# How to get the best and fastest emergency room care



## GNC Crohn's Man

How to get the best and fastest emergency room care..
Again bear with my spelling and grammar skills cause they weren't the best to deal with.. Plus when you are taking Valium based meds they have a tendency to decrease a bit...

This is if you are going to be admitted to the ER the normal way and not by the paramedics...:devil: 


You not a hero... If your going to to the hospital you are sick very sick.. If you are like me you would have been vomiting/dry heaving for about 3+ hours
before you even leave the house... Maybe even several hours or days... When I dry heave my whole body tightens up and basically goes into convulsions... So by the time my brother (he generally takes me to the hospital) gets me in the truck I am about ready to pass out and I can not walk on my own...

So get whomever to drive you up to the ER front door.. Get them to help you into a wheel chair... I think being put in a wheelchair and being wheeled in may help the triage nurse decide to send you back into the actual ER for treatment...

MAKE SURE YOU HAVE THESE THINGS with you or that the person driving and sitting with you at the ER waiting room has these things... (in my case it's generally my brother)... I will go into further detail as to why you need these items and what to do with these items.

1) Drivers License
2) Insurance Card
3) Less than $20 in cash (You need this is $5's and 1's) No $20's
4) A credit card or debit card that can act as a debit card
5) A trash can
6) Small thermal blanket


1) Drivers License

This is standard it does not matter what is on your license just so long as you have one... NEVER EVER EVER EVER EVER GIVE them more than one address... The address you give them is the address all bills will go to...It can be different from the address on the license... They WILL say that it won't be a problem to have a primary address and then a secondary billing address... And that t,hey can do this in the computer but just like anything the more info you give them the more stuff will get screwed up... So only give them the address you want the bill sent too... Phone numbers you can give them... As your primary phone number give them the number of the place you are currently living at or the one you use the most (such as a cell phone)..

They have about 5 or more different contact numbers for me at every different hospital I have ever been in... Let's see that would about 6 or 7 different ones (hospitals not hospital visits)... But my address is the same for all of them... My insurance is under my dad and my dad pays for my medical bills.. My parents are never going to move away from their house. So I don't ever have to worry about my medical bills, them getting payed, or dealing with the insurance claims... Until I get my own job security, and my own insurance. No I Do not live with my Mom and Dad (they live 180 miles east of here) But, we both use the same credit union so he (my Dad) can transfer money into my account whenever he wants too.
If you give them two different address then I'm gonna laugh at you and say I told you, so as they combine the two address and then they try to send that off into limbo land to get it paid... You will then get phone calls from collection agencies demanding payments on bills that you never received since the bill got sent off into postal limbo..

Trust me I've been there all of these things I'm telling you are from 1st hand experience not second or third hand...


2) Insurance Card

(if you don't have insurance I'm sorry but your playing Russian roulette with that hospital) If you do not have insurance you are more likely to get care at a religiously funded hospital. They may even be able to treat you for free or give you a major deduction in your medical costs... Just depends on the hospital... Example where in the south we have "Baptist Health" hospitals that are partial funded by the

NEVER go to a college hospital and NEVER go to a hospital that is funded by private investors.. They will always charge you full and The hospitals there are there to make money... Not lose it so they will more than likely boot you out the door unless your gonna just die right then and there... They will also NEVER cross off your medical bills even if you can not afford them... Again they are in the business of making money...

Also college hospitals are guess what? Full of medical and nursing students...
And yes they will make the same mistakes over and over again on you because every time you go in there will be a new set of student doctors/nurses.. Plus the only nurses/docs with lots of experience are having their hands full teaching the students...

I had a great doctor that I got along with great at a college hospital... She was in her fellowship though so once she completed that she left... I tried staying with that college hospital some more but it just wasn't worth it...

In choosing a GI doctor you must choose one that is both competent and experienced AND that is located in a good hospital with a good nursing staff...

I'm lucky now... I have a a very good experienced Doc now and plus the hospital his patients go to is literally right across the street from where I live... If I got the right room and the trees weren't in the way then I could see my house from one of the windows in the hospital...


3)A trash can - with a several plastic trash bags (I just put Wal-Mart bags in mine) covering it... unless you just want to throw away that garbage can.. It's up to you....

You need this to dry heave into... Save all of your dry heaving if you can until you ge tinto the ER waiting room... Do not hold back your dry heaving spells... Try to make them sounds as gut wrenching and as painful as you can... (You probably won't have to add to much emphasis on that if your like me when you go to the er)

If you think this is selfish or wrong then you obvisouly do not know how an ER works or the patients they receive there..

The ER gets 3 kinds of patients

A) People that don't have insurance or are just to damned lazy to go to the doctor. These are non life threatning situations that in 80% of all these cases could be solved at a docs office unless they neeed an x-ray... Again non life threatning....

B) Crazy people these people are literally crazy they may seem like they are suffering from physical symptoms they may just look crazy thye may look normal.... Either way the problem is physciatric.... Again non life threatiing...
Just really damned annoying...

C) Actual sick people.... Sometimes these people are more sick and in pain then you sometimes they are not.... The triage nurse will determine which ones should go back first...

4) A small thermal blanket... Go by Wal-mart or wherever right now if you do not already have one and by a small thermal blanket.. Why a thermal blanket and just a small one? It traps heat very very very well.. Plus you can get a small one... So that way your not luggign around a big blanket from home into the ER waiting room. You can just have a nice small thermal blanket drapper oer the knees of your strether... And sinceit is smalll you can take it on or off as you like. Also since it is thermal it doesn't let loose much body heat at all so if you wan tto get warm you can get warm quick and not have to worry about any kind of eletric device or ice hot patch.. Make sure you have one of these and you know where it is for when you go to the hospital.
Why? Because hospitals don't give out blankets in the ER waiting room... So you may get very very very cold... Once your inside the actual ER and in a bed you may or may not need it ... But you might be waiting out in the ER waiting room for up to 6+ hours so it is a very very wise invest ment to bring that blanket..

[5]5) The money is thier just in case you need some pettycash for whatever...

[6] The credit card is thier in case you have to make a payment or if you want anything ordered by phone (Like me I always order 3 regular breadsticks with just cheese sauce from papa's john's... Thier bread sticks are jus that backed bread no cheese no extra flavor nothing.... So it is a great starter carb fora low residue diet...

