This story was originally titled "10 Symptoms You Shouldn't Ignore" in the May 2008 issue. Subscribe to Canadian Living today and never miss an issue!
If you suddenly develop severe abdominal or chest pain, the odds are you’ll head straight to your nearest hospital emergency department. But it’s not always that easy to recognize a serious medical problem. To help take the guesswork out of when to seek prompt medical attention, the Mayo Clinic recently published a list of 10 symptoms you should never ignore. We reviewed the list with Canadian health-care professionals, who added their expert recommendations regarding these red-flag symptoms.
1. Unexplained weight loss
The Mayo Clinic recommends you see your family doctor if you experience an unplanned weight loss of more than five per cent in a month or of more than 10 per cent over six to 12 months, but people don’t usually think in terms of percentages, says Dr. John Gillis, an emergency room physician at the Dartmouth General Hospital in Dartmouth, N.S. “A big change in weight that doesn’t make sense based on what you’re doing is what you want to look at,” he advises. For example, if you’re someone who has always struggled with keeping weight off and suddenly you drop 10 or 15 pounds, that could be a concern.
Possible causes: depression, an overactive thyroid, liver disease, cancer.2. Persistent fever
A run-of-the-mill virus may cause a few days of mild fever, and it’s usually safe to wait it out. “A lot of times people can save themselves a visit to the doctor or the emergency room if they simply treat this kind of fever with acetaminophen or ibuprofen,” says Gillis. If, however, you have a low-grade fever (between 37.5 and 38.5 C) for longer than a week, check in with your family doctor. A higher fever (that is, anything over 38.5 C) may signal a more serious infection and requires immediate medical attention, especially if it’s accompanied by shaking and chills. “Generally, the higher the fever, the more likely it is you have an infection that might have gotten into your bloodstream, and that could be more serious,” says Gillis.
Possible causes: a urinary tract infection that has moved into the kidneys, some cancers such as lymphoma, and chronic infections such as tuberculosis.
3. Shortness of breath
If you’re an otherwise healthy adult who doesn’t usually have breathing problems and suddenly you’re struggling for air, head to emergency, advises Gillis. If young children are having difficulty breathing – especially if they make a high-pitched sound like a whistle when they breathe in – don’t panic, but do take them for immediate medical attention. “Children under one have small airways, and it’s always best to err on the side of caution,” says Gillis. If you or your child have asthma and you know the problem is caused by a specific trigger – cold air, smoke or strenuous activity, for example – it’s best to follow up with your family doctor.
Possible causes: asthma, croup (in children), whooping cough, anxiety, panic attacks, heart problems, a blood clot in the lungs, or lung or esophageal cancers.
Page 1 of 34. Unexplained changes in bowel movements
The key word to emphasize here is change, whether it’s in appearance or consistency of the stools, says Dr. David Armstrong, a gastroenterologist at Hamilton Health Sciences Centre at McMaster University in Hamilton. “Some people have a 20- or 30-year history of constipation, and I wouldn’t want them to feel they have to suddenly run to the emergency.” However, if the constipation is suddenly accompanied by symptoms such as vomiting, nausea or abdominal pain, you should get immediate medical attention. Anything that’s troublesome for more than a few days, such as diarrhea, should prompt a visit to your family doctor, adds Armstrong. If you have blood in your stools, or they’re black or tarry-coloured, that needs to be checked out as well.
Possible causes: infectious or bacterial gastroenteritis, food poisoning, inflammatory bowel disease (Crohn’s disease and colitis), irritable bowel syndrome, some types of cancer such as colon cancer.
5. Changes in mental state
Disorientation, confused thinking, hallucinations or sudden aggressive behaviour all require immediate medical attention, says Gillis. “If a person has diabetes, the low blood sugar that is making her confused can quickly lead to low blood sugar that is life-threatening.”
Possible causes: diabetes, an adverse reaction to a new medication, infection, head injury, stroke, dementia, psychotic breakdown.
6. New, or more severe, headaches (especially in those over age 50)
Most headaches are simply annoying and disappear by themselves with the help of a mild painkiller. But in some cases, they can signal a more serious disorder. “The first thing we look at is onset and severity,” says Gillis. A headache that comes on suddenly and feels like the worst headache of your life – what’s often described as a “thunderclap” headache – requires immediate medical attention. You should also go to the emergency room if you have a headache that begins or worsens after a head injury, or if the headache is accompanied by a high fever, stiff neck, weakness, numbness or speaking difficulties.
Possible causes: stroke, aneurysm, meningitis, brain tumour, concussion, bleeding on the brain after head trauma.
7. Short-term loss of vision, speech OR movement control
These are all signs of a possible stroke, and the sooner you get treatment, the better your outcome, says Gillis. Studies show that fewer than two per cent of stroke patients arrive at a hospital within the first three hours of a stroke – the time limit that makes them eligible for potential treatment with clot-dissolving medication. In the case of transient ischemic attacks (TIA), or mini-strokes, the symptoms (slurring, numbness of the face, arm or leg, drooping of the mouth, tingling, difficulty moving your arm) disappear within a few minutes to hours, but immediate medical attention is still required to make a recurrence less likely.
Possible causes: stroke or TIA.
Page 2 of 38. Flashes of light
If you’re suddenly seeing firework-like flashing lights or lightning streaks (unlike migraine flashes, which are not like a fireworks display) go to your ophthalmologist or the emergency department as soon as possible, advises Dr. Sanjay Sharma, a professor in the department of ophthalmology and epidemiology at Queen’s University in Kingston, Ont. Other eye symptoms to get checked out immediately include a noticeable increase in floaters (dark specks that seem to move across your field of vision), a sudden “curtain” over your eye and the sense that you’re looking through a red filter.
Possible causes: a retinal tear or detachment, which can lead to vision loss and even blindness.
9. Feeling full after eating very little
If you find that you are feeling full sooner than you normally do after eating, or if you’re vomiting or experiencing nausea or weight loss, see your family doctor as soon as possible. These types of symptoms develop slowly, so we tend to adapt to them and ignore them, says Armstrong. “You have to ask yourself, Was I like this a month ago, or six weeks ago?”
Possible causes: gastrointestinal disorders and some cancers such as pancreatic, stomach and ovarian.
10. Hot, red and swollen joints
It’s not uncommon to get some swelling and discomfort in the joints as we age, but if you’re getting all three symptoms together – the joint is hot, it’s red and it’s really swollen – get it checked out, advises Gillis. A bacterial infection requires immediate medical attention to save joint function and keep the bacteria from spreading elsewhere in the body.
Possible causes: joint infection, gout, rheumatoid arthritis.
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