Health Decision Guides

Weight gain in children, as in adults, is usually due to eating more or exercising less.

It can be caused by an illness or medication, though this is not common.

If your child has gained weight and you don't know why, you should call your doctor. This decision guide doesn't take the place of and shouldn't delay that call, but it will give you an idea of the questions your doctor may ask and the tests that he or she may order.

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Along with the weight gain, have you noticed that your child is having swelling, which might be most noticeable in the hands, feet, or face?

Yes, my child is having swelling.

No, my child is not having any swelling.

Welcome to our Decision Guide on Unintentional Weight Loss.

This guide is designed to provide insight as to why you are losing weight without purposefully trying to diet. The guide should be used as a complement to the care you receive from a health professional. It is not intended to replace direct interaction with your doctor.

Doctors become most concerned about unintentional weight loss if it reaches more than five percent of the usual body weight (about ten pounds), especially if your weight has not stabilized and continues to go down.

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It is quite common for weight to fluctuate a few pounds in either direction. People who tend to retain fluid and get swollen legs can quickly lose several pounds of water over one to two days. This is especially true if a person takes water pills (diuretics).

Weight loss related to water only is not the subject of this guide. Weight loss in this guide refers to a decrease in "dry" weight.

Most people who lose weight and are concerned about it often have a diminished appetite.

Has your appetite decreased?

Yes, my appetite has decreased.

No, my appetite is still good.

Vaginal discharge, itching and irritation are common symptoms that affect every woman at least once in her life. This guide will help you understand what may be causing your symptoms and will help you to know when it is important to seek medical attention.

It is normal for women to have a small amount of vaginal discharge. Normal vaginal discharge is cervical mucous, which is usually odorless and clear or light in color. Vaginal discharge will change over the course of a monthly menstrual cycle. Usually, vaginal discharge gets thicker and increases in quantity for a time between cycles, with these changes beginning about two weeks before the next period is due.

Most women notice less vaginal discharge after menopause than they had before menopause.

Have you already reached menopause?

Yes, I have started menopause or passed through menopause.

No, I have not reached menopause.

There are several infections that can cause vaginal discharge, itching and irritation. We will discuss the most common ones.

Yeast infections are extremely common in women. They can cause discharge, itching and irritation. Frequently, the symptoms of a vaginal yeast infection can be easily recognized:

• Is your discharge thick and white?

• Does the discharge look like cottage cheese?

• Does it smell yeasty, like bread rising in the oven?

• Do you have a lot of vaginal itching?

Yes, I have at least one of these symptoms.

No, I do not have any of these symptoms.

Sores (ulcers), blisters, pimples and lumps can form inside or nearby the vagina. These changes can occur with or without pain. This guide is intended to provide you with a better understanding of what may be causing your problem, if you have one of these changes. This guide is not intended to substitute for an in-office evaluation by your doctor.

Please choose the concern that fits best:

My concern is an ulcer, blister, or pimple.

My concern is a lump, growth, or swelling.

Where exactly is the lump, growth, or swelling?

On the skin outside the vulva

At the entrance to the vagina or on the vulva

Inside the vagina or bulging out from the vagina

Vomiting is very common in babies. Sometimes it can be entirely normal, like when babies spit up mouthfuls of breastmilk or formula after eating. Sometimes it can be a sign of illness or a blockage somewhere in the intestines. Less commonly, it can even be a sign of accidental poisoning or be caused by a bad bump to the head.

If your child is younger than one year and is vomiting, this health decision guide will help you understand more about what may be causing it and help you know when to call your doctor. Please note, this guide is not meant to take the place of a visit to your doctor's office.

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Vomiting sometimes is a sign of serious illness.

Do any of the following statements describe your baby?

• He has a fever (a rectal temperature reading of 100.4F or higher).

• His stomach looks swollen or hard, and is painful to the touch.

• He is acting like his head hurts (touching it, holding it) or he is having difficulty moving his head.

• He is refusing to drink or eat.

• He hasn't had wet diaper for more than six hours.

• He has not had a bowel movement in several days.

• He seems extremely tired or weak.

• He seems confused.

• He is very cranky (irritable).

• He has dark red spots on his skin that don't get paler when you press on them.

Yes, my baby has one or more of these symptoms.

No, this does not describe my baby.

Nausea with or without vomiting is common in children. Most of the time, the cause is not serious. The symptoms usually go away in a day or two and can be managed at home. However, there are times when you should alert your child's doctor immediately.

