From Denial to Hypochondria
What kind of patient are you? Do you run to the clinic for every little ache and pain, worried that it’s something serious? Or do you try to ignore nagging conditions, pretending they’re really not so bad, until your loved ones have to drag you to the doctor? Most of us fall somewhere in the middle of this spectrum of extremes. But oftentimes it’s hard to know—when do you really need to see your doctor?
It’s important to remember that every person is unique and the same symptoms could indicate radically different conditions in you than in your neighbor. So it is critical that you have a good relationship with a primary health care provider who knows your history and what’s normal for you. You should always consult with your own doctor about any concerns you have, and the two of you can establish a strategy based on your own personal experience and current health status. But there are some general guidelines to help you decide when to seek professional medical help.
Let’s start with the most urgent symptoms and conditions. If you experience any of the following, you should go to the emergency room immediately:
- Severe chest pain
- Severe headache
- Extreme shortness of breath
- Severe abdominal pain
- High fever (over 103 degrees)
And if you have the following kind of symptoms, it’s probably not urgent that you be seen right away; however, you should schedule an appointment for your physician to see you as soon as possible.
- Burning with urination
- New ankle swelling
- Significant fatigue
- Shortness of breath
Conditions like the following, when not accompanied by complications or known existing chronic illnesses, can most often be treated through proper self-care and rest:
- Mild cough and runny nose
- Back pain without numbness, tingling or weakness in you legs
- Nausea, vomiting and diarrhea lasting less than 24 hours
- Any brief pain that doesn’t recur
What about prevention? Everyone knows it’s a good idea to have regular check-ups but, unfortunately, many of us only go to the doctor when we are sick. During a routine exam, your doctor can give you appropriate screenings, address any non-urgent concerns you may have, and suggest behaviors to keep you healthy and well. According to your age, I recommend that you see your primary care provider at these intervals:
- 65-74: once a year
- 75-84: twice a year
- 85-94: three times a year
- 95 and above: four times a year
During your preventative visits, there are a number of key screenings you should have and health-related topics you should discuss with your physician.
- Smoking. Just don’t do it! It’s never too late to stop!
- Exercise. I recommend 30 minutes four times each week (start with less and work your way up, and always consult with your doctor before starting an exercise program).
- Nutrition. Three healthy meals a day; appropriate vitamin supplements can be beneficial.
- Mental Health. Stay active, and be aware of signs of depression.
- Weight Check - each doctor visit.
- Mammogram - yearly until age 85+.
- Breast Exam – yearly.
- Prostate Exam - yearly (PSA is optional up until age 75).
- Pelvic Exam/PAP Smear - if three consecutive normal exams prior to age 65, not needed.
- Check Stool for Blood – yearly.
- Sigmoidoscopy - optional every 5-10 years.
- Cholesterol - discuss with your doctor.
- Thyroid Function Test - every 2 years.
- Fasting Blood Sugar - every 2 years.
- Vision Testing - every 2 years.
- Influenza Vaccine - every year.
- Pneumonia Vaccine - once every 6-10 years.
- Tetanus Vaccine - every 10 years.
- Blood Pressure - yearly (if elevated, get 3 readings over 1-2 months).
- Skin Examination - yearly.
- Vitamin D Level, Bone Density (for all women, and for men at high risk) – yearly.
Disease Management (Be sure to discuss these issues with your physician!)
- Medication Awareness - prescription and over-the-counter drugs
- High Blood Pressure
- Heart Disease
- Arthritis/Chronic Pain
- Sleep Disorders
So, remember: it’s not necessary to fret and worry over every discomfort you experience in your body. At the same time, it’s unwise to ignore ongoing, nagging symptoms. Listen carefully to your own intuition, and consider what has been normal for you in your past. Having an established, trusting partnership with a primary care provider who knows you well and who provides regular preventative care is your best offense. And taking good care of yourself is also critically important. When in doubt, pick up the phone and schedule an appointment so your physician can address your concerns, ease your mind, and help you achieve the healthiest body and lifestyle possible for you.