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seeler's picture

seeler

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When are you sick enough to go to the hospital emergency room?

I am always conscious of health care dollars - I try not to go to the doctor, the clinic or the hospital unless it is absolutely necessary.  But how does a person know when it it is necessary?

 

I haven't been feeling well for almost three weeks now.  I've had a cold - ichy, watery eyes, running nose, or blocked nose, a bit of a sore throat, light headed, caughing and sneezing.  You all know the drill.  Finally last weekend I was starting to feel better - it had run its course.  Despite the fact that I am on immune supressant drugs, I though I had it beat.  I actually went out and did a few errands early in the week.  Then on Wednesday afternoon I started to notice a pain in my chest.  It got worse through the evening.  Despite taking Ibuprohnine I was almost in tears at bed time.  I managed to get to sleep.

 

1:30 in the morning I woke up.  The pain was worse.  It hurt to move, to lay on my left side, to turn over, to lay on my right side.  I woke my husband and asked him to drive me to the emergency room - ten minutes away.

 

Worried about long waits?  Just say 'chest pains'.  I didn't even have time to get my Medicare card out before they had me in triage.  Next thing I know I'm on a stretcher in a little curtained off cubicle.  Blood pressure, questions, EKG, questions, oxygen (awe, I could breath), blood tests - a trip down the hall for a chest x-ray.  The pain is easing up - its not as bad when I'm on my back with my head elevated and I think the oxygen helped.

 

The doctor read the results of all the tests.  No, it isn't my heart, or my lungs.  The x-ray didn't show anything.  In fact the only symptom is the pain (which is fading) and the slight cough.  He thinks it is an irritation of the chest wall and advises that I continue pain medication, and possible applying moist heat.   Shortly after 4:00 I am back home crawling into bed.

 

So, did I waste the doctor's and the emergency room's time and resources.  Or is the peace of mind of knowing that I am not dying of a heart attach worth it?   It was to me.  Everybody was so very kind to me.

 

But I still have the pain two days later.  If anything, I am weaker than before.  And I'm so tired of being sick.

 

Does the emergency department send records to a person's family doctor, or can he request them?  If I call my doctor's office on Monday and presuming that I can get past the secretary, will he know what is going on?   I can't keep living like this.

 

 

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trishcuit's picture

trishcuit

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 for starters, I believe any chest pain is a reason to go to the emergency. better safe than sorry.

In this case I would go to your family doc, who  knows your history and (I should certainly HOPE) take more time. Can you take antibiotics? It may have developed into something bacterial. The fact that you are getting weaker does not sound good to me.

DaisyJane's picture

DaisyJane

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I agree that chest pain is always a good reason to present to the ER.  It is also my understanding in this neck of the woods that ER notes are sent to the family doc.  I would see your family doc asap and tell him/her about your er visit.  I would make it clear when you call in (to your family doc) that you need to be seen that day.  According to my family physician that things that get you same day appointments are sore throat, fever, urinary tract infection or anything that might suggest you need to be antibiotics that day.

 

I know I struggle with when to take specialson to the er vs. when to page the pediatrician on call or try to get into one his doc's offices.  My general rule is....do I believe he needs medical attention right now?  Is this something that can wait until tomorrow? Do I believe his immediate health is at risk? I tend to go with my gut instinct and have generally learned to trust that gut instinct as often being correct. Generally if his breathing is compromised, he has had a serious seizure, I suspect a bowel obstruction or a form of pneumonia or I simply cannot figure out what is wrong then I go in. Similar to your experience we generally move through triage very quickly.  Apparently a medically fragile kid with a feeding tube in a wheelchair who is struggling to breathe is high priority (as I hope any kid struggling to breathe would be!).

 

Ultimately I don't think you should apologize for using the ER EVER if you truly think you need medical attention at that moment.  ER's are meant for people who believe something is seriously wrong and need a doctor to see them.  Most good physicians understand that WE are NOT doctors and are doing our best making such judgement calls.

kaythecurler's picture

kaythecurler

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Probably the answer to this question varies from place to place.  Where I am there is often a wait of up to three weks for an appointment at the office.  So the answers is

UTI?  Go to er.

Severe pain?  Go to er.

Sprain? Cut needing stitches? Bad cold lasting weeks?  Go to er.

There aren't enough doctors here to meet the ongoing needs of the community - if you have to see one you go to er.

Big downside to this is of course, the wait time.  I have met people who have waited for a full day and night to be seen.  True emergencies take precedence and sometimes the staff go from one to another.

