Metabolic syndrome and lifesaver are rarely seen in the same sentence. The metabolic syndrome is a cluster of high risk conditions which greatly increase the chances of developing diabetes and heart disease. If you've got waisted fat, your silhouette more apple than pear, plus two of the following, it’s time to undertake serious lifestyle changes.
Low serum HDL-cholesterol
Elevated fasting serum triglycerides
Elevated fasting glucose
Elevated blood pressure
My middle-aged patient clearly had trouble in a metabolic syndrome sort of way. She came to her appointment in overalls because she'd packed so much fat round her middle that jeans were yesterday's dream. Her problem that day, however, was upper right abdominal pain.
There was no telling whether or not she had a mass in her abdomen as her central fat mass was as round and tense as a full-term pregnancy. Her lower right ribs were tender to touch, and I concluded that she was suffering from the same sort of ribcage discomfort as an expectant mother might have just before giving birth. But this lady was so uncomfortable that I felt we'd best do a CT scan to check for an internal problem such as gallstones.
The CT result was bad news--she had a large mass on her right kidney. A cancer was found at surgery, completely contained within the kidney, with no evidence of spread. She was cured by a nephrectomy. But a month later she was back in the office, her abdominal pain unchanged from her original visit. The pain, in fact, was from her expanding waistline pressing out on her ribs. The kidney cancer was a most fortunate 'incidentaloma' found in passing by a just-to-be-sure-we're-not-missing-something CT.
Another patient from a different generation came to the office for a routine check-up. This young lady also carried a notable apple-like midriff. She felt well. We discussed dieting and exercise. No surprise though during the pelvic exam; I could not feel her uterus or ovaries. I routinely sent overweight women for further testing under these circumstances, but was it needed for this 20-something patient? No harm in doing an ultra-sound, however, and the scan was done. Her right ovary was quite enlarged, and the final diagnosis post-surgery was ovarian cancer found only on the ovary and nowhere else.
There’s no telling really in these sorts of circumstances. A physician can and does jump to conclusions, perhaps skipping the next step. I certainly have. I encourage you all to bring up this issue when you’re in the exam room and not sure of the problem, ask your doc is there anything else this can be. If the condition persists, ask them again!