Health Emergency: What To Do
Being selected for a full-body search at the airport, running into your boss during your bachelorette party, taking a trip to the emergency room...All rank pretty high as scenarios you'd rather avoid. Going to the ER is like firing someone Ã¢â‚¬” unpleasant, yet sometimes necessary. Granted, whatever symptoms have you doubled over in agony probably aren't life threatening Ã¢â‚¬” but you sure don't want to guess wrong. So if your last name is Knoxville, or if you have any suspicion that what you've got could be serious, get your butt to the ER, stat! And assuming you feel fine right now, read our cheat sheet Ã¢â‚¬” put together with top emergency physicians and medical experts Ã¢â‚¬” to learn more about some common health crises and what the chances are that the ailment is minor, pretty bad, or really bad. Even if you don't have McDreamy's pager number, you'll know when to call the ambulance Ã¢â‚¬” or just take two aspirin and call your doctor in the morning.
Quick quiz: What's the number one reason women go to the ER?
If you said abdominal pain and cramping, you win. (If you said bikini wax trauma, that was our guess too.) When someone stumbles into the hospital with a bad belly, figuring out what's wrong can be tricky. "There are dozens of possible causes of abdominal pain," says Kathleen J. Clem, M.D., chief of the division of emergency medicine at Duke University Medical Center and a spokesperson for the American College of Emergency Physicians.
Most of the reasons aren't serious: Your gastrointestinal system is more bulletproof than you might think. You've probably just visited that questionable Chinese joint one too many times. But if the pain is severe and coming from your lower right abdomen, you could have appendicitis Ã¢â‚¬” an inflammation of the appendix, a small pouch attached to the colon. (Just to make things interesting, though, Mother Nature occasionally puts the pain on the left side.) Another clue: You could experience nausea and even vomiting. You have a 7 percent chance of getting appendicitis sometime in your life. And if you don't get your appendix yanked fast, it can rupture in a matter of hours, spewing dangerous, potentially deadly bacteria all over your internal organs. Suddenly a little time in a crowded waiting room doesn't seem so bad, does it?
If your appendix winds up as guiltless as Floyd Landis, the trouble might be a kidney stone, which usually causes sharp, cramping pain that starts on either side (or sometimes both) and moves toward your groin. But bad as it hurts, a kidney stone is dangerous only if it blocks the flow of urine, which could cause an infection, Dr. Clem says. And your lifetime odds of getting one are just 10 percent. The offender could be the equally sweet-sounding gallstone, which typically causes sudden, sharp pain that moves from the middle of your abdomen to high on the right side under your rib cage, where the gallbladder is located. A gallstone is a nugget of hardened cholesterol and bile (a liquid that helps digest food) that settles in the gallbladder and irritates it. Lovely. You probably need surgery to remove it.
Remember going to the high school nurse with cramps and lying there in a fetal position with a hot water bottle for the rest of gym class?
These are not the cramps that drive women to the emergency room. If pelvic pain brings you to Moses Taylor Hospital in Scranton, Pennsylvania Ã¢â‚¬” ?especially if you're bleeding too Ã¢â‚¬” Richard O'Brien, M.D., is giving you a pregnancy test. No discussion. Why? An ER doc's biggest fear for a young woman (aside from her marrying Kevin Federline) is an ectopic pregnancy, when an embryo grows outside the uterus, usually in one of the fallopian tubes. Without medical treatment, a tube can rupture, damaging both the tube and the ovary. "It's a time bomb," Dr. O'Brien says. Yikes. Where's Jack Bauer when you need him? So if you're saturating a sanitary pad every hour, or if you're dizzy, light-headed, or weak, make your way to the hospital immediately, says Kristin E. Harkin, M.D., attending physician in the department of emergency medicine at NewYork-Presbyterian Hospital in New York City. Chances are you don't have an ectopic pregnancy Ã¢â‚¬” it happens in just 1 to 2 percent of pregnancies, says the American Society for Reproductive Medicine Ã¢â‚¬” but there's only one way to find out for sure.
Once the ER doc rules out pregnancy, she'll check off other possible culprits for your personal Red Sea: fibroids (noncancerous growths in the uterus); polyps (noncancerous growths around the cervix or uterine lining); or an infection like pelvic inflammatory disease, caused by bacteria moving up into the reproductive organs. All can cause bleeding Ã¢â‚¬” and all need to be addressed. Or you might just be having an unusually heavy period. It happens, especially when your hormones are in flux (when you're adjusting to the Pill, for instance).
But wait. Pelvic pain might also mean your ovaries are doing something funky. The worst thing it could be is ovarian torsion, in which one of your ovaries twists on its stalk, for reasons no one can quite figure out. Just like the little old lady who holds up the checkout line with her pile of coupons, the twisting blocks blood flow, which could cause you to lose your ovary, Dr. Clem says. Before you freak out, this ailment is very rare Ã¢â‚¬” less than 3 percent of women get it. A far more likely source of ovarian pain (and sometimes bleeding) is a cyst, a fluid-filled sac that forms every month during your menstrual cycle to hold the growing egg. Docs don't know why the cyst goes renegade in some women, becoming big and painful rather than getting absorbed by the body as it usually does. Ovarian cysts are very common when you're young, so there's no reason to worry it's the C word: Your odds of developing ovarian cancer between the ages of 20 and 45 are a tiny 0.11 percent. Your doctor may opt to remove the cyst through laparoscopic surgery (no hospital stay), or she'll just keep an eye on it to see if it's growing.
Be Still My Heart
Just so you know: Young women do not, as a rule, die of heart attacks.
