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Do I Need a Doctor?: Whether to Seek Help or Suck It Up in Nine Scenarios

Do I Need a Doctor?: Whether to Seek Help or Suck It Up in Nine Scenarios

That stuffy nose that’s been lingering since last week will go away on it’s own…right? More often than not yes, says Alex Lickerman, M.D., an internal medicine physician and Assistant Vice President for Student Health and Counseling Services at the University of Chicago. Head congestion that comes with a scratchy throat and tired eyes typically means virus, which unless caught early (see Tip 3 below) needs to run its course. Think sleep, soup, and the extra large box of tissues.

When should you be more concerned? In general, if you’re not sure whether to worry or sleep it off, either call your doc or schedule an appointment. In the meantime, here’s Lickerman’s advice on how to ID the red flags.

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Be patient. Most muscle soreness is the benign type caused by physical activity that the body’s not used to—think: your first CrossFit session—and will go away on its own after a few days. Try over-the-counter pain relievers like Tylenol or Advil to help ease the symptoms, Lickerman says.

RED FLAG: If soreness continues beyond a week (or if muscles ache even when you're resting), see your primary care doc to check if something more serious is going on. Although very rare, unusually intense exercise may cause rhabdomyolysis, which if left untreated can cause permanent kidney damage. 

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Hold tight. Low-back pain is the single most common complaint in primary care—and nearly all of the time, it’s musculoskeletal strain and the primary “treatment” is rest, Lickerman says. Your doc may recommend OTC pain relievers as needed, or Tylenol #3 with codeine (a narcotic) if pain is so bad you can’t sleep. Pain usually goes away within four to six weeks, but if it does linger beyond six weeks, it may be chronic low-back pain—which should be evaluated by a doctor.

RED FLAG: Pain or tingling down one leg or the other can indicate a slipped or herniated disk, or a pinched nerve root (sciatica)—all of which require medical attention. See your MD.

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Suck it up—and get some rest. Stuffy nose, blocked ears, and sore, scratchy throats are almost always telltale signs of a viral infection, Lickerman says. While OTC pain relievers and nasal decongestants can help relieve symptoms (and similar prescription-strength meds for severe cases), there are still no drugs to shorten the bug’s course once it’s struck. The exception: If started within the first 24 hours of the appearance of symptoms, zinc gluconate lozenges—available at the drugstore—taken every two hours can shorten the duration of a cold and reduce the severity of symptoms.

RED FLAG: If symptoms continue for a month or longer, get in to see your doc. They may be related to another condition. But, be patient—the typical course of a virus is three weeks. Also, be wary if you recently traveled somewhere where you may have caught something more exotic.

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It depends on your temp. Low-grade fevers up to about 101 degrees Fahrenheit are typically symptoms of viral infections—especially the ones that strike within the first few days of other symptoms—and need to run their course, Lickerman says.

RED FLAG: Fevers 102 degrees and higher that last longer than a few days could be a sign of a bacterial infection, which would likely require an antibiotic to clear up. Another sign of bacterial infection versus viral is fever accompanied with just one other symptom—sore throat or sinus pain on only one side. Bacterial infections tend to stick in one body cavity.

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Examine other symptoms. A lot of things can cause a cough, Lickerman says. If it’s part of a virus or common upper respiratory tract infection (if your throat’s sore and head’s congested), rest is best so your body can recoup.

RED FLAG: High fever, too? See previous slide—think potential bacterial infection (see your doc for antibiotics). Also, note unusual shortness of breath (from walking up stairs or across the office), which could be an early sign of pneumonia, fungal infections (in rare cases), or lung cancer (more so in patients over 50 and particularly those with a smoking history).

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Is it unusual? Most daily chronic headaches or migraines—even if they cause lots of pain—are not life threatening, Lickerman says.

RED FLAG: Be wary of anything unusual. Is it a pain you've never felt before? Is it in a location you don't recognize? More severe than your headaches typically get? See your doc. Recent head trauma? See your doc to be assessed for concussion, cognitive impairment, or internal bleeding (more of a concern after you hit 50). And a BIG red flag is a headache accompanied by a rash (classic red spots), which could be a sign of (life-threatening!) meningitis. Get to the ER right away.

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Play it safe. Unless you can identify the pain (i.e. indigestion) or it goes away on its own in a few days, check with your MD, Lickerman says. “Even if only via a brief phone screen, I always want to talk to patients who have abdominal pain—there are so many things it could be.”

RED FLAG: Look out for sharp pain that starts in the middle of the stomach and moves to the right lower quadrant; it's a sign of appendicitis. And in general, if the pain continues to get worse or continues for four days or more, see your doc. 

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See your doc—if it continues after about two weeks. People do not take their sleep seriously enough and do not realize there is a lot you can do to improve your sleep, Lickerman says. Your primary care physician is a great place to start to help you clean up sleep habits or refer you on for further help if needed.

Trouble falling asleep may be signs of anxiety; waking up early in the morning is often associated with depression; and waking up intermittently during the night may be linked to another medical condition. Sleep deprivation can seriously affect functioning; so don't wait much longer than two weeks to seek help if the problem continues.

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How often? Everyone feels down sometimes, but if moodiness is interfering with work, family, or friends, do not be wary of seeking input from your MD—starting with primary care. Everyone’s capacity to cope with tragedy, loss of a loved one, or other stressors, is different, Lickerman says. The rule of thumb is to mention it sooner rather than later, he adds. "Primary care doctors are absolutely prepared and trained to treat minor to major depression—or refer patients on for additional treatment as needed."

RED FLAGS: Ask for help if you notice your (or a friend’s) mood is interfering with your routine—or for more serious warning signs, like having suicidal thoughts.

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