Yahhhh I think I may be able to sleep noe ficing to take 2 more 1 mg adavian and 2 more resterall...

If not I'll just back here in a few more hours in on even further zombie state than I am nows...


Okays cya guys later.... And let me know if some of typing is illegable or misleading because again I'm not working at 100% brain poer here...

Ok cya later

Daniel

Just reading this post is giving me a headache; I am gonna polish it up, fix the horrendous grammar mistakes, and cut out the sections that aren't relevant.


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## Jeff D.

Nice post Daniel


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## GNC Crohn's Man

Next is part two... You are now in the real ER... First thing you do is as ask if you can get the ER doc to go ahead and right you up orders for pain and nausea meds... Try dry heaving a few times while doing this.. It speads up the process... They will say they can't give you anything until they get an I.V. in you and start you on a saline solution.... You say you can give me all of that together (iv. started and in, pain meds, nausa meds, and a saline drip) if the doc writes those orders while they are gettign you preped... The nurse should come back with the iv kit and a bag of saline... After they hoook that up ask them if that order for pain and naueas meds is up... It should be if you did this right... Now you should be free 


Also when they say to rate your pain scale never say anything other than 10... 
Also tell them your pain and nausea comes in waves so even if you don't look that bad right nown 5 minutes you may be biting through the sheets and in tears.

I'll finish this later... Gotta drug myself up nice and good if I plan on sleeping


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## kc0eks

I found that having my mom come with me helps a lot. I may be 22, but she seems to be good at conveying just how badly I hurt. I dont seem to be able to do that. 

But anyway, nice post  Always helps to be prepared, as the ER is not the most enjoyable experience to begin with,.


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## Skinsfan1229

I couldnt havent explaine dit better myself GNC crohns man!

oh and by the way, I do bring my mother with me also, seems to speed things up, and they tend to be more willing to give larger amounts at a time of pain meds. I have built a huge tolerance as I'm sure some of you have, and 1 or 2mg of daluadid doesnt do it anymore, I have to have between 4 and 6 mg at a time, and that will last about 45 mins. anything less then it will only last about 15 to 20 mins. 1mg is sometimes a joke and doesnt do anything.


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## Cara Fusinato

I just go in with 104° fever and they take it pretty seriously.  I also go to a "snobbier" hospital -- it's still a community, but the downtown community gets way more volume and this one is in the snobby part of town -- so they move people faster and have minor triage and major triage -- two tracks help tremendously.  I also cry a lot and it conveys pain better than sitting in stoic silence.  Then I turn on the charm and joke with the staff and express concerns about other people -- it wins them over and they help me 'cause they like me.  I mean, I'm not lying, I have a sense of humor and I do feel pity for others, genuinely.  They are just so used to being yelled at, that they appreciate the difference.  That's how I get the best and fastest care.


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## GNC Crohn's Man

Hey mickey can you sticky this post?


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## leonghoward

I try to have my wife with me .She worked at our local hospital , so she knows most doctors and nurses. It got me a private room. when I was admitted.


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## GNC Crohn's Man

Sticky this post please


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## Skinsfan1229

No problem


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## lau

*scream as loud as you can*

:ybatty: the first time that i went into hospital i screamed the room down because i was in that much pain and they took me in within about 3 mins. i found that screaming and crying (which wasn't done on purpose it really hurt that bad) really gets the attention that you need. but i dont ask for pain meds i usualyy get morphine and i hate it every time i have to get i throw up because it gives me really bad nausea.
the second and third time i dont remeber much i passed out and woke up on the revival table with all those heart moniters attached to me and all these really sticky moniters stauck i had to wait there until my bp got high enough for me to be moved until then no one was aloud to touch me not even for morphine. it took from 8 at night until 4 in the morning for it to rise far enough for them to be able to swap my bed to move me into a ward.
but i agree with the bin or at least park yourself next to a bathroom if you have to wait. thankfully i havent had to as of yet.
so scream as loud as you can hold you belly and draw all the attention to you so that even if there just putting you in to get some peace and quiet you go in pretty fast! 
i hope you dont have to use these tactics but if you have to you have to. 
oh and parents there always help that way there more likely to give you somthing because thenthey cant object to it later on.

laura


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## TammySue62

How do you get into emergency fast when you live in Canada? I have to show my health card, answer all these questions  that are not related to CD. I usually go by ambulance for to reasons,avoid the non related questions and skip by the trig room. I usually have a fever of 104 and the past 4 visits have been related to my picc-lines They get infected and have to be removed and a new one put in.



                                                                          TAMMY


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## lizziecee

*Er procedures....*

Well, my experience with the ER in America(or A&E as we call it here in England) was a little different, as I was visiting friends in Florida. It was over Christmas and New Year's and I thought I had flu, as my host had. I woke up one morning, had a high fever, muscular pains, uncontrollable diarrhoea and a severe rectal haemorrhage. Didn't want to make waves, so went back to bed. 7 hours later, went to the loo, and same thing happened, filled the toilet with red blood.  Told my friend and she rang their local hospital - they told her to get me there asap. I was bleeding horrendously and she had a new Cadillac so we put lots of old towels on the back seat. I could barely walk and my husband carried me into the ER room. The triage system didn't work in my case, until my lovely, aggressive friend went up to the receptionist (as I had by then sat on their loo for 2 hours pouring blood) and asked her name - got it, and Trish said: "I will hold you personally responsible if my friend dies!".

Wow, within minuties I was seen to, blood pressure negligent at 70/50 and last I remember is one of the medics saying: "we are losing her!". I had great care from then onwards,heart monitor,  IV drips for steroids etc.,  colonoscopy etc.,  - had crypt abscesses in my colon that had burst . I don't think I would have survived without my friend's intervention. I had international medical insurance, but the company refused to pay up - cost some $15,000 for 3 nights in hospital, but I pursued them and 9 months later got the bills paid. It was a nightmare, as my friend was worried her credit status would be compromised as I had to give her address.

I have since been diagnosed with breast cancer and have travelled back twice to Florida, (as my friend's husband has lung and kidney cancer) so as long as I stay with Trish, and have medical insurance, I figure I am okay. Wish you all had Trish in your lives - she is the angel on my shoulder.
Take care everyone - and hope you have someone who can be your advocate, when you are so ill, you don't care if you live or die. 

