Wednesday, December 21, 2016

The Successful Patient: What is a Medical Emergency?

The holidays bring together family, often including friends, and that means lots of potential for health issues. It could be as mundane as indigestion after Christmas dinner, or taking a fall while ice-skating. Or it could be something more serious. It pays to be prepared for anything. But when do you have a real emergency on your hands or something just masquerading as one? 

In the past, I've postponed taking action on a physical symptom because of my mother's voice in my head admonishing me not to bother busy doctors and ERs are expensive. In fact, several times I failed to take good care of myself and ended up in more serious trouble than I would have been if I'd not listened to my mother's voice. Nowadays, there are options to help with determining what treatment is needed.

Triage Nurse Lines
Most medical insurance companies now offer a phone number to a nurse triage or support line. Calling one of these nurses, usually an RN, can be helpful, especially for things like sprains, cuts, flu and broken bones (determining if it's broken or not). I've used a nurse triage line on occasion with mixed results. The nurses I've spoken with have been professional, caring, and worked hard to help me, but they didn't have the specialized knowledge to take into consideration my whole body and its issues and how they could be affecting me. They will tell a patient one of three things: instructions for self-care/instructions in case the condition worsens, a suggestion to go to urgent care, or a usually strong suggestion to get thee to the Emergency Room.


A similar kind of phone resource can be offered by large teaching hospitals. I've used this with much better success. I've called the hospital I usually go to -- it's a teaching hospital -- and asked for the Resident on Call for whatever specialty I've needed, e.g. gastroenterology, pulmonology, etc. The Resident on Call then calls me back and we discuss my symptoms.  Most doctors and clinics also provide a phone number to call after hours to talk with a doctor on call. I've used these too with success.

These phone services are usually free. Some doctors and/or clinics also provide the option for electronic consultation but this could require paying a fee depending on the reason for the consultation, and they usually require an appointment unless it's just sending an e-mail.

Urgent Care
This medical service is usually provided by a hospital or clinic. Urgent care is best when connected with a hospital in case a patient needs more than urgent care. I've gone to urgent care when I've had unexplained pain that I felt needed immediate attention to determine the cause, but I haven't been ill, and it's been after my doctor's regular hours. I know of people who use urgent care when they have the flu, fever, stomach flu, and other minor illnesses that may need treatment and it's after regular doctors' hours. Urgent care is cheaper than going to the Emergency Room.



Emergency Room 
So, when do you go to the Emergency Room? Listen to your intuition (your body) – if you feel you need to go to the ER, go.  Some symptoms that need immediate medical attention:
  •  Difficulty breathing
  •   Fainting or dizziness
  •   Chest or upper abdominal pain or pressure
  •   Uncontrolled bleeding
  •  Coughing or vomiting blood (also bloody diarrhea)
  •   Sudden or severe pain anywhere in body that doesn't stop
  •   Poisoning, includes food poisoning
  •   Major injuries, such as broken bones or head trauma
  •   Sudden facial drooping or weakness in an arm or leg
  •  Unusually high fever
 I've learned that every time I've waited to go to the ER, my intuition had been urging me to go. Every time I've gone, I was right to go, also, and all but one resulted in admission to the hospital for some serious stuff (pancreatitis, shortness of breath from inflammatory lung disease). There was a time years ago when I was experiencing a bowel blockage and in extreme pain for almost 2 days -- I could not move and lay in bed sleeping through it -- and I did not go to the ER. I should have gone. I was lucky that my bowel didn't rupture. I eventually went to my doctor and she figured out the problem so I could get treatment. But I'll never forget that pain.

So, during this holiday season, take care of yourselves!  

Happy holidays and a very merry New Year! 

 
 
 



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