How do you decide when to go to the doctor?

February 21, 2024 10:25 AM

This feels like a ridiculous question to ask at age 37, but how do you know when something that's happening with your body is worth asking a doctor about (or even a higher bar -- making an appointment??)

Like, if I told my doctor everything weird that my body did this year, we would be there all day! What kinds of things surpass the threshold for "yeah, I guess I should ask about this"? I am pretty good about going to the doctor for obvious acute stuff (broken wrist, head injuries, interminable sinus infection), but like...do I tell the doctor that my ankle hurts all the time? Or about intermittent stomach pain? Or about the fact that lately if I have even one cocktail I get violently ill? More migraines than usual??

Some of this comes from a long history of being dismissed by doctors (and often finding out later that something was wrong and treatable), so I'm afraid to ask them about something "dumb", even though though I really like my current doctor. But I also know that like, I'm middle aged, and I don't need to report every random ache and pain or asthma exacerbation. Is there a framework? A flowchart? How do you decide??

posted by goodbyewaffles to Health & Fitness (28 answers total)

does your provider have advice nurses available? mine does, and its awesome because you just call and request an advice nurse. once you have explained your basic concern they have a question tree to take you through to help determine whether you need to see a doctor. (they may even move you up to a telecall/videocall with a doctor next if they are not sure you need more). its a great way to let a professional help you make the decision with minimal commitment on any side.
posted by supermedusa at 10:28 AM on February 21 [7 favorites]

I think of it in terms of "is this affecting my life?" when I debate calling. I would say a joint hurting all the time or intermittent stomach pain would definitely fall in that category, as would an increase in migraines. I might save the alcohol thing to bring up at my yearly physical, but ymmv. My insurance has a nurse helpline in addition to the one my doctor has. I am older than you and have weird medical things so I opted to upgrade to a concierge practice so I have no guilt about calling about small things and I don't get dismissed. Studies show better outcomes with women doctors so that may be something to think about too.
posted by *s at 10:41 AM on February 21 [8 favorites]

I use WebMD's symptom checker to figure out what things might be and whether a doctor might help. They will encourage you to see a doctor about a lot of things, but I can kind of narrow it down based on what treatments they talk about. If it's not something a doctor is needed for or seems like massive overkill for whatever the impact of the problem is, I probably don't go see one even if WebMD says I should.
posted by jacquilynne at 10:52 AM on February 21

If you do not already get an annual check up, start doing this. These are typically longer appointments with your doctor where they can spend more time talking with you about different things like this. This will also give you a better working relationship with your doctor (or a chance to shop for a new one if you do get one who's dismissive) and give them a baseline about your health.

I agree with *s that for something that's affecting quality of life, like joint pain or a change in symptoms with something you currently manage like migraine increases, those are worth making a separate appointment for.
posted by carrioncomfort at 10:58 AM on February 21 [14 favorites]

I would tell my doctor about all the things you mention. Why not? If they are bothering you and you hope there might be some way to improve them, then telling your doctor is the right thing to do. They may well not get resolved, but it's worth bringing them up (though maybe not all in one appointment, since doctors usually aren't great at handling more than one or two things at a time).
posted by ssg at 11:01 AM on February 21

Your annual physical is the time to bring up weird but likely not enough to make an appointment just for that for yourself for. Might be worth writing things down to keep around for that!

For me, I sort of stick to the motto bodies are wierd for little random happenings that aren't really reoccuring or bothersome. If something is reoccuring that's different than before or bothersome I'll make a point to touch base about it.
posted by AlexiaSky at 11:04 AM on February 21 [2 favorites]

For me it's A: "is it affecting my quality of life acutely" and/or B: "is it persistently uncomfortable or getting worse" and/or C: "is it scary"

Like, I don't think every ache and pain that comes and goes is really problematic. We are sub-par machines and fallible and falling apart like any organic matter--shit happens. But I get I would consider seeing a doctor for any of the above.
posted by greta simone at 11:09 AM on February 21 [4 favorites]

I agree with carrioncomfort and AlexiaSky. The annual physical is when you should feel safe telling your doctor everything that's been bothering you.
posted by Stuka at 11:17 AM on February 21

If you're not a hypochondriac, and it sounds like you specifically are not, if you're concerned about something at the least ask for a tele-health appointment or send a message to the doctor on if you should come in. You're not aiming to make this a habit, clearly, I would just check in with your concerns. (and you can also ask your doctor this very same question you're asking here).

