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A layman's guide

What does it mean?

You didn't go to medical school, so how can you possibly understand the lingo your doctor uses? Don't fret. Help is available.

By ROBERT JOHNSON
Published February 10, 2004

 
[Times art: Teresanne Cossetta]

Even if we could read our doctors' handwriting, the medical terms they use would remain a mystery.

The jargon is baffling and made harder to grasp by the nerve-jangling pace of medical consultation in this age of high-volume managed care.

"There is a whole world of terminology that patients just don't understand. Doctors should be using plain language," says Duane Cady, a general surgeon in Syracuse, N.Y. Cady is leading a new education drive by the American Medical Association called the Health Literacy Project. "Our research indicates there are 45- to 90-million people in the U.S. who are "health illiterate': They don't understand the words the doctor is using to describe what's wrong with them and what to do about it," Cady says. "Especially in a place like Florida where there are so many older patients who may have difficulty hearing."

The AMA project is aimed at physicians. There will be training tapes and workshops in which doctors practice being understood by patients. Success is measured by whether the patients can repeat to the doctors a reasonable rendition of what they have been told.

There's some evidence the program is working, says Claudette Dalton, an anesthesiologist at the University of Virginia Medical Center. Dalton, who helped implement the program at the Charlottesville institution, says that after one year the number of patients scheduled for surgery who fail to show up for their appointments had dropped from 8 percent of the overall total to less than 1 percent. "When patients understand why a procedure is needed, exactly how it will be done and little things like which entrance to go to at the hospital, the efficiency of the treatment is much better," Dalton says.

But the responsibility for health literacy is shared by patients, she says. "If you just aren't getting what the doctor is saying, make him say it again." Taking notes is a good idea, too, she says. And libraries and bookstores offer medical dictionaries geared toward patients. Using one such tome, the Merck Manual of Medical Information, we look at some common terms, from A to Z, whose meanings may be clear to doctors but fuzzy to patients.

A

Aneurysm: A bulge in the wall of an artery. This can occur in the legs, chest, abdomen, neck or brain. Such a bulge pushes out and, if untreated, can rupture and cause internal bleeding.

Angina: Chest pain or a sensation of pressure that occurs while the heart muscle isn't receiving enough oxygen. The aching may occur beneath the breastbone, in either shoulder or down the inside of the arms. Also may be felt in the back, throat, jaw and teeth. Usually lasts only a few minutes.

B

Blood samples: Why do they insist on taking so much so often? Because analyzing the blood reveals the condition of such organs as the liver without slicing off a piece of them.

Bypass surgery: Grafting veins or arteries from certain parts of the body to a coronary artery (a passageway for blood) and to an artery that takes blood away from the heart. Blood flow is thus rerouted to skip over, or bypass, narrowed or blocked heart arteries.

C

Concussion: A brief loss of consciousness after a head injury that doesn't cause visible physical damage.

D

Dermatitis: Inflammation of the upper layers of the skin accompanied by itching, blisters and often oozing and scaling; also known as eczema. Among the many possible causes: chemicals used in making clothes and deodorants.

Dialysis: Treatment for kidney disease in which blood is removed from the body through an intravenous tube and filtered of waste before being returned.

E

Edema: An abnormal accumulation of fluid in cells, tissues or cavities of the body resulting in swelling.

EKG: Neither an accurate acronym nor abbreviation for electrocardiography, but that's what it means. The more accurate term ECG is being used more these days for this quick and painless diagnostic test that measures and graphs electrical impulses that flow through the heart as it beats.

F

Fibroid: A noncancerous tumor in the uterus that may grow larger during pregnancy. They can be microscopic or as large as a basketball. What causes them is unknown.

G

Golfer's dystonia: Not caused by too many rounds. These spasms, also called "the yips," occur in the hands and wrists. Golfers complain they can turn a 3-foot put into a 15-footer. Chronic dystonia can be a symptom of Parkinson's disease or a drug reaction.

H

Hamstring injury: Any damage to the muscles in the back of the thigh - the posterior femoral muscle area. This is common in athletes and can take the form of a strain or tear. Usually caused when the hamstring contracts quickly, as in sprinting.

