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Chronic Pain
When Should the Chronically Ill See a Doctor? Here's a Guide
If you are already chronically ill, how do you know when to see a doctor?
Posted March 17, 2016
I’ve lived with chronic illness for a long time. (Chronic Illness includes chronic pain.) Deciding when to go to the doctor can be a challenge. For example, about six months ago, I developed a nagging pain in my neck. It hurt even when I wasn’t moving. I assumed I’d pulled a muscle, so I toughed it out for two weeks. Then I went to the doctor. It turned out I was right. It was only a pulled muscle, and it resolved in another week.
But when the same thing happened with my knee and I waited several months to go to the doctor, it turned out I’d torn my meniscus in two places and I could have benefitted from receiving treatment months before I finally got myself to the doctor.
One reason I wait so long is that, due to several ongoing medical problems, I go to the doctor a lot…and I’m weary of it. I’m certain that if I were in good health, I would have seen a doctor about that knee within a week.
Before I offer these suggestions, I want to make it clear that I have no medical training. This piece is based on my personal experience and from what I’ve learned from the thousands of people who’ve written to me (some of whom are doctors). I also want to point out that many medical providers have hotlines where you can describe your symptoms to a nurse and get feedback on whether you should see a doctor and, if so, whether it should be right away.
What follows are the guidelines I’ve developed over the years. In deciding whether to go to the doctor, I’d ask these questions:
1. Is the symptom at issue a familiar one, meaning is it one of the ongoing symptoms of your chronic illness, but is simply more intense than usual?
Unless the intensification falls under #2 or #3 below, you could wait a few days and monitor the symptom. It may simply be part of the ups and downs of the symptom parade of your chronic illness, and so may improve on its own.
I had this happen a few months ago with a number of my ongoing symptoms. I said to my husband: “You know, if I weren’t already sick, I’d make an appointment with my doctor and ask him why I feel so sick!” Because all the symptoms were familiar ones, before making an appointment, I decided to cut back on my activities. I stayed in or on the bed for several days. The result was that the symptoms dropped to a familiar level.
Reflecting on what happened, I realized that I hadn’t been taking as good care of myself as I usually do. I was engaging in “activity creep”—doing more and more and ignoring my body’s pleas to rest. After listening to my body for a few days, my symptoms became less intense, and so I didn’t go to the doctor.
2. In contrast to #1, has one of those ongoing, chronic symptoms suddenly become so much worse that it feels as if it could be the sign of a new illness?
The line between #1 and #2 may not always be a sharp one, but it could be an important one. Number 2 differs from #1 in that, with #2, there’s not simply an intensifying of a symptom. Instead, there’s a change so dramatic that it feels as if it could be unrelated to your current illness.
In this case, it’s a good idea to go to the doctor. One of the difficulties you face as a person with chronic health issues is that a new, even serious, illness can appear but go ignored because you assume it’s part of your ongoing chronic illness.
If you’re not sure whether what’s happening falls under #1 or #2, out of an abundance of caution, make that doctor’s appointment.
3. Is your chronic illness one that could be life-threatening should one or more symptoms suddenly become severe (for example, asthma or diabetes)?
If the answer is “yes,” see your doctor immediately. In fact, what’s happening may warrant a trip to the ER. And this is important: if you’re not sure whether any of the symptoms of your chronic illness fall under this category, ask your doctor before the issue arises.
4. Do you have a new symptom that’s a normal part of life for everyone, healthy or not?
I’m referring here to symptoms such as shoulder or wrist pain after working at the computer for a while; stiffness when first getting up or after exercising; nasal congestion; an upset stomach; a headache.
If the answer is “yes,” you could wait a few days and see if it clears up before deciding to see the doctor.
5. Have you suddenly gained or lost weight without knowing why?
Make an appointment to see the doctor. It could be the sign of a new illness—especially if it’s unexplained weight loss.
6. Is a medication making you worse?
Contact or see the doctor.
7. Lastly there’s the list of reasons to go to an ER immediately:
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sudden, severe chest or abdominal pain;
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other signs of a heart attack or stroke;
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trouble breathing;
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heavy bleeding;
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a bad, wide-spread burn or other severe injury, especially a trauma to the head;
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poisoning;
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a severe allergic reaction to something;
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coughing up blood.
Most of us know intuitively when it’s time to go to the ER. As I write about in my latest book, when my husband began to have an allergic reaction in which his tongue started to swell, we went to the ER immediately because swelling in the mouth can lead to trouble breathing. It’s a good thing we went.
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I hope these guidelines have been helpful. I end with this: If you’re in doubt as to whether what’s happening warrants a trip to the doctor, err on the side of caution and make that trip.
© 2016 Toni Bernhard. Thank you for reading my work. I’m the author of three books:
How to Live Well with Chronic Pain and Illness: A Mindful Guide (2015)
How to Wake Up: A Buddhist-Inspired Guide to Navigating Joy and Sorrow (2013)
All of my books are available in audio format from Amazon, audible.com, and iTunes.
Visit www.tonibernhard.com for more information.
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You might also like “Don’t Be Intimidated in the Doctor’s Office: Six Strategies.”
