Dr. Mark Buckner

If this has been going on for more than 3 days, it is likely bacterial. There could be a number of reasons for this. I suggest that you go to the nearest ER or urgent care clinic so you can be tested and given IV fluids.

It sounds like this is a blood pressure level that constitutes an emergency, especially if the levels are consistent. More importantly, if she is elderly and has other medical diseases such as diabetes, this could be the beginning of a heart attack. It definitely warrants a trip to the ER.

Appendicitis is a tricky illness. Quite often, it does not present with the textbook symptoms. It often presents with patients having atypical symptoms. Classic textbook symptoms would be pain in the abdomen, often starting at the umbilicus, and then after a variable time moving to the right lower quadrant of the abdomen. It would be a constant pain. As it progresses, other symptoms would begin, such as nausea, vomiting, fever, and possible urine problems. The urine symptoms are because sometimes an inflamed appendix will touch and push on the bladder. It is always hard to diagnose a patient without being able to examine them, but if the pain is as severe as you say, I think it warrants a trip to the emergency room for labs, an exam, and probably a CT scan. Don't put this off too long, as the appendix can rupture, which will make the hospital stay longer and cause many complications.

Yes, someone could have a seizure if hit hard enough in the head. Depending on the mechanism of injury, being hit in the head could cause facial fractures or bleeding in the brain - which might subsequently cause of seizure. If someone is seizure prone (in other words, has had prior seizures or is at risk of them), they should have an evaluation done by a neurologist, and possibly be put on anti-seizure medicine.

This is a difficult question to answer, for one reason. We are all different -- I think of it as we are all wired differently. Because of that, there are a significant percentage of patients who do not present with the classical symptoms that we read about in books. For example, some patients never have any pain when they are having a heart attack (AMI FOR SHORT). They may only feel tired, or feel short of breath. The key is to prevent the AMI from happening, which means seeing your doctor, your PCP, regularly. Know what your risk factors are for having heart disease. Here is a list of risk factors that increase your likelihood of having an AMI, or heart disease. A family history, especially if people in your family have heart attacks at a young age, like 30-50 years old. This is probably the worst risk factor you can have and can't change. Smoking, having uncontrolled high blood pressure, high cholesterol, being overweight, not exercising at all, and having a poor diet, one that is high in fat. The classic symptoms of a heart attack, or AMI, are chest pain in any area of the chest, especially if the pain gets worse with exertion and gets better with rest. Other symptoms include shortness of breath, chest pain that radiates down either arm, or to the neck or back; getting sweaty with the chest pain is a bad sign. Nausea and vomiting are also possible symptoms. If you or anyone starts having these symptoms, don't wait and hope they will go away - ESPECIALLY IF YOU HAVE SEVERAL RISK FACTORS - go to your Dr. or to the ER. If someone has cardiac arrest in front of you, the first thing to do is have someone call 911, then hopefully someone has taken some type of CPR class. Check for a pulse, check to see if they are breathing, if their chest is rising and falling; if it isn't and there's no pulse, start CPR until an ambulance can get there. I recommend that all family members who have any risk factors at all take at least a basic CPR course.
Cardiac disease can be very tricky, even for a Board Certified ER Dr., again, because not everyone has textbook symptoms. I have personally found 2 patients over my >20 year career who complained of a toothache, but something about them wasn't right. I asked them cardiac questions, we did an EKG, and they were both in the midst of having a heart attack. So I never let my guard down when it comes to this diagnosis. Hope that helps.