Your health should be your top priority at all times. It is the foundation for everything else that you do in life. You know this. We know this. But when you’re busy with, well, life, it’s easy to forget just how vital it is to take care of yourself. Or when some health problems pop up, you might feel uncomfortable reaching out to your doctor.
Today, we’re featuring the advice that medical professionals gave about the health warning signs that they wish more people knew about, as shared in two online threads in the ‘Medicine’ online community. It’s a crash course about what not to ignore and a reminder not to put off your doctor’s appointment.
#1
Someone who is okay for a while but not doing as much as they were and maybe talking about giving things away or saying rather dark jokes about after they are gone or just saying they feel sick constantly, then suddenly one day getting very happy or almost relieved is someone who should not be left alone. This is a huge red flag and you should talk to them and directly ask them about it .
© Photo: grandpubabofmoldist
#2
I’m honestly shocked how many new onset diabetes with DKA I see and the parents didn’t think it was abnormal that their kid had lost 20 pounds in 2 months. Unintentional weight loss is **never normal.** It’s almost always associated with something serious, whether it be AIDS, new diabetes, or a malignancy. I feel like this should just be common sense but it’s apparently not.
© Photo: halp-im-lost
#3
I wish patients would recognize that it's not normal to be coughing all the time and short of breath with minimal exertion...
I hate cigarettes.
© Photo: fixture94
It’s sometimes tough to understand when you do and don’t need emergency assistance. On the one hand, you don’t want to clog up the medical system by going to the emergency room when you’re not in danger. Say, when you have a cold or a small injury that you can treat at home or at a pharmacy.
On the other hand, you want to be safe rather than sorry. You don’t want to put yourself in a situation where you delay medical help when you actually need it because you assume “it’s nothing” and that you’ll get better. After all, doctors know a lot more about potential health risks, and they have access to your medical history.
As a rule of thumb, you should seek immediate medical help if there are sudden changes in your health. And if you’re ever uncertain if you should head to the ER, call your doctor or healthcare provider for support.
#4
That shortness of breath and wheezing and “new onset” asthma in a healthy young man (army ranger which also means would never come to ER) who presents 3 times in 48 hours is probably not asthma.
Scanned him because his Sats 91% (this is a man who runs 10 miles before breakfast) which upset the nurses —initially—who were angry that he was back, bilateral saddle pulmonary emboli. Dodging bullets in the ER.
© Photo: heiditbmd
#5
If you have a sudden appearance of multiple new floaters or new flashing lights or new curtain in your vision, please get an eye exam asap not 3-4 weeks from now on a Friday afternoon. Usually it’s a posterior vitreous detachment sometimes accompanied by retinal tears.
© Photo: kereekerra
#6
Sudden sensorineural hearing loss has a normal ear exam. However, the symptoms, besides hearing loss, are a plugged ear and ringing. The plugged ear/aural fullness really seems to throw practitioners off. Practitioners WANT to see pathology when you look in the ear, thinking they have an ear infection. The tympanic membrane will look totally normal. But, there has to be pathology. Right? So they’re treated for an otitis media. Trust your exam that the ear looks normal. Dust off the 512Hz tuning fork (or even a 256) and perform a Rinne (middle of forehead or the top of the head). It will lateralize to the contralateral ear (if it’s an otitis media, it will most likely lateralize to the affected ear).
If you suspect a sudden hearing loss, call up your favorite otolaryngologist. We’ll happily fit them in to get them evaluated.
Globus/throat clearing is reflux even when there isn’t heartburn.
Facial pain and pressure around the cheeks/eyes as the initial symptom for sinusitis is not sinusitis. It’s a migraine headache.
© Photo: headholeologist
As Concordia University stresses, you should go to the emergency room if you have sustained severe physical trauma, lose consciousness, suddenly have a severe headache, suddenly feel pain in your chest, left shoulder or arm, light-headedness, jaw pain, or aching under your breastbone. Other troubling signs are severe shortness of breath, numbness or weakness in the arms or legs, disorientation, and blurred vision.
