Wherever Steve Hart looks, the 49-year-old technology consultant sees a reminder of the risk he took that damaged his eyesight. Hart’s once-perfect vision is marred by a small spot that will forever be out of focus, like viewing a 3-D image without the glasses—a result of the torn retina he ignored for three days. If he had called his doctor the Saturday morning that he started seeing little spots called floaters, the tear might have been repaired with a simple laser treatment; he could have gone back to work on Monday. Instead he waited until Wednesday to consult his physician, after he suddenly lost most of the sight in his left eye. By then, he needed surgery that would keep him out of work for four weeks, and his vision has never been the same.
“If you have changes in your eyesight, do not hesitate,” Hart says. “Wherever you are, call your doctor. It will save you an unbelievable amount of grief.”
But what Hart did—or didn’t do—is alarmingly common. Many of us are taught from an early age that the grown-up response to pain, weakness, or emotional turmoil is to ignore it, to tough it out. And because of the weak economy, more of us are toughing it out than ever before. A recent poll by the Kaiser Family Foundation reported that 45 percent of Americans are putting off medical care because of financial pressures. We tell ourselves this approach has no major consequences—that it may be inconvenient and perhaps painful but that it’s not really dangerous. Yet research is making it increasingly clear that in many cases, toughing out symptoms can cause irreversible harm.
That’s true for depression and migraines and even for the common sprained ankle. According to Jay Hertel, PhD, a leading expert on joint physiology, so many people ignore ankle sprains or discontinue treatment before the injury is healed that orthopedists cringe at the advice given to kids everywhere: “Walk it off.” Recent studies show that when you sprain your ankle, some of the sensory receptors in your ligaments (which help the brain know where your leg and foot are positioned) can be permanently damaged by improper care. As a result, the ankle loses a bit of its ability to communicate with your brain about how to avoid further trauma, and you become vulnerable to reinjury.
Protect yourself from annoying symptoms, lifelong pain, or worse. Here are seven ailments you should never ignore—and how to treat them.
1. The Worst Headache of Your Life
We all have headaches, but in some cases, a pain in the head can be a sign of a life-threatening medical emergency, like a ruptured aneurysm or a stroke.
What to do: According to experts at the Mayo Clinic, if you experience a “sudden severe headache like a clap of thunder,” especially if it gets worse despite resting and taking standard over-the-counter pain medicine, it might mean that an aneurysm—a weakness in the wall of a blood vessel—has ruptured, causing bleeding into the brain. That’s as bad as it sounds and requires immediate medical attention. A headache that’s accompanied by slurred speech or weakness on one side of your body is a classic sign of a stroke, most often caused by a blockage in the brain’s blood supply. You have a “golden window” of just a few hours in which treatment is most effective—get to an emergency room or call 911. If a worsening headache follows even a minor fall or blow to the head, it can be a tip-off to potentially lethal brain swelling. Call your doctor regardless of the time of day (remember that actress Natasha Richardson did not, and it cost her her life).
No one suggests that these painful and debilitating headaches require an emergency response. But studies have produced some troubling findings lately for women who regularly experience migraines with auras— perceptual distortions, usually visual, such as flashing or zigzag lights or blurred vision. These headaches used to be thought of as episodic, “with no trace they’d occurred,” says Lenore Launer, PhD, chief of neuroepidemiology at the U.S. National Institute on Aging (NIA). But not anymore. Launer’s studies at NIA found that women who get migraines with auras show small brain lesions—tiny areas in the cerebellum where tissue has died—at a rate nearly double that of women who aren’t saddled with migraines. Whether these brain changes are caused by migraines with auras or the changes cause migraines (or some combination of the two) is still being studied. But they are one more reason to get preventive treatment.
What to do: Anyone with severe or frequent headaches should see a doctor who provides the most up-to-date treatments, including help identifying and managing headache triggers along with medications that can abort attacks and control pain. There’s no evidence that these approaches will prevent or reduce brain lesions, but experts believe they’ll lower the odds of your migraines becoming chronic. (Some people suffer migraines 15 or more days each month, an agonizing way to live.)
Although many people view depression as minor, experts know it as a crippling disorder that should be treated promptly. Studies show that the longer you delay getting help, the harder it can be to get symptoms under control. And recent imaging studies have even led some researchers to suggest that the part of the brain called the hippocampus may shrink in people with multiple episodes of depression.
What to do: If you experience a persistent sad or anxious mood, feelings of hopelessness, lack of interest in work or hobbies, or recurring thoughts of dying or suicide, seek help from a psychologist, psychiatrist, or other mental health professional, says Kay Redfield Jamison, PhD, a professor of psychiatry at Johns Hopkins. Or at least make sure you talk frankly about your experiences with your primary care doctor, who should know when to refer you to a specialist. Decisions about how long to continue therapy, medication, or both are ones you should make with a health-care professional—not on your own. Too many people simply stop taking medications, which can result in a very rocky landing or even a relapse.
