Am I Dying?: Deciphering ailments without the jargon and unnecessary alarmism

SCIENTIFIC INQURIER: Can we start with some basic background information? Where do the both of you practice? What fields?

CHRISTOPHER KELLY/ERIC EISENBERG: We’re both cardiologists at Columbia University Irving Medical Center. We specialize in the diagnosis and management of all diseases related to the heart and major blood vessels.

SCINQ: What made you write the book? In a world of WebMD, Mayo Clinic online, etc., what does Am I Dying? offer over web based options?

CK/EE: We wrote the book for two main reasons:

In this country, healthcare is not always affordable and accessible. When someone has a new symptom, they often have to figure out on their own whether it warrants the time and expense to get an appointment with a professional. We wanted to make a very practical guide that covers most scenarios and offers clear advice on when to “chill out,” make an appointment, or get an urgent evaluation.

It’s hard to find good information online. Most of it is written by people who do not actually practice medicine, contains numerous errors, and/or has an unnecessarily alarming tone. We wanted to give the same advice you’d get from an office visit with a doctor. We also tried to make the book highly readable, practical, and even entertaining when possible. Finally, we try hard not to scare people unless it’s absolutely necessary.

SCINQ: How did you settle on which symptoms and conditions to focus on?

CK/EE: We chose about forty symptoms that we felt were common and important enough to merit further discussion.

SCINQ: Am I Dying? conveys complicated information in an accessible yet no less informative way. Was it difficult keeping the technical jargon to a minimum?

CK/EE: Thanks! We tried hard to make the book as readable and fun as possible. We know that medical information can be intimidating and confusing, so we did our best to make it more approachable. We read each chapter many times to make sure it was clear and succinct but also complete.

SCINQ: So let’s say one of your readers has chest pain somewhere down the line. How should they approach using Am I Dying? to decide what their next step is?

CK/EE: Chest pain is one of those symptoms that rightfully freaks out most people (and their doctors!). It can be a sign of dangerous conditions like a heart attack, which happens when part of the heart muscle isn’t getting enough blood. On the other hand, much less dangerous conditions – like bronchitis and acid reflux – can also cause chest pain. Our book covers chest pain in detail, but the gist is that it’s more likely to be a heart problem if the pain gets worse when you exert yourself, feels like pressure rather than a sharp pain, and isn’t related to body position. Pain that’s sudden-onset, sharp, and very intense is also alarming.

SCINQ: From the conditions highlighted in your book, which ones are the trickiest to diagnose? Which ones are really flashing red lights, meaning don’t even bother trying to figure out what you have. Just get to an E.R. as soon as possible.

CK/EE: Some of the really tricky symptoms to pin down include isolated recurring fever and/or unexpected weight loss. They’re usually a sign of a serious problem – like infection, cancer, or autoimmune disease – but the workup is pretty broad.

The most alarming symptoms, which should always prompt an immediate E.R. visit:
(1) crushing, unrelenting chest pain, especially if associated with weakness, shortness of breath, and/or nausea (heart attack)
(2) sudden-onset and sustained (>5 min) loss of sensation and/or strength in an arm or leg (stroke)
(3) sudden-onset slurred speech or inability to speak (stroke)
(4) high fevers and lightheadedness (sepsis, a bloodstream infection)

SCINQ: Self-diagnosing can be tricky at best, but it is often the first step. Can you offer any suggestions how people should approach it?

CK/EE: Part of the challenge is knowing how to actually describe your symptoms, so you can find relevant information. Some symptoms can be difficult to put into the right words. For example “dizziness” is a common symptom, though you’re much better off searching for “lightheadedness” or “vertigo,” which are more specific. Our book tries to help parse concepts like these in a way that many websites don’t.

Also, you’ll want to make sure you’re getting reliable information. A lot of websites have ulterior motives that are not always readily apparent. In general, you should stick with content written by actual physicians on non-commercial websites (usually for medical schools or large academic organizations).

SCINQ: Both of you practice in New York City. Are there any ailments or diseases that are particular to urban settings? Rural settings?

CK/EE: Everyone in New York is stressed, and that definitely increases the risk of heart disease. People also seem to forget to look up from their phones as they enter crosswalks.

Purchase a copy of Am I Dying? by Christopher Kelly M.D., M.S. and Eric Eisenberg M.D., F.A.C.C.

IMAGE SOURCE: Harper Collins (cover image); Creative Commons

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