[Health Column] Do Not Miss the Golden Time for Treatment

[Asia Economy] Many patients visit medical institutions due to concerns about temporary symptoms, but there are also quite a few who come when facing a serious situation.

Patients who visit ask the doctor whether they need treatment, and if so, what kind of treatment and until when they should receive it. Medical professionals use their expertise to recommend necessary treatments to patients, but the extent to which patients accept these recommendations varies. Factors influencing a patient's choice of treatment are truly diverse and complex, including personality, socio-economic status, and family relationships. Moreover, it is also true that prescriptions from medical professionals before a trust relationship is established significantly influence the patient's decision. Nevertheless, there are situations where active treatment is absolutely necessary. The following three cases are especially so.

First, in cases of symptoms that can lead to serious outcomes, immediate treatment is required regardless of the current severity of the symptoms. Missing the so-called golden time can be fatal.

Examples include headaches caused by subarachnoid hemorrhage, indigestion which may be a symptom of myocardial infarction, back pain indicative of aortic dissection, abdominal pain or peritonitis caused by internal organ bleeding. These are diseases with considerably high mortality rates. However, this does not mean that all headaches, indigestion, back pain, or abdominal pain are critical conditions. Because these symptoms are common and sometimes mild, patients should not decide on their own whether to seek treatment. Specialists naturally do not overlook such conditions and will do their best to persuade patients.

The second case is when early treatment guarantees much better outcomes considering the prognosis. This is the case of preventing a problem with a hoe rather than a rake, with representative examples being hypertension, diabetes, and various metabolic diseases. In addition, in the field of pain, early medication for shingles and early nerve treatment for complex regional pain syndrome fall under this category. The later these diseases are treated, the more difficult the treatment becomes due to complications and other factors.

Lastly, there are cases where there is a critical point in the disease progression, and missing the timing means functions cannot be restored. Acute renal failure, if treated properly, does not progress to chronic renal failure and kidney function recovers, but without treatment, it develops into chronic renal failure.

There is also a critical point in pain caused by nerve compression. Depending on the degree of nerve compression, autonomic nerve abnormalities cause changes in temperature sensation, with certain areas feeling warm or cold. As compression progresses, sensory nerve abnormalities cause numbness or pulling sensations, and further progression leads to motor nerve abnormalities causing weakness in movement. At that point, even if surgery relieves the nerve compression, motor disabilities remain, causing the patient to drag their foot or live with a weak hand for life.

Delayed treatment can lead to lifelong disabilities. Although a patient's situation may cause hesitation in treatment, in such cases, specialists should actively persuade the patient. Of course, they must strive to build trust with the patient. Patients should also not over-rely on empirical judgments or circulating knowledge but must receive a doctor's examination to avoid the worst outcomes. Missing the golden time for treatment can lead to the unfortunate situation where what could have been prevented with a hoe cannot be stopped even with a rake.

Park Yong-seok, Director of Haengbok Anesthesia and Pain Medicine Clinic