4. Ankle Sprains
When you sprain your ankle, you stretch one or more of the three main ligaments that hold the joint together. If you don’t treat the sprain properly, the fibers in these ligaments can heal in an inappropriately shortened or lengthened position, leaving you prone to further injury. Indeed, up to 30 percent of people who sprain their ankles develop “chronic ankle instability,” leading to a cycle of repeated injury.
What to do: If you turn your ankle and can’t walk on it at all—or even put weight on it—go to the emergency room to rule out severe ligament damage and broken bones. If you can walk without excruciating pain, wrap your ankle with a compression bandage to reduce swelling, and get off your feet.
Keep your ankle elevated as much as possible for 48 hours, applying ice for 20 minutes every two hours.
Even after the pain and swelling are gone, don’t consider yourself fully healed, says surgeon John Kennedy, MD, of the Hospital for Special Surgery in New York; to make sure you don’t reinjure your ankle, you need to strengthen it. Kennedy recommends a regimen of balance-improving exercises, including this one: Stand flat on one foot, with the opposite leg bent at the knee, then switch legs and repeat. Begin by brushing your teeth while standing flamingo-style for 30 seconds; work up to 3 minutes per leg.
5. Crushing Chest Pressure
Despite all the exhortations in recent years to take possible signs of heart attack seriously, a study in the Journal of the American Medical Association showed that 40 to 50 percent of those with symptoms still ignore them for up to six hours. Unfortunately, heart muscle begins to die within 30 minutes of the onset of an attack, according to interventional cardiologist David Fischman, MD, at Jefferson Medical College in Philadelphia.
Especially shocking: A recent study by researchers at NewYork-Presbyterian Hospital found that half the women surveyed would not call 911 even if they thought they were having a heart attack.
Part of the problem is that people expect a heart attack to hurt, yet the most dangerous symptom is not pain but pressure, according to Dr. Fischman. “Sharp pain is more likely to be musculoskeletal—annoying but not dangerous,” he says. “What you have to be careful of is sudden chest discomfort that feels like someone is sitting on your chest.
The feeling of pressure can also radiate into your arms, back, and jaw. If moving around or pushing down on your chest makes it worse, it’s probably not a heart attack; if it’s the same when you move, you need to be evaluated immediately.” Women need to be especially careful, Dr. Fischman says: They’re less likely to feel chest pressure and more likely to have easily overlooked discomfort in the arm, back, or jaw. “It’s crucial that you be aware of your body. If the feeling isn’t the norm for you, get it checked out.”
What to do: Call your doctor immediately—or, better yet, make the call while you’re on the way to the emergency room. “And it couldn’t hurt,” says Dr. Fischman, “to pop an aspirin on the way.”
6. Abdominal Pain
The world is full of bellyaches and bellyaching, but there are some abdominal pains you shouldn’t ignore. They can be symptoms of appendicitis or other potentially life-threatening conditions.
What to do: Sharp stomach pains that worsen when you move or wake you from a sound sleep could signal a dangerous problem—appendicitis or even a gall bladder or colon crisis, says Lawrence R. Schiller, MD, of Baylor University Medical Center. If the pains are accompanied by fever, swelling, or tenderness; vomiting, diarrhea, or constipation; a change in the color of your urine; or a yellowing of your skin or the whites of your eyes, contact your doctor immediately or go to the emergency room. Do the same if you have sudden abdominal pain that radiates to your back or groin, especially if you feel light-headed.
7. Sudden Changes in Vision
According to Julia Haller, MD, ophthalmologist-in-chief at Wills Eye Institute in Philadelphia, people may put off treatment for vision problems—as Steve Hart did when he experienced symptoms of a torn retina—because they’re tricked by the brain’s ability to compensate. “The brain readily shifts from one eye to the other,” she explains. “Many people will notice that things suddenly aren’t right with their vision, but because they are still seeing pretty well out of one eye, they don’t realize how bad the other one has become.” But sudden changes in vision can indicate a number of problems that require immediate treatment.
What to do: If you see flashing lights or floaters (which can look like dark spots, strands, threads, or webs), or if it seems like a curtain or shade is sliding over your field of vision—or if you suddenly just can’t see out of one eye—call an ophthalmologist immediately or get to the ER. While a retinal tear and a retinal detachment are among the more common conditions associated with these symptoms (especially in patients over 40), there are other possible causes that a specialist needs to rule out. Most can be treated relatively noninvasively if they are caught early: When a retina tears, there is a period of a few hours or a day during which it can be treated with a noninvasive laser technique. For a detachment, you’ll need surgery. “The longer the diagnosis is delayed,” says Dr. Haller, “the less chance you have of recovering your vision.”
Depending on the severity of your symptoms, you may be unable to drive yourself to the doctor or hospital. Dr. Haller says it’s okay to drive if you can see out of one eye—just don’t eat along the way. “It’s very possible you’ll need surgery,” she says. “And you can’t have it right after you’ve eaten.”
Stephen Fried is author of Appetite for America.