When there is a true emergency the service is fast and efficient.

kaythecurler's picture

kaythecurler

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this was a duplicate post

crazyheart's picture

crazyheart

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seeler, I am sorry that you are still not feeling well.And don't feel guilty about going to Emerg. That is what it is for - Emergencies and chest pain is an emergency. Go see your family doctor first thing Monday morning or call his answering service to see if he can meet you at the hospital. 3 weeks is too long.

Shaaron's picture

Shaaron

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In answer to your question about your records, the hospital I just went to yesterday here in Kingston actually asked if I wanted the record of my visit there to be forwarded to my doctor so I said yes.

 

Also, you can just plain ask them to send the record to your doctor. 

 

Plus you can ask your doctor's office to request a copy of the record from the hospital.

 

When Monday comes you need to be assertive and firmly request to see your doctor.  They normally set aside bits of time during the day for things like that.  With my previous doctor, for instance, you could drop in or phone and the nurse would sit you in a chair by the hallway to the exam rooms.  The doctor would know then that you had a quick question, or request for a script or that the nurse had put you there because it was urgent that you see him right then and he would stop to talk to you between other patients.

 

Don't delay with health issues... better to err on the ide of caution.  And don't ever think, not for a second, that you are wasting tax dollars.  Besides, they are your tax dollars.

Shaaron's picture

Shaaron

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In answer to your question about your records, the hospital I just went to yesterday here in Kingston actually asked if I wanted the record of my visit there to be forwarded to my doctor so I said yes.

 

Also, you can just plain ask them to send the record to your doctor. 

 

Plus you can ask your doctor's office to request a copy of the record from the hospital.

 

When Monday comes you need to be assertive and firmly request to see your doctor.  They normally set aside bits of time during the day for things like that.  With my previous doctor, for instance, you could drop in or phone and the nurse would sit you in a chair by the hallway to the exam rooms.  The doctor would know then that you had a quick question, or request for a script or that the nurse had put you there because it was urgent that you see him right then and he would stop to talk to you between other patients.

 

Don't delay with health issues... better to err on the ide of caution.  And don't ever think, not for a second, that you are wasting tax dollars.  Besides, they are your tax dollars.

Punkins's picture

Punkins

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You absolutely did the right thing going to the ER, Seeler.  Chest pain is nothing to screw around with.  Besides your heart, you could have had pneumonia, pleurisy, pulmonary embolism - and that's just what I can come up with right off the top of my head.  When you are in enough pain to be crying, you definitely should be going to the ER. 

 

I'm presuming when the doctor says a chest wall irritation, that would be from coughing?  My cousin had something similar to what you describe after having a cold for a while and that's what her pain ended up being from.  She was scared she had pneumonia. 

 

I hope you start feeling better soon, Seeler.  I'm sending out warm fuzzy "pain begone!" thoughts to you ...  

theofrog's picture

theofrog

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I had a similar experience some years ago. The doc said it was an imflamation of the cartilage in the rib cage. He put me on tylenol and sent me home. Always check out the chest pain. Immediately. I have friends who are alive because they did that.

Take care of yourself.

trishcuit's picture

trishcuit

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 I must also repeat that if you are feeling WEAKER, which would mean WORSE, then definitley go in.

Pinga's picture

Pinga

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seeler, I am hoping you are sleeping right now, and that it is a good solid sleep.  Sounds like you definitely need it.

 

That sounds scary..having that much pain.  If you aren't sure, then go to ER, especially for chest pains in my mind.  Though....I should say, I did have pains the other week, and my mother was bugging me to go.  I  did a quick google, as I figured they weren't to be concerned. (again, I was no where near the kind of pain you are talking about...just had an anxious mother)

 

When I do go in, I will generally say.: " If you had been in this spot, what would you have done".  Also, I will ask "could I have waited to see my doctor (he is quite responsive)".  By asking them, and asking for honest response, I learn to tune when I should & should not go.   This was especially important as a new parent.  I happened to have an ER nurse as a sister-in-law, so I would sometimes run things past her as well.

 

I know when I cut my thumb last christmas I asked....could I have just taped it?  The guy looked at me like I had rocks in my head, and then explained why it needed stitches. Then I said, ok, could I have taped it until my doctor was in, or the next day....same thing..he explained why it needed to be done then.

 

Anyhow, never hurts to ask, but if you are scared ...or have a sense you need to be there...go!

seeler's picture

seeler

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Thanks for the positive feedback and for your concern, friends.

