When to Call a Doctor: Denial Can Lead to Death

Taking charge of your own health care, deciding when to see a doctor, when an alternative practitioner might be more appropriate, and what you can handle yourself, is an intelligent, perhaps even necessary approach these days. Unfortunately, there are no easy guidelines — many physicians with years of training and experience often find such decisions difficult. Still, the more you know about how diseases can be treated, the more likely you are to make appropriate choices in managing your own and your family's medical care.

Tens of thousands of Americans die needlessly each year because of denial and delay. Among them are heart attack victims who wait an average of six hours to call a doctor, and other people who ignore for months the common warning signs of cancer.

By contrast, those who run to a medical specialist for every ache, pain, and sniffle not only drive up medical costs, but also increase their risk of adverse reactions from overtreatment. The ideal is to find a middle ground based on common sense and knowledge.

Whom to See

Everyone should have a primary-care physician to oversee and coordinate medical care. This might be a family practitioner, an internist, an osteopath, a pediatrician (for children), or a gynecologist (for women). The doctor may be a private practitioner or a gatekeeper physician with a health-maintenance organization or other managed-care group. The important thing is that she knows your medical history and has a stake in maintaining your health.

When you are injured or acute illness strikes, always turn first to a conventionally trained medical doctor. These practitioners are the best qualified to treat trauma and other emergencies, infections, diabetes, heart disease, cancer, and other serious illnesses.

If you suffer from a chronic pain syndrome or some other condition for which conventional medicine can do little, you might be better off seeing an alternative practitioner. And in many cases, you may be the best person to manage your illness, often under the guidance of a medical professional.

In the box to the right and on the next two pages is a listing of medical signs and symptoms and their possible causes. The remainder of the section describes more than 450 diseases and conditions, both common and rare, and provides information on how they are treated, not only by mainstream physicians but also by alternative practitioners and with self-care. It also details how disorders are diagnosed and lists some important questions you should ask the health professional to whom you entrust your medical care. The goal is to help you make informed decisions about your well-being.

Problems That Demand Prompt Medical Attention

Call your local Emergency Medical Service or get to the nearest emergency room if any of the following develop:

Possible Heart Attack

• Severe pain, lightheadedness, fainting, sweating, nausea, or shortness of breath
• Feeling of pain, pressure, fullness, or squeezing in the center chest that lasts more than two minutes
• Pain spreading from the center chest to the shoulders, neck, or arms

Possible Stroke or Mini-Stroke

• Sudden weakness or numbness on one side of the body, usually affecting the face, an arm, or leg
• Sudden loss of speech, or difficulty ; speaking or understanding speech
• Loss of vision or dimness, usually in 1 one eye or half of both eyes
• Unexplained dizziness, unsteady gait, lack of coordination, or falling
• Sudden severe headache unlike any experienced in the past
• Abrupt toss of memory or altered mental abilities

Possible Shock

• Cold, clammy, and pale skin
• Weakness and lightheadedness
• Rapid, weak pulse
• Rapid, shallow, and irregular breathing
• Agitation and feeling of apprehension

Possible Anaphylactic Reaction

• Severe swelling, especially around the eyes, mouth, and face
• Weak, rapid pulse
• Difficulty breathing
• Possible nausea, vomiting, and abdominal cramps
• Bluish tinge to skin and nails
• Confusion, dizziness, possible loss of consciousness

Possible Internal Bleeding

• Coughing or vomiting up blood, which may look like coffee grounds
• Blood in the stool or urine
• Bleeding from a body opening, such as the ears, nose, or mouth
• Abdominal swelling and tenderness
• Excessive thirst

Fevers

See a doctor as soon as possible if:

• Body temperature rises to 100.5° F {38s C) in a baby younger than 3 months
• Body temperature rises to 103° F (39.4° C) in a child or adult of any age
• Body temperature rises to 101° F (38.3° C) and stays there for three days
• Low-grade fever recurs or persists for two or more weeks
• Fever of any degree is accompanied by severe headache, stiff neck, swelling of the throat, or mental confusion