Love to all Crohnies,
Liz.


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## Maggie-Muffin

I agree the ER's in Canada can suck,all the stupid papperworkand then triage.Sometimes I luck out and don't have a long wait, but other times you could die there waiting
                                          ~~~HUGS~~
ika:


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## rattle

My experiance of hospital.Two years ago i had to be taken to AE by ambulance.I started being sick and had the runs pretty bad it started at 2.30pm by 6.00pm i collasped i could not stand up on my own.The wife was really worried and said should she call an ambulance i said yes.I will never forget the look own her face she just went white.
By the time the ambulance turned up i was in and out of conciseness.I was so cold even with four blankets over me.I was taken into AE and put right next to the nurses station.Thats when my wife said she relised just how ill they thought i was she was a manager at a care home for many years.
Within seconds i had three doctors working on me.I was not really with it and this is what the wife said happened.The doctors could not find a vein they had all collasped.She said the docs told her that if they did not get an iv in me i would have kidney failure within 30 mins.They managed to put two in the top off my arms.It took 10 litres of fluids and 2 litres of blood expansion to stabilise me.
I was then moved to a ward it was now 2.00am.But they had no room so they moved a table and put me there.Along comes the nurse (i just want to take your tempreture and blood pressue she said).My temp was really low and blood pressure was 46/ 52 (i dont think this machine is working) said the nurse.So she just left me to sleep although every hour they come over to check on me.
In the morning along comes the nurse for temp and blood pressure again.My temp was a bit higher but still very low,blood pressure was only 48/56 oh dear she says i think that other machine was working.
Within minutes the ward sister is at my bedside can you tell me what happened last night when your blood pressure was checked she said.I tell her about the faulty machine.The nurse was disciplined over it.Next thing i know i being transfered into a private room with onsuite bathroom this is all within 10 mins of the nurse taken my blood pressure.
Then the doc appears.She was really nice.She says you dont relise how ill you are.You will be nil by mouth for a while (turned out to be three weeks) next i have tubes going all over the place.I am still on two ivs and loads of meds.My surgeon comes round with loads of other docs you will lose part of your bowel he says.After 7 days they put a main line in to feed me through a bag as i was losing a kilo in weight a day.This was put in my left arm it hurt like hell after an hour so i call the nurse.It turned out the vein had collasped.So it was put in my neck.Again there was problems the doctor (a different one) used the wrong tube and could not get it set up.There was blood everywhere the bed was covered it was up the walls it looked like a blood bath.The main line in the the throat goes in the jugular i had to hold my finger over the hole untill he got the right tube.I was glad when it was set up as i could have bloods and meds done through it.
For the first week they took blood from both arms which were now brusied black and started bleeding when i moved my arms.When i had been in for nine days i could walk around with my little trolley with the one remaining iv.I had lost 20 pounds in weight and was still pretty weak.I woke up one morning and my iv has run out so i call the nurse.It is 8.00am dont worry she said i will come back and put a new one on for you.She did not return so i thought maybe i am ok to be off the iv.At 5.00pm some friends came to see me when visiting time was over i said i would walk some off the way with them.I only walked two hundred yards and said goodbye.I went to go back to the ward and relised i could not remember where it was and then started to feel unsteady.So i sat down then i heard a voice are you ok ? i looked up and it was a doctor.Not really i said can you remember the ward you are on ? said the doc no i replied.He looked at my arm band and helped me back to the ward.He rang the bell and the nurse opens the door does this gentleman belong to you he says.The nurse helps me to my bed you dont look good she remarks how long have you been off the drip, since 8.00am i said.At that point she ran out of the room and was back in seconds on goes a new bag.I should not have been off the iv for more than 30 mins it had now been 10 hours.The nurse stayed with me for a hour checking my vitals every 10 mins.
I was in Hospital for 23 days and had seven weeks off work.It just seemed to be one mistake after another that stay was not a good one.


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## Jvstin

due to the way I choose to look, the E.R. is always hesitant to give me pain meds straight up, sure they'll give me phen for nausea, but I don't get pain meds til after a CT usually.


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## kskitt

omg rattle, im just glad that they got you sorted in the end. How are things now?


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## MERF

lizziecee said:
			
		

> Well, my experience with the ER in America(or A&E as we call it here in England) was a little different, as I was visiting friends in Florida. It was over Christmas and New Year's and I thought I had flu, as my host had. I woke up one morning, had a high fever, muscular pains, uncontrollable diarrhoea and a severe rectal haemorrhage. Didn't want to make waves, so went back to bed. 7 hours later, went to the loo, and same thing happened, filled the toilet with red blood.  Told my friend and she rang their local hospital - they told her to get me there asap. I was bleeding horrendously and she had a new Cadillac so we put lots of old towels on the back seat. I could barely walk and my husband carried me into the ER room. The triage system didn't work in my case, until my lovely, aggressive friend went up to the receptionist (as I had by then sat on their loo for 2 hours pouring blood) and asked her name - got it, and Trish said: "I will hold you personally responsible if my friend dies!".
> 
> Wow, within minuties I was seen to, blood pressure negligent at 70/50 and last I remember is one of the medics saying: "we are losing her!". I had great care from then onwards,heart monitor,  IV drips for steroids etc.,  colonoscopy etc.,  - had crypt abscesses in my colon that had burst . I don't think I would have survived without my friend's intervention. I had international medical insurance, but the company refused to pay up - cost some $15,000 for 3 nights in hospital, but I pursued them and 9 months later got the bills paid. It was a nightmare, as my friend was worried her credit status would be compromised as I had to give her address.
> 
> I have since been diagnosed with breast cancer and have travelled back twice to Florida, (as my friend's husband has lung and kidney cancer) so as long as I stay with Trish, and have medical insurance, I figure I am okay. Wish you all had Trish in your lives - she is the angel on my shoulder.
> Take care everyone - and hope you have someone who can be your advocate, when you are so ill, you don't care if you live or die.
> 
> Love to all Crohnies,
> Liz.


Liz, my heart to you ...  I was going to suggest that one should mention that they are experiencing frank bleeding accompanied by extreme pain and that will ususally get attention in the ER.  Guess that's not the case in Florida, huh?

