Visit to PCP should be first stop after onset of new symptoms

Primary care examination

Dear Doctors: I am a 29-year-old man at a normal weight, and I eat a balanced and healthy diet. I've been having night sweats and sometimes also mild or moderate kidney pain. There is a history of cancer on both of my parents’ sides of the family. I'm not asking for a diagnosis, just advice on how to figure this out.

Dear Reader: With the recent onset of night sweats that are coupled with persistent kidney pain, we recommend that you see your health care provider as soon as possible. The symptoms should be explored, and your immediate family's medical history is a factor, as well.

There are a range of potential causes for the symptoms you have described. However, if they should point to a serious health problem, delaying a diagnosis that can pinpoint appropriate treatment or therapy is not a risk you should take.

Begin with your primary care physician. If you have been seeing him or her for a period of time, they will be familiar with your medical history. And if you have been having regular physical exams, they will also have access to test results that can provide useful information. These include a pair of blood tests -- a complete blood count and a metabolic panel, which are typically part of an annual physical.

The results yield information about how various systems in the body are functioning. These test results also act as a baseline against which the results of subsequent tests can be assessed. Significant differences from previous test results are often an important starting point for a diagnosis. If you have recently changed care providers, you can ask your previous doctor to share your medical records with your new physician.

In addition to evaluating your test results, it is likely that your doctor will ask to review and update your own medical history and that of your family members. It is important that you share the information about a family history of cancer. Even if you have already discussed your medical history in previous visits, going over it again is helpful, not only for the doctor, but also for you. It can jog your memory about symptoms or illnesses you may have previously omitted, and it allows you to fill in more recent details.

A medical history typically includes specifics about allergies, recent illnesses, major illnesses in the past, mental health issues, any surgeries and a detailed record of all immunizations. Be sure to include precise information about medications, as well as any vitamins or supplements you may be using.

When a condition is outside of a primary care doctor's sphere of expertise, they will recommend seeing a specialist. Which type of specialist is determined by the implications of your physical exam and test results. It's a good idea to get several recommendations so you can find the right fit. Important considerations include the doctor's credentials, compatibility with your health insurance, good communication (including with the staff) and their hospital affiliations. But most important, when you are asked to see a specialist, follow through.

(Send your questions to [email protected], or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10960 Wilshire Blvd., Suite 1955, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)

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