Aches, Pains & “Weird Things”

Where to go & how to stop spiraling when you’re sick or something feels…off

By Susan Trumpbour

Design by Justin Negard

Almost all of us procrastinate about our health, ignoring little signs—a symptom here, a worry there. A stomachache? Probably last night’s spicy food. A new lump? It could be a bug bite. A nagging cough? Just seasonal allergies. Suddenly, you’re wondering, “How would Dr. Robby approach my case on ‘The Pitt’?”

But that raises an important question: When should you stop dismissing minor annoyances and take action? And when you do take action, what type of doctor should you see, and how can you make sure your symptoms are taken seriously?

Recognizing when to act can be critical. “Catching an issue early can mean the difference between a minor problem, a major challenge, or sometimes even life and death,” Steven Abrams, a senior emergency medicine attending physician at Montefiore Medical Center in the Bronx who has spent nearly 40 years in the emergency room, sums it up well: “Early diagnosis is as good as it sounds; it’s a wonderful thing.”

With that in mind, we’ve asked two local ER specialists—Abrams and Shalom Sokolow, an emergency physician at Northwell’s Phelps Hospital who has been an ER doctor for 10 years—for tips to help you understand your symptoms and choose where to seek care, as well as how best to communicate with your doctor. Their advice will help you reduce uncertainty, get timely care and take confident steps toward protecting your health.

Understanding your body’s signals

No one knows your body better than you. If your gut is telling you something is wrong, you must listen. “If you’re feeling sick or scared and have no access to a physician, we in emergency medicine always say, ‘When in doubt, go to the ER,’” says Abrams. “There’s something called ‘the reasonable layman’—if your concerns are making you worried, scared or anxious, it is perfectly reasonable for you to seek emergency care. We don’t belittle your decision. We can reassure you about your condition or escalate as necessary. We’ll take care of you.”

Doctors are most concerned about sudden, short-term changes. “Patients with significant chest pain or shortness of breath should seek medical attention right away,” advises Sokolow. He says it is difficult to differentiate between a potential pulmonary embolism (PE) and other causes of chest pain or shortness of breath without advanced testing in the emergency department (ED). Identifying symptoms early and getting medical attention can prevent death. According to the National Institute of Health, 30 percent of untreated patients with PEs die, while a prompt diagnosis and treatment reduces this rate to between two and eight percent.

Another great example of trusting your gut is having an allergic reaction but no EpiPen. Immediate care can prevent a life-threatening outcome. “Any allergic reaction that involves trouble breathing or throat discomfort raises concern for anaphylaxis,” explains Sokolow. “Patients with these symptoms should seek help right away. This is especially true for patients with a history of anaphylaxis.”

Other examples include a new pain that doesn’t go away, changes in patterns, such as increased sleep or decreased appetite, or unexplained physical changes (such as a lump or a change in skin color), an extreme headache, or a lingering cough lasting more than three weeks.

Abrams says protocol tests can rule out serious problems. “When you come into the ED, we look for unstable vital signs or worrisome clues, such as trouble walking or swollen ankles,” he explains. “We’ll provide context, but we need to know about the changes.” This, along with the patient interview, determines which tests are needed and whether admission is necessary. ER doctors will often order a CT scan to rule out conditions affecting your appendix, liver, gallbladder and kidneys, which can help them rule out (or pinpoint) conditions affecting those organs. “If we don’t see anything suspicious but understand you are still uncomfortable, and nothing in your tests says we need to admit you or do more testing, we will set up further testing with a specialist,” Abrams explains. “This will help get to the root cause and prevent a worse scenario.”

Cancer is a good example. Sometimes patients are worried that a symptom might be due to cancer. “We might not always find that in the ER,” says Sokolow. “Our testing focuses on diagnosing and managing acute, potentially life-threatening problems. Yes, different types of cancers are life-threatening and very serious in the long term, but these aren’t necessarily the things that show up early in our testing.” However, Sokolow explains, if you are concerned about a family-related illness for which you do not yet have symptoms, tell the treating physician because you could be at an elevated risk. “If anything alarming shows up in the results,” says Sokolow, “we will inform the patient and provide a follow-up plan.”

