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    When To See a Doctor vs. Treat at Home

    Dr. Greg Rodocker Deaconess Clinic Family Medicine 01/14/2015

    Deciding when to see a doctor, whether for your own, a family member or a child’s illness, can be a difficult decision.   You know that sometimes a “virus is just a virus,” and that you just need to rest, drink lots of fluids, and give it a few days.  (I offer tips on that later in the article.) But sometimes an illness needs treatment, whether through antibiotics or other medications and symptom care.
    If you are unsure about whether to see a doctor or not, I encourage you to call your doctor’s office, send a MyChart message, or call an after-hours nurse hotline if you have access to one.  But sometimes, I find that when a patient really starts questioning, “I wonder if I ought to go to the doctor for this,” that’s often a sign that you need some medical attention. 

    However, here are symptoms that should prompt you to call your doctor’s office, use MyChart to request an appointment or send a message, or to visit an urgent care center:
    Note:  These are general guidelines and not a substitute for speaking with your physician or seeking care.

    • Respiratory infections
    • A temperature over 100.5 that lasts more than 3 days
    • Wheezing
    • Ear pain (or in small children, tugging at their ears)
    • Thick nasal congestion lasting more than 10 days.  (Note:  the color of the mucus doesn’t mean as much as some people think it does)
    • Red eyes that are draining or gunky.
    • Irritating rashes, or rashes that are concerning to you.
    • If you have significant body aches and high fever that came on very quickly. You may have the flu, and could benefit from an antiviral medication.

    Gastrointestinal illnesses  (vomiting and diarrhea)

    • Unable to keep enough fluids down to urinate 3 times daily
    • Vomiting or diarrhea  that lasts more than 2 days for adults, or 24 hours for children under age 2, or more than 12 hours for babies and toddlers
    • A fever of greater than 102
    • Significant abdominal pain
    • Bloody or “black tar” stools
    • Having nausea, vomiting or diarrhea off and on for longer than a month
    • However, there are also some symptoms that should send you straight to the emergency department.
    • Respiratory infections
    • Rapid breathing, which would be the inability to breathe and talk comfortably.  In babies, this could look like “sucking in” below their ribs.
    • Any fever in an infant 2 months old or younger.
    • Lethargy, or difficulty arousing.

    Gastrointestinal illnesses  (vomiting and diarrhea)

    • Severe dehydration.  When you just can’t get the vomiting and/or diarrhea to stop, and the person is getting dehydrated.  You can tell this by lack of urination or very dark urine, excessive thirst, dry mouth/skin, and weakness, lethargy or lightheadedness.
    • Bloody vomit or diarrhea.

    However, for many illnesses, self-care at home can be enough.  Here are some general care tips for an upper respiratory infection (a head cold), the most common illness in our society.  It can affect us any time of the year, but particularly during winter.  These are treatments I recommend for both children and adults:

    • Add some moisture to the air.  Try sitting in a steamy bathroom, or add a humidifier or vaporizer in the bedroom at night.  Also, nasal saline (spray or gel) or a neti pot with saline can help thin secretions and clear drainage.
    • In very young children, try saline nasal spray with nasal suctioning.  Since they can’t blow their nose, this is the next best thing you can do for them.  No, they don’t like it, but it really is helpful to get all that mucus out, and it can help prevent a secondary bacterial infection from settling in.
    • Push fluids.  Being hydrated helps the body get rid of infection, and
    • Elevate the head of the bed, or sleep in a recliner.
    • Decongestant, if used as directed, can help clear your head.
    • Ibuprofen and acetaminophen are appropriate for fever and aches.

    Gastrointestinal infections, with symptoms of nausea, vomiting and diarrhea, are unpleasant to say the least.  Because these infections are caused by bacteria, viruses or other parasites, sometimes it’s best to just let the illnesses “work themselves out of your system.”  Here are tips to help with that, and to minimize dehydration:

    • Encourage fluids.  When you’re nauseous I know nothing sounds good, but sips of beverages with electrolytes (sports drinks, Pedialyte), warm broth or even just plain water can help your body “flush out” the problem, and keep you hydrated as well.
    • Bland food, such as crackers, can help settle the stomach.  When someone is able to keep food down, I recommend the “BRAT” diet for a day or two:  bananas, rice, applesauce, toast.
    • If you have had several “rounds” of vomiting or diarrhea, or the illness has gone on for a full day, taking medication can help calm your system down.  When taken as directed, Pepto Bismol Immodium, Kaopectate, etc. can help set some balance back to your GI tract.  (Note:  Pepto Bismol can cause black stools.)

    Once again, if you are unsure about whether to see a doctor or not, I encourage you to call your doctor’s office, send a MyChart message, or call an after-hours nurse hotline if you have access to one.

    Finally, linked is a helpful guide for when you have other situations, and you can’t decide whether to go to the doctor, urgent care or emergency room.

    Dr. Greg Rodocker is currently accepting patients of all ages at his office at Deaconess Clinic Mary Street, located at the Deaconess Hospital main campus, in the Deaconess Physician’s Center.

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