I wish you well.  :sun:


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## TheyCallMeRC

My advice, if you are so bad off that you need someone else to drive you because you can't drive yourself, then call an ambulance. When you go by abbulance you are taken straight back to the trauma area of the ER. I have literaly spent 10 hours in the ER before, and I mean this is 10 hours before I receive any type of medical attn. from a doctor. My average stay before help is 3-4 hours before help but whenever I have ever gone by ambulance I am usually seen by a Dr. and given pain meds. and on my way to having a CT scan within 30 mins. I am not saying to abuse the system by any means, but you know when you need to be seen and when you need pain releif fast and this is one way I have found to be effective.


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## Guest

i had to go to a&e this last week. 2 hours after being put in a cubicle, i still hadnt been checked or spoken to by a nurse. 6 hours later i still hadnt received any painkillers, despite walking to the nurses station 3 times to request some. they did the wrong tests on me, ignored the history and warning signs i told them, and sent me home with an incorrect diagnosis. hence.. i have now had to wait for an outpatient appointment for the correct test, which is being done next week.

it seems we have to deal with 9 morons in the nhs, before we stumble upon one with a degree of intelligence and humanity.

sorry for the rant. it really got to me - i needed help, i went to the right place.. but    ended up just coming home and suffering anyway.


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## Kev

Well, that's the US heard from... (and apologies to dingbat, but I forget whether u hail from the UK or not)...  In my little neck of the woods, one could possibly 'beat' the queue in the Emergency Room lineup  (waited 12 hours last time I went there)
by calling an ambulance... thing of it is, they charge for that little extra - big time!
And, they perform a triage (assessment) enroute, which the admitting/triage nurse at the ER compares to their backlog...  so it might not achieve any extra
time savings.. and it sure will drain the old pocket book..  

I was told that, if I had to go to the ER, the best (not necessarily 'quickest) thing to do was the minute you got past the triage nurse and were seen to by any medico inside the ER system (ER nurse, resident, intern, what have you) WAS to insist on being seen by the oncall GI rep (nurse practioner, resident, etc)  AS anyone outside of the GI area just doesn't understand dealing w IBD.

Now, that's the situation in this part of the great frozen north with our public health system..  your little corner of the world may be a totally different scene


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## Guest

kev, i am in the uk 

when you say "insist on being seen by a GI rep", do the hospital staff actually listen to you over there? because here - they dont.


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## Kev

welll, tho not as lawsuit happy as some of our neighbours, Canadian doctors ARE sensitive to the possibility of a patient, thru a lawyer, taking a bite out of their paycheque.   IF I went into the ER, and specifically/formally requested being seen by an 'oncall' GI specialist (even if just a Nurse/Practitioner) and the ER staffer did NOT follow up... welll, if anything went wrong, that staffer could be in hot water.  I'd suggest the following:  Next time you feel that a GI based staff WITH more experience dealing with IBD issues would be best, and you ask for it...  any reluctance on the part of the A/E, emerg. staff (whatever) YOU ask for their FULL name... and make a point of letting them know you're noting their name... the time/date... and that you had requested this and they turned down your request.  Its amazing at times the power of a pencial N notebook.


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## Guest

thank you kev, i will definitely take heed of your advice. i think the difference over here is that we dont pay for the health service in the way you do (it comes out of our taxes, not private payment or personal insurance), so therefore we probably have less say in matters whilst in the hospitals. or thats how it feels anyway.

i must say tho, in all respect, it is only the a&e department where i have ever felt so neglected and ignored. all the other departments & wards seem to have a completely different attitude, and i've received brilliant care & attention in the past, and up to the present day, even if the waiting period is crazy long sometimes.


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## Kev

Well, we don't pay for it either... except for our taxes.  So my doc and I never exchange money...  and I have no idea of how much he/she charges the system for my visit.  BUT I CAN SUE... even tho I didn't personally pay a fee for a service..
It isn't over common, but it does occur.  I know a doctor who was sued... And I do know HOW much doctors (even Canadian doctors where it is rare) fear lawsuits.


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## heartofwisdom

I get in fast. I just show my open heart surgery scar and they fall over themselves getting me back in a bad and monitor. LOL


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## britt_l_andy

kc0eks said:
			
		

> I found that having my mom come with me helps a lot. I may be 22, but she seems to be good at conveying just how badly I hurt. I dont seem to be able to do that.
> 
> But anyway, nice post  Always helps to be prepared, as the ER is not the most enjoyable experience to begin with,.


So with you on that one! I was ways have my mom meet me at the er. And I am 23


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## jamie2462

*Just don't go...*

HI,

I went to the ER 8 times prior to being diagnosed and they didn't do anything for me except oooh and ahhh over my erythema nodusm (sores on legs), gave me advil which made things way worse and I am now waiting to see how much damage was done, and Oh this was a good one...SEND ME HOME WITH SALT ENEMAS (which I can tell you was a joy when it hit those internal FISTULAS!!!!):ylol2: :ybatty: 
AND FINALLY, being there 8 hours to hear "you just need to buy some tylenol" - LIKE BEFORE I CAME TO THE ER I WOULDN't HAVE TRIED EVERY DRUG known to man in my medicine CABINET!!!! AHHHHHHHHHHHHHHHHH

Now that I have been diagnosed, If I get an infection or anything I have to go in to get antibiotics and tell them I'm on Remicade...after the last couple of times I'm scared to see what they do even tho I will be telling them what I need they will probably hook me up to the wrong thing again....

Best of luck to all of you that make that trip to the ER...the ones here are better used for Gun shots and stabbings...they know how to fix the bloody ones, but if your problems internal whooooa buddy. :voodoo:


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## teeny5

I didn't go to the ER but I did go to urgent care.  I told them I have Inflammatory Bowel Disease and feel like my symptoms have worsened.  This seemed to put me through rather quick.  I didn't go into the details till I went in to see the doctor.


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## CKnowsBest

Ireland's a disgrace, you could spend four or five days in A&E. Yes - DAYS.


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## jamie2462

eeeesh.


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## Jonhenry

Last time I had to show up in the ER I didn't have to fake much, although I exaggerated to get my labs and scans done sooner. I was sick as hell and vomiting and exploding diarrhea everywhere. That kinda speeds it up I guess. When they can get a stool sample and blood right away and rush it off then they seem to run in with major painkillers which put me to sleep and I wake up and hear what the hell my body did to my intestines............I do raise holy hell if I'm in major pain in the er. If Im' pooping blood (not fissure blood, but real bad intestinal blood) then I do whatever possible to be soon ASAP.

