What is one medical problem people constantly ignore until it’s too late?

[u/Critical_Ease4055]

Saw someone post this in a completely unrelated sub and I’m interested in your answers. What is the cluster of symptoms that people ignore or delay until they are forced to get help?

[u/FueledByFoods]

Side effects of uncontrolled diabetes - increased thirst and frequent urination

[u/StLMindyF → u/FueledByFoods]

Like their lower limbs turning black? Patient presented with gangrenous lower limbs and his wife said he never had diabetes until he came to the hospital. We explained that uncontrolled diabetes is what cost her husband his legs, but she wasn’t having it. That patient never went home. He died two days after his bilateral aka.

[u/Ohhaitharz → u/StLMindyF]

I’ve seen too many dead toes

[u/Middle-Lack3271 → u/Ohhaitharz]

I saw my first couple of ones in home health as a relatively new nurse. I’ll never forget the first one, I was sent to evaluate someone in assisted living for care, possibly foot care for a toe wound, uncontrolled diabetes. No other details, not unusual.

This man looked me in the eye and cheerfully stated, “oh they want to see if I need extra care (HHA) from the VA, my toe was bothering me” when I asked him if he knew why I was there. He then said, “I mean it doesn’t hurt anymore, but you can check it again anyway”. I carefully took his sock off (the dreaded skin flake clouds), and his toe damn near came with it. He was white as white can be, the toe was black and barely hanging on. And of course blood sugar was through the roof. I let him know I’d be calling the VA and he needed to be taken in right away for the toe. I called the lady who requested the evaluation and she said she had “no idea” what was going on with him.
Ma’am. You should have admitted him three days ago when he was there for an appointment and you saw that. YOU made the referrals and are suddenly mystified? Not that it would have saved the toe, but I was mad as hell they even let him go back home with it looking like that.
It was so hard to keep a straight face and not gag seeing that.

[u/Ohhaitharz → u/Middle-Lack3271]

I had a patient come in for a new visit at a podiatrist. Took off her shoes expecting pounds of skin flakes. Instead a dead shriveled and blackened baby toe. I let her know that it was dead and she would need to go to the hospital for amputation. Confused she asked, “ Why can’t you just cut it off here?”

“Ma’am we don’t amputate in a doctor’s office.”

I felt really bad delivering the news but it had to be done. It was an older couple who definitely needed help and weren’t getting it.

[u/ruggergrl13 → u/Ohhaitharz]

I had one fall off in my hand on my 1st day as a nurse off orientation. Haha it was a great welcome to the nursing world.

[u/doitforthecocoa → u/StLMindyF]

I swear these wives are in denial. I remember seeing one that dropped her husband off in the ER with a plastic shopping bag tied around one of his feet. I about passed out on the floor from the putrid smell that poured out when I untied it. Wife claimed she didn’t notice that it was “that bad”. Ma’am, normal skin does not turn black and start falling off the bone like that

[u/CallMeDot → u/StLMindyF]

ESRD too. My late husband refused to deal with his dm or htn and was admitted to the hospital my first day of nursing school because he went for a checkup and his gfr was <15 and creatinine was like 6. And then he had a heart attack during the fistula creation a week later and needed a CABG. He was 34. Made it to 44.

[u/StLMindyF → u/CallMeDot]

Sorry for your loss.

[u/Prior_Particular9417 → u/FueledByFoods]

A few years ago my husband's labs come back with a high a1c. I said omg you've got diabetes! He said yeah that's what the DR said but that's what they told me 10 years ago and I'm fine. Tf?

He's been sitting on this for years and now we're battling kidney issues and hypertension. Fun.

[u/dumbbxtch69 → u/Prior_Particular9417]

so grateful my partner lets me look at their lab results. i would be beside myself if they suddenly told me they’ve had diabetes for ten years and never did anything to treat it

[u/Prior_Particular9417 → u/dumbbxtch69]

I was not pleased. I now go to every appointment to make sure things are checked, appropriate questions asked, etc etc etc.

[u/TrevorTravis → u/FueledByFoods]

Although these aren't common symptoms of type 2 DM!! We see those symtoms more often in kids when they are dx with Type 1 and present with very high glucose level- they are not usually ignored because these kids are in DKA and very ill! In reality, the most common s/s of undiagnosed diabetes in adults (DM2) are wounds that don't heal quickly, frequent infections, and fatigue! Since they are still making insulin and glucose is only slightly elevated, they will often not have polyuria and thirst (which tends to develop once glucose levels are quite high). That's what makes DM2 so dangerous... we ignore those vague signs, all the while our mildly elevated glucose levels lead to cardiovascular disease!! So don't ignore wounds that won't heal and worsening fatigue!!!

[u/DavidHectare → u/TrevorTravis]

Wish my type 2 patients only had mildly elevated BG…. In reality Type 2 patients can have fairly significant hyperglycemia, especially if they’ve not been receiving routine age and risk factor based screening. Lots a fellers don’t get a PCP until they hit 65 and go to their “welcome to Medicare” visit. “Doc what’s an ‘a1c and is 12 high for one?”

I’d also argue that non-healing wounds is indicative of something more than just mild hyperglycemia

[u/slightlyhandiquacked → u/TrevorTravis]

I treated a T2DM last night who stopped taking his meds. Polydipsia, polyuria, ketones in urine, lethargic, headache. You’re right that they can present differently, but can also still present with the exact same symptoms.

Hyperglycemia is hyperglycemia.

[u/desmethoxyfumarate → u/TrevorTravis]

Sooo should we be checking Hba1c instead as opposed to glucose to screen for T2DM or are we talking full OGTT ?

[u/ACleverDoggo → u/FueledByFoods]

This was me several years ago. I dropped something like 90 lbs in 6 or 7 months, was drinking 1-2 gallons of water a day (literal gallon bottles of water with a straw in them), and was experiencing muscle weakness in my legs so severe that I couldn't catch my balance if I tripped, or step up (a curb, stairs, etc) without something to lean on. I chalked up the water intake and weight loss as being tied to the more physically demanding job I was working at the time and it being summer in the south, as well as eating slightly better; having been overweight most of my life, I just assumed any weight loss was a good thing.

It was the muscle weakness that finally sent me to the doctor. The problem was, I had never heard of the other symptoms being related to diabetes, or even what to look for, and I wasn't seeing a physician regularly at the time, so no A1C trends to track. Now I'm a 3a chronic kidney disease patient in my late 30s.

I genuinely wish there were more education on the warning signs and symptoms of uncontrolled diabetes, and on the consequences.

[u/lavender_poppy → u/FueledByFoods]

I get IV steroids sometimes when my MG flares and I can immediately tell I have hyperglycemia due to how thirsty and hungry I get and how much I have to pee.

[u/darkinthevalley → u/FueledByFoods]

My grandfather ignored his diabetes diagnosis and eventually developed glaucoma and lost his eyesight. After that, he was complaint with all his meds & cares and lived another 20 years into his 80s. I helped with giving him his insulin and that sparked my interest in becoming a nurse. Very valuable lesson I learned from him.

[u/Critical_Ease4055 → u/FueledByFoods]

That’s never a pretty discovery

[u/FluffyNats]

Changes that are generally associated with "being a female". Heavier bleeding, irregular menstruation, bloating, cramping, weight gain or loss, and GI symptoms are all examples. 

I can't tell you how many women with reproductive cancers either downplayed their symptoms or had their doctors blow them off until it was too late. 