Another symptom that you shouldn’t ignore and head right to the emergency room, as per ‘Time’ magazine, is if someone you know is suddenly confused or their personality changes. This could be due to a number of things, like a stroke, infection, low blood sugar, etc. So, they need immediate care.
You should also be wary of sudden and unusual upper back pain, nausea, unexplained severe itching, extreme anxiety or a sense of doom, randomly passing out, leg pain or swelling in just one leg, and shortness of breath even while lying down.
#7
New elevated reflexes, positive Hoffman's, especially if also having balance problems or hand tingling, needs an MRI of the c spine and possibly the brain at the same time, asap.
I have caught more than ten cervical stenosis with myelopathy on patients sent for EMG with presumed diagnosis of carpal tunnel syndrome. Always with elevated reflexes in the upper extremities.
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#8
Just had one of these. Makes your heart sink. Kid with "sore throat and fever and her lymph nodes just won't go down."
Immediately feel all her matted nodes in her neck, her big spleen and liver. Pre-B Cell.
© Photo: dokte
#9
Kid complains of abdominal pain a few days/weeks before, isn't gaining weight or is losing weight, and all of a sudden screaming for juice/water/whatever *constantly*, then gets really sleepy and hard to wake up. Diabetes
Once you’ve finished reading through this post, think about taking part in the conversation in the comments. In your personal experience, what are some symptoms that you wish you had reacted to earlier than you did? Meanwhile, if you have a background in medicine, what advice would you give everyone to inspire them to live a healthier, longer, happier life? Let us know.
#10
"You know, I lost vision in that eye a couple weeks ago. But I had another appointment that day so I waited two weeks to come in." Or some variation. Happens all the time. If you suddenly lose vision in one eye, get to an eye doctor immediately. Don't wait. It's always less fixable with time.
#11
I really wish the approach to heart attacks wasn't to teach a "typical" (male) and an "atypical" (female) presentations. For one, women are half the freaking population, so it can't be *that* rare. My experiences in the ER so far have also been that anything heart related can present however it wants for both men and women.
The sickest cardiac patients I've had as a nurse in the ED (who weren't already dead or actively dying) didn't have any pain at all. They were just chilling and ready to go home. Sometimes they don't even know why they decided to come to the ED in the first place. They can't articulate why they showed up, and if they are in pain it's like a 2/10, but they're the ones who end up shipped out by helicopter straight into the fanciest hospital's OR because they need 500 CABGs and their aorta is about to explode.
© Photo: TentMyTwave
#12
It’s actually NOT OKAY to not have BMs for days on end, BMs that hurt, BMs that are bloody, BMs that produce rock hard stool, BMs that you have to force out like you’re birthing an infant, or BMs that make you feel like you’re going to pass out.
It’s actually NOT okay for women to leak urine for years with even mild abdominal contractions, laughing, bending over, sneezing, squatting, coughing, getting out of a chair, walking down the stairs, walking up the stairs, and basically anytime not laying down flat or sitting.
© Photo: Vronicasawyerredsded
#13
Sudden reduction in exertion tolerance. Especially in athletes. I’m worried about someone who runs 10km a day who all of a sudden taps out after 5km.
#14
Sudden mental health deterioration. I’m in a third year at medical school right now and in all of my shadowing there seems to be a huge pattern in late diagnosed MS and drop of mental stability. Obviously. Let me explain better.
Mental health nowadays is seemingly almost glorified. A ton of people are blaming things on “oh it’s just my OCD, ADHD, Dyslexia etc”. Undiagnosed as well. When these sudden changes can be huge tell tale signs of actual diseases. I saw someone come into our neuro department after some fasciculations we assumed to be benign. But she explained how they acted with her “anxiety and ocd” which she was undiagnosed. She had late stage MS.
