• fatigue...tired all the time...no energy
• high blood pressure (140/90 or higher): if in fairly sudden episodes, work-up for pheochromocytoma.
• extremity swelling: when it is chronic and pretty much without symptoms, think of lymphatic causes...especially if toes are also swollen. If swelling and calf pain, get to an emergency room because you may have a potentially fatal blood clot. If swollen, painful, and hot, you may have a bad infection...get to an ER.
• shortness of breath: this can be due to (1) brain deficits or (2) mental states (you "feel like" you aren't getting enough air), (3) lack of oxygen carrying capacity of blood (hemoglobin is too low, or has been poisoned, or blood flow is restricted because blood too thick, or arterioles too narrow...pulmonary hypertension), or restriction of oxygenated air getting properly close to circulating lung blood (COPD, emphysema, asthma). Another synonym term is dyspnea. Check familydoctor.org for diagnosis decision chart.
• weight loss: in working through this situation, it is of great importance to know whether the lost weight is due to conscious or subconscious intentional reasons and whether or not there has been a measurable (slight, mild, moderate, or severe) loss of appetite. If the appetite is normal and good, then the loss is likely due to the fact that the person is burning up more calories than they are taking in. Check familydoctor.org for diagnosis decision chart.
• chronic pain: This is an area of great difficulty in working up and depends a great deal on what the patient can tell you. Pain syndromes are potentially loaded with emotional aspects (proctalgia fugax, vulvodynia, fibromyalgia, tension headaches, and gastrointestinal motility disorders). I've seen a young patient with severe vulvodynia in a bad marriage become highly sexual in a good re-marriage. Write down when it occurs, what you were doing, how long it lasted, does it come and go or is it steady. And, try to give it a rating from 1 (barely notice the pain) to 10 (the worst pain I've ever had...then be prepared to tell your doctor what that worst pain was). See this page as to back & other pain. Check familydoctor.org for diagnosis decision chart.
• chronic cough
• tremor...trembling or shaking head, hands, etc.
• sexually transmitted disease genital ulcers.
• enlarged spleen.

(posted 2002; latest addition 6 September 2006)