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Once you've been diagnosed with a chronic illness, such as asthma, hypertension, heart disease or diabetes, one of the best things you can do to help keep your condition under control is work closely with your health care provider.
That means regular appointments, of course. But between office visits, symptoms may flare or new ones may crop up. How do you know if you're experiencing "just the usual," or if a headache, chest pain or shortness of breath is worthy of an immediate call to the doctor?
Here are some guidelines for when to call the doctor and when to self-treat.
If you have diabetes, rising blood sugar not responding to prescribed treatment is a reason to call the doctor. Patients with diabetes also have a high risk of heart disease and strokes. For this reason, they should get immediate emergency care for any symptoms of heart attack or stroke such as chest pain, sudden onset of weakness or paralysis and a loss of ability to speak.
Call the doctor if you have symptoms of diabetes, such as:
Increased thirst, urination or weight loss
High or low blood sugar that doesn't respond even though you're adhering to prescribed treatments
A change in vision
You have an acute illness such as respiratory or intestinal flu
Get immediate care for symptoms such as:
Indications of very low blood sugar (hypoglycemia), including confusion, weakness, paleness, sweating, and rapid heart rate; or in severe cases, seizures or coma
A sweet, fruity odor on the breath or speeding up of breathing and a very sleepy feeling (symptoms of ketoacidosis)
Vomiting or diarrhea for more than six hours
Tingling, numbness or burning pain in hands or feet
Chest pain, sudden onset of weakness or paralysis and a loss of ability to speak
Problems that worsen despite your following your doctor's advice, which may indicate long-term complications of diabetes; for example, dizziness or weakness when you suddenly sit or stand up; a wound that appears infected or doesn't heal (especially a foot wound); or vision problems, such as seeing flashing lights or large floating areas or spots
As long as a person with asthma follows an asthma action plan based on peak flow readings, the condition is rarely fatal.
Minor shortness of breath can be treated at home or in the doctor's office. If it's major, seek emergency care.
If you have asthma, it's important that you know what your typical symptoms are. Mild cases of asthma may include only some wheezing; more severe cases can rapidly progress from minor shortness of breath to a life-threatening situation.
Call the doctor if you have symptoms such as:
Trouble breathing, even after you've taken the medications according to your asthma action plan; or you have shortness of breath combined with tightness in the chest and wheezing
Persistent, dry hacking cough
Yellow, green, gray or bloody sputum, or thick sputum that you can't cough up
Itching, swelling, rash or difficulty breathing, which may be caused by a reaction to your medication
Peak blood flow dropping below 50 percent of your usual baseline
Sweating and severe difficulty breathing, which may be combined with pale or blue lips and fast heart rate and anxiety; call 911
Ideally, people with hypertension will be self-monitoring their blood pressure.
Call the doctor if you have the following symptoms and they are new, or, if you have had them before and they become worse:
Higher than usual blood pressure for three separate blood pressure measurements taken at different times
Dizziness that doesn't go away or persistent dizziness when you get up from sitting or lying down
Shortness of breath that occurs when you exercise or when you're lying down on your back
Irregular or rapid heartbeat or pulse
Weight gain from fluid retention
Symptoms of obstructive sleep apnea, such as snoring, difficulty breathing during sleep, and excessive daytime fatigue
Blood pressure of 180/110 mm Hg or higher
Fainting (generally associated with low blood pressure, or hypotension) or seizure (generally associated with extremely high blood pressure)
Chest pain that doesn't go away with rest or medication
Increasing blood pressure combined with headache, sleepiness, confusion, visual difficulties, numbness and tingling in the hands and feet, coughing blood, nosebleeds or trouble breathing; these are signs of a hypertensive emergency (malignant hypertension)
These organizations can provide answers to specific questions about living with chronic illness.
American Diabetes Association
Asthma and Allergy Foundation of America
American Heart Association
National Heart, Lung, and Blood Institute
National Cancer Institute
American Cancer Society
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