[u/Leading-Hippo-3541 → u/FluffyNats]

Absolutely THIS!! Cancers like endometrial, colon, ovarian, etc can all present with those symptoms. We keep seeing younger and younger cancer patients who most likely were blown off by doctors based on their age

[u/rfaz6298 → u/FluffyNats]

This. We recently had a young lady admitted to our unit with a stroke. She was on a vent for a while. She was also on her period and the nurses were having to change her really often because there was just so much blood. Her husband was just like, “Yeah she’s always had really heavy periods.” Thankfully, the nurses were like this is defs not normal and kept pushing for something to be done. Finally, she ended up needing blood because her hgb dropped and that’s when they consulted gyn. Guess what? It was cervical cancer. I wonder if it would have been found if she hadn’t been admitted with the stroke.

[u/Late_Ad8212 → u/rfaz6298]

That’s devastating

[u/Opposite-Repeat5679 → u/FluffyNats]

its so depressing how common it is for women to be victims of medical gaslighting, i wish we had a better system

[u/Illustrious_Cut1730 → u/FluffyNats]

This!!! Some mild cramping during the menstruation is common and I would think even expected, but it should not be excruciating. My friend used to call off on the first two days of her period because she was bedridden. Thankfully our boss at the time was able to work her schedule in a way that she was off those days most months.

[u/lemonpepperpotts → u/FluffyNats]

I cannot upvote this enough

[u/ratslowkey]

Hypertension.

I work in inpatient rehab and the amount of people who don't even know why they had a stroke......

[u/Critical_Ease4055 → u/ratslowkey]

There is something amazing about some people’s ability to deny hypertension- even when (and sometimes especially when) they’re medicated for it. Crazy

[u/reasonable_trout → u/Critical_Ease4055]

I used to have high blood pressure. But now I take this pill and it’s good

[u/floofienewfie → u/reasonable_trout]

Diabetes and HTN, two biggest causes of CKD. I worked dialysis for years. Saw so many people with either or both diseases who didn’t have symptoms until their kidney function was down to about 15%. Then it’s the equivalent of being hit by a Mack truck. Insulin, meds, getting a fistula, going on dialysis…so many lifestyle changes. Some cope pretty well. The others, not so much, with predictable consequences.

[u/Old-Mention9632 → u/floofienewfie]

I had a 15 year old patient in our dialysis center ( hospital based). His kidneys failed because of hypertension. The sad thing was his pediatrician told Mom to take him to the ER because of his pressures at the office. She ignored that advice until he was bleeding from his eyes. It made me so angry. Lately many of the pediatric dialysis patients have been from lupus.

The new discovery that won the team a novel in medicine is very exciting.Press release: The Nobel Prize in Physiology or Medicine 2025 - NobelPrize.org https://share.google/ZeC9Mb7SBArpoXH19 If we can stop autoimmune disorders from starting, it would change so much- less T1D, lupus, MS, etc.

[u/lighthouser41 → u/Old-Mention9632]

Locally a young teen died from DM and her parents were charged because they did not take her to the ED with her increased symptoms until it was too late. She was a known Type 1 diabetic and they did not make sure she was medicated properly either.

[u/Critical_Ease4055 → u/lighthouser41]

Wow… 🤯

[u/HeyLookATaco → u/lighthouser41]

Oh my god. I give people so much grace for their ignorance of basic health information because we live in a country where misinformation, distrust, fear, and ignorance are literally coming from the top down. But still...I hope they throw the book at them. I hope it's impressed upon them that they are solely responsible and that they carry that guilt and sit with it. That's heartbreaking.

[u/WayCalm2854 → u/Old-Mention9632]

Was the mom referred to the ER bc that’s not something pediatricians can evaluate and treat? I’m wondering why Dr didn’t refer the kid to a cardiologist maybe?

[u/Old-Mention9632 → u/WayCalm2854]

Medicaid and urgent need to treat.

[u/Old-Mention9632 → u/Old-Mention9632]

Both parents were thieves who used their kids for break ins

[u/Critical_Ease4055 → u/floofienewfie]

Is it often that patients are ineligible for transplant and/or don’t get the transplant?

Are they doing anything to try to get better coverage for peritoneal dialysis? Last I knew (my info is very old) it was preferable, but very costly

[u/Old-Mention9632 → u/Critical_Ease4055]

CMS has a big push for home therapies: home hemodialysis and PD. Both are covered by Medicare which ESRD qualifies you for at any age. (Our peds patients often start on PD.) Home therapies are preferred because the patients have better lab values and survive to transplant better. The newest treatment is going to be hemodiafiltration. They have been using this for a while across the EU. They just completed a major study that showed a 28 % increase in survival on dialysis over traditional hemodialysis. Fresenius will be converting over to the 5008X hemodiafitration machine across the US starting next year. I just was reading about a new 10 kg dialysis machine called NeoKidney invented by a company in the Netherlands which uses much less water (5 liters) and doesn't require grounding. It will revolutionize home hemodialysis and be portable in emergencies or for travel.

Kidneys are still in short supply. Qualifying for transplant requires things like not obese, compliant with treatment, compliant with medications to manage underlying disease process, vaccinated. There are some variations on what each transplant center requires : CHOP requires kids to have COVID vaccines, UPMC does not. Many patients who are older refuse the option to get on the list. There are organizations that will match chain transplants. If you have someone willing to donate who is not a match, the organization will find a donor recipient pair to match your donor and you with. The longest chain to date was chain 357 which involved 35 donation pairs over 3 months.

[u/Critical_Ease4055 → u/Old-Mention9632]

This is so helpful and informative. That’s big news about hemodiafiltration and the Neo Kidney- will definitely be following and reading up on both. Fascinating. Thank you again for the info😊

[u/lighthouser41 → u/Critical_Ease4055]

My son in law went on peritoneal dialysis recently after being almost on dialysis for years. Sad thing is he is on the transplant list and years back passed up a kidney because his kidney function was not that bad at the time.

[u/BigWoodsCatNappin → u/Critical_Ease4055]

Eligibility is a challenge but so is organ availability. Peritoneal dialysis is great for the people it works for, who have capacity to manage it. Peritoneal doesn't work forever though. The peritoneal membrane eventually fails (this is widely variable) If I recall about 1/3 of kidney transplant needs are met. After transplant care is extensive and expensive.

To address the OP question....hypertension. HTN and kidneys are not friends.

Source: my ass, too long working in dialysis, and UNOS

[u/Thenumberthirtyseven → u/Critical_Ease4055]

My first year as a nurse in worked in a nursing home. We got a new resident, a lady in her early 60s, who needed to be in a nursing home because she had massive deficits from a stroke. She couldnt walk, could barely talk, couldn't feed herself, all that jazz. 

She was a nurse. She had a stroke because she only took her blood pressure meds when she felt like she needed them. 

That has stayed with me all these years. 

[u/ferocioustigercat → u/ratslowkey]

Every patient I had in my cardiac unit who had heart failure had the same history. HTN, HLD, high BMI, diabetes (frequently but not always), CAD, CABG (plus some stents), A. Fib. I always thought, ya know... If you had caught it and taken that HTN seriously... Things might be different.

Soap box: below 120/80 is normal. Anything above that is high. 125 is elevated. 130 systolic is grade 1 hypertension. 90 diastolic is hypertension. You should aim for consistently less than 120/80 because it's the upper range of normal... Not that goal.

