Health Decision Guides

We're sorry you have hip 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 hip is prone to developing pain in part because its anatomy is complex and because it has a large range of motion. Some of these structures, including the bursae, muscles, tendons, or ligaments are common causes of hip pain, even when the joint itself is fine.

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Certain symptoms suggest the possibility of a serious cause of hip pain that requires evaluation right away.

Do you have hip pain with

• fever

• inability to walk or bear weight

• unintended weight loss

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

Yes, I have one or more of these symptoms.

No, I do not have these symptoms.

Welcome to our Decision Health Guide on Hot Flashes.

This guide is designed for women who are experiencing hot flashes during menopause.

Hot flashes occur when estrogen hormone levels decrease. Hot flashes are felt by about 85% of women during the years immediately before and after menopause. They are uncomfortable, but they are not dangerous. By answering a short series of questions, you will learn about typical hot flashes and ways to help relieve them.

The information provided in our guide is intended to augment the advice from your own doctor. You should always contact you doctor's office if you think your symptoms are even a little atypical. You want to be sure that they are just hot flashes related to menopause.

Click here to review the symptoms of a typical "hot flash."

Hot flash symptoms are remarkably similar for different women. Hot flashes are more common at night. A hot flash begins all of a sudden, with a surprising sensation of heat on your face and upper chest. This feeling of heat quickly spreads to involve much more of your upper body. The sensation lasts between two and four minutes. It is caused by dilating blood vessels near to your skin surface.

Many hot flashes cause women to perspire heavily, even to the point of soaking your clothing. Because a hot flash causes you to lose heat from your skin surface, it drops your body temperature slightly. When the hot flash subsides, your body goes to work trying to restore your core temperature to normal. During this recovery time, you can experience shivering, chills, and occasionally heart palpitations (extra beats or a sensation that your heart is racing).

Hot flashes can interfere with your sleep. Because they can awaken you repeatedly at night, they can cause daytime fatigue. Hot flashes and loss of sleep can interfere with your ability to concentrate on tasks, and for some women hot flashes and loss of sleep can contribute to depression.

Fevers can cause flushing and shivering as well, so take your temperature to make sure you are dealing with hot flashes instead of a fever. A fever is never caused by a menopausal hot flash symptom. If you feel hot and your temperature taken by a thermometer is abnormally high, you are experiencing a fever, not a hot flash.

Having reviewed this description, do you think your hot flash symptoms are typical?

Yes, I am having typical hot flashes.

No, my symptoms are not typical for a hot flash.

Welcome.

People say they feel dizzy when describing a variety of sensations. This guide is designed to address one type of dizziness, a feeling of lightheadedness when you stand up that gets better when you lie down. You will be asked a short series of questions that will lead you to information pertinent to your symptoms.

A lightheaded feeling may vary from a vague sense that your brain is "not clear" to the dramatic symptom of feeling like you will faint when you stand up.

Normally when you stand up, your blood pressure falls for a few seconds, but then rises to make sure that your brain gets enough blood flow. Becoming lightheaded when moving from a lying position to sitting or standing usually means that your blood pressure has fallen inappropriately. Doctors call this postural hypotension.

If your dizziness does not fit this description, then please visit our guide titled New Onset Dizziness.

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Have any of the episodes of lightheadedness resulted in fainting, blacking out, or losing consciousness?

Yes, my lightheadedness has resulted in fainting, blacking out, or losing consciousness.

No, my lightheadedness has not resulted in fainting, blacking out, or losing consciousness.

Welcome to this Guide about Loss of Urine Control for men.

Loss of urine or bladder control (also known as incontinence) is a surprisingly common problem, especially in older men.  It's estimated that 1.5 to five percent of men under age 65 experience problems with urine control.  After age 65 this number increases to between 15 and 30 percent, and up to half of people in nursing homes lose control of their bladder for some or all of the time.

Loss of urine control may develop for a number of reasons.  Problems with the bladder and prostate gland are probably the most common, but in many men the cause lies outside of the urinary tract.  For example, severe constipation and certain medications can reduce bladder control.  In some men, more than one problem is present.

It's also important to realize that some causes of incontinence are quite simple, while others are very serious.  In the same way, some causes of incontinence may be easy to treat, while others may be long-lasting.

Men who experience new loss of urine control should see their doctor. This guide is intended to provide helpful information while you are awaiting further evaluation, or to add to what you may have already learned after an evaluation by your doctor.  Please keep in mind that this information cannot replace a face-to-face evaluation with your own health care provider.

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It's important to know if you've had recent surgery, since men can lose bladder control if the bladder, prostate or other part of the urinary tract is damaged during a medical procedure. Radiation therapy can have the same effect.

Have you had recent surgery or a medical procedure that involves the urinary tract? Examples include

• prostate surgery such as radical prostatectomy or transurethral resection of the prostate (TURP, "roto-rooter" for enlarged prostate)

• bladder catheterization

• cystoscopy

• radiation treatment or radioactive seeds (for prostate cancer).

