Dr. Toshi Is In! "My doctor says that I have a 'chronic cough.' What does 'chronic' mean?"

Dear Dr. Toshi,

  "My doctor says that I have a 'chronic cough.'  What does 'chronic' mean? Also, how is this related to deciding whether to go to my doctor, an Acute Care clinic,  or the Emergency Room?"  

 You might think you know what a common word means, but sometimes common words mean something different when used in medicine. The words "chronic" and "acute" are examples of those.

Here are some brief definitions of the words "chronic" and "acute" according to the huge Steadman's Medical Dictionary: Chronic: 1. Term used to describe persistent disease or illness. 2. Referring to prolonged or long-term exposure to something.

The key words for chronic are "persistent" and "prolonged or long-term." But the definition for each medical condition may be different in terms of length. For instance, a chronic cough usually means a cough lasting more than eight weeks, but chronic dyspnea is difficult or labored breathing lasting more than one month.

Acute: Referring to a disease of sudden onset and brief course, not chronic.

The key words! Or acute are "sudden onset" and "brief course." So, when you hear a doctor say "chronic" or "acute," it's related to how long ago the symptom or medical condition started. Did it start today or did it start 30 years ago? Did it start an hour ago or two months ago? 

The summer is here, so you might be thinking about taking a trip somewhere (before another possible COVID-19 lock down). And you might need to see a doctor during your trip because something "acute" happened. Maybe you cut your finger. Maybe you started feeling sick with cold symptoms. Or you started having chest pain. What should you do? Should you go to an Emergency Room (ER)? 

You may see a sign for an "Acute Care" or "Urgent Care" clinic. This is a clinic where you can just walk in without an appointment if you need to be seen right away. As the name indicates (Acute Care/Urgent Care), you would go to such a clinic when you have an acute condition (or an acute worsening of a chronic condition) but not a chronic condition that hasn't changed in some time.

The next question is whether you should go to one of those clinics or to an ER.

Here's a tip: II you're having a serious symptom or condition such as chest pain, sudden shortness of breath, stroke-like symptoms, a severe allergic reaction, a deep cut, a burn, a psychiatric condition in which someone could be harmed, or some other serious medical problem, then you need to go to an ER. Also, it's usually better to call 911 instead of trying to deal with it yourself because you may need emergency help on the way to the ER, which an ambulance can provide. If you get something like cold symptoms or a minor cut that you normally would have gone to your doctor for, but it's a weekend or you're out of town, then you can go to an Acute Care/Urgent Care clinic. If you aren't sure, whether you should go to an Acute Care clinic or ER, then err on the side of caution and go to the ER. 

But if need to see a doctor for a chronic condition, it's best to see your regular doctor or provider unless something changed acutely.

Dr. Toshiko (Toshi) Luckow, MD is a Family Medicine physician at the West River Health Services hospital and clinics.