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Every year we read about people who ignored what seemed like a minor problem -- an "achy flu" or "just a headache" -- then wound up in the hospital. When actress Sharon Stone went to the emergency room because of a splitting headache, doctors found bleeding on the brain in time for her to make a complete recovery. Sadly, singer Laura Branigan never got that far. After a bad headache that lasted two weeks, she died in her sleep of a brain aneurysm in 2004.
So how do you know when a symptom that seems minor actually signals that something is seriously wrong? By paying attention to the company it keeps. An upset stomach may simply be the result of something you ate. But if you have one more than a couple of times a month, along with certain other symptoms, alarm bells should go off. A headache is usually just a headache, and an over-the-counter pain reliever generally takes care of it. But when pain is sudden and severe -- or lasts longer than three days -- get emergency help, says Lori Heim, MD, president-elect of the American Academy of Family Physicians.
Don't worry that you might be overreacting; if it turns out you're wrong, that's a good thing. The tragedy would be waiting too long and losing valuable time that could save your health -- or your life. To protect yourself and your family, learn the signs that could mean you've reached the tipping point for each of these five problems.
Normal causes include tension, fatigue, hunger, caffeine withdrawal or spending time in a hot, stuffy room. These headaches are bothersome but not dangerous.
When to get help: You suddenly develop a persistent, extremely painful headache on one side of your head that feels different from prior headaches. This may be temporal arteritis, an inflammation that can be cured with corticosteroids. Left untreated, it can progress to blindness. If the headache is sudden and severe with no known cause, you may be having a stroke or a brain aneurysm. Call 911 now. if you have a combination of headache, fever, and stiff neck, you may have viral or bacterial meningitis. Go to the emergency room. Viral meningitis gets better on its own in about a week, but bacterial meningitis can cause permanent brain damage or death if it's not diagnosed and treated early. In addition, if you get an aura -- a short-lived sensory disturbance that causes visual effects or tingling -- or if the headache affects only one side of your head, makes you nauseated or lasts much of the day, check with your doctor to see if you're having a migraine. Migraines aren't always an emergency, but your doctor may be able to treat them.
Normal causes include eating a heavy meal or having too much caffeine or alcohol. if antacids make your stomach feel better, it's not an emergency.
When to get help: If the indigestion develops into an aching pain around your navel that shifts to the lower right of your abdomen and becomes tender (you may also have nausea or vomiting). This could signal appendicitis. Call 911 immediately or go to an urgent-care center or emergency room. If you repeatedly develop indigestion-like symptoms after exercise that aren't relieved by antacids, it may be a sign of heart disease. Mild to severe upper-right abdominal pain, especially after eating a fatty meal, can signal gallstones. Although the situation is not always an emergency, follow up with your doctor right away.
Normal causes include overeating, water retention, irritable bowel syndrome, or your menstrual cycle. Eating certain foods, such as beans, which cause you to develop gas as you digest them, can also make your abdomen feel swollen and uncomfortable.
When to get help: If bloating occurs more frequently and is accompanied by pelvic or abdominal pain, an urgent or constant need to urinate, persistent nausea, or a feeling of fullness quickly after eating. If you can't get an appointment with your gynecologist within a week, tell the doctor's receptionist that your symptoms resemble those of early-stage ovarian cancer and that the situation is urgent. Many physicians keep time in their schedules for emergencies and this could be one. (Ovarian cancer is not very common and you are far more likely not to have it, but if you do, finding it fast is essential.)
Normal causes include a cold or flu. Symptoms usually subside within a week and may leave you feeling draggy for a while longer. Rest, plenty of fluids, and nonprescription medication to bring down fever help relieve the symptoms.
When to get help: You suddenly develop a high fever and painful sore throat with difficulty swallowing and nausea. In rare situations, streptococcal bacteria can trigger toxic-shock syndrome, an unusually virulent infection that can be mistaken for an extreme case of flu. If you can't reach your doctor, go to the emergency room immediately. These symptoms could also be the first sign of life-threatening pneumonia.
Normal causes include a recent change in your diet, an increase in exercise, or going through a period of serious emotional stress, such as a death in the family or losing your job.
When to get help: You lose 10 pounds or more with no reasonable explanation, which may mean you have an overactive thyroid, a treatable condition. But it could also be a sign of cancer. See your doctor promptly to check out all possible causes. The longer you wait, the more you risk missing the earliest chance for treatment. If you also have to urinate frequently and have blurred vision, fatigue, or excessive thirst, you may have diabetes. Getting early treatment for this condition limits the risk of heart disease, stroke, kidney disease, blindness, and many other diabetes-related health problems.
Originally published in Ladies' Home Journal, January 2009.