Medical Symptoms Never to Ignore…or else
Maurice A. Ramirez, DO, American Board of Disaster Medicine
Millions of people ignore symptoms that they should pay attention to right away. They think a high fever will go down or stomach pain will go away—but symptoms such as these can be signs of dangerous, even life-threatening, conditions. Here, symptoms that should never be ignored…
ABDOMINAL PAIN
Severe abdominal pain often is a symptom of a medical crisis.
Possibly happening…
• Appendicitis.
• Gallbladder problems.
• Diverticulitis (an infection of the wall of the intestines).
• Aortic aneurysm (weakened or bulging area in the aorta, the major vessel that feeds blood to the body).
• Tumor.
Urgent: If the pain doesn’t go away within five minutes, call 911 or have someone drive you to the emergency room (ER).
If you wait too long: While most of these conditions can be resolved quickly with immediate surgery, waiting can make the problem worse. Example: Appendicitis can become a ruptured appendix—and instead of going home the day after your surgery, you may end up in the intensive care unit.
SHORTNESS OF BREATH
You start to have trouble breathing.
Possibly happening…
• Chronic Obstructive Pulmonary Disease (COPD), such as emphysema.
• Congestive heart failure, in which the heart doesn’t pump strongly enough to keep blood from backing up into the lungs.
• Heart attack.
• Asthma attack or anaphylaxis (throat constriction caused by a severe allergic reaction).
• Pneumonia.
Urgent: If you are slightly short of breath—you can still speak a sentence without having to stop and take another breath—you can drive yourself or ask someone to drive you to the ER unless you also have chest pain (see page 3).
If you are huffing and puffing, turning blue and/or cannot finish a sentence without taking another breath—what ER doctors call “one-sentence dyspnea”—you are in severe trouble. And “four-word dyspnea”—you cannot speak four words without taking a breath—is extremely dangerous, and you should be on a ventilator. In either case, call 911.
If you wait too long: Depending on the condition, there could be damage to the heart and possible death from lack of oxygen.
HIGH FEVER
A fever is cause for concern if it is higher than 103°F and is accompanied by a stiff neck, severe headache and/or a rash.
Possibly happening…
• Meningitis.
• Rocky Mountain spotted fever.
• Pneumonia.
Urgent: Go to the ER fast.
If you wait too long: Serious infection can lead to shock (when the body’s circulatory system fails to maintain adequate blood flow).
If you have pneumonia and wait more than four hours to have the high fever treated, you are more likely to die of pneumonia.
HIVES ALL OVER
You suddenly have itchy, red bumps over much of your body. This may be accompanied by difficulty breathing…pale, cool and clammy skin…or a weak or rapid pulse.
Possibly happening: You’re having an allergic reaction to an insect bite or sting, a food or other type of allergen.
Urgent: Go to the ER, and don’t leave without a prescription for epinephrine (EpiPen). Cases of “hives all over” often will spontaneously recur over the next month—even if you aren’t exposed to the allergen again—getting worse each time. The epinephrine can short-circuit a severe allergic reaction. Caution: Once you use your EpiPen, don’t assume that the problem is gone. Go to the ER immediately.
If you wait too long: Anaphylactic shock, a life-threatening drop in blood pressure that also can result in difficulty breathing, dizziness and/or loss of consciousness.
SUDDEN VISION OR HEARING LOSS
You’re suddenly blind in one or both eyes and/or deaf in one or both ears.
Possibly happening: This is almost always a stroke.
Urgent: Call 911.
If you wait too long: Loss of vision and/or hearing, as well as other stroke damage, possibly leading to death.
DIFFICULTY MOVING OR SPEAKING
You can’t move part of your body, and/or you start slurring words.
Possibly happening…
• Stroke, caused by a clot blocking an artery to the brain.
• Cerebral aneurysm (ruptured blood vessel in the brain).
• Brain tumor.
• Tumor or bone chip in the spinal canal, pressing on a nerve.
Urgent: Call 911, even if the paralysis or slurred speech goes away. A temporary disconnection between your brain and the rest of your body is always cause for concern.
If you wait too long: If you don’t receive treatment for a stroke or ruptured blood vessel within six hours, your odds of future disability are 50%. If you are treated within three hours, there is a 70% chance of full recovery.
An undiagnosed tumor can damage the brain. An undiagnosed impediment in the spinal canal can destroy the nerve, causing permanent loss of function, even paralysis.
CHEST PAIN
Most people know that chest pain is a dangerous sign—and yet people with chest pain typically wait six hours before going to the ER. Then it’s often too late to receive treatments that can stop or reverse damage to the heart, brain and other vital organs.
Possibly happening…
• Heart attack.
• Pulmonary embolism (blood clot in a lung artery).
• Aortic aneurysm (a tear in the body’s largest artery).
Urgent: If you have chest pain for more than five minutes, call 911. Do not drive to the ER or ask someone to drive you. You need emergency care in an ambulance.
If you wait too long: Heart muscle can die, causing permanent heart damage or death…a partial aortic tear can develop into a full tear, causing a stroke.
Bottom Line/Personal interviewed Maurice A. Ramirez, DO, an emergency room doctor at Pasco Regional Medical Center, Dade City, Florida. He is a specialist in emergency and disaster medicine and founding chair of the American Board of Disaster Medicine. Dr. Ramirez supervised triage at Louis Armstrong New Orleans International Airport in the days immediately following Hurricane Katrina.
He is currently working on a book called You Can Survive Anything, Anywhere, Every Time.
(Article originally published October 15, 2007)
Reprinted with the permission of:
Boardroom Inc. and Bottom Line Publications, Inc.
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