Signs you might be experiencing an allergic reaction:

• a drop in blood pressure
• difficulty breathing
• dizziness
• facial or throat swelling
• hives
• rapid heartbeat

Patients at higher risk for PE include:

• prior history of a blood clot
• recent surgery or major injury
• recent hemoptysis (coughing up
• blood)
• leg swelling (deep vein thrombosis)
• those who use steroids or hormones
• (including birth control)

Choosing the right waiting room

Trying to decide where to go when you’re sick or hurt is like choosing a checkout line at the grocery store. You jump on the shortest line, thinking you made the best choice, but then the person in front of you needs a “price check,” and you realize it wasn’t the right move after all. The same goes for choosing among the ER, urgent care or your GP’s office—you make the wrong decision, and you’re either waiting forever or possibly in the wrong place altogether. But where you should go “depends on the medical situation, the context or perhaps a combination of the two,” says Sokolow.

The ER

Sokolow stresses that if you or a loved one is experiencing a life-threatening medical condition, go straight to the ER without hesitation. In general, those symptoms are:

• any acute, life-threatening situation
• chest pain
• difficulty breathing
• severe injury
• stroke-like symptoms (change in balance and/or vision, facial droop, arm or leg weakness, speech difficulty)

There are other situations when visiting the ER would be the right choice, even though it’s not necessarily a life-threatening circumstance. These include:

• An injury during “off hours,” like in the middle of the night
• A high temperature, which varies depending on the person. Abrams advises the following:
  • For infants younger than three months, a temperature of 100.4°F or higher requires a call to your doctor or an ER visit.
  • For older babies, a fever of 101°F or higher calls for the same, especially if accompanied by symptoms such as poor feeding, drowsiness or rash.
  • Adults who are immunosuppressed, receive chemotherapy or dialysis, or have a transplant
  • Seniors with a fever or low temperature, as both are worrisome for infection
• Concern for exposure to HIV
• If the person regularly experiences limited or no mobility
• You need a rabies or tetanus vaccination

In short, the ER is your safety net; it’s a place anyone can go, whether they are insured or uninsured. A patient can come in and be treated regardless of their economic status.

Urgent care

“Urgent care is more for management,” Abrams explains. He compares walking into an urgent care center to going into a bank. To make a deposit at the bank, you need cash and an account. At urgent care, you can’t get in unless you have cash and insurance. If you think urgent care is the right move, ask yourself:

1. Do I need a quick procedure (a few stitches, splinter removal, treating a minor burn)?
2. Am I hoping for a diagnosis and/or a prescription?
3. Do I want to be tested for the flu, strep throat, RSV and/or COVID-19?
4. Am I able to walk on my own?
5. Is my concern urgent but not life-threatening?

If you answered “yes” to any of the first three, along with “yes” to the last two, then proceed to urgent care. And if you arrive at urgent care with symptoms more severe than they are capable of treating (for example, you are dangerously weak, appear dizzy, or have fainted), they’ll send you to the hospital, sometimes calling an ambulance for you. In other words, visit an urgent care center if you are experiencing non-life-threatening symptoms.

Your primary care doctor

“Visiting your physician is the best way to receive comprehensive guidance or a referral if you require a specialist’s evaluation,” says Abrams. “As impersonal as these doctor visits may seem, you are on a pathway with your primary care physician. As we say in the ER, with your doctor, someone owns you, someone owns the results, someone owns the referrals, someone collates them and someone decides what step you should take next. Your doctor is the one who gives you the necessary examination and compares it to your personal benchmarks, which are determined based on your age, gender and family history. They recommend screenings and provide intervention guidelines to help you avoid a health crisis.”

How to tell your story

Talk honestly—don’t hide things because you’re embarrassed. Trust us, your doctor has seen and heard it all. Chances are, whatever you have going on, it doesn’t even make the top 10 weirdest things of the week.

Doctors are good at connecting the dots, but they need the necessary information to do so. They can’t read minds, so you must provide the details. Two of a doctor’s most important superpowers are to be a good listener and to decode “layperson” language. As a patient, your words are essential, but there’s no need for you to talk in medical terms. Instead, the most important thing you can do as a patient is to be honest and specific. The more details you give, the less time a doctor will spend playing their least favorite game: Guess That Symptom.

“A patient should not worry or be nervous about presenting their history or symptoms in the most organized manner,” says Sokolow. “It is our job as physicians to try to get the right answers, regardless of how you tell the story.” Instead, he recommends you focus on the following when describing your symptoms: when they began, how often they occur and if they’re getting worse. Be clear, direct and polite—that, he says, is the best way for everybody to move forward.

“For example,” says Sokolow, “if someone comes in with abdominal pain, I might ask what happened that day. Did the pain get better or worse over the course of the day? Is there anything specific that makes it come or go? Are you having other symptoms, like vomiting or diarrhea?”

Is getting a second opinion cheating? Asking for a friend.