If you feel pressure, tightness, or pain in your chest or upper abdomen, or if you have heart palpitations (an irregular heartbeat that feels like fluttering) lasting longer than a couple of minutes, get to the ER just in case. But more likely, there's a benign explanation for your heaving bosom. "Chest pain can be something as simple as inflammation of your chest wall, which is not dangerous at all," Dr. Clem says. "It can be caused by coughing, twisting, exercising, straining a muscle, even the common cold." As for heart palpitations, if Heath Ledger isn't in the room, too many double espressos are more likely to blame. Or it could be you're so stressed that you're having a full-blown freak-out, otherwise known as a panic attack. "The symptoms of a panic attack are real," Dr. Clem says. "People feel much the same things as someone who's having a heart attack," including a racing heart, sweating, trembling, dizziness, nausea, and shortness of breath. (All totally understandable reactions to being within 50 feet of Heath.)
If you feel like you swallowed a hummingbird and your heart is beating faster than normal for a minute or two, "it's not a big deal if it's a one-time thing," Dr. O'Brien says. There's likely a logical reason for your racing heart Ã¢â‚¬” say, you just started running again after spending the winter watching Fox Reality. The better shape you're in, the quicker your postexercise heart rate will return to normal.
No one likes playing mind games, especially trying to guess whether your killer headache will live up to its name.
Think of this as a checklist for your next really bad headache Ã¢â‚¬” if any of the following apply, Dr. Clem says, go to the ER: You'd call the headache the worst of your life; it came on very suddenly; and/or you're having seizures, weakness in your arms or legs, changes in your vision, slurring of your words, neck pain, nausea, or vomiting. Any of those could signal an aneurysm Ã¢â‚¬” a weakening in the wall of a blood vessel, which then bursts, Dr. Clem says.
Docs will most likely do a CT scan or an MRI to find out whether it's an aneurysm and rush you to surgery if necessary, Dr. O'Brien says. (Relax, though: Just 2 percent of the population ever has a brain aneurysm.) It's also possible that you're having a stroke, though that's pretty unusual for a young woman too. Here's the good news: Arnold Schwarzenegger was right Ã¢â‚¬” "It's not a tumor!" Brain tumors rarely cause headaches.
Something far less scary is probably causing your head to feel like a post office doorjamb on April 15. It could be a cluster headache, where pain drills in on one side; a tension headache, with pressure that encircles the head and sometimes the neck; or a migraine, an excruciating headache caused by the swelling of blood vessels in the brain, says Kristen Matteson, M.D., of Women and Infants Hospital in Providence, Rhode Island. If Tylenol helps ease the pain, see if your doctor can provide better relief next time Ã¢â‚¬” or even prevent bad headaches entirely.
Any time you're having trouble breathing, don't wait until your nails dry.
Don't set the TiVo to record Prison Break. Don't update your playlist. Leave for the emergency room pronto. You might have a pulmonary embolism (PE), better known as a blood clot in your lungs. Another clue that it could be a PE: Your heart is beating fast Ã¢â‚¬” more than 100 beats per minute. A PE can block blood flow, damaging your lungs and other organs, and it can be fatal. ER docs can diagnose it with something called a ventilation-perfusion scan, then put you on blood thinners or a clot-busting drug. Yes, it's serious. About 600,000 Americans a year get a PE Ã¢â‚¬” luckily, your risk doesn't really jump till after 60. It's much more likely that you're in the middle of an asthma or panic attack or having an allergic reaction (see below).
Few things say "ER" (not to mention "cancel a date") like a serious allergic reaction.
If you're breaking out in hives, your face is doing its best impression of Rush Limbaugh, and you're having trouble breathing or swallowing, that's exactly what's happening. You and some food, drug, or insect are getting along as well as Donald Trump and Rosie O'Donnell. In a worst-case scenario, you could suffer anaphylactic shock. That's a drop in blood pressure that may cause you to throw up, black out, or even die, says William H. Anderson, M.D., an allergist and asthma specialist in Bellingham, Washington. The ER docs will probably give you an injection of epinephrine (aka adrenaline) to reverse swelling and relax the muscles in your airways and lungs. Got the antihistamine Benadryl (diphenhydramine) on hand? Take it as you're racing to the ER Ã¢â‚¬” it may head off a more severe attack.
If hives are your only symptom, though, an anti?histamine should be enough to deflate your face and clear it up so it doesn't resemble a topographical map of the Rockies. "Hives alone could be a contact allergic reaction, such as to a cosmetic or lotion," Dr. Anderson says. Or maybe it's a medication you took Ã¢â‚¬” some can make you more sensitive to the sun, causing skin rashes in certain people. Both problems are minor enough for your dermatologist to handle them.
Kneed to Know
You like to kick it like Mia or spike it like Gabby, but now your knee is screaming like a Deal or No Deal contestant.
Chances are good you've torn your ACL (anterior cruciate ligament), a key stabilizer of your knee joint, says Kathy Weber, M.D., director of women's sports medicine at Rush Medical Center in Chicago and team physician to the Bulls and the White Sox. (We may look better in shorts than men, but the downside is that female athletes are up to four times more likely to tear an ACL, thanks to anatomical differences that affect how we jump and land, Dr. Weber explains.) Other ER musts: Your leg is at an unnatural angle (yeah, imagining that gives us the willies too); there's rapid swelling, bleeding, or signs of infection; or you hear a "pop" in your knee. On your way to the hospital, ice the injury if you can, Dr. Weber recommends: "It reduces swelling, pain, and bleeding."
An ER visit will involve an x-ray to rule out a fracture. Then your doc will stabilize your knee, give you some pain drugs, and tell you to see an orthopedist. If the tear is bad, you may need to schedule surgery. And hope you scored the winning point, because you're going to be benched for a while.