Live with it, or see a doc?

March 2, 2008 12:16 am

IT'S NOT EASY to know when to call the doctor. You don't want to seem like a hypochondriac, but you also don't want that cold you've had for the last week to turn into a rampant case of pneumonia because you preferred to tough it out.

A symptom that may seem innocuous can indicate a disease or injury that will worsen without medical care. So, we've consulted area doctors and other sources to help determine which symptoms are mild, and which can't be ignored. And speaking of doctors, see Page E6 for five reasons why you should have a primary-care physician.

--Lauren Jurgensen

You should go to the doctor if

You're short of breath:

If this symptom is accompanied by intense chest pain, it could be a heart attack. Shortness of breath can also be a sign of pneumonia, allergies and asthma, said Dr. Nariman Dash, a local ear, nose and throat specialist. Another possibility is a pulmonary embolism, or blockage of the pulmonary artery, which can be fatal.

See a doctor immediately if you are struggling to breathe, especially if you also have chest pain. You'll need urgent care for a heart attack or pulmonary embolism.

You're coughing up or blowing out green phlegm:

If you have discolored mucus for more than seven days, you may have a bacterial infection such as sinusitis. Or, if you're also coughing hard and frequently, you may be suffering from bronchitis.

See your doctor if the symptoms persist for more than a week. Your doctor may prescribe an antibiotic. But usually, green phlegm just means a common cold or virus, Dash said. For that, over-the-counter balms should suffice.

Your child is running a fever:

A fever of more than 100.4 in a baby less than 3 months old can mean the baby has an infection, or is dehydrated or overheated. Fever in older kids is usually a sign of infection. Try reducing it with acetaminophen or ibuprofen.

Newborns should see a doctor right away, said Dr. Haleh Rajee of Pediatric Partners of Stafford. Children under 2 should see a doctor if their fever is accompanied by wheezing or trouble breathing. Older kids generally don't need a doctor's care unless their fever lingers for several days. But any feverish child who is confused, lethargic or dehydrated should see a doctor. (See aap.org for more.)

You discover a lump in your breast or anywhere else:

A lump can be a cancerous tumor or a benign cyst. Before heading to the doctor, a young, pre-menopausal woman should wait through a period cycle to see if the lump goes away, said Dr. James Daniel, head of Mary Washington Hospital's cancer navigator program. Breast tissue can go through benign changes during a cycle.

A post-menopausal woman who finds a lump in her breast should see her doctor right away and get a mammogram. A pre-menopausal woman should see a doctor if the lump remains after a cycle. Any woman should see a breast specialist if she has a normal mammogram but still feels a lump afterward. Anyone who finds a lump elsewhere, such as on the back or chest, should see a doctor as soon as possible if the mass grows or doesn't fade away.

You're experiencing chest pain:

Along with being a sign of a heart attack, chest pain can be a symptom of many non-cardiac conditions such as heartburn, pleurisy, pinched nerves, shingles, cancer or costochondritis (an inflammatory problem).

Seek emergency care immediately if you feel a persistent pain or tightness in your chest (and especially if the pain is accompanied by nausea, sweating, dizziness or shortness of breath). The sooner you get treatment, the more likely you are to reduce damage and survive if it is a heart attack.

You have a wound that isn't healing:

Wounds can be slow to heal because of underlying conditions such as diabetes or poor circulation. If a wound is accompanied by redness, swelling, heat or pus, it's probably infected, said Joan Miller, clinical coordinator for MediCorp's Rappahannock Wound Healing Center.

See a doctor as soon as possible if you think the wound is infected, Miller said. If you aren't experiencing symptoms of infection, see a doctor if your wound hasn't healed after several weeks, because you may have an underlying problem hindering the healing process.

You take a blow to the head:

Some blows cause nothing more than a headache or bump. Others cause concussions or more severe injuries. Serious concussions can lead to neurological damage and increase your risk of developing epilepsy. Fortunately, most concussions are mild and heal fully with rest.

You should see a doctor if you experience prolonged memory loss, head pain or dizziness, or if you experience nausea, impaired balance, ringing in your ears, vision problems or a loss of smell or taste, says the Mayo Clinic. Any child who has been knocked unconscious should see a doctor. (See mayoclinic.com for more details.)

You miss your period:

Pregnancy tends to be the most common cause of a missed menstrual cycle. But other causes include chronic illness, stress, low body weight and premature menopause. (Unlike pregnancy, these conditions usually lead to only a temporary break from menstruation.)

The Mayo Clinic advises on its Web site that a woman see a doctor after missing three periods in a row. But most women will want to take a pregnancy test after their first missed period. If you take a few at-home tests and all come back negative, yet your period is still absent, see a gynecologist.

You feel pain when you urinate:

This symptom can indicate anything from a urinary-tract infection to a sexually transmitted disease such as chlamydia to a yeast infection. It can also be a sign of kidney or bladder stones, or of a sensitivity to soaps or perfumes used near or on the genital area.

Painful urination, also known as dysuria, should be checked out if it lasts more than a day, or if there's blood in your urine, says the Mayo Clinic Web site. Also see a doctor promptly if you experience drainage or discharge from your genital area. Treatment varies by condition, but often includes prescription medication.

You're suffering abdominal pain:

You could have a viral infection, or your appendix could be on the verge of bursting. Or you could have something else entirely. Abdominal pain can stem from problems in a variety of organs, including the gall bladder, pancreas and colon, the Mayo Clinic says.

See your doctor as soon as possible if the pain is so bad that you can't eat; if it becomes worse or is accompanied by a fever or chills; or if you're short of breath, dizzy, bleeding, vomiting or have pain radiating to your chest or shoulders. Also seek care if you vomit blood or find blood in your stools or urine, or if your abdomen is swollen or tender.