No, it’s not cheating, especially to confirm a diagnosis or treatment protocol. It’s being thorough; your health is too important for a monogamous relationship. Doctors get it and even recommend it. If they don’t, then it’s time to find a new doctor. “It’s the patient’s right to get a second opinion,” states Abrams. “But, if it’s a critical situation, you will need to sign a release to be discharged. The hospital doesn’t want to be responsible if you drop dead the minute you leave the ER.”

A medical diagnosis can feel overwhelming, and certain treatment protocols might seem aggressive, so it’s natural to want to confirm what you’ve been told. Another opinion can validate your doctor’s diagnosis and treatment plan, offer a different viewpoint that may alter your treatment, or, sometimes, it can even uncover a misdiagnosis or provide you with alternative, less-invasive treatment options.

According to Loyola Medicine, specific reasons for considering a second opinion include the following:

• You disagree/are uncomfortable with the diagnosis or treatment approach
• You have a serious or rare condition and want an expert or team of experts who specialize in that condition
• You’re considering surgery
• You have multiple treatment options to choose from
• Your doctor can’t figure out what is wrong
• You’re told you have no options

Can the internet help?

We’ve all been there: searching WebMD, Googling, checking AI and spiraling from “mild headache” to “rare tropical disease” while asking your family if you look flushed. Your blood pressure rises, you start worrying about your heart, your imagination spins out of control, and suddenly, you’re experiencing a rather severe case of “cyberchondria.” Yet, in reality, most headaches are harmless. So you force yourself to focus on this fact to ease your anxiety and prevent your symptoms from feeling worse than they are.

While trying to crowdsource your medical mystery from every corner of the internet might seem like a good idea, our experts suggest caution. Abrams believes one of the most frustrating experiences for a patient searching the internet is the superficial answers it provides, no matter the symptoms or the tool used. “You may be directed to Joe’s asthma site, which has the look and feel of the Centers for Disease Control and Prevention’s (CDC) website, and you think whoever this is knows what they are talking about,” Abrams explains. “But this could be fake content, which means you’re receiving information and remedies that may not be valid; it might be sponsored by a third party and biased.”

Sokolow shares another problem. “These sites and software programs are often constructed by throwing out a lot of possibilities, some of which are more mundane or obscure, while others are potentially alarming. This happens for a combination of reasons, and unfortunately, there’s a litigious element to it; the site doesn’t want to be on the hook for telling somebody their symptom was benign when it turns out to be more dangerous. A patient could Google a sore throat and end up with something alarming and bizarre that is not the least bit plausible for their situation.”

And while AI tools, especially large language models (LLMs), allow for a more interactive conversation and can typically handle follow-up questions, they’re often pulling from highly credible sites and personal/unverified ones. And although many provide a “This is not a substitute for medical advice” disclaimer, that doesn’t fully eliminate the anxiety their answer has created.

However, Sokolow says there is a benefit for patients who search online: they gain useful insight that can help them provide more clear and precise language, such as clarifying if they’re experiencing a throbbing pain or a dull one. It may also help them understand what might be causing their symptoms.

How to avoid downward spirals

If you are Googling your symptoms 10 times a day and thinking about them constantly, it’s time to call your doctor or visit the appropriate waiting room to save you from your overactive imagination. It’s best to be upfront and say you’re afraid something is wrong, even if that means you share your self-diagnosis. Doctors don’t judge.

“I highly recommend that if a patient is worried about something, they tell us,“ Sokolow advises. “We won’t think badly of you; we want to put you at ease. And we might be able to simply tell you that you don’t have that condition, or we might say, ‘You know what, if you’re worried about this, let’s talk about it a little more, and we can run some additional tests so you feel better.’”

What you don’t want is a situation where you leave the doctor without addressing or discussing your concerns. “That is a total waste of everybody’s time,” says Sokolow. “A good doctor will ask you directly, ‘What is worrying you the most? Is there a particular diagnosis you are considering that you want to talk about? Is there something we haven’t discussed that you want to make sure we bring into the conversation?’”

The bottom line: Don’t wait

You’re the CEO of your health—own it. No one else will advocate for you. To receive an early diagnosis and increase your chances of a full recovery, the best thing you can do is to schedule and attend your regular checkups, stay up-to-date on screenings and talk openly with your doctor about any concerns.

That’s the power of early diagnosis. Surprises are for birthdays, not for health scares. The last thing you want when it comes to your health is to wonder, ‘What if.’ Instead, you should always aim for ‘I’m so glad I did.’

This article was edited by Julie Schwietert Collazo and fact-checked by Gia Miller. The artwork is courtesy of the National Gallery of Art’s open access program.

This article was published in the May/June 2026 edition of Connect to Northern Westchester.