I figure I deserve as much, and they always help and with my history I seem to get into ct scans and stuff right away, and pain management and finding out what bacteria is taking over my GI tract and if I need anti-biotoics or not. For some reason the hospital I go to doesn't like to put you on antibiotics for more than 2 weeks, something about exposure and resistance, I don't know. The less I listen the Less I worry, might be a bad thing. Any opinions?

Thanks, 
Jon


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## Peggy

Thank god for the NHS in the uk we get treatment when we need it, no charge this all comes out of our nationalminsurance our Doctors are not always uo to speed but if you explain yourself they get the picture quite quick. Peggy


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## kenny

same here in Canada. Helps if you can get your bp down below 80 for triage assessment tho. They get you pretty speedy that way


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## Nyx

@all the Canadians...the fastest way to get in is to scream in pain and dry heave or vomit.  I was in in 3 minutes flat.  Make sure you bring a family member or friend though, so they can do the paperwork for you.  Sad, but true!


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## Sunshine120

*Wow*

*GREAT INFORAMTION*


			
				GNC Crohn's Man said:
			
		

> How to get the best and fastest emergancy room care..
> Again bear with my spelling and gammer skills cause they weren't the best to deal with.. Plus when you are taking valium based meds they have a tendence to decrease a bit...
> 
> This is if you are going to be admited to the ER the normal way and not by the paramedics...:devil:
> 
> 
> You not a hero... If your going to to the hospital you are sick very sick.. If you are like me you would have been vomiting/dry heaving for about 3+ hours
> before you even leave the house... Maybe even several hours or days... When I dry heave my whole body tightens up and goes into bassicly convulsions... So by the time my brother (he generally takes me to the hospital) gets me in the truck I am about ready to pass out and I can not walk on my own...
> 
> So get whomever to drive you up to the ER front door.. Get them to help you into a wheel chair...
> 
> MAKE SURE YOU HAVE THESE THINGS with you or that the person driving and sitting with you at the ER waiting room has these things... (in my case it's generally my brother)... I will go into further detail as to why you need these items and what to do with these items.
> 
> 1) Drivers Liseance
> 2) Insurance Card
> 3) Less than $20 in cash (You need this is $5's and 1's) No $20's
> 4) A credit card/or debit card that can act as a debit card
> 5) A trash can
> 6) Small thermal blanket
> 
> 
> 1) Drivers Liseance
> 
> This is standard it does not matter what is on your liseance just so long as you have one... NEVER EVER EVER EVER EVER GIVE them more than one address... The adress you give them is the adress all bills will go to...It can be different from the address on the liseance... They WILL say that it won't be a problem to have a primary adress and then a secondary billing address... And that t,hey can do this in the computer but just like anything the more info you give them the more stuff will get screwed up... So only give them the adresss you want the bill sent too... Phone numbers you can give them... As your primary phone number give them the number of the place you are currently living at or the one you use the most (such as a cell phone)..
> 
> They have about 5 or more different contact numbers for me at every diferent hospital I have ever been in... Let's see that would about 6 or 7 different ones (hospitiles not hospitle visits)... But my address is the same for all of them... My insurance is under my dad and my dad pays for my medical bills.. My parents are never going to move away from their house. So I don't ever have to worry about my medical bills, them getting payed, or dealing with the insurance claims... Until I get my own job security, and my own insurance. No I Do not live with my Mom and Dad (they live 180 miles east of here) But, we both use the same credit union so he (my da) can transfer money into my account whenever he wants too.
> 
> If you give them two different addresss then I'm gonna laugh at you and say I told you, so as they combine the two adresss and then they try to send that off into limbo land to get it paid... You will then get phone calls from collection agencies demanding payments on bills that you never received sicne the bill got sent off into postal limbo..
> 
> Trust me I've been there all of these things I'm telling you are from 1st hand experince not second or third hand...
> 
> 
> 2) Insurance Card
> 
> (if you don't have insurance I'm sorry but your playing russuian roulette with that hospital) If you do not have insurance you are more likely to get care at a relgiously funded hospital. They may even be able to treat you for free or give you a mjor deduction in your medical costs... Just depends on the hospital... Example where in the south we have "Baptist Health" hospitals that are partial funded by the
> 
> NEVER go to a college hospital and NEVER go to a hospital that is funded by priviate investors.. They will always charge you full and
> The hospitals there are there to make money... Not lose it so they will mmore than likely boot you out the door unless your gonna just die right then and thier... They will also NEVER cross off your medical bills even if you can not afford them... Again they are in the buisness of making money...
> 
> Also college hospitals are guess what? Full of medical and nursing students...
> And yes they will make the same mistakes over and over again on you because everytime you go in thier will be a new set of student doctors/nurses.. Plus the only nurses/docs with lots of experince are having their handsful teaching the students...
> 
> I had a great doctor that I got along with great at a college hospital... She was in her felllowship though so once she compeleted that she left... I tried staying with that college hospital somre more but it just wasn't worth it...
> 
> In choosing a GI doctor you must choose one that is both compatent and experinced AND that is located in a good hospital with a good nursing staff...
> 
> I'm lucky now... I have a a very good experinced Doc now and plus the hospital he is lisceanced too is literally right across the street from where I live... If I got the right room and the trees weren't in the way then I could see my house from one of the windows in the hospital...
> 
> 
> 3)A trash can - with a several plastic trash bags (I just put walmart bags in mine) covering it... unless you just want to throw away that garbage can.. It's up to you....
> 
> You need this to dry heave into... Save all of your dry heaving if you can until you ge tinto the ER waiting room... Do not hold back your dry heaving spells... Try to make them sounds as gut wrenching and as painful as you can... (You probably won't have to add to much emphasis on that if your like me when you go to the er)
> 
> If you think this is selfish or wrong then you obvisouly do not know how an ER works or the patients they receive there..
> 
> The ER gets 3 kinds of patients
> 
> A) People that don't have insurance or are just to damned lazy to go to the doctor. These are non life threatning situations that in 80% of all these cases could be solved at a docs office unless they neeed an x-ray... Again non life threatning....
> 
> B) Crazy people these people are literally crazy they may seem like they are suffering from physical symptoms they may just look crazy thye may look normal.... Either way the problem is physciatric.... Again non life threatiing...
> Just really damned annoying...
> 
> C) Actual sick people.... Sometimes these people are more sick and in pain then you sometimes they are not.... The triage nurse will determine which ones should go back first...
> 
> 4) A small thermal blanket... Go by Wal-mart or wherever right now if you do not already have one and by a small thermal blanket.. Why a thermal blanket and just a small one? It traps heat very very very well.. Plus you can get a small one... So that way your not luggign around a big blanket from home into the ER waiting room. You can just have a nice small thermal blanket drapper oer the knees of your strether... And sinceit is smalll you can take it on or off as you like. Also since it is thermal it doesn't let loose much body heat at all so if you wan tto get warm you can get warm quick and not have to worry about any kind of eletric device or ice hot patch.. Make sure you have one of these and you know where it is for when you go to the hospital.
> Why? Because hospitals don't give out blankets in the ER waiting room... So you may get very very very cold... Once your inside the actual ER and in a bed you may or may not need it ... But you might be waiting out in the ER waiting room for up to 6+ hours so it is a very very wise invest ment to bring that blanket..
> 
> [5]5) The money is thier just in case you need some pettycash for whatever...
> 
> [6] The credit card is thier in case you have to make a payment or if you want anything ordered by phone (Like me I always order 3 regular breadsticks with just cheese sauce from papa's john's... Thier bread sticks are jus that backed bread no cheese no extra flavor nothing.... So it is a great starter carb fora low residue diet...
> 
> Yahhhh I think I may be able to sleep noe ficing to take 2 more 1 mg adavian and 2 more resterall...
> 
> If not I'll just back here in a few more hours in on even further zombie state than I am nows...
> 
> 
> Okays cya guys later.... And let me know if some of typing is illegable or misleading because again I'm not working at 100% brain poer here...
> 
> Ok cya later
> 
> Daniel


