6. Triệu chứng

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Symptoms
1
Nurse: How does it feel? A little deformed, isn’t it?
Patient: Yes, there’s a huge lump just above the ankle. And there’s quite a lot of bruising.
Patient: And just here, it’s very swollen.
Nurse: Is it painful when you move it?
Patient: Yes, very.
Nurse: Can you move your toes?
Patient: It’s difficult, they’re numb – I can’t feel them at all.
2
Nurse: How are you feeling?
Patient: I feel so hot. What does the thermometer say?
Nurse: Yes, you do have fever. Your temperature is a little over 38. Have you got a sore throat?
Patient: Yes, it hurts when I talk.
Nurse: I can see spots. Any redness?
Patient: Yes, my chest and back are all red.
Nurse: And do you feel tired?
Patient: Yes, constant tiredness. And my legs feel achy, too.
3
Nurse: How’s it going?
Patient: I’ll be glad when this is over. Doing anything is really tiring.
Nurse: Oh dear. Do you feel dizzy at all?
Patient: Yes, some days I feel dizzy and sometimes sick.
Nurse: When do you feel sick, mostly?
Patient: In the mornings. And I’m very constipated – haven’t been to the toilet for three days. Sorry to moan.
Nurse: That’s all right. We all need a good moan sometimes. What about pain?
Patient: No. No pain.



1
Nurse: OK, Mrs Hales?
Patient: Not too bad, thanks.
Nurse: What happened to you?
Patient: I had a fall.
Nurse: Where does it hurt?
Patient: From my wrist to my elbow.
Nurse: What about your shoulder?
Patient: That's fine.
Nurse: Let's have a look — swollen, isn't it!
Patient: Yes, it is, isn't it.
Nurse: You've had an x-ray, haven't you?
Patient: Yes, l have.
Nurse: Anything broken?
Patient: No, just bruising.
Nurse: You aren't on any other medication, are you?
Patient: No, I'm not.
2
Nurse: How are you feeling?
Patient: Not bad, thanks — a bit sore.
Nurse: What happened to you?
Patient: I fell off my bike
Nurse: Where does it hurt?
Patient: Here, around my wrist.
Nurse: Can you move your fingers?
Patient: Yes, I can,slowly.
Nurse: Is it painful?
Patient: Yes, very! I've also got a cut on my leg —look.
Nurse: Oh, that's deep, isn't it!
Patient: Yes, it is deep. Will I need stitches?
Nurse: Maybe. Have you had stitches before?
Patient: No, never — and l don't want any!
Nurse: You've seen the doctor, haven't you?
Patient: No. I haven't seen him yet.



A helpline call:
Mother = mother of child
Nurse: National Health line. How can I help?
Mother: Oh, hello. It's my little boy — he's seven. l'worried, because he's got a terrible cough.
Nurse: OK. So, can you describe the cough? I mean, does he wheeze when coughs?
Mother: Yes he does.
Nurse: Does he wheeze when he breathes in or when he breathes out?
Mother: Mm… When he breathes in. Yes, not when he breathes out.
Nurse: When he coughs, does he cough up any blood?
Mother: No, but sometimes when he coughs. He vomits.
Nurse: l see. Does he have any allergies?
Mother: No. l don't think so.
Nurse: Right. Does he have a fever? Have you taken his temperature?
Mother: Yes, he's burning. The thermometer says 37 degrees.
In the UK, the most common reason given for taking time off work is "flu-like symptoms",which are typically a fever and aches and pains in the body.
Sandy McGuire
I operate the telephone helpline on the graveyard shift - that's the one from midnight to the morning.
Although it's quiet and still in the streets outside, it's not so quiet in the office. The early hours of the morning are sometimes the busiest time, when the telephone never stops ringing.
People call the helpline for information or advice, or sometimes they just need to hear a friendly voice. We talk to people who are depressed and worried, and sometimes in pain. Sometimes we get some funny enquiries - yesterday, a teenager phoned because he had swallowed some chewing gum and he was afraid he was going to die!
We can't see our patients, so we have to be very good on the phone. We have to learn how to do it, because it doesn't come naturally. We have to know to ask the right questions so that we get clear and accurate answers, and we have to be able to speak in language anyone can understand.
Signs and symptoms Night coughing

Here are descriptions of four possible conditions that can cause a child to cough in the night.
Asthma
Children with asthma cough, and wheeze when they breathe out. They become very short of breath when an attack occurs .
Pneumonia
The symptoms of pneumonia are a temperature of over 39ºC, fast breathing, sometimes accompanied by vomiting and sometimes coughing blood.
Croup
Children under three years old sometimes get croup. They have a sore throat and they wheeze when they breath in. When they cough, it often sounds like a dog barking.
A cold
Sometimes a child has a cough and a fever with a cold. a bad cough can make a child vomit.


I used to have complete faith in doctors. Now I'm fighting to make them understand that they don't have all the answers.
Dave Harries
Gulf War veteran - Cựu chiến binh vùng Vịnh
MYSTERY SYNDROMES

When you are ill, you expect your doctor to tell you what you have, and then to treat you. But sometimes people have symptoms whose cause is not understood, and for these people it can be difficult or impossible to get treatment.
The main symptom of Chronic Fatigue Syndrome (CFS) is an overwhelming feeling of tiredness. The tiredness is so disabling that it is impossible for the sufferer to continue normal physical and mental activities. Other symptoms include muscle aches and pains, poor sleep, loss of appetite, a recurrent sore throat, and swollen glands in the neck. Sufferers often undergo many tests for known diseases, which prove negative, and many feel that doctors see them hypochondriacs.
After the Gulf War of 1991, tens of thousands of ex-soldiers suffered chronic illnesses which doctors still cannot explain. Symptoms include dizziness, numbness in the arms, rashes, severe headaches, mood swings, and persistent, extreme tiredness. The cause remains a mystery, but the symptoms have been given the name Gulf War Syndrome. Some soldiers believe they may have been exposed to chemical weapons without knowing, and others blame the vaccinations they were given before they went to war. Military officials say that Gulf War Syndrome is not a real illness. There is no doubt the ex-soldiers are ill, they say, but their symptoms are simply the result of stress.
Maybe one day the cause of these syndromes will be known and will be treatable. But for people like ex-soldier Dave Harries, the first step is for their condition to be recognized by medical profession. Then people will believe that their symptoms are not imaginary.

Body bits
Tongue diagnosis

Zetsu shin is used in traditional Chinese medicine. Practitioners examine the tongue in order to diagnose illness and to find out about the personality of the patient.
Colour
Blood problems are associated with a white tongue. Yellow indicates a disordered liver and gallbladder. Blue or purple shows up a disorder in the digestive system. Purple on the underside shows the immune system is not working effectively. A dark red tongue can be a sign of inflammation or ulcers in the body.
Movement
The flexibility of the tongue shows the general condition of the digestive system.
Width
A wide tongue is good, for it shows a physical and psychological balance. A narrow tongue indicates sharp thinking.
Tip
A rounded tip shows a state of good physical and mental health. People whose tongues have a pointed tip have aggressive personalities.