consultations is low, people’s satisfaction levels with their online experience since the lockdown is quite high.

Just 6% of survey respondents had an online or combined online/telephone health appointment during the height of the pandemic in Ireland, while three in five people had a consultation by telephone, but 77% of those were satisfied with a telephone appointment and 59% pleased with an online consultation.

*About the research: This research is part of the 2020 Pfizer Health and Science Index, which is a nationally representative sample of 1,050 adults, carried out by the Behaviour and Attitudes Research company. Fieldwork was completed between 23 June and 8 July 2020, with all interviews conducted online.

CervicalCheck

Ninety per cent of women have not responded to cervical screening invitations this year, according to Dr Nóirín Russell, Clinical Director of the national screening programme CervicalCheck.

Speaking at a recent Irish Hospital Consultants’ conference, she said that of 110,000 women sent postal invitations, only 12,000 turned up for their appointments.

“It is deeply worrying and concerning,” she said. “CervicalCheck has been back up and running since early July. The culture has been that women wait to respond until they got their first and second reminder, but while there is a lot of fear about coming into healthcare settings, I would like to urge women to attend on their first invitation.”

Since the inception of the CervicalCheck programme in 2008, the incidence of cervical cancer has fallen on a yearly basis, says the RCSI, with over 50,000 high grade precancerous lesions detected and treated.

Breastcheck

Appeals are also being made to women between the ages of 50 and 69 to take up their BreastCheck invitation when it arrives. The national breast screening programme invites women in this age group to get a free mammogram every two years. All women should be breast aware, however and check their breasts regularly. See www.cancer.ie/cancer-information-and-support/cancer-types/breast-cancer/how-to-check-your-breasts for how to do it properly.

Arthritis – how pandemic has impacted on care

Cancellation of appointments for tests or treatment has been an issue for many also since March.

According to an Arthritis Ireland survey, more than four in 10 (44%) people with inflammatory arthritis had a hospital appointment to see their consultant cancelled or postponed during COVID-19.

The finding is contained in a survey published by Arthritis Ireland to mark World Arthritis Day 12 October.

One-third (32%) of respondents had scans, blood tests or other tests cancelled or postponed, while 23% had an appointment with a physiotherapist or occupational therapist cancelled or postponed.

The research was undertaken during the summer at the end of the initial lockdown and was completed by 1,133 people.

Arthritis Ireland chief executive, Gráinne O’Leary said: “People with arthritis have been significantly affected by COVID-19, in terms of their physical health and their mental wellbeing.

We need urgent action to ensure that people with arthritis can access these services and healthcare professionals in a timely fashion. Arthritis is a chronic, destructive disease – it doesn’t stop while we’re trying to solve the pandemic,” she stated.

Prof Geraldine McCarthy, president of the Irish Society for Rheumatology and consultant rheumatologist at the Mater Hospital, has appealed for more rheumatologists, advanced nurse practitioners and triage clinics.

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