----------



## Chefferson

Also helpful (at least in the US) - 

- Call your doctor on your way to the hospital. If the ER is alerted to your arrival, you will be seen faster.

- Don't fake it. If they figure out that you are not as bad off as you're acting, your service *will *be slower.

- TYPE up a list of all your medications, with dosages, and carry it with you. It will make triage faster. Same goes for medical history, including surgeries and your blood type. The nurses love it when you can save them time.

- Announce that you have Crohn's when you get there. If you just go in dry heaving, they'll assume it's the flu. If you're dry heaving with Crohn's, you may be seen faster considering the complications we can have.

- Don't wear anything metal if you can. That way you won't necessarily have to get into a gown for a CT or xray. Ideally, this would be a tank top and sweats/yoga pants and a zip up hoodie you can easily remove.


----------



## Lisa

When I go to the ER - for whatever...I make sure I don't wear any metal (including underwire bra!).....usually have sweatpants, t-shirt..carry my insurance card and drivers' license for id purposes.....oh, and my cell phone so I can call anyone who needs to be notified if I get admitted (like hubby or Mom). 

My last trip(s) were for kidney stones a few years ago - ER thought it was dehydration and sent me home after fluids and pain killers......then wehn I showed up again @2 hours later doubled over again and vomiting was fast-tracked in.....to be given the pain meds I'm allergic to!

Make SURE you repeat any allergies - Dr/nurse will NOT always look at your chart if you come back within a short time!


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## Keona

The sociologists at my school did a study on ER rooms and those who were dressed better/clean cut (even those who brought the sick individual) got in quicker.   I worked in ER and ICU and payed attention to this and it is true even though it is a triage system.
________
Rc162


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## mneilsen2084

Thank you, all of you. I learned tonight that many people with crohn's (not just myself) get nauseated badly. Lately I have been spending roughly 80% of my day feeling nauseous. 
I live in Boise Idaho, where the ER docs look at me like I am a nut job for going to them for Crohn's. I haven't bothered to go in for about eight months now because I got tired of being treated like a hypochondriac or having to wait for ever to see a doctor. Only to be prescribed pain killers and no actual symptom reducing medications.


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## ellecubed

Thank you so much for this lovely and informative post.


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## Kathryn

Prior to moving last year, I always called my doctor when I knew a hospital visit was coming upon me.  I would make an emergency appointment to go see him at the beginning of the day, and I would go in, and he would fill-in hospital admittance papers for me and call ahead (or his nurses would).  

If the hospital had a room, I would go straight away.  If not, I'd either hang out at his office for a couple of hours or I'd go back home and wait until he called.

I know this wouldn't work in the sort of emergency that happens in five seconds flat, but if I've been really sick for a number of days/weeks/whatever and my doctor's aware of it, it seems like the best way to get into the hospital is to bypass the ER completely. 

-Kathryn


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## Trev

being in pain, doubled over doesnt seem to get you in any quicker where i live, the only time i get urgent attention is when i get something in my eye or arc eyes from welding. eyes seem to take priority.


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## Inwe

I live in Canada and I`ve been to the hosptial twice. The first time I waited for hours! OMFG I almost died. The second time I learned.

The nurse told me it was like a 6 hour wait. So my parents and I took chairs and sat right outside the triage nurse station. I pretty much just cried loudly (my insides hurt like a bitch but I guess I played it up a bit). I also tried to make eye contact with the nurse at all times. My Dad kept going up to the nurse too and asking. I also had bags so I could throw up. After about 25mins we got it. Not bad I thought.

What really pisses me off is people who clog up the emergancy room with STUPID things. There were so many drunk people who stumbled in wanting to `sleep it off`somewheres. The nurses even knew them by name! UGH. The medical clinics were still open at the time (and are free in Canada) and a lot of people`s problems could be fixed there. Emergancy rooms are for emergancy!


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## IBD

Interesting "how to". Luckily, I haven't been to the ER since I was diagnosed, and I don't plan on it!


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## Jeeknee25

I have had my share of ER visits...and something that must be done is, remember to choose your hospital wisely. Not necessarily by convenience. Some hospitals won't administer the necessary meds b/c they are VERY strict. Try to go to the same ER the nurses will start to know you and you build a rapport with them once they know your story & suffering. Be sure to go to the ER when the hospital is slow...usually mid-week and late evening/night time. 
Hope this helps!


