No one wants it, but pain is the body’s way of getting your attention when something is wrong. You probably know your body well enough to know when the pain is just a bother, maybe from moving furniture a day or two before or eating two cheeseburgers. It’s when pain might signal something more serious that the internal dialogue begins:
“Ok, this isn’t something to fool around with.”
“But I have an important meeting.”
“And how many meetings will you miss if you land in the hospital?”
“I’ll give it one more day.”
If in doubt, get medical attention, always.
NO.1: WORST HEADACHE OF YOUR LIFE
Get medical attention immediately. If you have a cold, it could be a sinus headache. But you could have a brain hemorrhage or brain tumor, both of which are relatively uncommon. Nevertheless, with any pain, unless you’re sure of what caused it, get it checked out.
Especially for elderly people, but not confined to them, of course, we, doctors, have been trained to expect that when someone says they have the worst headache in their life, it is a classic sign of a brain aneurysm. Go immediately to the Emergency Room.
NO.2: PAIN OR DISCOMFORT IN THE CHEST, THROAT, JAW, SHOULDER, ARM, OR ABDOMEN
Chest pain could be pneumonia or a heart attack. But be aware that heart conditions typically appear as discomfort, not pain. And you shouldn’t wait for pain. Heart patients talk about pressure. They’ll clench their fist and put it over their chest or say it’s like an elephant sitting on their chest.
The discomfort associated with heart disease could also be in the upper chest, throat, jaw, left shoulder or arm, or abdomen and might be accompanied by nausea. The 18- or 25-year old is not too much of a worry, but if a person has unexplained, persistent discomfort and knows they’re high risk, they shouldn’t wait. Too often people delay because they misinterpret it as heartburn or gastro-intestinal distress. Get to an emergency room or physician’s office. If it turns out to be something else, that’s great.
Intermittent discomfort should be taken seriously as well. There might be a pattern, such as discomfort related to excitement, emotional upset, or exertion. For instance, if you experience it when you’re gardening, but it goes away when you sit down, that’s angina. It’s usually worse in cold or hot weather.
A woman’s discomfort signs can be more subtle. Heart disease can masquerade as GI symptoms, such as bloating, GI distress, or abdominal discomfort. It’s also associated with feeling tired. Risk for heart disease increases dramatically after menopause. It kills more women than men even thought men are at higher risk at any age. Women and their physicians need to be on their toes.
NO.3: PAIN IN LOWER BACK OR BETWEEN SHOULDER BLADES
Most often it’s arthritis. Other possibilities include a heart attack or abdominal problems. One danger is aortic dissection, which can lead to major blood vessel rupture, and which may appear as either a nagging or sudden pain. People who are at risk have conditions that can change the integrity of the blood vessel wall. These would include high blood pressure, a history of circulation problems, smoking and diabetes. Of course, the danger of rupture of a blood vessel from dissection is fatal hemorrhage (bleeding to death).
NO.4: SEVERE ABDOMINAL PAIN
Still have your appendix? Don’t risk the possibility of a rupture. Gull bladder and pancreas problems, stomach ulcers, and intestinal blockages are some other possible causes of abdominal pain that need attention.
NO.5: CALF PAIN
One well-known danger is deep vein thrombosis (DVT), a blood clot that can occur in the leg’s deep veins. Of course, it can be life-threatening, as a piece of the clot could break loose and cause pulmonary embolism (a clot in the lungs). Cancer, obesity, immobility due to prolonged bed rest or long-distance travel, pregnancy, and advanced age are among the risk factors.
Sometimes there’s just swelling without pain. If you have swelling and pain in your calf muscles, see the doc immediately.
NO.6: BURNING FEET OR LEGS
Many, many people who have diabetes don’t know it. In some of these people, peripheral neuropathy (nerve problems in the limbs) could be one of the first signs. It’s a burning or pin-and-needles sensation in the feet or legs that can indicate nerve damage.
NO.7: VAGUE, COMBINED, OR MEDICALLY UNEXPLAINED PAINS.
Various painful, physical symptoms are common in depression. Patients will have vague complaints of headache, abdominal pain, or limb pain, sometimes in combination.
Because the pain might be chronic and not terribly debilitating, depressed people, their families, and health care professionals might dismiss the symptoms. Furthermore, the more depressed you are, the more difficulty you have describing your feelings. All of this can lead the doctor astray.
Other symptoms must be present before a diagnosis of depression can be made. Get help you’ve lost interest in activities, you’re unable to work or think effectively, and you can’t get along with people. And don’t suffer silently when you’re hurting.
See you next week.