askthedoctor Early Treatment
Even if there are no symptoms (yet), many common chronic diseases require treatment now to prevent future complications. By Rear Adm. Joyce Johnson, D.O.
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Attention Must Be Paid
■ If your health care pro- vider reports a problem, listen carefully. Ask about treatment options and what the likely complica- tions are if your disease is left untreated. When you understand the treatment options and long-term risks of a disease, you can make an educated choice regarding treatment.
t often comes as a surprise when a health care provider diagnoses a disease that is asymptomatic early in its
course. Many times a routine examination or screening will identify a warning sign that leads to further evaluation and, eventu- ally, a diagnosis. Ideally, after receiving a di- agnosis, you will work with the health care provider to develop and follow a treatment plan to prevent the disease from advancing. Many common diseases, such as glau-
coma, hypertension, osteoporosis, and Type 2 diabetes, as well as less common diseases such as cancer, are asymptomatic early in their course. Often people focus on the immediate asymptomatic state and do not perceive a problem. However, these diseases are progressive and, if not ad- dressed and treated, become symptomatic and eventually can become extremely dif- ficult to manage. Many diseases are most responsive to therapy early in their course. Routine eye exams check for glaucoma
(increased pressure in the eye). Treatment involves regular eye drops or, in some cases, laser or other eye surgery. Untreat- ed glaucoma can lead to blindness. Nearly every visit to a health care pro-
vider includes a check for hypertension (high blood pressure). Some pharmacies even have equipment so you can check your own blood pressure. If your blood pressure is high, then it should be retested and evaluated further. Exercise and weight loss can lower blood pressure. Medication might be required, often for life. Untreated high blood pressure can lead to strokes
4 8 MI L I T A R Y O F F I C E R O C TO B E R 2 0 1 0
(which often bring paralysis, an inability to speak, and the need for nursing home care) and other vascular and heart disease. Osteoporosis, or loss of minerals from
bones, is diagnosed with a DEXA scan — an X-ray-like scan of selected bones. Treatment for osteoporosis includes supplemental vitamin D and calcium and a medication to decrease bone loss. Un- treated osteoporosis contributes to stress fractures of the lower spine, which can be very painful and difficult to manage. Hip fractures also are more common and, even when appropriately treated, can lead to a loss of mobility and require nursing home care, especially in older people. Type 2 diabetes mellitus (which has been
called “adult onset diabetes” and “non-insu- lin dependent” diabetes) often has no early symptoms; it is diagnosed from routine tests that assess blood glucose levels. The goal in management of type 2 diabetes is to reduce blood sugar levels. Weight control, diet, and exercise sometimes are adequate to control blood sugar; oral medication might be need- ed. Insulin shots sometimes are needed late in the disease. Untreated diabetes leads to many different types of problems, including blindness (from retinopathy), chronic renal failure (requiring dialysis), neuropathy, and vascular disease.
MO
— Rear Adm. Joyce Johnson, USPHS-Ret., D.O., M.A., is vice president, Health Sciences, Battelle Memorial Institute, Arlington, Va. Find more health and wellness resources at www
.moaa.org/wellness. For submission information, see page 18.
PHOTO: STEVE BARRETT
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