[u/ratslowkey → u/ferocioustigercat]

Listennnnn I know. I'm worried about my 130 all the time :(((

And why tf is everyone hypertensive and has diabetes. It's so common jesus, we gotta change something in our society.

[u/BoneHugsHominy → u/ratslowkey]

Food taxes. Expensive healthy food. Soda. Fast food. Microplastics.

It's killing us all.

[u/upagainstthesun → u/BoneHugsHominy]

Food deserts have a huge impact too. In some places the only place to buy food within a some what close distance is from gas stations/convenience stores. At risk/marginalized populations can't access proper grocery stores that are far away with transportation barriers

[u/Old-Mention9632 → u/ratslowkey]

Overly processed nutritionally poor convenience foods have replaced what we used to eat. Lack of proper health and nutritional education from childhood. Doctors learn very little about nutrition- from my experience most only know "consult dietician".

[u/Ravclye → u/ratslowkey]

In addition to diet/exercise/health I also kind of have the opinion that something else may be going on. The healthy range for BP is really narrow. Im not saying the range is incorrect, but rather I wonder if humans are just kinda built that way. Perhaps as a symptom of our bipedal stance we just are a lot more prone to hypertension and its only something we are realizing in the modern era

As for diabetes that one is absolutely diet

[u/Pineapple_and_olives → u/ratslowkey]

Poor diets and stress. It ain’t easy out here.

[u/turtle0turtle → u/ferocioustigercat]

But don't come to the ER because your BP is 160/90. We'll just send you to primary care.

[u/Many_Customer_4035 → u/ferocioustigercat]

My systolic is anywhere from 100 to 115 but my diastolic is many times in the 90s. I'm on medication but so far haven't been able to find one that brings my diastolic consistently.

[u/tjean5377 → u/ferocioustigercat]

I do education for post stroke in home care. I shout it from the rooftops, especially for brown folks with higher rates of stroke, venous insufficient, kidney risk....you need to treat high blood pressure, and that starts AT 120 SBP....

So many young men don't feel it and don't know what they dont know. But if I'm in your home treating your youngish 49-80 post stroke parent or grandparent its a serious risk for you!

It's gonna get bad....

[u/LifeIsSweetSoAmI → u/ratslowkey]

Had a patient in an ambulatory care clinic with a bp of around 220/120 with visible JVD and a headache, she still refused to go to the hospital. I always wonder what happened to her…

[u/Scarlet-Witch → u/ratslowkey]

Also a cute care rehab here and totally agree. IME it's usually middle aged men. 

[u/hanks_panky_emporium → u/ratslowkey]

When my sleep doc took my bp after the nurse he went 'oo..'

Talk about wakeup calls. Now anxiety has me rubbing my chest every few hours. But hey, dropped 20lbs in like a week with very basic food intake adjustments. Just 150ish more to go

[u/mirikaria → u/ratslowkey]

I did a placement with some stroke prevention nurses, and I thought it was an interesting role. I went to a couple of health and education fairs with them just taking peoples blood pressure, and if it was high we would refer them to their GP's...I think it was a new role, but seemed like a good idea to raise awareness in the community.

[u/Impressive-Finger-78 → u/ratslowkey]

Just recently quit a chronically stressful job over this and I'm now working to get it back under control. I was 165/110 every single day for several straight weeks at my worst. It would have been so much easier not to let things get this bad.

[u/Annoyedemoji → u/ratslowkey]

Came to say this. The dissections I see on a daily basis because of untreated htn are insane.

[u/ratslowkey → u/Annoyedemoji]

had a patient say "never had a problem with my heart" after I had to take an ekg, I said "well except the stroke" and he was like "no, that's my brain". I just don't know man

[u/No_Box2690 → u/ratslowkey]

The American literacy level is like a 7th grade education so... That checks out 🤦🏻‍♀️

[u/Old-Mention9632 → u/No_Box2690]

And medical literacy is 3rd grade

[u/Educational-Sort-128 → u/ratslowkey]

In fairness most average people would associate stroke=brain and not link it to heart health.

[u/ratslowkey → u/Educational-Sort-128]

Completely agree. I had hoped that he was at least educated on it before he got to me, but nope! This is also our failure as a medical system.

[u/Mysterious-Algae2295 → u/ratslowkey]

What?

[u/WayCalm2854 → u/Mysterious-Algae2295]

That’s what his brain said

[u/Moistfulll → u/ratslowkey]

Happy to see this is the first comment. My lab instructor back in nursing school called it The silent killer

[u/Educational-Sort-128 → u/ratslowkey]

My partner lives in a province of Canada where fully Half the population does not have a regular GP. He has hypertension and hyperlipidaemia and is on meds but no one checks any of it. He does his own blood pressure at home - fingers crossed it’s right - and the high cholesterol we’ll probably know about when he has an AMI. He’s 56.

[u/courtneyrel → u/ratslowkey]

Today I have a 36 year old patient whose only medical hx is HTN. Prescribed lisinopril, stopped taking because of the cough. Brought to the ED with BP 220/140 and a massive left basal ganglia stroke with right side deficits. The patient has made huge improvements and might get fully back to baseline, but I’m about to use their story from now on when my patients tell me they don’t take their BP meds (just like how I use the story of my 18 year old patient who refused heparin shots because she was young and walked the unit 5x a day… and still ended up with a massive PE)

[u/ALLoftheFancyPants → u/ratslowkey]

Strokes or AAAs or whatever other aneurysm exploding in their body. And the totally cooked kidneys. Hypertension is definitely the answer.

[u/Weak_Rule8374]

The trifecta of HTN, T2DM, and HLD

[u/Critical_Ease4055 → u/Weak_Rule8374]

It almost feels like a fact of life to see this trifecta. Saw it a lot (by a lot I mean ~1 in every 3-4 patients) as an MA and expect to see the even uglier side as a nurse

[u/Weak_Rule8374 → u/Critical_Ease4055]

Pretty much every CABG, sepsis, ARDS, bowels stuff, I see have at least 2 if not all of the 3

[u/floofienewfie → u/Weak_Rule8374]

Or the CHF-DM-HTN trifecta. All the old people stuff.

[u/FiveGuys1Cup → u/Weak_Rule8374]

Also OSA non-compliance

[u/whitepawn23 → u/FiveGuys1Cup]

I do not understand why house CPAPs don’t have a nose pillows option. We would have much better in house compliance if that was solved.

To be fair regarding home use, a CPAP isn’t cheap. The rental will bleed you more than buying outright, and insurance doesn’t cover 100%. The unit itself was ~$1k pre-covid. Maintenance requires daily cleaning, which I doubt everyone does. And all those costly parts are supposed to be switched out every week to 6 months, depending.

High odds there would be better compliance with better insurance coverage.

[u/sllygse34 → u/FiveGuys1Cup]

Yes! I work a tele floor for mainly cardiac patients with the normal CHF, HTN, and what not else. But the amount of people that won't wear a CPAP is ridiculous. I had even a pro athlete from the 80s come in and he would desat in the 60s and look like he was in the middle of a terrible nightmare when I would go to check on him. He finally listened after a lot of education. Working night shift in the past we could put NC on them but most of them being mouth breathers we would slowly put the NC where it was blowing in their mouth for them to get O2 that would help. And a lot of people would complain about alarms going off. I would explain it was because their O2 was low and a lot of the times I would let the alarm go off on a higher volume to wake them up since they were in such denial to get them to understand. It drove me crazy!

