7 Pains you should never ignore

In March 1997, my dad had a small stroke. Unlike most men, he went to a doctor to discuss his symptoms— weakness on his right side, a problem with balance, blurred vision. Two years later, he was gone, a victim of a fall down a flight of stairs at our home.

He was only 59, a little more than a decade beyond where I am right now. When I reach that age, my daughters will be in their mid-twenties, when life is just opening up for them.

And I guarantee you, I plan to be there for them, even if all they want from me is a loan to tide them over until payday. In fact, there’s a lot I still want to experience in life. Often, my personal to-do list is shunted to #3 on the priority list, behind family and work obligations.

But I promise you, I intend to get to the stuff I want to do, which is one of the reasons I wrote The Better Man Project. It’s all about motivation and strategy that will engage guys—like me, like you, maybe like your dad—in the DIY projects that will improve their lives right now. It’ll help us all tackle problems like too much weight and too few workouts, plus a healthy dose of relationship rehab to keep love ones close, and bed sheets smokin’.

Of course, none of that will happen for me if, like my dad, I check out early.

Perhaps you worry about the same?

Let’s face it: A lot of men die young. In fact, guys between the ages of 20 and 40 are twice as likely to die than women. One big reason: We ignore our symptoms, even dizzy spells or chest pains, without scheduling the potentially life-saving session with a white coat.

Not long ago, we asked writer Allen St. John to put together a list of 7 pains men should never ignore. These are not negotiable. If you feel one, call your doctor right away. And then thank me, on your 60th birthday. It’s one my dad never saw, but you and I will both want to party through.

1. SUDDEN GROIN PAIN

What it feels like: It’s as if you were kicked below the belt, but the pain is not quite as intense. Sometimes, it’s accompanied by swelling.

What it is: It’s probably called testicular torsion. Normally, a man’s testicles are attached to his body in two ways: by the spermatic cords, which run into the abdomen, and by fleshy anchors near the scrotum.

But sometimes, in a relatively common congenital defect, these anchors are missing. This allows one of the spermatic cords to get twisted, which cuts off the flow of blood to the testicle. “If you catch it in 4 to 6 hours, you can usually save the testicle,” says Jon Pryor, M.D., a urologist with the University of Minnesota. “But after 12 to 24 hours, you’ll probably lose it.”

Another possible cause: an infection of the epididymis, your sperm-storage facility.

How to fix it: A surgeon will straighten the cord, and then construct artificial anchors with a few stitches near the scrotum. If it’s just an infection, antibiotics will take care of it quickly.

2. SEVERE BACK PAIN

What it feels like: Similar to the kind of agony you’d expect if you’d tried to bench press an armoire. The usual remedies—heat, rest, OTC painkillers—offer no relief.

What it is: “If it’s not related to exercise, sudden severe back pain can be the sign of an aneurysm,” says Sigfried Kra, M.D., an associate professor at the Yale school of medicine. Particularly troubling is an abdominal aneurysm, a dangerous weakening of the aorta just above the kidneys. If it bursts, you’ll die within minutes.

A less threatening possibility: You have a kidney stone. More pain, but you’ll only wish you were dead.

How to fix it: Once the aneurysm’s dimensions are determined, via a CT scan, it’ll be treated with blood-pressure medication or surgery to implant a synthetic graft.

3. PERSISTENT FOOT OR SHIN PAIN

What it feels like: A nagging pain in the top of your foot or the front of your shin that’s worse when you exercise, but present even at rest. It’s impervious to ibuprofen and acetaminophen.

What it is: Probably a stress fracture. Bones, like all the other tissues in your body, are continually regenerating themselves. “But if you’re training so hard that the bone doesn’t get a chance to heal itself, a stress fracture can develop,” explains Andrew Feldman, M.D., the team physician for the New York Rangers. Eventually, the bone can be permanently weakened.

How to fix it: You’ll be told to stop all running until the crack heals. Worst case, you’ll be in a cast for a few weeks.

4. SHARP PAIN IN THE ABDOMEN

What it feels like: All the metaphors apply—knife in the gut, bullet in the belly, skewer in the stomach—except this attack is from within.

What it is: Since the area between your ribs and your hips is jam-packed with organs, the pain can be a symptom of either appendicitis, pancreatitis, or an inflamed gallbladder.

In all three cases, the cause is the same: Something has blocked up the organ in question, resulting in a potentially fatal infection. Exploding organs can kill a guy. See a doctor before this happens.

How to fix it: If the pain is in your lower-right abdomen and your white-blood-cell count is up, says Dr. Kra, it’s probably appendicitis (outcomes the appendix).

Pain in your upper abdomen with high white blood cells usually spells an inflamed gallbladder (goodbye, gallbladder).

And if it hurts below your breastbone and certain enzymes in the blood are elevated, then pancreatitis is probably the culprit. (The pancreas stays, but a gallstone may be blocking things up. If so, the stone and the gallbladder may have to come out.)

5. TRANSIENT CHEST PAIN

What it feels like: A heavy ache that comes on suddenly and then goes away just as quickly. Otherwise, you feel fine.

What it is: It could be indigestion. Or it could be a heart attack. “Even if it’s very short in duration, it can be a sign of something serious,” says John Stamatos, M.D., medical director of North Shore Pain Services in Long Island and author of Painbuster.

Here’s how serious: A blood clot may have lodged in a narrowed section of a coronary artery, completely cutting off the flow of blood to one section of your heart.

How much wait-and-see time do you have? Really, none. Fifty percent of deaths from heart attacks occur within 3 to 4 hours of the first symptoms. You’re literally living on borrowed time.

How to fix it: A blood test checks for markers of damaged heart tissue. Treatment: angioplasty or bypass.

6. LEG PAIN WITH SWELLING

What it feels like: Specifically, one of your calves is killing you. It’s swollen and tender to the touch, and may even feel warm, as if it’s being slow-roasted from the inside out.

What it is: Maybe deep-vein thrombosis, or DVT, which occurs when blood pools in your lower legs and forms a clot. Next thing you know, that clot is big enough to block a vein in your calf, producing pain and swelling.

Unfortunately, the first thing you’ll probably want to do—rub your leg—is also the worst thing. “It can send a big clot running up to your lung, where it can kill you,” warns Dr. Stamatos.

How to fix it: Doctors will try to dissolve the clot with drugs, or outfit vulnerable veins with filters to stop a clot before it stops you.

7. PAINFUL URINATION

What it feels like: Relieving yourself has become an exercise in expletives, and your urine has a rusty tint.

Related: 4 Things You Never Want To See In Your Pee

What it is: Worst case? Bladder cancer, according to Joseph A. Smith, M.D., chairman of the department of urologic surgery at Vanderbilt University. The pain and the blood in your urine are symptoms of this, the fourth most common cancer in men.

Smoking is the biggest risk factor. Catch the disease early, and there’s a 90 percent chance of fixing it. Bladder infections share the same symptoms.

How to fix it: Doctors diagnose this by process of elimination. Urinalysis first, to rule out bugs, followed by inserting a scope to look inside the bladder. If you have a tumor, it’ll be treated with surgery, radiation, or chemotherapy.