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## Grumbly-Guts

Just wanted to let you all know that in Canadian emergency rooms, patience is a virtue!  Damn they move slow!  There are ways however to speed up the process.
Ambulance always work
having EVERYTHING u will need helps 
and be OVERLY POLITE & HUMOUROUS regarding the questions you have to offer 
oh and don't hide hpw badly you feel.

I find when you are nice to staffers it really works in your benefit, not only for getting a bed faster BUT for seeing the doc faster (as you become memorable to the nurse), better tx, faster ivs, meds, testing and response when you need them for something.

I also have found that some docs think they are the "shit"!  lol, you couldn't possibly know more than they do.  You almost need to medically "dummy down".  I am NOT saying to pretend you are stupid and have no idea what's going on especially with "your" disease and how "you" feel.  Still do that but drop the medical jargon.  (docs think we shouldn't understand that stuff-they are the ones who went to medical school didnt you know? *rolls eyes*).  I have found when I would go ion and talk to an er doc or nurse and started using all the "proper" terminology she torted at me that I mst be mistaken and should not believe everything I read on the net, or that I must have misunderstood, or even if I had had "that-whatever I said" confirmed by medical testing and which doc confirmed it.  It's madness!  So while "your" GP or gastro, or surgeon or anyone else familiar with you may be alright with you being so "educated" the er staff is "usually" not impressed.  Also if you "demand" meds and always say its 10/10 pain (even if not- which I might add I have done myself) you may be pegged as a "drug seeker" as all medical files and hx of rx's are on file and linked on the computer through your provincial insurance coverage number.  (this happened to me [labelled drug seeker] when I wasn't, it got so bad that when I went to the ER 4x in a week for severe D and vomitting, migraines and dehydration a doc actually came in and told me I would need to seek other means of help, in the form or drug rehabilitation and they wouldno longer offer me pain meds, I even told her tht was fine as long as she fixed the cause.  She said I was the cause nd kicked me out.  Went to GP and she called the head of the gastro dept. who I might add met me in the ER when the GP ordered me back.  I was immediately admitted, bypassed the ER and was placed in iso. for a month, why? B/c I was dx with C. dif.!!!  It took awhile to remove the stigma attached to my name though.

Hope that's helpful!
GG


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## JynxGirl

Having now experienced three hospitals in Canada because of my disease, I've learned a few tricks too. Being polite helps, but if you're in there because your pain is off the charts, don't even bother trying to talk to them. 
I have done the crying and screaming bit, however, in my case, it was legitimate. I explain my symptoms as best I can, and if I'm ignored for more than five minutes without help, I start crying harder.  (I am very sensitive when I'm in pain and being ignored makes me feel worse...)
Another trick I learned from my new GP was to bring in a letter of diagnosis from your gastro... They can't ignore that.


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## Mountaingem

Just want to thank you for the great suggestions! I went to the ER a month ago and I got treated right away, thanks to your info, especially about vomitting loudly in the waiting area lol. Since I had an abcess in the illium I didn't have to fake it...my hubby employed the screaming part when the nurse wanted to take a beat-up gangbanger before me.  He (loudly) reasoned with the nurse-non life threatening, he can wait...and it worked!


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## DustyKat

Interesting read but at the same time frustrating to think what many of you have to endure to receive treatment.

Is it different when children present?? I can't imagine that it would be grossly different here to what many of you experience as adults so it must be different for children. 

I have had Roo at emergency twice (same hospital) and Matt at emergency twice (different hospitals). On all occasions they were taken into emergency as soon as I completed the paper work.........and I don't think it's 'cause I look scary! 

Dusty.


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## laward

GNC Crohn's Man said:


> Next is part two... You are now in the real ER... First thing you do is as ask if you can get the ER doc to go ahead and right you up orders for pain and nausea meds... Try dry heaving a few times while doing this.. It speads up the process... They will say they can't give you anything until they get an I.V. in you and start you on a saline solution.... You say you can give me all of that together (iv. started and in, pain meds, nausa meds, and a saline drip) if the doc writes those orders while they are gettign you preped... The nurse should come back with the iv kit and a bag of saline... After they hoook that up ask them if that order for pain and naueas meds is up... It should be if you did this right... Now you should be free
> 
> 
> Also when they say to rate your pain scale never say anything other than 10...
> Also tell them your pain and nausea comes in waves so even if you don't look that bad right nown 5 minutes you may be biting through the sheets and in tears.
> 
> I'll finish this later... Gotta drug myself up nice and good if I plan on sleeping


great job....been there.....couldn't of said it better!!!!


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## Bliss

I am new here but I wanted to add to the list!  I am in Canada so this is how it works for me...

Like others said be really nice (that isn't a show for me, I am really nice  )

If you are pretty sure you know what it is then list off all the obvious symptoms of that even if you don't have one or two of them.  

There is a little sign that says "If your symptoms worsen or change please tell the triage nurse"..... I have whom ever I am with go up every 20 mins and say "It's getting worse" or "The pain has moved" etc.

Now I didn't do this on purpose but man it worked.... I had rectal bleeding, not bloody stools and it was coming out in a trickle when I got there but while I was waiting it started to come out like a stream and I messed the chair/floor/my clothes.  I was in a room with a nurse in seconds flat.

Most important is be respectful.  I realize how busy the staff is and how many people are coming through.  My pain is the most important to me but everyone else feels the same way about their pain/illness.  I once waited for hours and hours and hours. I was so angry I wanted to scream......I found out later that all 3 ER Doctors where in the trauma with a 3 car pile up that involved 7 people (4 of which where small kids...2 of which they lost).  I wasn't so angry any more....

I didn't have much respect for the ER staff until a year ago I nearly died (not Crohn's related).  It was clear to me then that they have a purpose.  Bad bedside manner and all; they literally saved my life and they did it quickly, professionally and effectively in the minutes they had left to save me.  That's all I look for in an ER.


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## AndiGirl

Thanks for the advice Crohn's Man.  I end up in the ER at least a couple of times a year, and of course it is always Crohn's related.  The last two times that I ended up in the ER (May 2010), I discovered that I was the only sober patient.  Two of the patients had alcohol poisoning, one had an alcohol related accident, and another one drank alcohol with a prescription drug.  I was already very nauseated because I had a partial blockage.  When the woman next to me with alcohol poisoning started vomiting, I almost joined her.  The only reason that I know so much about the other patients, is in the ER, you are separated by curtains.  You can hear everything.  So much for privacy.


