When should you go to the doctor?
I am a doctor and sometimes I am not even sure. I worry when my daughter’s cough won’t go away.
Does this headache mean I have a brain tumor? Does my son need IV fluids because he’s been puking for two days? Does my whole family really have H1N1?
No one is going to be able to tell you with 100 percent certainty when to go to the doctor, but I’m a doctor and a mom; this is what I have learned.
The cough that won’t quit
A trip to the doctor might not be needed if the cough has just started or if everyone else has it; it’s probably a virus that has to run its course. Even “bronchitis” doesn’t generally respond to antibiotics unless you are a smoker. Usually a cough shouldn’t prevent you from going to work or the kids from going to school.
Go to the doctor if your cough has lasted more than two weeks. You may have a lingering cold, but it could be pertussis (whooping cough), gastroesophageal reflux, a sinus infection or a sign of a more severe problem.
Go to the doctor if you are short of breath, but are able to speak in full sentences. Call 911 if you can’t string three or four words together without difficulty.
Is it the flu?
Colds creep up on you and bring with them nasal congestion, a runny nose, mild headaches, occasional fevers lower than 100 degrees and a general feeling of yuckiness. You don’t need me to tell you you have a cold; just take some over-the-counter medicines to treat your symptoms and go back to school or work tomorrow.
Come see me if your symptoms last more than 10 days.
Seasonal flu and H1N1 hit hard and fast and can be very dangerous for children under 2, seniors older than 65, pregnant women and patients with chronic medical conditions. Fevers above 101, coughing, moderately severe headaches, body aches and feeling like you’ve been run over by a stampede of elephants are not unusual.
Take the same medicines you might for a cold, drink plenty of fluids and go to bed (with a stack of DVDs) and plenty of tissue. You may be there for a while — up to seven days.
Call the doctor immediately if you have flu-like symptoms and are pregnant. Also call if you have chest pain or pressure or shortness of breath, especially if you suffer from asthma. Pneumonia develops quickly in the young, the old and the chronically ill.
The brain tumor headache
A trip to the doctor might not be necessary if your headaches are infrequent and relieved with acetaminophen or ibuprofen or if you know you should be wearing your glasses, but aren’t. Even children get headaches every once in awhile. It’s OK.
It’s NOT “OK” if you have never been diagnosed with migraines and you develop nausea and vomiting, blurred vision or dizziness with headaches. If headaches awaken you from sleep or if you have never had a headache in your life and now you have them frequently for two to four weeks, you need to be seen by your doctor.
You need to call 911 if you have the “worst headache of your life” for that pain may reflect a bleeding blood vessel in your brain. Also call 911 if your headache is associated with difficulty speaking, weakness in your limbs or a facial droop.
You may be having a stroke and rapid treatment could mean the difference between life and death.
The pukey kid
Put the child to bed with a “whoops bucket” and keep him at home if he is otherwise healthy. Make sure he has plenty of fluids that he sips slowly in small quantities. Diarrhea often accompanies vomiting and a small child or an elderly person can dehydrate rapidly.
Oral rehydration solutions that you can make at home are better and cheaper than electrolyte replacement drinks. Find the recipe at www.rehydrate.org. Add a sugar-free drink mix to make it taste good. This “stomach flu” may last three to five days.
Make sure everyone in the house washes their hands often to prevent spread of this very contagious illness. Take him to the ER if his mouth looks dry and pasty and his eyes are sunken and dull and he has no energy. Get to the ER quickly if he develops right, lower abdominal pain and has a fever above 101.4.
Taking care of your family is a difficult job and you can do it. Take care of yourself. Be informed. Listen to your intuition. Find a doctor who will listen to you.
Dr. Kathleen Meehan-de la Cruz is a member of Fisher-Titus Medical Center's staff and practices at Monroeville Family Care Center, 136 North Ridge St., Suite B.