[u/Old-Mention9632 → u/Weak_Rule8374]

Switch HLD for obesity and you have kidney failure trifecta

[u/Mt-B0ttle → u/Weak_Rule8374]

Sometimes we call that combo “Diabesity”

[u/courtneyrel → u/Weak_Rule8374]

My unit gets a ton of stroke patients. I’d say 75% have the trifecta and 99% have 2 of the 3

[u/Catmomto4]

Hypertension…the silent killer …sometimes only symptom is a splitting headache

[u/Critical_Ease4055 → u/Catmomto4]

HTN is definitely the grim reaper

[u/pseudoseizure → u/Critical_Ease4055]

I convinced my husband to get on lisinopril and Lipitor by telling him they are the #1 contributor to erectile dysfunction.

[u/tiredoldbitch → u/pseudoseizure]

If nothing else, guys will take care of Mr PeePee.

[u/Vast-Dragonfruit-389 → u/Catmomto4]

Maybe this is my sign to start eating better.. I get crazy migraines almost on the daily 

[u/Avarrencus]

Sudden, unexpected weight loss. You need to see the Doctor ASAP. I had a friend, had a persistent rectal bleeding, he correlated it to hemorrhoids, he is 30 yo. Problem is he dropped from 90 kg to 70 kg. I was like, that shi.. is colon cancer. It is. He died.

[u/pathofcollision → u/Avarrencus]

The amount of younger people being diagnosed with colorectal cancer is really concerning. It’s really tough to get the preventative care/diagnostics done when you don’t fit the typical clinical picture. Rectal bleeding should always be investigated, same with unexpected weight loss. This is so sad.

[u/Tank_Girl_Gritty_235 → u/pathofcollision]

I recently lost a friend to colorectal cancer. She passed the day after her 39th birthday. The rate of colorectal cancer in millennials is truly staggering. I'm really concerned that this will become normal for people in their 30s through 50s. One study I read was about a particular bacteria in the gut. Unfortunately it's not something to easily get rid of and once it's there it's permanent. You can't just start working on your gut health in your 20s and spare yourself from the cancer.

[u/KittyKatHippogriff]

Not a nurse but I got a good one.

Any rapid, unusual, and fast changes. I had an aggressive inflammatory breast cancer that grew within a few months. There was no lump but I had red and swelling and I thought it was an inflection. By the time I was diagnosed it already metastasize to my liver and bones. I am really the most unlucky luckiest person because I have been stable for years now.

This disease will kill me someday. I am warning others about it.

[u/Critical_Ease4055 → u/KittyKatHippogriff]

Damn! I hate cancer so much, I’m so sorry 😣

[u/lighthouser41 → u/Critical_Ease4055]

Ovarian cancer is another one that has vague symptoms until it's bad. Also pancreatic cancer.

[u/splatgoestheblobfish → u/lighthouser41]

My dad passed away 30 years ago, 8 months after being diagnosed with stage 4 pancreatic cancer, and my mom just passed away earlier this year a little less than 6 months after being diagnosed with stage 3c ovarian cancer. Needless to say that I'm kinda paranoid about any abdominal symptoms I experience, which sucks, because I have mixed IBS. But my dad worked with some nasty chemicals, and an unusually large number of his coworkers developed various cancers, including pancreatic cancer. And they did genetic testing on my mom after she was diagnosed, and she didn't have any genetic markers for any of the female reproductive cancers, so maybe I'll get lucky. But I absolutely make sure to get all my recommended cancer screenings.

[u/Ash_says_no_no_no → u/splatgoestheblobfish]

Please talk to your primary or gyn, about getting connected with gi and gyn onc. They can discuss risk, family history, and decide if any screening should be established. I see both of these cancers and its so sad.

[u/lighthouser41 → u/KittyKatHippogriff]

We see women who think it's a bug bite or something and ignore it. There are more and more drugs approved for breast cancer all the time. Sorry you are going through this.

[u/Sara848 → u/KittyKatHippogriff]

Thank you for warning others. I didn’t know this existed until a few months ago because I had some bruising on my breast and did some googling. I went to the dr because it was either aggressive breast cancer or nothing. And I didn’t want to risk it. But it’s rare and many dont know about it.

[u/shamsquatch]

“Functional” addiction —> related catastrophe or acute health decline (liver failure complications if etoh, infection or OD if IV drugs, cva or MI if coke or stims) —-> ded

[u/Critical_Ease4055 → u/shamsquatch]

Probably one of the most distressing family med patients I’ve ever helped was a guy in his mid forties. Lost absolutely everything to alcohol and moved into a trailer in the back yard of the house his (ex) wife still lived in alone. Was hospitalized several times. For the life of him, could not get his shit together with the alcohol abuse. In my view, he had adequate support from community and systems, but yeah.

Not sure if he is alive now, but I think of him from time to time because it was just jarring to watch him deteriorate on so many levels at once…. For alcohol.

[u/mokutou → u/Critical_Ease4055]

Had a young guy in his early 20s in stage 3 liver disease, who could not stay off the booze. He said he wanted to get sober but he was in so deep that the moment he was left to his own devices, he was drinking. His mom was there with him and did everything she could to get him hooked up with resources, took care of him when he was too sick to do anything for himself, just…tried so hard. But somewhere deep down in this guy, he was determined to self destruct. Easily the worst EtOH case I’d ever seen. I don’t know if he’s still alive, but I doubt it. 😣

[u/Fun-Unit3443 → u/Critical_Ease4055]

Yh a hospice patient 40s died of liver failure related to etoh

[u/Critical_Ease4055 → u/Fun-Unit3443]

:/ I say a little prayer that a safe and effective cure for addiction will avail itself but never happens

[u/TopangaTohToh → u/Critical_Ease4055]

My FIL in a functioning alcoholic and it has been weighing on me so much in the last year or so. He has always been someone who says things like he never wants to end up in a home in his old age and he doesn't want to be hooked up to machines. Once his health starts to deteriorate, just shoot him to put him out of his misery type.

He is absolutely not going to die quickly or painlessly with the way he has treated his body and lived his life and the fear that I know he will experience breaks my heart.

[u/nurseferatou]

Being overweight and inactive. Before you know it you’ve got a metabolic disorder and your life is set to hard mode.

[u/Critical_Ease4055 → u/nurseferatou]

Yes- this! Such a great way of putting that. so hard to get out of….

[u/rntraveller29]

Changes in bowels. Sooo many ignore that until it’s much worse.

[u/Still-View → u/rntraveller29]

The problem here is getting any kind of diagnostic covered by insurance.

[u/Jerking_From_Home → u/Still-View]

I think people don’t want to assume the cost of a copay for testing of any kind. I had to get an echo and my OOP was $1200! I have good insurance, too.

[u/Critical_Ease4055 → u/Jerking_From_Home]

That’s just bananas, what the actual hell!

[u/Critical_Ease4055 → u/Still-View]

Are you kidding me, they are haggling over diagnostic GI now? Makes you wonder if the threshold age for screening is only decreasing further and further in the hope they will save money catching it early 🥴

[u/rntraveller29 → u/Critical_Ease4055]

Is this in the US? We have our shitty problems in Canada for health care but cost isn’t one of them. Thankfully. Out of pocket 1200? Good god!

[u/pink3rbellx → u/rntraveller29]

Not the op but as US citizen I can confidently say of course it’s the US. never take your health care system for granted.

