Why I Reach for Decode Body Messages

Part of my job is knowing which descriptions change the appointment, and I think patients should know that list too.

Things that stop the appointment and start a referral. Unexplained weight loss. Fever with pain. Night pain with no mechanical explanation. Progressive numbness or weakness. Loss of bladder or bowel control with back pain. A hot, swollen, red joint. Chest pain or breathlessness on exertion. A headache that came on in seconds or is the worst you have had. Any bleeding after menopause, between periods, after sex, or from the bowel. A new or changing lump or skin lesion. New severe pain in anyone over fifty who has not been assessed.

For any of those, the right answer is a doctor, that week, and I will say so and write the letter rather than treating and reviewing in a fortnight.

Things that change what I do but not who does it. Pain that does not vary with position, which means it is probably not mechanical. Symptoms that started with a new medication. A pattern that tracks the menstrual cycle. Pain that is worse the day after activity rather than during it, which is the tendon pattern.

Things people apologise for mentioning and should not. Bowel habits. Bladder leaking. Pain with sex. Mood. Alcohol intake. All four change management significantly and all four routinely go unmentioned. The clinic is in Lane Cove, opposite the library.