Health Decision Guides

Welcome to the Decision Guide for Swallowing Difficulty.

Swallowing problems can be associated with pain, but that is not always the case. This interactive guide can help you to identify some of the causes that might explain your symptoms and to anticipate the recommendations that your doctor might make for your evaluation.

Swallowing problems need to be evaluated by a doctor because swallowing difficulty can arise from a serious medical problem. This guide is intended to be used as a complement to discussions with your doctor, not as a substitute for evaluation by your doctor.

You will encounter a small number of survey questions about your swallowing symptoms as you proceed through this program. Your answers to these questions will help us apply our information to your personal circumstances.

Let's get started.

Is your swallowing problem brand new (present for a day or less)?

Yes, my problem is brand new.

No, my problem has been present for longer.

Welcome to our Decision Guide on Swollen Glands.

The term "swollen glands" is often equated with enlarged lymph nodes. However, lymph nodes are not actually glands. They are small bundles of white blood cells. One of the ways the body's immune system responds to infections and inflammation is to greatly increase the number of white cells in the lymph nodes causing them to swell.

Most often swollen lymph nodes are caused by an infection or some other benign condition. Less commonly, lymph nodes enlarge related to cancer.

We have lymph nodes throughout our bodies. The parts of the body where people and their doctors can see or feel swollen lymph nodes include the neck, armpit, and groin areas.

This guide will help you understand the most common reasons for swollen glands that you may feel in one or multiple parts of your body.

If you feel swollen glands only in your neck and no where else, your will learn more about your condition by visiting our Health Decision Guide called Swollen Glands in the Neck. If you are not sure, continue with this guide and also visit the Swollen Glands in the Neck.

Click here to begin.

This guide is for informational purposes only. It is not intended to replace the evaluation and advice of a health care professional.

Glands that remain persistently swollen for more than one month require evaluation by your doctor.

Have your glands been swollen for more than one month?

Yes, they are swollen for more than one month.

No, they are swollen for less than one month.

Cough is very common in children. When your child coughs, he is pushing air out of his lungs to clear his breathing tubes, which can be blocked for all sorts of reasons. Infections (from the mild to the more serious pneumonia, asthma, and allergies are among the more common causes, but cough can be caused by other things as well.

Answering the following questions in this health decision guide will help you understand more about what usually causes children to cough, and help you know when you should contact your doctor for medical care. Please note, this guide is not meant to take the place of a visit to your doctor's office.

Click here to begin.

Coughing sometimes can be a sign of a serious illness. If your child is coughing, please read the following carefully.

Do any of the following other statements describe your child?

• When my child breathes, I can see his nostrils flare, his belly move out, his ribs stick out, and/or his neck muscles tighten.

• When my child breathes in, he makes a whistling or high-pitched noise.

• He grunts when he breathes out.

• His lips, mouth or fingertips are blue.

• He is pale.

• He can not talk or can not finish a sentence without stopping to take a breath.

• He has swelling of the face, lips, eyes, or neck.

• He has hives.

• He is sleepier than usual for the time of day.

• He is not moving normally.

• He is not answering questions normally or seems confused.

Yes, one or more of these statements describes my child.

No, none of these statements describe my child.

Welcome to this symptom guide about tinnitus. We're sorry to hear you have this problem!

While tinnitus is often called ringing in the ears, that's just one way people with tinnitus describe the problem. Others describe hearing a hissing, whooshing, roaring, or buzzing sound, or experiencing a beating sensation in the ear. So, for the purposes of this guide, we'll stick with the more general term, tinnitus.

There are a number of causes of tinnitus. This guide will cover some of the most common, but it is not exhaustive; rarer causes will not be covered. In addition, tinnitus results from just about any cause of hearing loss. For example, excessive buildup of wax in the ears may cause hearing loss and tinnitus. However, this guide will focus on tinnitus rather than hearing loss.

By answering a short series of questions, you will learn about the more common reasons for tinnitus and the cause that most likely applies to you. This guide is not intended to replace a face-to-face meeting with your doctor about these symptoms. Many causes of tinnitus require an in-person examination and testing to diagnose.

Let's get started.

Have you had any significant injury or trauma to your head, neck, or ears recently?

Yes, I have had recent injury or trauma.

No, fortunately, I've had no injury or trauma recently.

Good!

Because certain causes of tinnitus are more likely in older people, the next question is about your age.

Are you over the age of 55?

Yes, I'm over the age of 55.

No, I'm 55 or younger.

Welcome to our Health Decision Guide for women who are concerned about excessive body and facial hair (called hirsutism).

By answering a short series of questions, you will learn about the most common reasons for hirsutism.

The guide is intended to provide information. It is not intended to make a specific diagnosis; nor is meant to replace a face-to-face evaluation with your doctor or other health care professional.

Click here to start.

Approximately 10% of American women believe that they have more body hair than they should.

There is great variation in hair pattern in different ethnic groups and in people from different parts of the world. Mediterranean women and those from the Near East and India tend to have more body hair, but this is completely normal for them. Asian American and Native American women tend to have less body hair, and that pattern is normal for them.