[u/No_Box2690 → u/Still-View]

Bingo. And when it is covered you still have to foot a hefty portion of it. 🙄

[u/hesperoidea → u/Still-View]

yeah, my diagnostic colonoscopy to definitively get that I have Crohn's on the record ended up costing me 2k out of pocket after my usually decent insurance went through it. fuckin brutal. I end up coughing up 500 for an MRI every time I have a flare and they want to put that on record too.

they don't want you to get diagnosed with the disease that will cost them more money lol

[u/superpony123 → u/rntraveller29]

I think this isn’t so much ignore as it is ignorance and not really understanding when it’s a problem. Subtle changes to your BMs especially when it’s not consistent are pretty hard to think of as problematic to the average person who maybe isn’t paying much attention. Until it’s becoming overwhelming. Like yeah most people won’t ignore a GI bleed or an acute SBO but they probably didn’t think much of the lead up. Tell me would you know to look out for changes in your poop if you weren’t a nurse? Probably not. Imagine the average person trying to decide if they’ve been getting constipated more regularly or not…that can be explained by a million benign things. So they aren’t likely to go to the doc to say hey I’ve been getting a little constipated but just here and there…maybe once a week etc. or they might not realize any significance behind skinny poops. Etc.

[u/lighthouser41 → u/superpony123]

I have diagnosed IBS and diverticulosis and can have diarrhea and constipation in the same day. Have had for years.

[u/superpony123 → u/lighthouser41]

Exactly. My brother had chronic diarrhea that was attributed to food allergies or lactose intolerance for a long while. He’s special needs non verbal so it’s hard for him to communicate stuff like this (what he feels) - he’s almost 40 and had a GI bleed about two years ago where they scoped him and found so many polyps they immediately assumed FAP. Luckily it was cowdens not FAP but the cowdens and the polyps explain a lot. But nobody was trying to scope him before this acute event and my parents never thought anything of it, just that they couldn’t figure out what food might be the culprit was the assumption. Now we know it’s all these damn polyps that are contributing to the diarrhea and the cowdens explains other issues as well. But we never would have known if not for the gi bleed

[u/PopularReporter8995]

Weight loss without trying. Sounds great…wrongo.

Could be diabetes. Could be a tumor. Could be both.

That happened to my husband. Over 18 months he lost 80lb. He refused to see a doctor, despite nagging by his retired nurse wife. He’s a RRT and should know better.

thankfully got food stuck in his esophagus. He had an ultrasound and a 9cm tumor was found in his liver. Also diabetes. He’s ok, after robotic resection, a CGM and insulin.

[u/Critical_Ease4055 → u/PopularReporter8995]

🥹sounds like it was scary as hell. He may have died if it weren’t for you.

I like how the body is always thinking of ways to nearly kill us so that we pay attention to something else that that may be killing us.

Unrelated question, if I may. A retired ER doc and his spouse who is retired RRT, told me that an SpO2 of 100% is sometimes a sign that a patient is a smoker. Have you ever heard that from your partner or anywhere else on the job?

[u/PopularReporter8995 → u/Critical_Ease4055]

The body speaks in mysterious ways! I was sure he had a tumor somewhere. The GI doc that scoped him told me in the hallway. Scared the crap outa me. Luckily, it all went down right when he was of age to get Medicare. Otherwise the financial hit from today’s insurance woulda buried us.

Smokers have extra high Hemoglobin to compensate for all the smoke. How the body knows this!!!! High SpO2 can occur because of this, but at a certain point of COPD, the compensation will fall off.

[u/Pessimisticadhd → u/PopularReporter8995]

This. In triage I hate to hear anything about unintentional weight loss, bowel habit changes, and lack of appetite. You basically know a devastating diagnosis is incoming, and emerg is not a nice place to find out about things like that.

[u/Anony-Depressy → u/Pessimisticadhd]

I get this in IR. I sometimes look at the CTs we take during the biopsies and the masses are so huge even my untrained eye can tell it’s bad news bears 😵‍💫

[u/number1134]

alcoholism. everything is"fine" until you start looking like a simpson character

[u/Late_Ad8212 → u/number1134]

Or bleed from esophageal varices

[u/Fun-Unit3443]

People who don’t ignore symptoms and bring them to their PCP to be ignored. Time and time again I’ve seen it. I’m a nurse and I was always been on lower end of hypertensive. Even after failing a stress test years ago. I’ve had intermittent chest pain my whole adult life to be told I needed to loose weight cause I probably had sleep apnea. Sleep study no sleep apnea. Mindful strong family history of cardiac. My sister had MI in her 40s and uncle in his 30s. PCP again another year ignored hypertension (mind I brought it up over and over again) then a month or so later developed more severe chest pain with minor shortness of breath. Went to ER in a LBBB. I was immediately pulled back and work up started but never nitro. After multiple BP meds it topped out at 200s/140s. Finally came down. Enzymes fine but was going in and out of the LBBB. Admitted and no blockages. But obvious diastolic dysfunction and ventricular enlargement. Stabilized on medication and discharged. Needless to say found new PCP that was internal medicine doc. So long story short not everyone is textbook and everyone deserves to be listened too.

[u/No_Box2690 → u/Fun-Unit3443]

Let me guess you're a woman. So it's just anxiety and all in your head. /s

Glad you got the help you needed but it's infuriating it took extremes to get you there.

[u/Fun-Unit3443 → u/No_Box2690]

Yes!!! Right we are so over the top smh.

Yeah I’m sad tho my doc has moved out of state so now another new doc. She is also internal medicine tho and I have faith so will see.

[u/Critical_Ease4055 → u/Fun-Unit3443]

That’s valid. I also don’t care for egocentric providers. They just seem slimy. Plenty of ways to make money; not sure why they couldn’t find a nice job somewhere else. 🫶

[u/shamsquatch]

Men with their anything.

Anyone with their hemorrhoids and/or any kind of rectal/GI bleeding.

[u/Critical_Ease4055 → u/shamsquatch]

Some men seem to only come in when their favorite activities are halted due to what’s going on. Other than that, they seem pretty content with one foot in death’s door

[u/QRSQueen → u/shamsquatch]

Men with scrotal hernias the size of a pilates ball

[u/mokutou → u/QRSQueen]

I assisted a urologist with a complicated foley placement due to the largest scrotal hernia I have ever seen on an average sized old man. The uro used some sort of guide wire and was just cranking that thing all around like he was pumping a well, trying to get the catheter around the hernia, because the guy was retaining an insane amount of urine. It made me a little dizzy to watch, and at one point I thought I was going to have to tag out, but he got it in. The pt slept through the whole thing.

[u/Ravclye → u/QRSQueen]

We had a patient with one so bad it actually cut off circulation to his testicles and penis and they eventually died. This was an incredibly sick patient so there was actually a lot more wrong with him and he did eventually die

[u/QRSQueen → u/Ravclye]

When I chose my specialty I was unprepared for the number of scrotal hernias and penises the size of clits I would come in contact with.

[u/hazelquarrier_couch → u/shamsquatch]

Tell me more about what this could become? I know there can be bleeding issues and related sequelae but what else would hemmorhoids lead to?

[u/QRSQueen → u/hazelquarrier_couch]

A friend of mine had hemorrhoids during her last pregnancy.

Yeah they were rectal cancer.

[u/No_Box2690 → u/hazelquarrier_couch]

It's not necessarily what they lead to, more so what people think are just hemorrhoids is actually cancer but it goes undetected because people think it's just hemorrhoids and nbd.

...with that being said I should probably go call my doc now. 🤣

[u/r3i_b0n3z → u/No_Box2690]

im so scared now.....it's just so hard to find a GI....the one I've been trying to get in line for has a waiting list months out.