Yes, I've had recent surgery or another procedure.

Nope, I've had no recent surgery.

This guide will walk you through several questions about your loss of urine control (urinary incontinence). Based on your answers, you will have a better understanding of what may be contributing to your loss of urine control.

Millions of other women share your feelings about this problem. Women (and men) are often reluctant to talk with their doctors about it because it is an embarrassing subject. Also many women wrongly believe that this is just part of growing older and nothing can be done. Today many effective treatments are available to help.

Women often have more than one reason for loss of urine control. To get the most from this guide, explore all the possible answers even if you find one set of answers that fits you the best.

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Sometimes loss of urine control can be caused by a very serious medical problem that needs immediate medical attention. Please consider the following questions.

• Did the loss of control start suddenly, within the last few days?

• Do you have loss of control over your stool or bowel movements as well?

• Do you have any new weakness in your arms or legs?

• Do you have any numbness or tingling?

• Do you have new back pain?

• Did you pass out or lose consciousness when you lost control of your urine?

• Are you or were you slurring your speech?

• Do you or did you experience a loss of vision?

Yes, at least one of these is true for me.

No, none of these are true for me.

Welcome to the Low Back Pain Decision Guide

We're sorry your back is bothering you!

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.

Let's get started.

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Sometimes back pain can be caused by a condition that needs immediate medical evaluation.

Do you have a history of any of the following:

cancer

fever with your back pain

severe or incapacitating low back pain

weight loss

recent significant trauma (such as a fall or car accident)

inability to control your urine or bowels?

Yes to one or more of the above.

No to all of the above.

The scrotum is the pouch below the penis that holds the testicles. Problems affecting the testicles and scrotum can be alarming at first. The good news is that most often the condition is not a serious one. To be certain, a man should contact his doctor if he discovers a new lump or has persistent pain within the scrotum.

This guide will provide you with the more common reasons for your symptoms with suggested actions based on your responses to a short series of questions. The information in the guide is not intended to replace a face-to-face evaluation with a health care provider.

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Let's start by focusing on the nature of your problem. It's most helpful to know if you are concerned about a lump (painful or not painful), or pain without any lump or swelling.

Do you have a lump (whether painful or not), or, do you have pain without a lump?

I have a lump.

I have pain, but no lump.

Welcome to our Decision Guide about Missed or Irregular Periods.

Many women experience absent, short, skipped or irregular menstrual periods at some point in their lives. Through a series of questions, you will learn about the more common possibilities to explain your personal situation.

The guide's purpose is to provide understanding and advice to women who have irregular menstrual periods or who have missed a period. 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.

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The most common reason for missed, skipped or irregular periods is pregnancy, often an unexpected or unplanned pregnancy.

Do you think you are or could be pregnant?

Yes, I am or may be pregnant.

No, I absolutely know that I am not pregnant.

This guide was not designed to substitute for office-based care. Rather, the purpose of this advice guide is to assist you to get the most out of a medical evaluation that is performed by your doctor.

Repeated episodes of nausea and vomiting can arise from a variety of medical causes, including some serious conditions. Vomiting can deplete you of fluids and electrolytes, sorepeated vomiting requires medical treatment if it results in a lasting lightheaded feeling or weakness. Please take the time today to arrange a medical evaluation, if you have not already done so.

Identifying the source of nausea and vomiting can require multiple doctor visits and multiple tests. By completing our advice program before your evaluation, you may be able to more clearly identify symptoms or features related to your nausea that are clues to its cause. Our goal is to help you proceed more quickly with your doctor toward the tests or procedures that can correctly identify the cause. This guide can not adequately consider significant previous medical history that you may have. With a more full understanding of your past health, your own physician may choose a different path to evaluate your symptoms.

You will encounter a number of questions about your symptoms as you proceed through this program. Your answers to these questions will help us to personalize our recommendations for you.

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To begin thinking about your nausea and vomiting, we should know whether the problem is brand new or whether this has been a recurring problem.

How long have you had your symptoms?

My symptoms began within the last five days.

My symptoms have been recurring for more than five days.

Welcome. Nausea and vomiting can make life miserable. When they occur during pregnancy, they can feel like they steal the magic and fun out of being pregnant. It probably won't make you feel any better, but you have lots of company — most women experience some nausea during pregnancy. Although this is sometimes called morning sickness, it can actually occur at any time during the day.

By answering a short series of questions, you can figure out whether your nausea and vomiting are related to your pregnancy or if they might be caused by something else.

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Repeated episodes of vomiting can deplete you of fluids and electrolytes, no matter what the cause.

Have you been vomiting so much that you feel lightheaded or very weak?

Yes, I have.

No, I am not lightheaded or especially weak.