There is also variation between families that should be kept in mind in deciding whether hair growth is excessive.

Do you have more body hair than your female relatives?

Yes, I have more body hair than my female relatives.

No, I don't have more body hair than my female relatives.

Welcome to the Symptom Guide about tooth and jaw pain. We're sorry you are in pain!

This guide is intended for people who have jaw, gum, or tooth pain.

The goal of this guide is to provide information while awaiting evaluation with your dentist, doctor, or other health professional. Or, it may be useful for additional information after you've seen a healthcare provider. Please keep in mind that this guide is not intended to replace a face-to-face evaluation with your doctor or dentist. 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.

First off, it's important to get emergency care if your symptoms sound like a dangerous condition or an immediate threat to your health. For example, jaw pain can sometimes be a symptom of angina or a heart attack.

Are you experiencing jaw pain when you exert yourself or with emotional reactions? Do you have jaw pain that is associated with chest pain, shortness of breath, sweats, or nausea?

Yes, I have one or more of these symptoms.

No, I do not have any of these symptoms.

That's good. That makes a heart-related cause of your symptoms less likely.

Do you have jaw or tooth pain along with facial swelling, high fever, shaking chills, a severe headache, or feeling faint?

Yes, I do have those symptoms.

No, I do not have any of these symptoms.

Welcome to the symptom guide on hand tremor. This guide will ask you a series of questions about involuntary hand shaking, trembling, or what is more commonly called tremors.

Keep in mind that, at least to some degree, everyone has a tremor. It's simply impossible to keep your hands perfectly still! So, deciding when involuntary movement of the hands is abnormal can be tricky. And the range of conditions that can cause a hand tremor is vast. Be sure to see your doctor if you've noticed you have tremors, especially if they are getting worse.

This guide is not intended to replace a face-to-face evaluation with your doctor. The goal of this guide is to provide information while awaiting evaluation with your doctor or other health professional. Or, it may be useful for additional information after you've seen a healthcare provider.

Finally, the diagnoses provided here 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 tremors could have a thyroid problem and have a familial tremor.

Click here to get started.

First, we'd like to ask about symptoms related to the most common causes of hand tremors.

Does your tremor stop when you're at rest, increase in certain positions (such as with your arms and hands outstretched), and decrease when you try to use your hands?

Yes, that sounds like me.

No, that's not the trouble I have.

Welcome to our guide, Understanding New and Severe Abdominal Pain.

New and severe abdominal pain always needs to be closely evaluated by a doctor. It is frequently a sign of serious illness. This guide was not designed to substitute for office-based care.

If you are having new and severe abdominal pain, this pain may be frightening to you because of its mystery -- the abdomen contains many important organs that could be the source of your pain. It may seem like a daunting task for a doctor to diagnose the source of your symptom; in fact, there are more than a hundred medical conditions that commonly result in abdominal pain.

Despite the long list of possible causes for abdominal pain, your doctor will be likely be able to narrow down the possibilities to a short list after initial evaluation. Your experience may be less frightening to you if you understand the way that doctors begin to make sense of your symptom, and the reasons for ordering certain tests.

The purpose of this guide is to help you to understand a common way that doctors think through abdominal pain. This guide may also enable you to provide a more helpful medical history during your doctor's evaluation.

This guide was intended for people with new abdominal pain -- pain that has been present for less than two weeks. If your pain has been present for longer or is recurring from previous episodes, please visit our Guide for Recurring Abdominal Pain.

Click here to begin.

In this guide, we will start by identifying where you feel the pain most strongly. The middle third refers to an up-and-down stripe from the bottom center of your ribs, down through your navel (belly button) and ending above your pelvic bone. The sides of the abdomen refer to the outer one-third on each side of the middle third.

When your body was first forming as an embryo, a part of your development included the "migration" or rearrangement of several of your body organs. The nerves that connected to your organs did not re-wire as the organs rearranged. For this reason, some organs cause pain in a location different from where they are now located.

A specific location of pain in your abdomen is a very valuable clue, but it does not always lay blame on the organs that are located in its vicinity.

Please select the location where your pain is felt most strongly:

In the middle third of my abdomen

On one side or the other

All over my abdomen

Weight loss in children is always concerning. The only exception is when overweight children lose weight under a doctor's supervision.

Any unexplained weight loss in a child warrants a call to the doctor. This decision guide does not replace that call and should not delay it, but will give you an idea of some of the questions the doctor will have, and what tests or treatments may be ordered.

Children lose weight when they are either not getting enough calories or are burning up more calories than usual due to illness or other reasons. Let's look at the possible causes of weight loss in your child.

Click here to continue.

Along with the weight loss, does your child have any of the following?

- Fever

- Vomiting and/or diarrhea

- Cough, sore throat, ear pain or chest pain

- Decreased urination

- Increased sleepiness

No, my child does not have any of these.

Yes, my child has one or more of these.

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.

Please click here to continue.

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.