How to tell if that little "twinge" is a sign of something much, much, worse

We all have little aches a n d pains. Usually we ignore them. But there are times when doing so can be dangerous—or even deadly.

Take the case of Dr. J. Edward Hill, president elect of the American Medical Association and a contributor to Bottom Line/HEATH. A few years ago, he experienced fatigue that got worse. He ignored it for a long time—until his heart stopped! Fatigue had been the only symptom of a serious heart condition, and Dr. Hill needed emergency bypass surgery to save his life.

So how can you tell when your symptoms are harmless and when they're a cause for worry? Dr. Hill offers the following guidelines:

• Abdominal Pain. Most abdominal pain is caused by gas, stress, or an infection. But if your pain lasts more than 2 days, you should see a doctor to rule out gallbladder disease, ulcers, and stomach cancer. If your stomach pain is accompanied by other symptoms, such as fever, nausea, or vomiting, the problem could be appendicitis. The pain typically begins around the navel and shifts to the lower-right abdomen over 6 to 12 hours. If you have these symptoms, get to an emergency room immediately!
• Back Pain. Most back pain is caused by muscle pulls or spasms. The best way to treat it is to simply apply an ice pack during the first 24 hours after pain starts... switch to heat after 24 hours... and take aspirin or ibuprofen. But if your pain is accompanied by fever and neurological symptoms, such as tingling, numbness or shooting pains down one or both legs, get medical attention at once! These symptoms may indicate a spinal infection, which is relatively rare, but can cause permanent damage.
• Chest Pain. How do you know whether chest pain is a health emergency or a false alarm? Look for these signs: If the pain is sharp and stabbing, or it's on the left side of the chest, it's likely caused by psychological stress. And if it hurts when you move in a certain way, it's probably a pulled muscle or other injury. Call your doctor to rule out anything more serious. But, if you have a heavy, crushing sensation in the central chest... or if it's accompanied by sweating or nausea... or if the pain radiates to the arms or jaw, the chances are good that you're having a heart attack. If you get any of these symptoms, do NOT wait. Call an ambulance right away!

  While you wait for the ambulance to arrive, unlock your front door and chew 2 aspirin tablets to thin the blood and prevent a blood clot. Doing this can save your life!

• Constipation. Most constipation is due to insufficient fiber and/or water in the diet. Try to get at least 25 grams of fiber daily, along with 2 quarts of water. Start your day with a high-fiber cereal... snack on fresh fruits... and eat more beans, whole grains, and vegetables. Do this and you should be fine. But beware: Sudden constipation or alternating bouts of diarrhea and constipation may be a sign of colon cancer. Call your doctor—you may need a colonoscopy to determine if cancer is present.
• Fatigue. It's normal to be exhausted after a hard day, but persistent fatigue isn't normal, especially when it suddenly worsens. If you're tired all the time, it may be your body telling you that you need more sleep. Try going to bed and getting up at the same time most days of the week. Limit your intake of caffeinated beverages to one or 2 servings daily. Eat nutritious meals, and exercise regularly—it promotes deeper sleep. If you're still tired... or if your fatigue gets worse in the absence of any lifestyle changes... you should suspect heart disease and get an immediate checkup. This is especially true for women, because fatigue, not chest pain, often is the first symptom.
• Headache. About 90% of headaches are tension headaches, caused by fatigue or emotional stress. Aspirin, ibuprofen, and acetaminophen are effective at relieving pain—see which works best for you. Stressreduction techniques, such as yoga, can also help. Migraine headaches are more severe, but they usually can be controlled or prevented with ibuprofen or prescription drugs, such as sumatriptan (Imitrex®). But if your headaches increase in frequency... are unusually severe... or are accompanied by nausea, slurred speech, or vision changes, you should see a doctor immediately. These symptoms could be a sign of stroke, infection in a brain blood vessel, meningitis, or even a brain tumor.

  Important: Call 911 if you suspect a stroke or experience an excruciating headache that comes out of the blue. This is known as a "thunderclap" headache, and it may be due to a potentially fatal ruptured blood vessel in the brain.

• Heartburn. Most of the time, this burning sensation is due to indigestion. Nothing to worry about: Just take an over-the-counter remedy, and avoid fatty and spicy foods. But heartburn that occurs more than once a week can cause serious damage to the esophagus. Consult your doctor for the proper medication.

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(Excerpts “BottomLine” Health)