#15
Working in an ER, I similarly wish more women knew that cardiac symptoms are not as clear when compared to men. Nausea, vomiting, dizziness, etc. are far more common in women with STEMIs compared to men, whereas men often have some form of chest, arm or jaw pain.
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#16
"I've been getting full early for awhile now, my stool is pale, my urine is dark, and my wife thinks my skin is getting yellow."
Pancreatic adenocarcinoma in the pancreatic head.
I hate having that conversation.
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#17
When a 70+ year old chronic smoker says: "I quit last week".
I've posted this before. Anecdotally, there's only thing that's going to persuade a patient who has been smoking for 50 years to quit and that is the patient's *own* realization that *something* is up. On direct questioning, you are almost sure to find that he or she has been coughing up blood, or losing weight, or developed angina . . .
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#18
Palliative/Hospice care:
- sudden oozing of stool that doesn't seem to end: call the family asap (rectal sphincter is relaxing; pt is probably has minutes to an hour left).
- family is finally accepting of patient's prognosis, and comfort care initiated. Family from a different state or country calls: NO (faraway family will demand everything be done and guilt-trip the proxy and threaten to excommunicate them if they don't do what they want).
#19
1)After a "Succesfull" Epidural block the patient starts complaining of shortness of breath, then stops talking, then stops breathing = accidental subarachnoid injection.
2) Intraoperative rising EtCO2 and rising patient temperature = Malignant Hyperthermia.
3) Pediatric patient develops intraoperative bronchospasm, then a rash then full blown shock = latex allergy.
© Photo: eddie_00p
#20
"For the last couple days my kid's gums bleed like crazy when I brush his teeth, it's strange!" (Cancer)
Any kid younger than 12 complaining of back pain trigger my pinna to twitch. (Cancer/infection)
"He was breathing really, really fast a while ago, but now he's starting to slow down and sleep some." (Respiratory arrest)
#21
Infant, six months old, "just does these odd arm lunges sometimes."
West syndrome.
#22
"Ive been sweating excesively in the middle of the night"
You have been coughing? : Answer = Yes, time to look for Tuberculosis
You have been coughing : Answer = No, time to look for cancer
Another example I really hate in pregnant women
"My baby was moving a lot last week, but he hasnt moved or kicked all this week, Im a bit concerned"
Ok, lets take a look
(In my head: WHY DIDNT YOU CAME EARLIER!?)
Another one:
Jehova witness with hemophilia -.-.
#23
Fevers with bone pain. There's the usual myalgias accompanying any sort of viral infection, and then there's the bone pain of acute leukemia when they're wheeled in and placed on a PCA.
#24
Know someone who was concerned that they were losing weight. NP congratulated them because their BMI hd previously been slightly high and dropped plenty. Turned out it was an autoimmune disease and weight loss is a common symptom before it is diagnosed.
#25
Prodromal schizophrenia sxs, which can be mainly the "negative " symptoms like uncharacteristic social withdrawal, loss of motivation, anhedonia in a patient who does not otherwise appear to meet MDD criteria. If you question closely, you may find they actually do have subtle positive symptoms-- sensory distortions, unusual thoughts and sensations.
#26
Children who are older with well thought out asthma plans for viruses who come into ED because it just isn't working 'anymore' should set of alarm bells.
Bonus points for
- we have been battling this for 3 or more days
- sleep is disturbed
- child is anxious about sleep
- they really hates cannulas, they will just keep crying as hard as they can
- they are far too little to understand and comply with bipap
That kid is asking for a tube, it will not be easy to keep them oxygenated since they are trapped, collapsed, plugged. And a child with hypoxic brain injury secondary to your intubation is just such a sad prospect.
#27
Any symptom that is steadily worsening and not responding to treatment. Any at all. It's almost always a good prompt to tell that patient to maybe hang around for some additional studies and it's a marker for the kind of patient that requires some time to pause whatever you're doing and consider "is there anything severe that we're missing or do I have enough information to handle this person as an outpatient"
Personally I believe any patient who has a symptom that meets those conditions, regardless of how irrelevant it may seem always warrants close following.
