Weight loss
Weight that keeps creeping up, a waist that has grown, weight that came with sugar, BP, thyroid or fatty liver, or medicines that may be adding kilos. He looks for the reasons behind it — thyroid, sugar, sleep, medicines, meals and the day’s routine — and makes a plan you can keep: food, activity and, where it suits you, medicine. No crash diets, and no promised kilos.
Have ready: your weight and waist measured in the morning, your height, recent sugar, thyroid, cholesterol and liver reports, and a note of what you eat on a normal day.
Losing weight without trying is different: it needs checking, so tell him.
Brain and nerves
Headaches and migraine, fits (epilepsy) that need ongoing care, lowering the risk of a stroke and the care after one, and numbness, tingling or burning nerve pain, such as from sugar.
Have ready: a diary of the headaches or fits (when, how long, what happened), any CT or MRI report, your sugar and BP readings, your medicine strips, and a video of a fit if someone recorded one.
Go to hospital now if the face droops, an arm or leg suddenly goes weak, sight is suddenly lost, speech is suddenly slurred, the worst headache of your life comes on suddenly, there is a first-ever fit, a fit lasts more than five minutes, or fits come one after another. Call 112; every minute counts.
Sugar, thyroid and hormones
High sugar readings or a new diagnosis of diabetes, thyroid reports that don’t look right, other hormone and metabolic problems, and tiredness nobody has explained. He goes through your readings, your meals and routine, and every medicine you take.
Have ready: glucometer readings with dates and times, your latest HbA1c and thyroid (TSH) reports, and the strips of the medicines you take.
Go to hospital now if a very high sugar comes with vomiting, drowsiness or fast breathing: call 112. If a low sugar with sweating or shaking does not improve after taking sugar, call 112 and keep taking sugar while you wait, if you can swallow safely. If a low sugar comes with confusion but the person can swallow safely, give sugar and call 112. If they are drowsy, having a fit or cannot swallow safely, call 112 and give nothing by mouth.
Lungs and breathing
Asthma or COPD that is not well controlled, a cough or chest infection, colds and sore throats that keep coming back, and allergies with sneezing, runny nose or wheeze.
Have ready: how long the cough has lasted, your temperature readings, any chest X-ray, your inhalers (he may ask you to show how you use them), and oxygen readings if you have a pulse oximeter.
Go to hospital now if you are too breathless to finish a sentence, your lips or face turn blue or grey, your reliever inhaler is not helping, your oxygen reading stays below 92% (or below your usual, if you have COPD), or you cough up blood.
Heart and BP
Raised BP readings at home, a cholesterol report, heart disease in the family, heart failure that needs regular follow-up, and the question of whether a medicine is still right. He looks at your risk as a whole, not at one number.
Have ready: a week of home BP readings, morning and evening; your lipid profile; any ECG or echo report; with heart failure, your weight each morning; your current medicines.
Go to hospital now if there is chest pain or pressure, including heaviness spreading to the arm, jaw or back, or coming with sweating, even if it feels like gas; sudden or worsening breathlessness; or fainting. That is not for a video call: call 112.
Blood and anaemia
Low haemoglobin, tiredness and breathlessness from anaemia, iron or vitamin B12 deficiency, and a blood count (CBC) that came back abnormal. He looks for the cause, not only the number.
Have ready: your CBC reports, old and new; iron and B12 reports if done; whether you are vegetarian; for women, whether periods are heavy; your medicines.
Go to hospital now if you are breathless at rest, have chest pain or faint, or have bleeding that will not stop.
Liver and gallbladder
Fatty liver seen on an ultrasound, liver tests (LFT) that came back raised, jaundice, hepatitis B or C, and gallbladder stones or pain, which can come together with liver trouble.
Have ready: your liver function tests, ultrasound report and hepatitis reports; how much alcohol you drink, honestly; every medicine, tonic and supplement you take.
Go to hospital now if there is yellowness with drowsiness or confusion, you vomit blood, stools turn black, or yellowness appears during pregnancy.
Stomach and gut
Acidity and gastritis, bloating and IBS, Crohn’s disease or ulcerative colitis (IBD) that needs follow-up, loose motions or constipation that will not settle, and blood in the stools, which should always be checked, even a little.
Have ready: how long it has been going on, what makes it better or worse, any stool, blood or scan reports, endoscopy or colonoscopy reports, and the medicines you have tried.
Go to hospital now if you vomit blood, stools turn black, you pass a lot of blood, there is severe tummy pain, you feel faint, or you cannot keep fluids down or pass very little urine.
Kidneys
Kidney damage from sugar or BP and its follow-up, protein or blood in the urine, kidney stones, and urine infections that keep coming back.
Have ready: your creatinine and urine reports, older ones too so he can see the trend; any ultrasound; your BP readings; and every medicine, because some doses change when the kidneys are weak.
Go to hospital now if you pass very little or no urine, or have severe pain in the side with fever, shivering or vomiting.
Joints
Joint pain and stiffness, swollen joints, arthritis, and gout with high uric acid.
Have ready: which joints hurt, whether they are stiff in the morning and for how long, your uric acid and other blood reports, any X-rays, and which painkillers you take and how often.
Go to hospital today if one joint turns hot, red and very swollen, especially with fever.
Skin
Rashes, itching that will not settle, hives, and skin infections and boils, including skin changes that come with sugar, thyroid or other illness.
Have ready: clear photos in daylight, taken on different days; what you have applied or taken; and any new medicine, soap or food just before it started.
Go to hospital now if a rash comes with swelling of the lips, tongue or face or with trouble breathing, or with fever and blistering or peeling skin.
Fever and infections
Any fever, from viral fever, dengue, typhoid and malaria to urine and chest infections; fever that keeps returning or has no clear cause; and infections that keep coming back. He works out what needs a test, what needs a medicine, and what needs a hospital.
Have ready: your temperature readings with times, how many days it has lasted, any test reports (blood count, dengue, typhoid, malaria, urine), and what you have already taken.
Go to hospital now if fever comes with drowsiness or confusion, a stiff neck, a fit, breathlessness, bleeding from the gums or nose, very little urine, or, in dengue, severe tummy pain, repeated vomiting, feeling faint, or cold, clammy hands and feet, even once the fever has settled.
Everyday illness
Body ache, weakness, poor appetite, a cold that lingers; the common illnesses everyone gets. And the bigger picture: a stack of reports nobody explained, many medicines from different doctors, an older parent with several conditions at once. He reads it all together and explains it in plain words.
Have ready: all reports in date order, every medicine strip or a photo of it, and your previous prescriptions.
