It’s true that a “tincture of time” cures many ills. While you might take a wait-and-see approach to the occasional headache, a muscle strain, a head cold, or a mild bellyache, there are some symptoms that simply should not be ignored. According to Cortez family physician Jill Schenk, MD, there are a number of symptoms — some obvious and others somewhat obscure — that deserve the attention of you and your physician.



Go directly to the ER



“Some conditions warrant an immediate visit to the emergency room,” said Schenk. “If you have chest pain or other heart attack symptoms or a headache that feels like the worst pain ever imagined, those are emergencies.” Any symptom, condition, or injury that threatens “life or limb” should be treated immediately at the hospital. In addition to severe chest or head pain, other emergent symptoms include seizures, uncontrolled bleeding, fractures, shock, sudden paralysis, loss of consciousness, and poisoning. “This is obviously not a complete list,” said Schenk. “If you think something is seriously wrong, don’t hesitate. Get to the emergency room.”

There are times, however, when serious — even potentially life-threatening — symptoms are not so obvious. “If you start a new medication and develop a rash, consult with your doctor,” said Schenk. “If that rash appears on a mucus membrane such as in the nose, mouth, around the eyes, or in the vaginal area, that’s an emergency.” These types of rashes may indicate an adverse whole-body reaction to a drug. “I’ve seen this associated with starting certain seizure medications, but it can happen with many other types of drugs as well,” said Schenk.

Another relatively uncommon but very dangerous symptom is a rash, joint pain or swelling, shortness of breath, or tan-colored urine following a strep infection. “This is more of a concern in children, but it can also happen in adults, and these symptoms may indicate scarlet or rheumatic fever, both of which are very serious,” said Schenk. If any of these symptoms appear post-strep throat or after a suspected strep infection, go the emergency room or walk-in clinic unless you can get an appointment with your doctor immediately.



See your doctor



Many symptoms that are not emergencies can nonetheless indicate serious problems and warrant a visit to the doctor. “A mole that changes or bleeds should get your attention,” said Schenk. “I’ve seen people who’ve gone two or three years watching a mole that bleeds, then crusts over and seems to heal, and then bleeds again and it turns out to be something like a stage 3 melanoma. Had it been treated early, the outcome for the patient would have been very different.” If a mole changes in size or color or bleeds, or if any type of skin lesion doesn’t heal within a month, see your doctor.

Besides occasional constipation or diarrhea caused by a stomach bug, any other bowel symptoms or changes should be evaluated by a doctor. “Rectal bleeding, unexplained weight loss, or narrowing of the stool can be symptoms of possible gastrointestinal cancer,” said Schenk. “It’s important for people to understand that pain is rarely a symptom of early colon cancer. If you have bowel changes or bleeding but no pain, don’t be fooled. It is still very important to be evaluated.” Sometimes blood in the stool is caused by a bleeding stomach ulcer and that, too, should be evaluated. “Don’t get lulled into thinking that blood in the stool is just a bleeding hemorrhoid. I don’t want patients to take anything for granted when it comes to the GI tract,” said Schenk.

Thanks to years of public awareness campaigns, most women now know not to ignore a breast lump. “This is not an emergency, but a woman should see her doctor for an exam within a week or so if she discovers a new breast lump,” said Schenk. This holds true for nipple discharge or breast pain as well. “Pain isn’t usually associated with breast cancer, although a few less common types of breast cancer can present with a painful lump. Breast pain more often indicates mastitis or fibrocystic disease, both of which can be treated,” said Schenk.

“I tell anyone who has had a respiratory infection to expect to have a slowly-improving cough for four to eight weeks,” said Schenk. “But if a cough persists without improvement after two weeks, you should see your doctor.” This is especially true if the cough is associated with a fever or is bringing up blood. “This may indicate pneumonia or other lung problems, which should not be ignored,” said Schenk.



Babies are special



A low-grade fever in an adult is usually not cause for alarm, but newborn babies are special. “An infant under a month old with a rectal temperature of 100.5 degrees or more should be taken to the hospital immediately,” said Schenk. “We presume this is an emergency until proven otherwise.” Certain bacteria specific to newborns can be extremely dangerous and could cause meningitis, an infection of the brain lining. Sometimes a baby’s only symptom will be a fever, but the baby might also be either lethargic or jittery, not interested in eating, not wetting the diaper regularly, resistant to being touched or held, or sensitive to light or sound. “If a parent has any hint that anything seems off, they should check the baby’s temperature rectally and if it’s 100.5 or more, go to the ER,” said Schenk. “We don’t mess around when it comes to newborns.”

Pregnant women who experience abdominal pain should take it seriously. “Severe pain may indicate an ectopic (tubal) pregnancy, which can be life-threatening,” said Schenk. Belly pain during pregnancy can be tricky, however. “Especially in pregnant women, pain often radiates to different areas which makes it hard to pin down the cause. Abdominal pain could also turn out to be a kidney stone or gallbladder disease,” said Schenk.

A woman who is 24 weeks or more into her pregnancy and experiences vaginal bleeding or leakage of fluid should been seen by a healthcare professional. “The nurses at the hospital’s family birthing center can do an initial evaluation and contact the woman’s doctor,” said Schenk. After 24 weeks, a woman should also seek attention if she does not feel her baby move for 12 or more hours. “If this occurs, go the hospital and the nurses will monitor the baby and then contact the woman’s physician if further testing is needed,” said Schenk.

With all symptoms, patients should listen to their intuition. “You know your own body better than anyone,” said Schenk. “When in doubt, get medical attention.” It’s better to be safe than sorry, as the old saying goes.



Southwest Health Notes is a public service feature provided by Southwest Memorial Hospital in Cortez, Colorado. The information provided herein is not intended as patient-specific medical advice or as a substitute for consultation with your personal healthcare provider.