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Sunday 19 April 2020

20 Health Problems That Can't Wait

Health care is drastically different in the post-COVID-19 world. Visiting the doctor's office used to be the norm, but because of the highly infectious and deadly virus, most doctors are working remotely, only offering telemedicine visits, and routine medical care is being postponed. However, health problems don't stop just because there's a pandemic going on, says Maria Vila, DO, a family medicine specialist in Morristown, New Jersey, and medical advisor for eMediHealth. However, "depending on your emergency, you may need in-person care, so you have to decide if you should go to an urgent care or an ER and potentially expose yourself to COVID-19," she says. So what constitutes the need for care? We asked health experts around the world to weigh in on the most pressing health problems that can't wait until the pandemic is over. 
1

Chest Pain

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Chest pain can be due to various issues, including musculoskeletal problems, persistent cough, pneumonia, anxiety, a panic attack, or a heart attack. "If you are not sure about what is happening, you should call your doctor to go over any associated symptoms and help you decide if in-person care is best for you," says Vila. If you have a history of heart disease, however, and are experiencing chest pain, with symptoms such as shortness of breath, dizziness, sweating, left arm pain or tingling, or jaw pain, you should call 911 immediately.
2

Rectal Bleeding

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If you notice any rectal bleeding, don't put it off until after the COVID-19 pandemic. "Rectal bleeding can be due to benign things, such as hemorrhoids, or more serious issues such as an actual gastrointestinal bleed or a flare-up of inflammatory bowel disease," says Vila. "How this is handled will depend on your medical history, but if the bleeding is significant and persistent, you will need to be seen in an ER." If you've had one episode of a small amount of bleeding or have a history of inflammatory bowel disease, you should call your doctor. They may be able to suggest treatment and keep you out of an ER or urgent care, where you can be exposed to COVID-19.
3

Seizure

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If you have a history of seizures, you'll know how to respond if you have one and will likely have medication at home, says Vila. "In this scenario, you can call your neurologist or your doctor and likely be managed over the phone or via a telemedicine video call," she says. If you don't have a history of seizures, however, you will need to be seen in an ER.
4

Leg Swelling In One Leg, With Or Without Calf Pain

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Vila says it isn't normal to have calf or leg swelling in just one leg, whether or not it's associated with calf pain. "This can be a symptom of a DVT (deep vein thrombosis) or blood clot," she says. "If this happens, you can call your doctor. He or she will question you about risk factors for a DVT. These can include a recent long trip in a car or train, trip on an airplane, history of blood clots, history of coagulation disorder, cancer or recent surgery." However, to get an official diagnosis, you will need an ultrasound (called a venous doppler) of your leg veins to look for the clot. "Then you can be started on blood thinners if it is positive," she says. "If the new leg swelling is associated with shortness of breath, this is an emergency, and you may be having a pulmonary embolus. You should call 911, since it can be fatal if untreated."
5

A Worsening Skin Infection

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Don't let a skin infection go from bad to worse. If your skin condition is worsening despite oral antibiotics, you need to be seen by a medical expert. "A skin infection or cellulitis that is not responding to oral antibiotics will require IV antibiotics, which will be done in a hospital setting," explains Vila. Before going to the hospital, contact your doctor. Depending on your history and the severity of infection, they may try changing your antibiotic first.
6

Loss Of Consciousness

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Syncope, or loss of consciousness, without an obvious cause is usually a reason to head for the emergency room. "If you have passed out, you will need to be evaluated in an ER to rule out a cardiac cause or a stroke," says Vila. However, there are instances in which losing consciousness doesn't need urgent evaluation in an ER. One example: if you're taking a new blood pressure medication and you stand up quickly and pass out. This may be due to too much medication and resulting low blood pressure. "In this case, your doctor can lower your dose of medication, and you may be able to avoid a trip to the ER."
7

A Deep Cut

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Some small lacerations or cuts can be treated with over-the-counter adhesive surgical tape strips. But depending on a cut's location, length and depth, you may need stitches, which can be done at an urgent care center instead of the ER, says Vila.
8

Broken Bone

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Obviously, a broken bone cannot wait. "If you have a fracture where the bone is protruding through the skin, or the area of the body with the broken bone is deformed, you will need to go to an ER," says Dr. Vila. "If you suffered an injury that makes you think you have a broken bone and the pain is tolerable, no bone is protruding through the skin, the area of the broken bone is not deformed, you can try to call your doctor and do a telemedicine consult to decide on treatment." Some fractured areas like fingers or toes may be treatable with taping or splints you can buy at a pharmacy, and your doctor can advise you on what to do to avoid the urgent care or ER.
9