 

Actually this morning I am feeling better.  I haven't needed to take pain pills since yesterday afternoon and I actually was out and walked a block last evening - the first I had been out of the house since Wednesday at the ER.  I still am breathing shallowly, but try to remind myself to take a somewhat deeper breath once in awhile (laughter helps).  I still have tenderness - actual pain if I lay on my left side.  I am still weak, but maybe a little stronger than yesterday.

 

Tomorrow I will phone my doctor and try to get past the receptionist.  I will also make sure that the records from the ER are sent to him.  I will get in to see him as soon as possible.

 

I am still not better, but I seem to be on the right path.  I'll try going to church this morning.  A change of scene, a little exercise, something to think about other than my breathing, might do me the world of good.

abpenny's picture

abpenny

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Sorry to here you've been through such a rough patch, Seeler.  If a pain is unusual and scares you...go to er. 

 

I'll be wondering what your family doc says...pls let us know. 

trishcuit's picture

trishcuit

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 In retrospect it does sound like your ribs and chest took a beating from the coughing. I strained the cartiledge in my ribs once and there are few pains to compare to rib pain. The doctor taped my ribs and the support helped.  Several days later, taking that tape OFF, that was another thing.  Made me glad I am not a man with a hairy chest.

Pinga's picture

Pinga

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Seeler, glad to hear you are feeling better.   Here's hoping the mending continues.

kenziedark's picture

kenziedark

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 It may also depend on where we are.  Here in Alberta we also have something called Urgent care.  I've never got, but if I understand it right it's for those more minor cases that don't need to go to emergency (not life threatening) but still should be dealt with in short order.  They're not open 24/7, but have better hours that my family doctor.  

But my doctor is great.  If me or the kids needed to get in, she'll make every effort accomodate.

trishcuit's picture

trishcuit

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 Sort of like a walk-in, for if you need a couple stitches  something? They can also tell you if you need to get your a** up to the hospital.

Namaste's picture

Namaste

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Hi Seeler. Sorry to hear of your trip to the ER, but glad to hear that you're feeling a bit better now. I think you absolutely did the right thing in going to the ER. Better safe than sorry. I think there are some things that you just don't mess around with and should get yourself to the ER asap, including: chest pain, difficulty breathing, unusually heavy bleeding, very high fever, or extreme pain where you can barely stand up. I think it's worth getting anything that is causing you a lot of discomfort or worry checked out.

pommum's picture

pommum

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Seeler - sorry to hear that you haven't been well. Most doctor's reserve a spot each day for what they call urgent cases, so call your doctor's office tomorrow and explain the situation and that you need to be seen right away. Under the circumstances they should make a spot for you! Hope you feel better soon.

lastpointe's picture

lastpointe

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Chest pain is a reason to go to emerg.  Massive bleeding too.  Unable to breath.  Possible broken bone.

 

Unfortunately many patients go with minor reasons.

 

You did the right thing.

 

You say you have had cold and flu symptoms for three weeks.  Possibly you have had two or three separate colds , when you start recovering from one you got the next one going by.

 

Or you could have had one cold, it developed into a bronchitis or pleurisy type infection.  After three weeks i would see the doc.

 

Be specific about the dates you have been ill., the symptoms. 

 

If you have a bad cold/cough you can do things like break a rib or pull chest muscles which causes terrible pain but have no long term affects.  But you may need relief from the coughing and if it has settled into a chest infection you need antibiotics. 

 

Call the doctor, put pressure on the receptionist for an appointment.

 

I also seldom go the the doc and when i call  i always say something like  " you know I haven't been here in three years because of illness so if I am calling now you know I must be feeling terrible and need to see him today.".....

seeler's picture

seeler

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Hi folks and thanks for your concern.  My family doctor phone yesterday when he got the report from ER and I had an appointment today (right past the receptionist). 

 

He agreed that I did the right thing in going to emergency since I was in pain and frightened that something serious might be wrong.  Actually the chest X-ray did show a bit of something on the left lung - that's where the pain was - and it didn't sound right today - so he's ordered another x-ray.

 

He's taken me off the immune surpressant that I had recently started taking for my crohns and ordered a little machine that I breath into every now and then to encourage deep breathing.  (We'll do a different treatment to keep the crohns in check - I'm symptom free from that problem right now)

 

Actually, with his encouragement I think I am on the road to better health.  Each day I will try to do something.

 

We'll check in after the x-ray in about two weeks and see how everything is going.  I am going to be a whole lot better by then.

