5 Common Misdiagnoses
Not Quite RightYou have an urgent need to pee all the time, and when you go, it's uncomfortable. This happens a lot.
Misdiagnosis: Urinary tract infection
What it really is: Painful bladder syndrome (interstitial cystitis)
With this chronic condition, the tissues of the bladder wall become inflamed, resulting in pelvic pain and the same symptoms as a urinary tract infection. However, unlike a UTI -- a bacterial infection that can be brought on by sex or an errant bathroom-visit wipe -- the cause of PBS is unknown. "UTIs are more common, so a lot of doctors misdiagnose the problem over the phone and just call in a prescription for antibiotics," says Charles Ascher-Walsh, MD, the director of gynecology at the Icahn School of Medicine at Mount Sinai in New York City. The anti-inflammatory effects of the antibiotics may make you feel better temporarily if you have PBS, but they'll never clear up the real condition. On average, it takes about four years before a correct diagnosis is made.
The fix: "When you have repeat UTIs, you need to see your doctor for an exam and additional tests," Dr. Ascher-Walsh advises. Be sure to tell him how often symptoms occur as well as what seems to cause and relieve them. If he determines you have PBS, he may prescribe a medication like Elmiron, which is believed to help replenish damaged areas of the bladder wall; a tricyclic antidepressant like amitriptyline to treat the chronic pain; and/or a bladder bath, a procedure in which the doctor uses a catheter to coat your bladder with a cocktail of meds to suppress inflammation. For at-home pain relief, try soaking in a warm bath or placing a heating pad on your achy pelvis. Drinking a glass of water with a teaspoon of baking soda, which lowers urine's acidity, can also help. Some women find that certain foods and drinks spark or worsen their symptoms. "Eliminate the most common culprits: anything with caffeine -- including chocolate -- or carbonation as well as citrus and other vitamin C-rich foods," Dr. Ascher-Walsh suggests.The inside of your ankle hurts when you run or walk, and it looks a little red and swollen.
Misdiagnosis: Ankle strain or sprain
What it really is: Excessive foot pronation
With normal pronation, after your heel strikes, your foot rolls inward until it's flat on the ground. Then, when you push off to take a step, your weight shifts to the front inside of your foot and the big-toe joint. Overpronators, however, continue to roll farther to the inside as they shift their body weight. This motion puts strain on the tendons and ligaments around the ankle, causing pain that can be dull and achy at times and sharp at others.
The fix: Many specialty running stores do gait analysis, which captures your foot motion on camera as you run and indicates whether you overpronate. You can also look at the bottom of your running shoes or everyday flats to check the wear pattern: If the heels are more worn down on the inside edge, tilting inward toward the arch, you're rolling in too far with each stride. "Try orthotics or arch supports to limit pronation," says Joe Ellis, a podiatrist and the author of Running Injury-Free. Also, choose stability shoes for your workouts and whenever possible wear casual and dress shoes with firm backs for maximum support.
What it really is: Exercise-induced asthma
EIA is a no-brainer for your doc to ID if your symptoms stop when your workout ends. It gets tricky, though, if you have signs only once in a while or if the cough and fatigue last for days, which is especially common if you have allergies.
The fix: Tell your doctor about the onset and severity of symptoms, how long they last, what aggravates or alleviates them and how hard you work out. Ask her for a pulmonary function test with a methacholine challenge, which measures your lung capacity and rate of airflow, says Robert W. Jones Jr., MD, an internist and a quality-review officer at the Cleveland Clinic Medicine Institute. Although EIA is a chronic ailment, symptoms usually improve with gradual cardiovascular conditioning and the avoidance of potential triggers, such as exercising outdoors in cold weather or where there's heavy air pollution, working out on days when the pollen count is high, and swimming in chlorinated pools. You may need to puff on a quick-relief inhaler to open your airways before and sometimes during your workout. Check with your physician.
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