Stroke Symptoms

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If you experience any symptoms of a stroke, you need to seek medical attention ASAP. Although stroke symptoms vary widely from case to case, Richard Payden, MD, family medicine physician at UCHealth Primary Care-Estes Park, says to look out for the following: new or sudden onset of confusion, difficulty with speech (slurred speech, loss of meaning of words, not being able to get the word you want out), facial droop, numbness or tingling on one side of the body, weakness on one side of the body, or generalized weakness that is new or of sudden onset. "These are symptoms that shouldn't be ignored, as getting to the hospital within the first few hours of your symptoms starting is very important to treatment options," he says.
10

Sudden Shortness Of Breath

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Sudden shortness of breath may indicate problems with your lungs or heart which have the potential to be serious. "It could be something as simple as you're out for your daily walk on your normal route when you realize you're short of breath, even though you're only five minutes into what would normally be an easy 30-minute walk," says Payden. "It could be that you can't speak a full sentence when usually that's no problem. Or there may be other symptoms that occur along with the shortness of breath, including chest tightness, cough, dizziness or nausea." Shortness of breath could also be a symptom of COVID-19. Call your doctor ASAP. 
11

Severe Pain

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Anytime you experience severe pain, including a sudden severe headache (which may feel like the worst headache of your life), chest pain (especially with associated shortness of breath, nausea, dizziness, jaw pain, or pain going down one or both arms), severe abdominal pain, or severe extremity pain, call your doctor. "Each of these may indicate a serious illness," says Payden.
12

A Dental Emergency

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During the COVID-19 pandemic, most dental offices are only seeing patients who are experiencing dental emergencies. "You can't really go to a doctor or dentist during the COVID-19 lockdown, short of telemedicine, or risk exposure," explains Charles Sutera, DMD, FAGD. "To simplify it into a recipe, patients can consider five key, critical situations when it's essential to call and potentially see their dentist despite social distancing concerns."
These include swelling, uncontrolled bleeding, pain, trauma from an accident, or a dental concern for any person with a severe underlying condition such as active chemotherapy, uncontrolled diabetes, or similar. If you're experiencing something else, try reaching out to your dentist to see if it warrants a visit. 
13

Severe Abdominal Pain

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COVID-19 hasn't stopped gallstones or appendicitis from happening, says Jill Grimes, MD, board-certified family physician and author of The Ultimate College Student Health Handbook. "If you're having steadily increasing or severe abdominal pain, especially along with fever, you need to be examined," she says. 
14

Heart Attack Symptoms

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If you experience any heart attack symptoms—especially chest pain or a "heavy-pressure sensation, like an elephant sitting on your chest"—call 911, says Grimes. "If you have known high blood pressure, high cholesterol, diabetes, and/or a family history of heart disease, we don't want you ignoring symptoms of a heart attack."
15

Urinary Tract Infections

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No, your urinary tract infection can't wait until after the COVID-19 pandemic to be treated. "A UTI can progress from a simple, easily treated bladder infection to a more serious kidney infection that could require hospitalization to treat," says Grimes. "Call your doctor if you're having burning, urgency or [increased] frequency when you urinate."
16

STDs

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Same with a potential sexually transmitted infection. "Early signs are similar to UTIs, plus discharge," says Grimes. "If these go untreated in women, they can progress to pelvic inflammatory disease (PID), which can lead to chronic pelvic pain or infertility."
17

Shingles (Zoster)

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"If you develop burning, hypersensitive skin on one side of your body, then a day or two later begin seeing bumps that turn into clusters of blisters, don't wait to call," says Grimes. Why? You might have shingles, and the medication to alleviate the condition must be started within the first couple days of symptoms.
18

Allergies Or Hay Fever

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Although allergies may not be a life-or-death situation, they should be treated, especially because their symptoms can closely mirror COVID-19, says Daniel Atkinson, GP clinical lead at treated.com. "As the weather begins to improve, people with allergies might be quite concerned for their health and well-being at the best of times, but now particularly in the context of COVID-19," he explains. "We all need to be as vigilant as possible in stopping the spread of the virus, and that means staying home at all times, excluding for reasons outlined by the government. For people with allergies, this might require them to think a little bit further in advance in relation to their treatments." Furthermore, if you have allergies that cause sneezing, it's really important to stay indoors and cover your mouth and nose. "Some people can carry the virus asymptomatically and spread it when they sneeze as a consequence of their allergies," says Atkinson.
19

A Severe Allergic Reaction

woman suffers from choking and cough from allergic reaction to peanut. Danger of nuts and food allergy
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An allergic reaction to a medication, food, or other substance cannot wait. "Any anaphylactic reaction to an allergen needs emergency treatment," says Leann Poston, MD, a physician with InvigorMedical.com. 
20

Meningitis

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If you have symptoms of meningitis—including a stiff neck, fever, and headache—seek medical attention immediately, says Poston. 

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