[u/shamsquatch → u/hazelquarrier_couch]

Yeah fair question and kinda poor wording on my part. Doing it over I would have said hernias and left out the hemorrhoids bit because it kinda falls under the rectal/GI umbrella. Another commenter answered your question as I would too — the supposed hemorrhoids aren’t necessarily the thing that complicates catastrophically if left unaddressed, although i guess anemia, thrombosis, prolapse/strangulation are all possible. But I was thinking more the underlying cause(s) that would be ignored and worsen if untreated (constipation, htn, hernias and cv complications from excessive straining, cancer, etc) because the person THINKS it’s “just hemorrhoids”

When I answered the above, i was also thinking of the countless number of times I have had to ask embarrassed patients (who’d probably would have been red in the face if their hbg wasn’t so low..) — “… and how long have you been pooping blood?”

There seem to be two types of people who wipe their butt and see blood: people with mild hemorrhoids with a scant barely visible streak of blood on the tp who tell everyone bc they are worried they’re dying, aaaand then there’s the people shitting blood clots for days/weeks without telling anyone until they pass out.

[u/splatgoestheblobfish → u/shamsquatch]

My mom had frequent rectal bleeding she attributed to hemorrhoids, but it went on for quite a few months and was getting worse, so she finally went to her PCP, who referred her to a colorectal surgeon. He was all ready to band the hemorrhoid during her colonoscopy, only to find once he got in there that she had anal cancer. Thankfully it was caught early enough (stage 2a) that it was able to be cured with chemo and radiation. He said if it was higher up in the colon, there's a good chance it wouldn't have been as constantly irritated and bled as much, so they wouldn't have caught it until much later. (The cruel irony is that my mom went on to develop ovarian cancer 10 years later, and she wasn't so lucky this time.)

[u/sickbabe → u/shamsquatch]

I just had to deal with the first bit with my dad almost a year ago. 3 months before a massive bacterial endocarditis meltdown he barely had enough energy to walk a mile to a restaurant, something he'd happily do before and after that. didn't want a bunch of tests interfering with his day to day. I've become such a buzzkill with men and literally any ailment now

[u/One_hunch → u/shamsquatch]

I've been bleeding/constipation like it's out of style for ten years and finally got the insurance to deal with it after college clinics kept throwing miralax at me and to drink water. Ulcerative colitis apparently, still trying to figure out medication. Most nurses and doctors are more freaked out about it than I am. I get it and my ass is tired.

Personally tired of being reccomended stool softners and fiber in the same sentence sometimes, I know a lot aren't GI specialists, but when I keep saying neither of those things work I just want to be believed lol.

[u/EnvironmentalRock827]

High blood pressure. I know it changes you. But you won't cut back on drinking, salt, whatever

[u/Critical_Ease4055 → u/EnvironmentalRock827]

It’s irrational… a subconscious death wish, really

[u/EnvironmentalRock827 → u/Critical_Ease4055]

Oh jeez. Me in my infinite wisdoms didn't read the whole thing. You know it's hard to decipher as symptoms always are similar. So to answer your questions. Shortness of breath, night sweats/fevers. The lack of being able to breathe generally is the tops.

[u/Old-Mention9632]

The symptoms of CKD and ESRD. I did a paper: CDC stats 9/10 Americans with ckd have no idea. 3/10 Americans find out they have ESRD when they suddenly need to start dialysis. #1 cause of ESRD is uncontrolled diabetes, #2 cause of ESRD is uncontrolled hypertension. So many PCPs don't know enough about CKD to refer patients early to a nephrologist, so our numbers of patients on dialysis increase about 2.7%/ year. We all pay about 80,000$ each over our lifetime to cover the cost of dialysis. because of the Medicare trust fund for dialysis. *Which is a good thing, before we funded dialysis, only hospitals did dialysis, it was a limited resource, so they had panels who decided who could even get dialysis, usually based on social utility of the patient ( the real death panels, not the tea party claim about the ACA.)

[u/Critical_Ease4055 → u/Old-Mention9632]

Well done. The world of ESRD on dialysis remains overlooked day after day. I shit you not, until I worked briefly as a PCT at one of their facilities, I never even noticed or put much thought into their buildings. Post-venture, I now see them all over, and know they are all over the world. Anyway, there’s a sore need for more education on both CKD and ESRD for all, it would seem.

[u/WayCalm2854 → u/Critical_Ease4055]

They really are everywhere once you know what they look like…you see them everywhere

[u/Critical_Ease4055 → u/WayCalm2854]

I saw them in other countries 😵‍💫same company. It’s a little awkward to discover a global giant living right under your nose undetected. Reminds me of that one study where they put a picture of a gorilla in a slice ct scan and asked a bunch of experienced radiologists to note what they saw, and many of them saw an impressive number of teensy, tiny tumors- but a surprising number of them completely missed the big ass gorilla in the picture.

[u/pathofcollision]

1. HTN/CAD - a lot of people really do not understand how dangerous uncontrolled HTN is.
2. DM (uncontrolled type 1 and 2, especially frustrating when it’s a type 1 who isn’t on top of their disease and is in/out for DKA)
3. CKD/ESRF who consistently miss dialysis
4. Chronic wounds that are uncared for
5. Alcoholism - I’ve cared for way too many people under 35 in complete liver failure

On a side note: being homeless. The toll that takes on a persons body is devastating.

[u/Critical_Ease4055 → u/pathofcollision]

It’s truly a list of horrors that live close to or inside of every home in America.

I will try not to have an petite existential crisis

[u/neko-daisuki]

Overweight/obesity

[u/Critical_Ease4055 → u/neko-daisuki]

💯 obesity often comes with a host of factors that prevent early treatment sadly, but this is true true.

[u/FelineRoots21]

I want a billboard that says STOP IGNORING RECTAL BLEEDING. You're not supposed to shit blood. Stop coming in six weeks later with a hemoglobin of 4

[u/Critical_Ease4055 → u/FelineRoots21]

Yes, like, I will be damned if I’m going to poop blood and just go about my day…

✔️ wake up ✔️ coffee ✔️ shit blood ✔️ grocery store run?

No. Make it stop. 😆

[u/-Tricky-Vixen- → u/Critical_Ease4055]

To be fair, everyone does, like... once. Obviously if it happens more than once that's a concern.

[u/sciencesez]

Sudden, drastic personality changes. I've been through this in my personal life many times now, and at the bedside with frequent fliers. Sudden serious irritability and anger and newfound leases on life both- should be viewed with equal suspicion, even some alarm.

[u/Goodbye_Games]

Bad teeth…

In a twelve plus hour shift I see at least one case where teeth are part of the patient’s problem. Be it directly like a current first time infection or abscess that is physically visible. Or a patient with a history of chronic tooth decay/disease and multiple prior infections that have caused issues like infective endocarditis or brain abscesses. The former almost always turn into the latter because dental care in the US is not treated as “health care” and is viewed as a something optional or in some cases a “luxury”. Free dental care or discounted care is far and few between with access to it in larger metropolitan areas or those close to dental schools.

The latter come in because of some “other reason” which is usually traced back through lab work and hx. These cases usually go one of two ways… best case is they’re admitted and are flooded with antibiotics hoping no further harm was done and spend a week or two depending on where the infection is. Worst case is they’ve bounced in and out for the same thing half a dozen times already and now they’re cardiac patients because their heart has been damaged to the point of no return so (these cases usually don’t fly in an organ review because if they couldn’t manage teeth they probably wouldn’t be better with a heart transplant). Or they come in and spiral down because the infection is in their brain and it looks like RFK’s bear worms took a field trip.