Bottom line, listen to your body. If something doesn't seem normal, get it checked out.
posted by Unsomnambulist at 11:20 AM on February 21

(also, NOT a ridiculous question at 37... if anything, nows when to really start asking questions about not just your health, but how to navigate the health care system ... you're only going to need it more and more as you get older!)
posted by Unsomnambulist at 11:25 AM on February 21 [1 favorite]

Hah, I really have no idea. I've had a wounded nose for over 12 years and I only now started to go to the doctor about it. I was told I had to go to an out of town specialist about it and frankly, I didn't want to put the time and effort, gas, driving, in person doctor, etc. into it for a stupid minor chronic problem that doesn't really impede my life. I'm only doing it now since I'm out on medical leave and have the time. Also I thought it could just be cauterized and be fixed in a one-off, but turns out it can't be fixed. Wound is too large to cauterize, also so high up that when it scabs, it blocks air flow so it bleeds when I sneeze, and...now I kinda wish I hadn't bothered, but I have another appointment next week. I never want to go in over petty tiny stuff anyway.

Honestly, assuming you have insurance/the money (which are probably the first considerations), I think it's a case of "does it really bother you/impair your quality of life" combined with "is there anything that can actually be done about it?" Like I have a friend who basically should live at the ER and is constantly told she should go to the ER every time she has another incident, but she complains the ER has no idea what to do with her and do nothing but run tests, and usually her incidents die down on their own, so then she's all, why go?

In your case, they sound like at least the first two and last one are chronic problems, but I'm not sure if a doctor can do anything about them, either. I like the advice nurse suggestion, and also, do you have the ability to email the doctor and ask before going in person or anything like that? And let's face it...if you're female, can you bring some guy along with you to "translate" if you're expecting to be blown off? All of that sounds like "you're gonna get referred to a specialist" stuff, though, and then you may be doing a lot of visits trying to figure out why those parts won't heal.
posted by jenfullmoon at 11:27 AM on February 21 [1 favorite]

You know when you go to the doctor and they have you fill out that insane 3 page medical history form where you tick yes or no on everything from runny nose to rash to uncontrollable bleeding to I went to pee and my kidney fell out? Basically if it's on that list, which is very long and extremely comprehensive, you should tell your doctor about it.
posted by phunniemee at 11:37 AM on February 21 [1 favorite]

I don't know in general but I did find out the hard way that if you have something you think might be a UTI, go in as soon as you can - don't wait for it to go away on its own.
posted by trig at 11:48 AM on February 21 [2 favorites]

So I have a chronic pain issue (fibro), and this means I'm particularly bad about mentioning when things hurt to my doctors. My PCP told me on my last visit that I'm reaching the age that I need to pay attention to anything that impacts my ability to eat and keep down food, sleep restfully, think clearly, or move around. She said she totally understood that there's gonna be things that I just get used to (like really bad cramping and horrible periods) but it's better to err on the side of caution than to ignore symptoms that can indicate a larger issue. So that's how I found out I had a massive fibroid and got a hysterectomy.
posted by teleri025 at 1:27 PM on February 21 [2 favorites]

But I also know that like, I'm middle aged, and I don't need to report every random ache and pain or asthma exacerbation.

Okay, this whole thing of 30-somethings saying, "I'm old now so things hurt" is for sure a meme right now, but I think it's actually quite harmful (in addition to being annoyingly ageist) because I don't think it's good to accept this level of discomfort and pain. This stuff will get worse if you don't start managing it now. You've got a lot going on, and a regular doctor's visit (please go every two to three years for a physical, even if you don't do it every year) are an important part of healthy aging. Those are the kinds of places where you can bring up intermittent issues. At 37, small aches and pains that aren't managed can become more painful or chronic. You're not even 40. Please get over feeling sorry for yourself for being old. There are lots of very healthy, active 60- and 70-somethings out there. They didn't get there by throwing up their hands and not talking to doctors and ignoring pain.

