Day 253: Carnett’s Sign, And Other Ways I’ll Predict My Own Demise

originally published September 9, 2012

Today’s article is a public service, written at great sacrifice by the author. I’m no hypochondriac, and I’ve been fortunate enough to have avoided any particularly serious medical concerns in my lifetime. But reading about stuff like this makes me cringe a little with sympathy aches. Writing about it is even less pleasant. These are the sacrifices I make for pretend pseudo-journalism.

Today’s journey into medical science comes courtesy of Dr. John B. Carnett. In 1926, Dr. Carnett came up with Carnett’s Sign, a simple way to narrow down the cause of abdominal pain. Here’s how it works:

Lie down on your back. Lift up your head and shoulders to tense your abdominal muscles. Does that relieve the pain? If so, congratulations! The problem is actually rooted in your abdomen. It may be that your appendix is ready to pop like a pumpkin stuffed with fireworks. Or maybe the Chicken Marsala you had for lunch hates you, and plans to exact its revenge upon your for the unfulfilling life and premature death bestowed upon it by Foster Farms.

If tightening the ab muscles does ease the pain, then congratulations! You may have a rectus sheath hematoma (which is probably as bad as it sounds), a hernia, or something called nerve entrapment syndrome, which is when your nerves have been enticed by a police officer to commit a crime they otherwise would not have committed. I think.

Let’s have a look at some of the other medical signs out there, because I have 750 words left and apparently I love to suffer with imaginary symptoms.

While I was hoping that Dahl’s Sign had something to do with chocolate factories or giant peaches, it’s actually the only way I can imagine a chronic lung condition can affect your elbows. Unless you cough violently and whack your elbow into a doorframe, I guess. Does that happen?

Actually, people with Chronic Obstructive Pulmonary Disease find it a lot easier to breathe while sitting when they lean forward like that tiny-headed bald guy up there. Their elbows lean into their thighs, and apparently that can lead to erythema of the skin. That’s fancy-talk for the skin turning red at the point of contact.

Over time, haemosiderin (or, gooey blood-stuff) seeps out of the red blood cells and changes the pigmentation of the skin in those spots. This is called Dahl’s sign. Perhaps this could all be avoided with the purchase of some elbow pads. Consult your physician.

I included the above picture because the actual photos associated with Matchbox Sign are, to say the least, disturbing.

Let’s say you’re a psychiatrist. A patient shows up with a tiny container (perhaps a matchbox, which is where this name comes from) filled with fibers and other anomalies that they claim they yanked, peeled, or stripped off their skin. Would you scream? Run out of the room? Throw a burning crucifix at the patient and tell him to return to the abyss of hell from whence he came?

No, you’re a professional. You’ll diagnose him with delusional parasitosis. That’s the belief that one is infested with parasites, and the Matchbox Sign is a dead giveaway.

This one might get you staring at the earlobes of strangers on the bus, if for no reason other than you can save their lives. What you’re looking for is Frank’s Sign, which is a diagonal crease that begins at the tragus – that’s the southernmost tip of the ear’s opening, right at the top of the lobe – down across the lobe to the rear corner of it. That crease may look like a birth-related quirk, or maybe some new hipster fashion trend (is lobe-folding a thing yet? Can I get a trademark?), but it may actually point to some serious medical concerns.

It’s been hypothesized that Frank’s Sign could indicate the presence of cardiovascular disease or possibly diabetes. Some studies have rebutted any link between Frank’s Sign and cardiovascular disease, and the fact that its discoverer, Dr. Sanders T. Frank, has a first name for a last name and a last name for a first name, makes me doubt it entirely.

Both Steven Spielberg and George W. Bush have the Frank’s Sign ear-crease.

This next one is pretty cool. I mean, it’s horrible and awful and everything, but the science behind it is fascinating. Pemberton’s Sign shows up in a medical examination when the doctor instructs the patient to raise his or her arms as high above their head as they can reach. If doing this causes the face to flush, causes a wheezing sound when the patient breathes, or an elevation of the jugular venous pressure (in the neck, but your doctor will hopefully know this), then hooray! The patient has a positive Pemberton’s Sign!

Of course there isn’t much cause for celebration here; this sign probably means the patient has a tumor in his or her lung.

Here’s the one that’s going to keep me up tonight, taut and panicky under the covers, listening for the gurgling sound of my imminent demise. It’s called Riesman’s Sign. Essentially what happens is you hear a bruit over your eye. What’s a bruit? I had to look it up, and I’m sorry I did.

A bruit is the “unusual sound” that blood makes as it gushes its way past an obstruction of some sort. A bruit could be an early indicator of Grave’s Disease. This often finds its way into a human body around midlife (great!), can build over years before being diagnosed (I’m doomed!), and affects nearly twice as many women as men (actually… that works out okay for me).

Graves Disease is a serious condition, though a quick glance at the symptoms puts me somewhat at ease. I don’t think this one is going to creep up on me, at least not this year.

Reading about medical diagnoses never fails to set my blood on a low boil. It could be the very lack of worry I’ve had to devote to my health over the years that prompts a greater worry for the future. Perhaps the best thing to do is just shut up and live my life, enjoying what’s left of my relative youth.

But I’ll still be listening for that unusual sound above my eye tonight. There’s just no conquering some neuroses.

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