Heart attack: A medical emergency in which some of the heart's blood supply is suddenly and severely reduced or cut off, causing the heart muscle to die.

I

Irritable bowel syndrome: Abnormal contractions of the digestive tract, usually leading to diarrhea. May be caused by stress, diet, drugs and hormones. Bouts of constipation may also occur.

J

Joint noises: No, they don't clang. But this is the medical term for those common creaks and clicks you may hear in wrists and knees. Usually harmless, such noise in the base of the kneecap may be a sign of arthritis.

K

Knee-jerk reaction: A common test of the spinal cord's well-being by a tap on the knee, from which a nerve pathway travels through the thigh to the lower back.

L

Lazy bowel syndrome: When the large intestine becomes addicted to laxatives. Caused by excessive use to relieve constipation.

M

Magnetic resonance imaging (MRI): The use of high-frequency radio waves and a magnetic field to produce detailed images of the body's interior.

Myocardial infarction: Fancy name for a heart attack.

N

Neoplasm: General term for a tumor, whether cancerous or noncancerous.

Nits: Shiny grayish globules in human hair that are lice eggs. Easier to see than lice themselves.

O

Occupational therapy: Exercises that go beyond basic range-of-motion and muscle strengthening to enhance a patient's abilities in self-care, work and leisure activities.

Otitis media: Better learn this if you have kids: It's the common ear infection.

P

Peptic ulcer: Round or oval sore where the lining of the stomach has been eaten away by digestive juices.

Prolapse: When support for an organ gives way and dropping occurs. Commonly associated with pelvic conditions, when weakness or injury to ligaments, connective tissues and muscles can cause prolapse of the bladder, rectum or uterus.

Q

Quadrantectomy: A small-excision breast cancer surgery in which the cancer is removed by taking about 25 percent of the breast.

R

Rapid eye movement: Sounds stressful, but REM, as it's often called, is actually the deepest form of sleep. While it's happening the eyes, though closed, move rapidly due to high electrical activity in the brain. Most dreaming occurs in this state.

Referred pain: An ache in one area of the body that is actually caused by a problem elsewhere and signaled through pathways in the nervous system that transmit multiple messages. Thus pain from a gallbladder may be felt in the shoulder.

S

Sepsis: A bacterial infection in the bloodstream.

Shock: No, not a tingling feeling you can get from a faulty electrical appliance. Shock is a life-threatening condition in which blood pressure is too low to sustain life. It can be brought on by an accident or heart attack. Victims should be laid down and kept warm with feet elevated to help blood flow to the heart.

T

Tags: Soft, small, flesh-colored or slightly darker skin growths that develop mostly on the neck, in the armpits, or in the genital area.

Tinnitus: Noise originating in the ear rather than in the environment. Tinnitus is a symptom and not a specific disease. Sufferers may describe the noises as ringing, buzzing or hissing. Among the causes are anemia, exposure to loud sounds, ear infections and excessive aspirin use.

U

Uric acid: A naturally occuring waste product in the blood. But excess amounts can form to cause gout, resulting in joint pain and fever. Uric acid, normally removed in the urine, can also cause kidney stones.

V

Varicose veins: The precise cause of this condition is still not known, but they're there for all to see: abnormally enlarged veins in the legs that bulge under the skin. There is no cure, but relief may be had through surgery or injections.

Virilization: The development of exaggerated masculine characteristics, usually in women, often from the adrenal glands overproducing testosterone and similar hormones.

W

White coat hypertension: Temporary high blood pressure brought on by the stress of visiting the doctor.

X

X-ray: An invisible stream of radiation that can be aimed to penetrate body tissue and assist in taking photographs used for diagnosis.

Y

Yeast infection: Unrelated to rising bread. Yeast is a normally harmless fungus that's often present in the skin, intestinal tract or vagina. But sometimes the fungus, encouraged by other conditions, can cause infections that produce a burning rash.

Z

Zoster: Just a fancy word for old-fashioned shingles. So what are shingles? A painful skin rash caused by a reawakening of the dormant chickenpox virus.

- Robert Johnson is a freelance writer in Orlando.

[Last modified February 9, 2004, 11:16:52]


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