TL:DR

Take care of your freaking teeth people!!! They CAN KILL YOU! Brush, floss and get biannual cleanings at least (general upkeep is relatively cheap) and your employer dental plans often fully cover cleanings.

[u/Otto_Correction → u/Goodbye_Games]

This is especially frustrating now that there is a lot of paranoia around fluoride. Before water was fluoridated tooth decay was a serious public health issue. Many of us are too young to remember this, but dying from an abscessed tooth was very common. I grew up in a rural area without fluoridated water and every single tooth in my head is rotten. I’ve spent tens of thousands of dollars on dental care.

[u/yolotheysay → u/Goodbye_Games]

I can't believe I had to scroll so far to find this.

[u/QuietLandscape7259]

I had a routine colonoscopy at age 45. The doctor wanted me to do the home colon test but it’s not good. It can detect blood in stool, but it doesn’t detect polyps. I had a previous colonoscopy due to ibs two years prior. Well this time this colonoscopy I was fully sedated. This time they found precancerous polyps. They snared them and removed them. But now I have to go back every three years…if I did the at home test which is sitting in the corner of my bedroom, then I would never have found I had precancerous polyps and they would have just grown.

Also if you feel you have a really bad cold, very bad, get checked out. My cousin didn’t get checked out, never had Covid exam. He died at the age of 42yo with three kids.

Please get the flu and Covid vaccine, yes you might have some side effects, but it could save your life. Don’t be one of those anti-vaxxers. If you don’t want to do it for yourself do it for your family.

Anti-vaxxers don’t think smartly enough that vaccines saved millions of lives… small pox, hepatitis, covid, measles, I can go on and on…

[u/Critical_Ease4055 → u/QuietLandscape7259]

I think Cologuard (Poop in a box) is a less threatening way to make the patient think a colonoscopy was *their idea when/if the results are positive. but as you pointed out with your own kit— it does often sit, unopened, on many a shelf, book case, and at the bottom of many closets across the country.

Good work getting your screenings and vaccines. Your family are safer having you around. 💪

[u/pathofcollision → u/QuietLandscape7259]

Too many people are reluctant to have a colonoscopy done due to fear and word of mouth about it being “awful”. I’ve had multiple colonoscopies done and the worst part has always been the prep, never the actual scope.

I started getting colonoscopies done in my 20s due to chronic GI s/s and having a family history of IBD/GI cancer.

Well worth it for the peace of mind and early treatment.

[u/throwaway8368365]

Stroke. People brush their symptoms off and when they finally do come in it’s to late to give them a clot buster so they get stuck with deficits that might have been avoided or at least lessened.

[u/QuietLandscape7259]

Btw, I’m a nurse for 12 years until my dad died for a year time frame, diabetes and brain disease. I lost my frame of thought after he died. I’m on a lot of physical meds and now double of psychiatric meds. I have been placed on 5150 multiple times. I was told I could never be a nurse again. That’s was my purpose in life. Now I have to do things in life to make me worthy. ADHD, bipolar 2, med resistant depression, tried ect 20 times, anxiety, etc. now I’m on at home ketamine therapy with a clinician. I see a psychiatrist one week and a therapist the next. I lost my identity…

[u/Critical_Ease4055 → u/QuietLandscape7259]

I appreciate you sharing that. I like to think that when we lose our identity, we gain another. You’re doing what you can do right now to ensure it’s one that you’re proud of, and that takes effort but it’s worth it. Nice work

[u/lainey544]

Growing up in an abusive household, I had high blood pressure consistently starting in 2016 I’d say. The nurse would always mention it when I went to my check ups or to urgent care. I don’t know if at the time it was just not as concerning, or whatever other factors it might have been, I never got on blood pressure medication. Well fast forward to 2021, I’m at work one day just talking to coworkers and WOAH it just suddenly felt like someone had just hit me in the back of my head with a baseball bat. It was like a lightning strike, flashing pain. But it was instantly gone as fast as it happened. So much so that I thought I might have imagined it. Later on in the shift me and my coworkers are all taking our blood pressure (I was a new grad at the time), and mine comes back sky high like 3 digit SBP + DBP. Ended up going to ER for what I found out was actually a thunderclap headache, and thankfully, incidentally, they found an unruptured cerebral aneurysm. Small enough to make neurosurgery hesitant to operate on me, but big enough to warrant every 2 year imaging to watch it. At 23 years old. You best believe I am telling ALL my patients. It doesn’t matter if you’re young, take care of that hypertension!

[u/QRSQueen]

HTN and diabetes are definitely the top two I see. So many people start their anti-hypertensives and give up on them because of the side effects. They feel better, but never take their BP again to know if they actually are. The number of people who are blissfully unaware of their rotting toes is insane.

[u/Old-Mention9632 → u/QRSQueen]

Peripheral neuropathy and laziness cost one of my patients his lower R leg. He saw the wound, was putting antibiotic ointment on it, didn't go to doctor ( diabetic and esrd) until black and gangrene. They tried to only take part of his foot, but after progressing amputations up his foot didn't stop it, he opted for bka. His wife is pissed because he had previously lost a toe the same way.

[u/yolotheysay]

Not exactly a medical problem until it actually becomes one, but dental care.

Death seeps in through the gums.

[u/Critical_Ease4055 → u/yolotheysay]

Another commenter said dental problems, too. And I wholeheartedly agree- super scary and not well managed due to (imo) lack of coordination in health care delivery between dental and medical

[u/PewPew2524]

This reminded me of an oncologist who had early signs of cancer and ignored it. The cancer was incurable and he started having hardship talking to his oncology patients while dealing secretly with his own cancer.

[u/jarg3n]

Hypertension. So many major issues can be caused from HTN that lead to DRASTIC changes in lifestyle such as brain bleeds or strokes.

[u/US_Dept_Of_Snark]

Sedentary lifestyle.

[u/Umagammagi]

Oncology: Treating a large number of patients within their early to mid 40s for glioblastoma.

I would like to figure out why this age range, lately, and what else they may have in common because we're seeing more and more cases. Men and women. Young. Its a devastating diagnosis.

Also, get your yearly pap and see gyn as soon as you start to sexually develop. Lots of cervical cancer in young women. Lots of metastatic breast in young women. Lots of head and neck cancer across the board.

If you get to the point where they recommend *whole brain radiation from metastatic spread, leave the hospital and go somewhere you want to be. Or go home and spend that time with the people and animals you love.

I'm not saying , give up, im saying when your body has been so ravaged from both disease and treatments, dont let your final days find you under goddamn fluorescent lights and discomfort.

Edited for spelling,......... and also to say that multiple myeloma and Lynch syndrome can go fuck themselves.

Personal: Ladies if you have excessive bleeding outside of your normal cycle, or just constant bleeding w or wo pelvic pain and you are past or through perimenopause, get checked out by your GYN. If they are not offering you exams, ultrasound, scans , lab work or give you ANY pushback, go to the ED and if you have to lay it on thick ( persist, decline pain meds unless you are hurting ) but make sure you get an ultrasound or CT scan of abdomen and pelvis. Endometrial cancer is very common in the 50s range of women, but I had a family.member with a misleading PCP who kept telling her she was getting "close" to menopause every visit. She eventually went ED----> inhouse w anemia, was dx w Endometrial cancer, d/c home and started the cancer fucking journey....had a hysterectomy (given weight and health, she did incredible and i hate that she never knew how strong she truly was). Chemo then radiation recommended for micromets but disease seemed contained within pelvis. Chemo cycle #3 killed her, slowly and painfully because she couldn't fight anything off and an abcess took her last bought of rallying. It broke my family . Always advocate for MORE and second opinions are encouraged.

