Did you know your primary care provider can help with that?

You’re wrapping up an appointment with your doctor, just about to walk out of the exam room, when the thought occurs. While we’re here, can I ask about one more thing?

These “door handle questions” can seem small, but they’re important for your health and well-being.

“Sometimes there are changes that people just think are normal, but it’s like, ‘No, we can actually do some things about that,’” said Makayla Bretschneider, M.D., who practices family medicine at Sanford Watertown Clinic in South Dakota.

“We manage a lot of different things. We see a lot of different things. So even if it’s something that we maybe haven’t necessarily seen before or dealt with before, we’re not afraid to say, ‘We’re going to start here.’”

One benefit of bringing the issue to your primary care doctor is they’ll often start with a broad approach, taking several causes into account. That list narrows as they work with you to develop a treatment plan.

“Your primary care is hopefully someone you’ve seen before, so they know you better. They know based on your medical history or things that you’ve been diagnosed in the past, ‘These are things that I’m more concerned about or are more likely,’” Dr. Bretschneider told Sanford Health News.

The subtle signs

Not every symptom can seem like a telltale warning.

High blood pressure is a silent killer because symptoms don’t always feel overt. Frequent headaches, vision changes and chest pain are all possible signs of high blood pressure and should prompt a visit with your doctor.

“Blood pressure can impact your kidneys, so you can have worsening kidney function, which you don’t always have signs of if you’re not getting seen regularly and having some lab monitoring,” said Dr. Bretschneider.

Symptoms for diabetes and prediabetes, such as increased thirst or urinating more frequently, can also be difficult for patients to recognize.

“Diabetes is hard on your nerves. Numbness, tingling in the feet can happen and your blood sugars don’t have to be way out of control,” said Dr. Bretschneider. “We’re seeing some people with really high A1Cs, and they had symptoms, but they didn’t really put it all together.”

‘I’m feeling more tired lately’

That rundown feeling is no fun for anyone. But you’re not alone.

Fatigue is among the more common concerns raised by patients, including trouble falling asleep, difficulties staying asleep or not feeling well-rested after waking up. It also can have several causes.

“Fatigue is one that’s probably a good place to start with your primary care just because we can look at things broadly,” said Dr. Bretschneider. “We can actually work up a diagnosis and treat without you having to go see a specialist.”

Factors your doctor may consider when diagnosing fatigue include:

• Medical and family history
• High blood pressure
• Overweight
• Menstrual cycle factors such as heavy bleeding
• Iron deficiency
• Anemia
• Smoking
• Alcohol

Those factors also determine the initial steps for treatment.

“If I have a 40-year-old male who has high blood pressure, who snores at night, we might check some lab work, but we’re probably sending you for a sleep study,” said Dr. Bretschneider. “If I have a 30-year-old female who has a period every month and is bleeding for seven days and bleeding through onto her clothes one or two days, we’re probably going to start by getting some blood work to check your hemoglobin because that is a more likely thing.”

You doctor can also conduct depression and anxiety screenings to see if mental health could be influencing sleep habits or restfulness.

“Some people don’t always come out with that right away. They think that’s just the way their mood is and the way they’re feeling is just normal,” said Dr. Bretschneider. “With depression, you could be sleeping a lot more, but still feel not well rested. Anxiety can interfere with your sleep, or you’re not getting good sleep at night, because your mind’s always going.”

‘My skin feels irritated’

Dry skin. Itching. Rashes. It’s an unsettling feeling when skin-related issues creep up seemingly out of nowhere.

“A lot of treatment for that is starting with an oral antihistamine just to help decrease that allergic response. Sometimes it could be a topical steroid,” said Dr. Bretschneider. “Ultimately, it’s likely removing whatever’s triggering it, which can be difficult for people to try and nail down.”

Then the scavenger hunt begins. Soaps, lotions and detergents are common culprits. Your primary care doctor can help with recommendations, such as neutral or fragrance-free products or over-the-counter options. They can also help identify other possible sources of irritation.

“Even just something new in your environment,” said Dr. Bretschneider. “Did you get a new plant? Is there something else that came in that’s maybe not directly on your skin, but could be in the environment that you’re in every day?”

‘I’m getting sick a lot’

Even common health issues have niche concerns.

Cold, flu and sinus infections can often be treated at home with rest, hydration and over-the-counter medication, but the frequency or severity of those illnesses raises questions.

“If you’re having more than a couple a year, or if it seems like you treat it and it’s back in a couple weeks, a month, I would recommend reaching out to your primary care,” said Dr. Bretschneider.

Your doctor could help determine whether a structural issue is making you more vulnerable to sinus-related illnesses.

“If you have deviated septum or polyps or just things within the nasal cavity, that could be predisposing you to that,” said Dr. Bretschneider. “Then we can get you to see ENT (ear, nose and throat) and get more definitive treatment and management of it.”

‘This has been hurting for a while’

Pain is a problem with an array of possible solutions.

The conversation with your doctor will often start with conservative pain management with common medications like Tylenol or ibuprofen. Depending on your medical history and mobility, a closer look may be needed.

“We can get an X-ray in clinic that’ll show us arthritis, if there’s any alignment issues, things like that,” said Dr. Bretschneider, adding that physical therapy is a typically great place to start for treatment.

Steroid injections in the joint are also a possibility your doctor could recommend.

“If we get the imaging and we see there’s arthritis, we’ve tried physical therapy, we’re trying the conservative stuff and we’re not getting good relief, then we can try a steroid injection and see how that goes,” said Dr. Bretschneider. “You can get at least a good amount of workup and treatment through primary care before going to a specialist.”

‘What can I do for weight loss?’

Developing healthier habits doesn’t have to be a solo mission. Your primary care doctor can help create plans for diet and exercise or even help with weight loss goals that are already in motion.

“Most of time when people are coming to us to talk about it it’s because they’re at a point where they’re ready for something to help them with some lifestyle changes that they’ve already made. And there are quite a few options for that,” said Dr. Bretschneider. “You don’t also have to go to the weight loss clinic. A lot of us do weight loss management as well.”

Weight loss management conversations can center on opportunities for healthier living such as:

• Engaging in a physical activity you enjoy
• Identifying areas where you’re getting extra sugar or extra calories
• Finding alternatives for a sweet tooth

Your primary care doctor can also talk through GLP-1 medications and other possible treatments. That discussion will include finding which medication might be the most beneficial based on health conditions like blood pressure issues, anxiety, depression or pre-diabetes.

“It shouldn’t be the only thing we’re using for weight loss, but it can help with weight loss,” said Dr. Bretschneider.

Ask the question

You know your body better than anyone, which means you know when something doesn’t feel right. And no question about your health is too small or too sensitive to address.

“When it comes to more private or sensitive things like female reproductive stuff – or even for men, like erectile dysfunction, BPH (enlarged prostate), urinary stuff – those are things that people don’t necessarily want to bring up a whole lot. And those are things that we can actually really help with,” said Dr. Bretschneider.

Annual visits also go a long way toward establishing a relationship with your primary care doctor. Those appointments can make asking the niche questions feel like less of an obstacle and provide a better foundation for finding answers.

“The least that can happen is we run some tests and everything comes back normal and we give you the reassurance that everything looks fine,” said Dr. Bretschneider. “We could also catch something relatively early on and be able to treat it and make you feel better, whether it’s something simple or something more complex.”

You can find a provider or a nearby clinic online. You can also schedule an appointment by phone or on My Sanford Chart.

Learn more

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Posted In
Family Medicine, Healthy Living, Internal Medicine