Learn to Observe Yourself

The careful physical examination requires skill and experience. Some important observations can be made at home. If you can report accurate information on these points, you can further help your doctor.

Temperature
Don’t say “fever” or “running a temperature” or “burning up.”  But a thermometer, read the instructions, practice shaking the thermometer down, and be able to report the exact temperature. If you have a small child, buy a rectal thermometer and learn how to use it.

Pulse
If the problem involves a rapid or forceful heartbeat, know exactly how fast it is beating. Feel a pulse in the arm or throat, or put an ear to the chest. Count the exact number of beats occurring in one minute, or have someone do this for you. If you think that there is a problem with the pulse, determine whether the beat is regular or irregular. Is the heart “skipping a beat,” “turning flip-flops,” “missing every other beat,” or is it completely irregular? A pulse irregularity often gone by the time you reach the doctor. If you describe it accurately, your doctor may be able to understand what happened.

Breast
The mammary tissue is normally a bit lumpy.  Adult women should carefully examine their breasts every month in order to detect changes. Press the breast tissue against the chest wall, not between the fingers. Try several positions-lying down, sitting, and with the arm on the side being examined raised over the head. Look particularly for differences between the two breasts. If you note a suspicious lump, see the doctor immediately. Many women delay out of fear. Please don’t. Very few lumps are cancerous, but if the lump is malignant, it is important that it be removed early. Often the patient can feel a lump that the doctor misses; help the doctor locate the problem area.

Weight
Changes in weight are frequently very important. Know what your normal weight is. If your weight changes, know by how much and over what period it changed.

Other Findings
Know your body. When something changes, report it accurately. A change in skin color, a lymph gland on the back of the neck, an increase in swelling in the legs, and many other new events are easily observed. Just as important, knowledge of your body will help you avoid reporting silly things. The “Adam’s apple” is not a tumor. “Knobs” on the lower ribs or pelvis are usually normal. The vertebra (bone) at the lower neck normally sticks out. There is normal bump at the back of the head-the “knowledge bump.” I’ve known patients to report each of these as emergencies.