When Should We Treat Ourselves and When Should We See a Doctor?
Knowing what we can manage ourselves, when first aid is enough, and when professional medical help may save a life
lim ju boo, alias lin ru wu (林 如 武)
Modern medicine has given us extraordinary powers to diagnose and treat disease. But there is another form of healthcare that begins much closer to home: what we do for ourselves every day.
We can prevent many illnesses through sensible eating, regular physical activity, adequate sleep, maintaining a healthy weight and avoiding harmful habits.
At the same time, we should understand an equally important principle:
Not every health problem should be treated at home.
Knowing when self-care is appropriate and when we should seek professional medical help is an important part of taking responsibility for our own health.
Perhaps the simplest way to understand this is to think of healthcare as having three levels.
The Three Levels of Health Care
1. Emergency crisis — act immediately.
We should learn to recognise situations such as a possible heart attack, stroke, severe breathing difficulty, unconsciousness or major bleeding. These are not conditions for home treatment. They require urgent professional medical help.
2. Minor illness and injury — know what we can safely do ourselves.
Many everyday problems, such as a simple cold, a small cut, a minor burn or an uncomplicated sprain, can often be managed initially with sensible self-care and basic first aid. But we must also recognise the warning signs that tell us when medical attention is necessary.
3. Everyday health — prevention is largely in our own hands.
For much of our lives, the most important healthcare may be what we do before we become ill: eating sensibly, remaining physically active, maintaining a healthy weight, sleeping adequately, avoiding tobacco, using alcohol sensibly, managing stress and undergoing appropriate health checks.
These three levels are not alternatives to one another.
They are complementary.
We need to know when to act immediately, when we can care for ourselves, and how to prevent illness in the first place.
1. Emergency Crisis — Act Immediately
Some medical emergencies give us very little time to think.
A person suddenly develops severe chest pain, becomes breathless and sweaty, and complains of pain spreading to the arm or jaw.
Another person suddenly develops weakness of one side of the body, has difficulty speaking or develops facial drooping.
Someone else may suddenly collapse and become unconscious.
These situations are very different from an ordinary headache, cold or minor injury.
They may represent a heart attack, stroke, cardiac arrest or another life-threatening emergency.
The most important lesson is simple:
Do not wait to see whether the problem goes away. Get emergency medical help immediately.
Knowing a few warning signs can sometimes make the difference between life and death.
Possible heart attack
Severe or persistent chest pressure or pain, especially when accompanied by breathlessness, sweating, nausea or pain spreading to the arm, shoulder, back, neck or jaw, should be treated as an emergency.
Do not simply assume that it is indigestion or muscle pain.
Possible stroke
A useful way to remember the major warning signs is FAST:
F — Face: Is one side of the face drooping?
A — Arms: Is there sudden weakness or inability to raise one arm?
S — Speech: Is speech suddenly slurred, confused or difficult?
T — Time: Time is critical. Seek emergency medical help immediately.
Other sudden neurological symptoms, such as loss of vision, severe imbalance or sudden confusion, can also be warning signs.
Cardiac arrest
A heart attack and cardiac arrest are not the same thing.
A heart attack occurs when blood supply to part of the heart muscle is blocked.
Cardiac arrest occurs when the heart suddenly stops pumping blood effectively.
A person in cardiac arrest may collapse, become unconscious and stop breathing normally.
This is an extreme emergency.
If someone is unresponsive and not breathing normally, emergency services should be called immediately and cardiopulmonary resuscitation (CPR) started if the rescuer knows how to perform it. An automated external defibrillator (AED), when available, can provide potentially life-saving treatment while professional help is on its way.
The important principle is:
In a true emergency, time is tissue and time is life.
2. Minor Illness and Injury - Know What We Can Safely Do Ourselves
Fortunately, most of us encounter many more minor illnesses and injuries than life-threatening emergencies.
A simple cold, for example, may cause a runny nose, sore throat, cough and mild fever. In an otherwise healthy adult, rest, adequate fluids and appropriate symptomatic treatment may be all that is required.
A mild episode of diarrhoea may similarly settle with rest and careful replacement of lost fluids and electrolytes.
Minor headaches, uncomplicated muscle aches and some other short-lived problems can also sometimes be managed at home.
But self-care does not mean ignoring symptoms.
We should always remain alert to deterioration.
If an illness becomes severe, persists unusually long, or develops worrying symptoms, medical advice should be sought.
Minor injuries and first aid
There is another area where ordinary people can do a great deal for themselves: first aid.
A small cut, superficial graze or minor burn does not necessarily require a visit to hospital.
For a small cut, wash your hands, gently clean the wound with clean running water and apply gentle pressure with clean gauze or cloth if it is bleeding.
Once the bleeding has stopped, protect the wound with a clean dressing.
For a minor burn, cool the affected area under cool running water for about 20 minutes. Ice should not be placed directly onto a burn because it can cause additional tissue injury.
For a minor sprain, protecting the injured area and allowing it to rest can help. Cooling the area with something cold wrapped in a cloth may help reduce pain and swelling.
These are simple examples of first aid, not substitutes for medical care.
When a minor injury is no longer minor
A wound that initially appears small may sometimes require professional attention.
Medical assessment is important when bleeding cannot be controlled, a wound is deep or gaping, there is loss of sensation or movement, a foreign object is embedded, or an animal or human bite has occurred.
