Wellness Wednesday: The dangerous gap between feeling well and being well

Our entire framework of personal health is built on sensation. Everyday you naturally assume that you are healthy. But what if that assumption is the most dangerous thing about modern wellness culture? This is the gap nobody talks about, the space between feeling well and actually being well. And it's wider than most of us realise.

'Being fine'is a false alarm. Silent hypertension affects roughly 1.28 billion adults worldwide, according to the World Health Organization, and nearly half of them don't know they have it. The same is true for prediabetes, the CDC estimates that 96 million American adults are prediabetic, and more than 80% are completely unaware. Conditions like fatty liver disease, early-stage kidney dysfunction, and even certain cancers can spend years developing in total silence, long before any symptom surfaces. A study published in The Lancet found that nearly 40% of cancer diagnoses globally are still made at an advanced stage, largely because early disease is symptom-free and people simply don't present for screening.


Feeling fine is not the same as being fine. It's a distinction most of us never really sit with, because why would we? If nothing hurts, if we're getting through the day, if the mirror shows someone who looks reasonably healthy, the assumption is that the body is doing its job.


But that assumption has quietly killed people.


For this Wellness Wednesday edition, TOI Health sat down with Dr. Abhinav Mishra, Senior Consultant, CTVS, at Yatharth Super Speciality Hospital, Sector 20, Faridabad, to discuss why assuming that "feeling fine" means "being healthy" can be a dangerous mistake.

What's the biggest health surprise you've seen in a patient who said, "But I feel completely fine"?

Dr. Abhinav Mishra: Some people think that because there are no symptoms to indicate a problem, they do not have disease. There are things like high blood pressure, diabetes, and high cholesterol that can go on silently damaging your arteries for years before any outward signs develop. There are many examples of people who feel perfectly well yet, when examined, turn out to be suffering from significant coronary artery disease due to blockages in their arteries. Regular preventive health care check-up examinations can find these hidden problems before they progress to the point of causing you a serious or even fatal heart attack.

What are the most common misconceptions people have about being healthy? Is looking fit or maintaining a normal weight enough to guarantee good health?

Dr. Abhinav Mishra: A lot of people tend to believe that if you have a lean physique or are in great shape, then you are healthy as well. Just because you look healthy does not mean your body is actually healthy, since there are underlying issues like high cholesterol, high blood pressure, type 2 diabetes, or hereditary heart disease, that may exist. You can appear to be fit but still have an increased chance of developing serious medical conditions because your actual health is based on your behaviours, metabolic status, cardiovascular health, and routine health care visits as opposed to your physical appearance.

If someone feels perfectly fine, what key health numbers should they still monitor regularly to avoid being blindsided by a future heart attack or stroke?

Dr. Abhinav Mishra: There are many different health measures that might be monitored on an ongoing basis even if a person does not show signs of poor health. These measures could include blood pressure, fasting blood sugar (HgA1C) or glucose, blood fats, BMI, waist circumference, and kidney function. Additionally, periodic heart testing for people over forty years of age may be warranted, as well as for diabetic patients with a family history of heart disease. Because high blood pressure, glucose and blood fats frequently do not produce any symptoms, they are likely to play a large role in the development of a heart attack or stroke. Being able to monitor these parameters on an everyday basis will allow for early identification and treatment of problems and significantly improve health status over time.

Can someone exercise regularly, eat reasonably well, and still be at risk for serious cardiovascular problems? What factors are often overlooked?

Dr. Abhinav Mishra: Even if individuals exercise routinely and eat well, they may still be susceptible to cardiovascular illness; this is due to the presence of other concealed probabilities such as family history, heredity, smoking tobacco products, alcohol consumption, stressful lifestyles, inadequate sleeping patterns, and inability to control chronic health conditions, such as hypertension and disease processes like diabetes, which may all add to their predisposition to developing cardiovascular disease. Some persons will also have genetic dispositions that cause them to have elevated cholesterol levels despite their healthy lifestyle choices. Regular health evaluations and a thorough assessment of all risk-associated elements will be necessary for the identification and reduction of cardiovascular disease risk.


So this Wellness Wednesday, the most radical health act you can commit to isn't a new supplement stack or a fitness challenge. It's booking a check-up you've been putting off because you feel okay. Because "okay" and "healthy" are not the same thing, and your body won't always tell you the difference.