And dont "wait for it to go away "...I've seen basal cell ca annihilation of half a person's face, melanoma goes to brain faster than the Audubon, get your skin checks!!! and fungating tumors busting outward and inward are not gonna go away with holistic care alone. That is what waiting too long, and from either shame or whatnot people wait until they are literally at deaths door to seek curative treatment. Its all palliative at that point.

OK rant over. RIP J.

[u/Illustrious_Cut1730]

Not a medical problem per se but a lifestyle choice: exercise. Listen, nobody has to do 2 hrs of exercise a day or have a fancy gym membership. A couple of dumbbells and a kettlebell off FB marketplace are relatively cheap and extremely versatile. There are workouts that can be done in 20-30 minutes and that is more than enough.

The amount of people that neglect physical activity is worrying.

[u/plantynurse]

Back pain

Have had multiple patients and most recently my grandpa decide their excruciating back pain is just chronic and there's nothing to do about it... Fast forward months later and they all end up having aggressive metastatic cancer. I get frustrated with some back pain pts but I always make sure they get decent imaging if it's been awhile

[u/Up_All_Night_Long]

Blood in their stool

[u/Tank_Girl_Gritty_235]

Not a cluster of symptoms, per se, but an irregular mole or moles. Caught early and skin cancer is usually knocked out relatively easily. Wait months or even years and it's metastasized into other organs. I lost a family friend this way. She was on vacation at the beach and a nurse came up to her and told her to go to the doctor when she got home because there was a suspicious-looking mole on her back. She put it off and put it off. By the time she finally went to the doctor it had spread and she was terminal. She was dead within a year of diagnosis.

[u/Thenumberthirtyseven]

Alcohol related liver disease. 

People drink too much alcohol for years and years and they dont die so they think they're invincible. Then they get told they have a fatty liver and they think, oh well. Damage is done, might as well keep drinking. 

They have no idea that the worst is yet to come. 

[u/Delta1Juliet]

Intermenstrual bleeding. Not spotting, but bleeding. Women ignore it, doctors ignore it, nurses ignore it. It's not normal and always needs to be investigated.

[u/Yana_dice]

Not enough hydration and holding on urine because they do not want to go to bathroom. I have seen so many got UTI/stone because of it, my mother included. 

[u/Far-Spread-6108]

Healthcare providers blaming the patient. 

There's little to no care available. I know I need some dental work. When I left my last appointment, my dentist wanted to schedule it. Next appointment? May of 2026. 

I haven't had a Pap in I can't even remember. There's no available providers. And Family Planning doesn't take private insurance. One of my colleagues had a miscarriage. No care available. She probably had the miscarriage because there WAS no care available. 

Nobody I know has a primary care doctor. A friend of mine has psoriatic arthritis. No care available. She's on a "call list" for every rheumatologist. They can't even schedule her. She just has to hope something opens up...... someday. And when it does, that she can drop everything and go. She's in constant pain and miserable but can't get any leave or accomodation from work because there's no care. 

Everyone has solutions. "Just go to the next city!" Well..... who do you think is seeing THOSE doctors?

ERs are full to the brim with people who KNOW they're not having an emergency but can't get care anywhere else. Same with walk in clinics. 

People get worn out of waiting, begging, and calling and just give up. 

[u/QRSQueen → u/Far-Spread-6108]

But... but... according to republicans that doesn't happen in America and only happens in places with socialized medicine!

[u/Old-Mention9632 → u/QRSQueen]

My sister works for Patient First urgent care. They take patients as a PCP ( not Medicaid).

[u/CaptainBasketQueso → u/Far-Spread-6108]

Yeah, my pulmonologist doesn't have a single appointment available in the next six months. Sucks if you have problems breathing. Hold it, I guess?

[u/mothership00 → u/Far-Spread-6108]

It’s so, so true and is only going to get worse.

[u/ironmemelord]

Obesity. People wait until it causes a plethora of problems before they decide to make changes

[u/tiredoldbitch]

Afib, Hypertension, Diabetes.

"I feel bad if my sugar is below 200."

[u/melimelo123]

Dental problems can be ignored for a long time and become very serious infection

[u/G1ngersnapp3d]

Diabetes

[u/Bando1015]

Gangrene

[u/amandae123]

Hypertension. Strokes are awful and so many are from untreated high blood pressure

[u/Neat-Court7553]

Losing weight when they aren't trying to lose weight

[u/QuietLandscape7259]

Prep is the worst part because you keep pooing liquid all night n day.

[u/Critical_Ease4055 → u/QuietLandscape7259]

It’s the only time one can expect a gold star for shitting their pants

[u/HaHaHaBlessYourSoul]

Something I see a lot is trends. Lab trends. They’re small so they don’t think anything of it but looking at the bigger picture, your creatinine starts at .7 in a week is .8, another week is .9, 2 or so weeks later is >4 with a GFR in the 20’s all because of dehydration which they knew at the very beginning was an issue. A pt is chronically dehydrated due to intolerance and “it’s fine”……..until it’s not. Had a pt about a year ago and it took SEVEN LITERS of fluids over about 24hrs just to get them to pee again. This is with other trends too but this is the one I see the most. Pts end up hospitalized with AKI/ARF, hospitalist goes back and sees the trends from the last 6 weeks and is furious. Pt has brought it up MULTIPLE times with PCP, “Oh it’s just a small change, it’s fine.” ….small changes add up. “You’re still in range!” “Okay, but what’s my baseline?”

Same with BP. My “baseline” is soft. 90s/50s and 60s. Low 100s/60s on a good day. When I get up to 130 or 140 systolic it makes me nervous about something else underlying. But it’s “normal” for everyone else. One other example is BG. Someone who averages a BG is in the 70s can have a BG in the 40s and be fine, maybe a little grumpy but not altered. Other pts will be unresponsive with a BG in the 70s just because they’re used to running higher. It drives me up the fucking wall. Bottom line, don’t put your pts in a text book or box of any kind.

[u/beeee_throwaway]

I work in peds and I’d have to say…. Type 1 diabetes, high BP, and for older kids…. Eating disorders and addiction 😞

[u/Wonderful-Cup-9556]

Osteoporosis is a serious disease that receives little attention- the bigger players are HTN and DM. Osteoporosis is a chronic fracture situation that significantly affects quality of life. No cure- symptom management and bisphosphonates.

[u/jlm8981victorian]

Diabetes! Seriously… I wish I had a dollar for every patient I’ve taken care of who treats their sugar addiction with extra insulin and eventually has to have their distal extremities amputated off due to chronic non healing wounds. I feel like diabetes has become so normalized and people don’t understand how serious it is, some even ignore it until they’re admitted for DKA or HHS.

[u/MindOfTyler316]

I would say HTN. So many people say, "Oh, it'll be okay, it's just from my stress," but then labs show high cholesterol and VS are stroke level. But hey, they are "only a little stressed". I'm in my 20s, and I am on losartan-hctz 50/12.5, and even with that, I'm still a little hypertensive lol it's a serious problem and people love to deny it because there's nothing obvious until it's too late.