Increasing redness, warmth, swelling, pus or fever may indicate infection.
Serious burns, extensive burns, electrical burns and burns involving important areas such as the face or major joints should also receive medical attention.
Similarly, a suspected fracture or significant head injury should not be dismissed simply because the person remains conscious.
First aid is meant to help us until proper medical care is obtained when it is necessary.
3. Everyday Health — Prevention Is Largely in Our Own Hands
Perhaps the most important level of healthcare is the one we practise every day.
Many of the diseases that trouble us today are not caused by a single infectious organism. They develop gradually through a complicated interaction between our genes, ageing, environment and lifestyle.
These are often called lifestyle diseases.
They include obesity, type 2 diabetes, high blood pressure, heart disease, stroke, fatty liver disease and some forms of cancer.
Our daily habits cannot control everything. Genetics and ageing matter, and some diseases occur despite excellent lifestyles.
But our behaviour can nevertheless have a profound influence on our health.
Food is more than calories
For many years, nutrition was discussed largely in terms of calories, protein, fat, carbohydrate, vitamins and minerals.
These remain important.
But food is far more complicated than a collection of nutrients.
Fruits, vegetables, legumes, whole grains, nuts, seeds, herbs and other plant foods contain thousands of naturally occurring compounds. Some have antioxidant, anti-inflammatory or other biological activities.
This does not mean that eating a particular food will magically prevent disease.
There are no miracle foods.
Rather, it is the overall pattern of eating that matters.
A varied diet containing plenty of vegetables and fruits, appropriate sources of protein, whole or minimally processed foods and reasonable amounts of healthy fats is generally more sensible than relying heavily on highly processed foods.
Exercise is another form of medicine
We tend to think of exercise as something we do to lose weight.
It is much more than that.
Regular physical activity helps maintain muscle, improves insulin sensitivity, supports cardiovascular fitness, assists weight control and contributes to psychological well-being.
Exercise does not necessarily mean going to a gym.
Walking, cycling, gardening, swimming, climbing stairs and other forms of regular movement can all contribute to physical activity.
For older people, even modest activity performed regularly may be more realistic and sustainable than an ambitious exercise programme that is quickly abandoned.
Consistency is often more important than intensity.
Sleep, stress and the rest of our lifestyle
Our lifestyle is not only about food and exercise.
Chronic stress can affect sleep, appetite, behaviour, blood pressure and many other aspects of health.
Sleep is equally important.
We sometimes regard sleep as wasted time because we have so much to do. But the body does not regard sleep as wasted time.
Sleep is an active biological state during which numerous regulatory and restorative processes take place.
A healthy lifestyle therefore includes not only what we eat and how much we exercise, but also how we sleep and how we manage the stresses of everyday life.
Avoiding tobacco is particularly important, while alcohol, if consumed, should be used sensibly.
Regular health checks can also help detect conditions such as high blood pressure, diabetes and abnormal cholesterol before they cause obvious symptoms.
The medicine cabinet is not the whole answer
Modern medicine is extraordinarily valuable.
When blood pressure is dangerously high, medication can save a life.
When blood sugar remains too high, medicines may prevent complications.
When cholesterol is dangerously elevated, appropriate treatment can reduce cardiovascular risk.
But there is an important question we sometimes forget:
Should medicine be the only treatment?
A tablet may lower blood pressure, but it does not necessarily correct the habits that contributed to the problem.
A medicine may lower blood glucose, but it does not replace healthy food or physical activity.
Medicine and lifestyle therefore should not be enemies.
They should work together.
And lifestyle management should never be used as an excuse to stop prescribed medication without medical advice.
Some people will require medication even when they follow an excellent lifestyle.
The goal is not to avoid doctors and medicines at all costs.
The goal is to use them wisely and when they are needed.
We should neither fear doctors nor depend on them for everything
There are two extremes that we should avoid.
The first is to rush to the doctor for every minor ailment that could safely be managed with sensible self-care.
The second and potentially much more dangerous is to avoid doctors altogether and attempt to treat serious disease ourselves.
Both approaches can be harmful.
Healthcare professionals possess knowledge and diagnostic tools that we do not have at home.
At the same time, we should not surrender responsibility for our own health.
Good healthcare is a partnership between the individual and the medical profession.
We should learn enough about our bodies to recognise what we can safely manage, while also recognising the warning signs that tell us when professional help is needed.
The best prescription begins before the illness
Modern medicine can do remarkable things.
It can rescue people from infections, heart attacks, strokes, severe injuries and many other serious diseases.
But another form of medicine is available to us every day.
It is how we live.
Every healthy meal, every walk, every hour of adequate sleep, every cigarette avoided and every effort to maintain a healthy weight contributes to our long-term health.
And when illness or injury does occur, knowing a little first aid and knowing when to call for professional help can sometimes make an enormous difference.
Perhaps the wisest approach is therefore neither:
“Treat everything yourself.”
nor:
“Leave everything to the doctor.”
It is to know the difference.
Act immediately when there is an emergency.
Treat minor problems sensibly when it is safe to do so.
And make healthy living our everyday form of preventive medicine.
We cannot control everything that happens to our bodies.
But we can control many of the things we do to them.
And perhaps that is one of the greatest lessons of modern healthcare:
The doctor may save us when we are seriously ill.
First aid may help us when we are injured.
But every day, much of our health remains in our own hands.
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