 

 

Kappa's picture

Kappa

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Sometimes people go to the ER because they don't HAVE a family doctor. I know it is a problem in my part of Ontario right now. Recently, the College of Physicians and Surgeons told the Physicians in Ontario (I think it was primarily this province where it was happening) that no, they were not allowed to "screen" new patients, i.e., fail to take on patients who contacted them for services because the patients had chronic medical conditions, were elderly, etc. Forgive my colloquialism, but DUDE, WTF was up with that?! Ethical breach!! Ethical breach!!

 

I believe you were perfectly justified in going to the ER, especially given that you were on immune suppressants...it could have been something NASTY! It sounded like it might be pneumonia, especially if there was something on the Xray. I'm not a physician of course: this is from knowing others who've had pneumonia (thankfully, never myself). Sounds like you have a good family doctor to, so I'm glad to hear that. Take care of yourself and rest up!

Pinga's picture

Pinga

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Seeler, do take care of yourself.  Sounds like you have a wonderful family physician.

Izziem's picture

Izziem

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It is always a good idea to go to the emergency room with chest pains.  I went through the same thing myself several years ago.  I also did not have a heart problem, but they did pin down another issue that they thought it could be, so I did not come away feeling that it was for nothing.  But given your health issues, I think you did the right thing.  There is a list posted by the American College of Emergency Physicians that says when you should come to the ER.  Very helpful in those times that you're just not sure.  I think your symptoms are on the list as "go"! 

jesouhaite777's picture

jesouhaite777

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Don't mess with the chest .....

qwerty's picture

qwerty

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You're sick enough whenever you think you are sick enough.  Often you are sick enough the day before you actually decide to go.  In short, seeler you've been around long enough that you are the best judge.  In addition, if you are anything like me you get miserable when you get sick and so when you arrive at the ER don't give a flying F_ _ _  about whether your attendance is considered politically correct anyway. 

 

And seeler when you're running around doing errands with most of the symptoms of pneumonia ... you're sick enough.

carolla's picture

carolla

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Phew seeler, I was worried ... then the dates on the posts started getting me confused ... then I realized this incident was a year ago!   Did you ever sort it out? 

Tiger Lily's picture

Tiger Lily

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Hey I didn't catch the date thing.  I was a bit worried too.

seeler's picture

seeler

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I too was surprised that this thread from a year ago surfaced again.  It reminded me of how I spent most of last winter.   I've been surprizingly health this winter.  No colds or  sniffled or sore throats.  I had both flu shots - regular and H1N1.  No reaction; no flu.  Lets keep it that way.

 

Northwind's picture

Northwind

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I was a little worried too......until I saw the dates, and knew that seeler had been posting lately. I am glad you are okay seeler.

 

My husband took a little trip to the Emerg in May. We contemplated whether to go to the hospital or to the walk-in. We decided that because his symptoms were so unusual for him, we'd go to the Emerg. Well, his BP tanked when he was there, and he got bumped up the triage list in a flash.........turns out it was some sort of allergic reaction. He has been fine since.

 

It can be a difficult call, but you have to do what you think is best. The staff there get paid to treat you whether you are being a nuisance or not.

Tiger Lily's picture

Tiger Lily

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Glad to hear that you're having a good winter health-wise this year Seeler!

Abygail's picture

Abygail

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I had some pretty major surgery this year in CT. The doctor and his staff were terrific. I still couldn't get out of the place quick enough. This is just due to my hatred/fear of a hospital room.
Drug Rehab Tucson

Dcn. Jae's picture

Dcn. Jae

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I always think that if you're wondering if it's time to go to the emergency room -- then it's time to go.

 

 

 

Judd's picture

Judd

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1) Chest pains, Kidney stone pains

2) Broken Bones

3) when the bleeding doesn't stop from an injury

4) difficulty breathing

5) high fever (over 103)

6) anaphylactic shock

7) stroke symptoms

8) injury to eye(s)

9) concussion, gunshots, knife wounds, bite wounds

10) poisoning.

11) siezures

12) when you know the kid (baby) is hurt, but he (she)  won't cry.

- and that's just the ones I've experienced

Mely's picture

Mely

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In BC they have an 811 line that you can call and speak with a nurse to ask for advice.  I had a funny episode last year when my heart suddenly started racing (250 bpm) out of the blue.  I felt weak and dizzy.   After awhile I called the 811 line , and the nurse told me to call an ambulance.  But I didn't do that, I had my husband drive me to the hospital.  Like Seeler, I didn't have to wait at all but was rushed in.  I ended up having some sort of injection which actually momentarily stopped my heart, and sort of reset it so it beat normally again.  It has never happened again (yet, knock on wood).

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