#28
Kinda specific, but new onset afib after esophagectomy or bowel resection.
It’s most likely due to fluid shifts, or circulating catecholamines, or the normal BS…but everyone should ask themselves *”could this be an anastomotic leak?”*.
© Photo: AnatomicKillBox
#29
Sudden sensorineural hearing loss is an ENT (semi) emergency! The front office of every ENT knows to triage them in quick. Not that putting them on steroids raises the chance above natural recovery of hearing all that much. It just sucks telling somebody "we have nothing to offer you it's been 3 months also have you heard of a cochlear implant 🤗...".
#30
I was shocked to see how long some elderly patients had been having melena, but never told their doctor about it, or the times it has “accidentally” come up.
#31
1. Middle aged Indian male "I've got a little tickle in my chest."= STEMI
2. Older smoker with cough and SOB x 3 weeks. Just gave up their 2 pack a day habit a week ago. = CANCER.
#32
Consult for an "ileus" in a patient with no reason for an ileus, and they have an elevated white count and lactate. It's mesenteric ischemia, and it's probably been ignored for days at this point. If it's embolic, there's hope. If it's thrombotic disease in a vasculopath, game over.
#33
OB: Hypertensive pregnant patient who presents with epigastric pain to the point she is rocking in the bed, or with severe intractable nausea and headache, or with "new shakiness". Start the MgSO4!
#34
Paramedic: "He was fine an hour ago but started feeling nauseous and threw up before laying down"
Come into the room to find a pool of sweat and grabbing their head with a pale face complaining of 10 pain in head. My life just got 100x worse for the next hour while I attempt to transport this pt to the only hospital within an hour going 95 down the open highway.
#35
Sudden onset of coughing, especially when related to positional changes, in a post-pneumonectomy patient. (Bronchopleural fistula).
#36
In Emergency Medicine, I've heard "if the patient is sweating, you should be sweating because something bad is going on". Or they are withdrawing which looks miserable, but less life threatening.
#37
Yes it's common. You'd find the new 2022 acute chest pain pathway from ACC interesting to read then.
Cardiac chest pain may present like this (quoting them):
"Symptoms described as a pressure, tightness, squeezing, heaviness, or burning should be considered consistent with ACS. Pain locations other than the chest can also occur and include the shoulder, arm, neck, back, upper abdomen, or jaw. Other associated symptoms include shortness of breath, nausea, vomiting, diaphoresis, fatigue, and mental status changes, which, in some cases, may be the predominant symptom. In contrast, symptoms described as sharp, fleeting, related to inspiration (pleuritic) or position, or localized to a single point are unlikely to represent myocardial ischemia."
I.e. anything other than sharp/pleuritic pain is a fair game for cardiac pain. Burning pain is not automatically a GERD/GORD!
#38
Unilateral wheezing is no bueno and needs imaging
New clubbing in an Copd patient is a worrisome finding.
#39
Loss of deep tendon reflexes in infant botulism. Often presents as constipation, poor feeding and floppy. The DTRs clinch it. And you need to order BabyBig immediately at a cost of $45,000 based solely on clinical hx and exam. Lab verification takes a long time and maybe be falsely negative.
#40
My least favorite (resident clinic): Metabolic appearing patient with complaint of numbness and burning in feet. A1c at this point is just a number, and we won't be able to fix the foot pain. Let alone the retinopathy and nephropathy.
#41
Diabetic with epigastric funny feeling and/or nausea. With my luck it's a silent MI. Had one the other day brought in as food poisoning.
#42
Yeah, I have been told my voice has changed recently, oh and if I lie flat I just cough and can't breathe at all. But thats fine, because my bears is still as glorious as ever
Anaesthesia.
#43
People, even healthcare professionals, don’t seem to realize just how unremarkable s/s of PE can be. I (surgical nurse) always tell my patients (especially ortho) to get to the hospital ASAP if they have new or worsening respiratory symptoms.
