In most instances, a patient who comes into the doctor’s office complaining of a sore throat does not have a serious medical condition. But you’d be surprised to hear what people who come to the emergency room believe they are suffering from. Between Google and other search engines, most patients I see in my emergency department have already self-diagnosed their malady well before seeking my insight and opinion. There are times when a patient hits the nail on the head — for this reason, it’s always wise to see a doctor when something feels off. But many times the Google searchers are simply wrong. Here are five experiences I’ve had with incorrect self-diagnoses: 1. I Have Appendicitis An accountant once came into my ER thinking she had appendicitis because she had pain in her right upper quadrant and active vomiting every time she ate something spicy. But appendicitis is typically associated with pain in the right lower quadrant and is generally unaffected by specific foods. Turns out, my patient had a gallstone and was eventually scheduled for outpatient surgery. It’s not uncommon for parents to believe their child has appendicitis at the earliest onset of abdominal discomfort. Abdominal pain can have many causes, however — everything from reflux and food sensitivities to ovarian cysts, constipation, or infections. When in doubt, or when the pain is worrisome, always seek the advice of your medical provider. 2. I’ve Been Bitten by a Spider People with minor skin infections often sign in to the emergency department insisting that a spider has bitten them. I always ask them to describe the color and the size of the offending arachnid, and I have yet to have a patient who actually witnessed the event. Spider bites really aren’t as common as you’d think. Most of the time, the reason for the irritation is an abscess, or collection of inflammatory cells due to a skin infection or ingrown hair. Bites from spiders, such as Black Widows or Brown Recluses, cause very specific symptoms. Whereas both types of bites can lead to redness, swelling, and pain, black widow bites are often associated with muscle cramps, abdominal pain, and weakness. Brown recluse bites generally lead to severe skin involvement, skin cell death (necrosis), and severe tissue death. 3. I Have Meningitis A patient once came into my ER convinced his 4-hour headache was a result of bacterial meningitis, but without any of the associated symptoms one would expect, such as neck stiffness, fever, vomiting, or weakness. In many cases, a headache is a secondary symptom of some other common illness, such as allergy-related congestion or a viral infection. The definitive test for meningitis is a lumbar puncture — a spinal tap — a procedure in which I insert a long needle into a patient’s lower back and collect cerebral spinal fluid to test for bacteria. It’s an extreme measure to take when it’s unlikely you have meningitis. 4. I Have chest pain and I Think I’m Having a heart attack In most cases, chest pain may have nothing to do with your heart. Recently, I cared for a middle-aged male who came to see me directly from work, convinced he was having “the big one.” He had a horrible pain in the middle of his chest, but his EKG, chest X-Ray, and lab tests were normal. It turned out that the man had a case of acute pancreatitis. Other patients who similarly thought their chest pain was due to a heart issue ended up being diagnosed with pneumonia, pain from early shingles, and even severe heartburn. Although chest pain often is a symptom of something other than a heart attack, you shouldalways see your physician or visit the emergency room if you’re experiencing chest pain. It could be a sign that you are at increased risk of having a heart attack in the future. For this reason, emergency physicians often recommend that someone complaining of chest pain follow up with a visit to a cardiologist. 5. I Have Cancer Every week, I have moms bring in children whose noses won’t stop bleeding. Oftentimes, they have looked online and are convinced that their child has cancer or a bleeding disorder. In most instances, however, nosebleeds are due to excessive finger exploration, or there’s a foreign object I have to fish out. It’s crazy what kids put up their noses — I’ve pulled out Lego heads, beads, and rocks. Many times, if there’s one, there’s a second in the other nostril! It’s important to stay informed about your symptoms and in tune with your body, but online symptom checkers or search engines are never a substitute for professional evaluation. You should always see – or at least call — your doctor when something doesn’t feel right. The ER is your best option for life-threatening situations, but the more regularly you see your primary care physician, the better the relationship you’ll build. That way, your regular doctor can be your first line of defense when you spot something out of the ordinary. Jeremy J. Corbett, MD, is chief health officer of Nurtur, which focuses on prevention, behavior change, healthy lifestyle, clinical innovation strategies, and improving health outcomes. He practices as an emergency room physician in Lexington, Kentucky, where he lives with his wife and three children. Source