I am sorry you've been dismissed by doctors. That sucks, and it's wrong. It sounds like you have a good doctor now, so think of this as a way of taking advantage (in a good way) of a better situation.

My suggestion is to keep a list on paper or on your phone so that when you do go to the doctor, you don't have to remember all these individual things. And, it's good to be going regularly (every year or so), so that it's no big deal to reach out in between.
posted by bluedaisy at 2:11 PM on February 21 [4 favorites]

Response by poster: bluedaisy I totally get where you're coming from and I think you're right, but I am also an athlete and so have basically had random aches and pains my whole life, usually from overuse or falls, or just like, echoes of old injuries. I definitely don't feel old, but I try to be realistic about what I can expect re: physical discomfort when I throw my body around on hard surfaces five days a week when I'm not a youth anymore. (Part of it with the ongoing ankle issue is like -- I worry that if I ask the answer will be "stop doing sports that ask so much of your ankles")

Thanks so far everyone, this is helpful. I do get a physical every year but I feel like it's so wild to come in to that appointment with a list of like 28 things. Maybe I should just write them all down and try to triage before my appointment. And then, right, figuring out what kinds of things rise to the level of "make an appointment before your next physical in eight months"
posted by goodbyewaffles at 2:43 PM on February 21

Old sports injuries that never healed properly are exactly why you should go in and get your ankle checked out. Signed, limeonaire, lifelong athlete, one month into physical therapy for a weird bump and ankle pain that means I have Achilles tendinosis. Go see an orthopedist.
posted by limeonaire at 2:51 PM on February 21 [3 favorites]

Oh and for the migraines you could see a neurologist. For the stomach stuff, I'd say start with your primary care physician.
posted by limeonaire at 2:55 PM on February 21

Best answer: I think it's worth seeing a doctor if you have a concern that either
- is so acute that over the counter medication like Tylenol, cough syrup etc doesn't solve it,
Or
- it's so chronic that you end up taking over the counter medication more often than, say, 2-3 days a month.

Also, if you are extra worried or feel dread about it. Trust your intuition! Feeling dread or wrongness is actually a symptom that many people report for serious stuff (my friend had a painless but severe glaucoma attack, serious enough to require emergency surgery. Usually those are painful but her only symptom was blurry vision and a feeling that "something feels so bad and wrong that I don't want to be in my body."

It's also totally ok to just see the doctor for routine maintenance more than once a year. So rather than only scheduling by calendar, maybe it would psychologically help you to just keep a running list of concerns and see the doctor whenever something pings more than usual, even if it hasn't been a full 12 months since your last visit. And at that visit, bring up all the items on your list!

For a data point I am a very healthy person, and I see my normal doctor 1-2 times per year and some kind of specialist maybe 4 times per year as well, for things like routine cancer screenings or iron testing, plus maybe 3 visits a year to walk in clinics for things like bad sprains or strep throat. So I'm being seen by a doctor almost once a month and that's for someone with no major health issues!

It's totally ok to access care when you feel you need it! I'm sorry doctors have been dismissive of you (happens to me too and it sucks!!) and I hope
this thread encourages you to access health care whenever you want it!!
posted by nouvelle-personne at 3:05 PM on February 21 [5 favorites]

Best answer: Good medical care also includes interrupting a worsening track of some symptoms you are experiencing, like more frequent migraines. A good work-up with a neurologist with a focus on migraine can easily result in strategies to prevent migraine headaches and lessen those you do get.

Just today I met a woman and somehow we got to talking about hand pain - we are both craftspeople. I had successful, transformative surgery on badly arthritic and painful thumbs while she, a fiber artist, is convinced from consulting Dr. Google that she has rheumatoid arthritis in her hands - she has palpable nodules in several fingers - but is afraid to go to a doctor. I told her that rheumatoid changes can be prevented, but not reversed, and hope she finds the courage to get her condition evaluated or fiber arts may be much more painful in the future.
posted by citygirl at 3:50 PM on February 21 [1 favorite]

Speaking as someone who probably, on average, sees any kind of medical professional about once every three or four years, I can tend to be dismissive of the idea of seeing a doctor for something that isn't either actually debilitating and doesn't have a logical reason based on something I did or that has been chronic enough that I decide it's never going to get better on its own. I know I probably should (being 62 and still fooling myself I'm young) get an annual check-up or something. I should have learned my lesson last year when I finally went to a doctor for shoulder pain that was both debilitating and had been going on for over a year. Turned out I had torn several tendons and, with a cortisone shot and some careful resting of the shoulder, it's 99% better (that's the best I can hope for, apparently).

