Second-guessing symptoms
Ignoring certain health clues can be a mistake. Here's when to see a doctor.
- Reviewed by Toni Golen, MD, Editor in Chief, Harvard Women's Health Watch; Editorial Advisory Board Member, Harvard Health Publishing; Contributor
Should you or shouldn’t you? When this question arises, it can mean a tough decision lies ahead. But few have weightier consequences than whether it’s time to see a doctor.
It can be hard to know when to ride out certain symptoms or when to stop and seek medical attention. That’s because there’s often gray space between the two options, a Harvard expert says.
To be clear, we’re not talking about symptoms such as chest pain, difficulty breathing, trouble moving or speaking, or sudden numbness, weakness, or vision loss — all of which are medical emergencies. Other health changes also plainly require a clinician’s assessment, like a lump in your breast or unexplained weight loss.
But while many symptoms resolve on their own, others linger, making us wonder if they’re more serious than they seem. Most, fortunately, turn out to be minor, says Dr. Daniel Sands, a primary care doctor at Harvard-affiliated Beth Israel Deaconess Medical Center.
“Viewed broadly, we could say there are a lot of things that should get you to see a health care professional,” Dr. Sands says, “but if everyone went to the doctor every time they had a symptom that might, under some circumstances, be concerning, we would quickly outstrip the health care system capacity. It can definitely be a dilemma.”
Signs to seek help
Here are some nebulous situations that warrant a doctor’s visit.
Drawn-out cold symptoms. Cough, fatigue, and low-grade fever can indeed signal a cold, but if they drag on, it might mean you have pneumonia. “You won’t know that something bad isn’t going on unless you see a doctor,” Dr. Sands says. “And if you’re having fatigue that’s not getting better despite plenty of sleep, you need to be seen, even if your fatigue isn’t accompanied by other symptoms.”
Fever lasting more than four days. Fever alone, even a low-grade one, can indicate an infection or inflammatory disorder for which the cause needs to be identified to get the proper treatment. “Fever is a warning sign there’s something going on,” he says. “If you have one for a long time, you have to figure out why.”
Unexpected symptoms when starting a medication or after a surgical procedure. Adjusting to a new drug often brings symptoms you’re not used to, but they usually ease. “If they’re mild and not interfering with daily living, you might try to ride them out for a week or two,” Dr. Sands says. “If they’re severe or listed as dangerous on the label, hold the next dose and get in touch with your doctor.”
Do the same for any symptoms you experience shortly after surgery. Problems such as uncontrollable bleeding, difficulty breathing or urinating, or redness, pain, or swelling around the surgical site need prompt medical attention. Your discharge instructions usually list a phone number to call for advice, even for less serious post-surgical symptoms. “At least be in touch with your primary care doctor, who can help you decide whether to call your surgeon, come to the primary care practice, or go to the emergency room,” Dr. Sands says.
Digestive problems. Everyone experiences vomiting or diarrhea once in a while. But contact your doctor if you can’t take even sips of water for more than eight hours or if diarrhea is bloody or relentless. Digestive distress can stem from a panoply of causes — medication side effects, pregnancy, infection, lactose intolerance, or irritable bowel syndrome among them — but is usually benign and short-lived.
While blood in the stool often comes with hemorrhoids, it should always prompt a call or visit to your doctor. “Also, if you’re having gastrointestinal symptoms and you’re losing weight, that requires medical evaluation,” Dr. Sands says.
New or worsening mental health issues. You may be all too familiar with mood problems such as anxiety or depression, but they cross a line when they stop you from getting out of bed, working, or functioning in your house-hold. “Symptoms so severe that you can’t manage are certainly an indicator you need to see a doctor,” Dr. Sands says.
What’s the right care setting?Getting a flu shot is different from having a broken bone set or undergoing a check-up—and where you seek these health services can vary, too. Here’s what distinguishes each type of care setting: Primary care office. This offers ongoing and preventive care, chronic disease management, health screenings, and treatment for minor illnesses and injuries. The primary care nurse can also help you discern whether you need to be seen for your symptoms and in what setting. But an enduring doctor-patient relationship is perhaps its greatest feature, says Dr. Daniel Sands, a primary care doctor at Beth Israel Deaconess Hospital. “In the best of all possible worlds, you have a primary care doctor who’s your ally and fallback, the one you can always go to,” he says. Emergency department (ED). Open 24/7, EDs are the place to go for immediate life-threatening or serious conditions. They frequently offer access to advanced testing and highly trained specialists. “But they’re busy places, and you will often have to wait,” he says. Urgent care center. This can be the right place if you need prompt treatment but your problem isn’t life-threatening—such as an infection, sprain, or cut. “They can be ‘ED lite’ in the way they’re designed,” Dr. Sands says. “If they need to, they’ll send you off to an ED.” Retail clinic. Typically nestled in pharmacies or big-box stores, these clinics offer basic services for minor illnesses such as rashes, sore throats, or urinary tract infections, along with vaccinations and certain health screenings. “I wouldn’t go to one for a complex condition, but they’re good at routine care,” Dr. Sands says. |
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About the Author
Maureen Salamon, Executive Editor, Harvard Women's Health Watch
About the Reviewer
Toni Golen, MD, Editor in Chief, Harvard Women's Health Watch; Editorial Advisory Board Member, Harvard Health Publishing; Contributor
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