Nausea or vomiting associated with one or more of the following symptoms should prompt an immediate call to the doctor's office:

• severe abdominal pain

• a bad headache

• a stiff neck

• fever of 102F (39C) or greater

• frequent diarrhea

• appears dehydrated

• not making urine.

Vomiting that seems to be getting worse or that lasts more than one to two days also should be discussed with your doctor.

If your child is older than one year, this health decision guide will help you understand more about what usually causes children to vomit, and help you know when you should contact your pediatrician for medical care. Please note, this guide is not meant to take the place of a visit to your pediatrician's office.

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Your child is vomiting and you are concerned.

When your child vomits, is it a greenish-yellow color, does it contain any blood, or does it look like coffee grounds?

Yes, this describes my child's vomit.

No, that does not describe my child's vomit.

The disappearance of periods in a woman of reproductive age is called amenorrhea.

If menstrual periods never started, this is referred to as primary amenorrhea. When periods have become established and then stop occurring, doctors refer to this as secondary amenorrhea.

Amenorrhea of either type always requires medical evaluation.

This decision guide is designed to help women with secondary amenorrhea understand what may be causing it and the questions your doctor will want to ask.

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The most common cause of amenorrhea is pregnancy. The standard initial test for all women with secondary amenorrhea is a urine or blood pregnancy test. Even if you do a home pregnancy test and it is negative, your doctor will probably want to repeat it.

Assuming that you are not pregnant, the pattern of your periods before they stopped provides clues to possible causes.

Before your periods stopped, had they been fairly regular?

Yes, I used to have regular periods.

No, my periods were never regular.

We're sorry you have wrist pain!

The goal of this guide is to provide information while awaiting evaluation with your doctor, or for additional information after you have seen him or her. Please keep in mind that this guide is not intended to replace a face-to-face evaluation with your doctor. The diagnoses provided are among the most common that could explain your symptoms, but the list is not exhaustive and there are many other possibilities. In addition, more than one condition may be present at the same time. For example, a person with rheumatoid arthritis could also have tendonitis.

The wrist is prone to pain because it is frequently overused and has a complicated anatomy, with many structures packed into a small space.

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Certain symptoms suggest a serious cause of wrist pain that requires prompt attention. It's important to ask questions about these symptoms first.

Do you have severe wrist pain and any of the following symptoms:

• fever

• redness

• marked swelling

• inability to use the joint

• recent significant trauma (a fall, car accident, etc.)?

Yes, I have one or more of these symptoms.

No, I do not have these symptoms.

Coughs and colds are experienced by most adults two to four times per year and more frequently by children. It is not necessary for you to see a doctor if you are having symptoms of an uncomplicated viral infection in the respiratory tract (ears, nose and sinuses, throat and chest). On the other hand, your doctor should evaluate you if you are having symptoms that suggest a more serious cause, such as a bacterial infection, or if your symptoms aren't manageable with over-the-counter remedies or the passing of time. The purpose of this guide is to review your cough and cold symptoms and to identify specific patterns of illness for which a doctor's evaluation is recommended.

You will encounter a number of questions about your symptoms as you proceed through this program. Your answers to these questions will help give you suggestions most pertinent to you.

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Upper and lower respiratory tract infections commonly cause several symptoms simultaneously. Even so, one symptom probably dominates your illness. Identifying your most dominant symptom can be a good way for us to get started.

What is your most bothersome symptom from the list below?

Cough, wheeze, or breathing difficulty.

Sore throat.

Runny nose, stuffy nose or sneezing.

Hoarse voice or lost voice.

Ear pain.

We're sorry to hear you have gout (or may have gout).

The goal of this guide is to provide information while awaiting evaluation with your doctor or additional information after you have seen him or her. Please keep in mind that this guide is not intended to replace a face-to-face evaluation with your doctor.

First, some background information about this guide and about the condition itself:

Gout is a condition in which one or more joints become inflamed when crystals of urate (also called uric acid) deposit there. Urate is a byproduct of normal bodily functions and is removed from the body by the kidneys.

This guide will ask you a series of questions and depending on your answers, information will be provided and additional questions asked until the conclusion.

Would you first like more general information about gout? Or, would you prefer information more specific to your own situation?

General information about gout

I'd like to learn more about my own specific situation.

Okay. The information below is organized into the following sections:

1) How is gout diagnosed?

2) How severe is your gout?

3) What are the treatment options?

4) What happens over time?

Let's get started!

Diagnosis of gout

I'd like to learn more about my own specific situation.