All this to say - listen to your body (as others have said). If you think it's something unusual, there's no obvious cause and you can afford it, looking after your body is important because it's the only one you get. I don't think you're middle-aged by any means at 37, but you know when something is wrong so spending less time just putting up with it is a good thing. Maybe, if you're feeling like enough little things are going on, have your physical every six months instead of yearly? It might give you a better chance of focussing on prevention, especially with things like migraine.
posted by dg at 5:21 PM on February 21 [1 favorite]

Also, I've gotten in the habit of trying to use my Physcial Therapy days each year on my insurance if I manage to make it a year without injuring myself in some way. They renew, I have a body I use in non optimal ways. Every year I learn something new about my gait or my body weaknesses or things I can strengthen in a safe way. Overall it's been very enlightening and useful and keeps me healthier overall. So that's a great way to bring up ankle pain or other mobility issues that may not be serious and get some one on one help by very educated people about it.
posted by AlexiaSky at 6:01 PM on February 21 [1 favorite]

I am also an athlete and so have basically had random aches and pains my whole life, usually from overuse or falls, or just like, echoes of old injuries

Those echoes become screams, though. What if the answer for your ankle isn't "Don't do ankle sports" but instead "Here are some ways to strengthen your ankles differently so you can do these activities with less pain and injury"?

I hurt my lower back kayaking when I was in my early 20s. I did get treatment for it at the time. However, now, about three decades later, I am feeling some of those echoes and wished I had done more to manage whatever that injury was then. So take it from someone a decade or so ahead of you: talking to your doctor about the list of 28 things is a fine idea. And getting physical therapy for your ankle and other old nagging injuries can be good too.
posted by bluedaisy at 6:03 PM on February 21 [2 favorites]

Not everyone needs an annual checkup. In Canada they are phasing these out. Going to the doctor with a list of 28 things exposes you to risks of over treatment.

There is no definitive list of when you should and shouldn’t go to the doctor. A lot of it boils down to attitude. I don’t like making appointments, taking time off work, and doing uncomfortable things to address something that I can cope with. I am really comfortable with wait-and-see, and pretty comfortable with sucking things up. I go to the doctor when I stop being able to do things I need to do, like breathe or work.
posted by shock muppet at 9:48 PM on February 21 [2 favorites]

Every health insurance plan I've had for the past decade or so included a free 24/7 nurse line you could call to describe your symptoms and get triaged as to whether you should just wait for it to go away, treat at home, make an appointment with your PCP, go to a walk-in clinic today, go to the ER now, or call 911.

So I would suggest starting by examining your health insurance card to see if there's a number like that printed on it.
posted by Jacqueline at 9:02 AM on February 22

When the question is "should I see a doctor about this" the answer is Yes.
posted by Billiken at 10:46 AM on February 22

Best answer: I’m a GP. I would recommend going to the doctor every time you have 3-5 random things, with a 20-30 minute appointment. That’s probably the absolute limit of what I can start to sort out.

It’s actually more of a palaver if you never come and then once every a year show up with a massive list of issues to sort out all at once.
posted by chiquitita at 12:32 PM on February 22 [5 favorites]

I just started seeing a GP after 20+ years of not having one. I'm a "it's probably nothing" type regarding issues with my health and a chronic under-sharer. My GP is really good at asking the questions (which seem very routine/checklist) that had me open up and discussing issues I was having and also didn't realize I was having. I find it very methodical and thorough. So I'd say it might be more of finding a good doctor who can asses, triage, and filter your concerns rather than putting the responsibility on you.
posted by simplethings at 7:55 PM on February 22 [1 favorite]