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## Junot

I went to the ER twice last month took 7 hours til I finally got in a bed, I was puking all over the place, the other ER patients became more worried about me than themselves. Canada tries to boast about their healthcare but its been aweful for years


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## maxibear

*i just went to the er 2 days ago*

i dont even bother calling my gi, since he is affiliated at the hospitol, call ambulence, took some food just in case and my wallet and a walkman. have done this 4 times, so no big deal


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## shamrock15

Gotta love the ER's. I live a 10 minute walk away from one hospital in Ottawa. Convenient enough so that I have had my wife drop me off, bring the car back home and meet me back in the waiting room for kidney stones. 3 hour wait that felt like I had an elephant on my back. Normally, when I go in with Crohn's I get in pretty quick, but I get meds quicker on the kidney stones. Worst wait, my doctor had refused to allow me regular blood tests to track my anemia. Ended up in the ER for 24 hours for two units of blood.

The worst waiting - the year I got married, it was very apparent that I needed to go under the knife. Was told that I was going to need to  wait 3 months before I could even see my surgeon, let alone get the surgery! Well, I had a surefire way of short-circuiting that. At the time, me and tacos were not best of friends. Guaranteed way to cause a partial or full obstruction. Three hours after a very tasty dinner, my last for a month and change, I was admitted and had my surgery a week later (that's a whole different story).

As for law suits - I looked at that route because of my previous GI. Because I had a 25 year active file, I was basically told it would take about $1 million to even get the case to court. Be very careful about burning that bridge, because if you're in a small town you can rest assured that all of the staff will know who you are, won't want to treat you for fear of suits. I am in complete agreement with the "treat them as well as you can" line. It's worked very well for me.


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## SS410

Thanks for your post GNC.
My husband has Crohn's and Friday was ER day.  We did absolutely nothing in your post so....he was seen by the screener person, then on to the next step, they felt his stomach and said that it feels fine.  He then waited in an uncomfortable chair for 1 1/2 hours.  He decided he would rather lay in bed at home in pain that in the hospital waiting.  It was horrible.  
It feels like he is the only one in Reno with Crohn's and that his doctor doesn't know what to do and no other doctors want to see him.  I should also mention that his doc was on vacation starting Friday and all this week.  
Good times!


----------



## lulu2

GNC Crohn's Man said:


> How to get the best and fastest emergency room care..
> 
> Also college hospitals are guess what? Full of medical and nursing students...
> And yes they will make the same mistakes over and over again on you because every time you go in there will be a new set of student doctors/nurses.. Plus the only nurses/docs with lots of experience are having their hands full teaching the students...
> 
> 
> 
> Just reading this post is giving me a headache; I am gonna polish it up, fix the horrendous grammar mistakes, and cut out the sections that aren't relevant.


Little bit harsh; student doctors and nurses need to learn somewhere and on someone..... otherwise in the future you're gonna get fully qualified doctors making those mistakes you speak of because they never made and learnt from the mistakes in the first place. I'm a student doctor, all being well I qualify fully in 6 weeks and I have never ever made a mistake that has harmed a patient because we're so well supervised, but I have seen lots of patients and learnt from the potential mistakes I might have made on them had the doctors supervising me not done their jobs so well. I'd say GO to a teaching hospital, you will get double the care!! The med student will want to see you and then the doctor will also see you to ensure the student didn't miss anything!


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## Grant

Been through A&E with gut blockages 3 times in the last 18mths & TBF they've been fantastic & very understanding. Got me through to the medics very quickly. My worst one was after vomiting for hours I got uncontrollable leg cramps through losing all my body salts.
But a NG tube works wonders. It empties my stomach & takes the pressure off my gut.


----------



## mayhavecrohn's

*thank you crohn's man that helps giving us all this tips*

thank you crohn's man that helps giving us all this tips i always try to have someone take me to the er when i need to go and to be honest i need to go now but dont have anyone to take me right now i always try to take my laptop and a few other things just in cause they keep me i will try to update if i do find someone to take me or if they have to keep me i was just in the hospital last week for 3 days because the stomah pain and blood in my stool and was thowing up and could not eat or drink anything because everytime i do i will throw up or it goes straught through me i am in so much pain i can barly stand it any longer


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## TerminalIleum

Some tips for Canadians, my experiences are based on south-western Ontario and Toronto over the last four years.

I'm basing this off Daniel's post, and modifying where necessary.

You not a hero... So don't be one. If you're in severe pain / flaring up go see one, as your GI probably won't have time to see you for a couple of months.

So get whomever to drive you up to the ER if you can. When this is not feasible (I presently live in Toronto, alone, and without a car) bite the financial bullet and take a cab. Subway, and other public transit is not smooth as a rule, and if your inflammation is resulting in micro fissures, you don't want to shake your intestine more than you need to.

MAKE SURE YOU HAVE THESE THINGS with you or that the person driving and sitting with you at the ER waiting room has these things. I will go into further detail as to why you need these items and what to do with these items.

1) Health card
2) Insurance Card / Information
3) Less than $20 in cash (You need this is $5's and 1's) No $20's
4) A credit card/or debit card 
5) A trash can / bag



1) Health Card

The one and only. If you forget everything else on your list, remember this.
In Ontario, make certain you have the correct one, with an address you can at least obtain mail from. Make certain that if you have the new green ones, it hasn't expired. If you need to renew yours. try a smaller town like Paris that has the required facilities. the larger cities sometimes require appointments in order to renew.


2) Insurance Card

(if you don't have insurance in Canada, you're probably okay!) One thing your (overly high with good reason) taxes pay for is your hospital stay. Private insurance generally pays for things like semi-private or private rooms, drug prescriptions once you are discharged. You don't need it for your hospital visit per say, but a semi-private room is much nicer then sharing a ward of six.

As for which hospital you go to, if your area has a selection, try to find one with a GI department. 

As for teaching hospitals are guess what? Full of medical and nursing students...
And yes they will make the same mistakes on you. Mostly this involves IV insertion (it takes time to learn) and with the pain associated with a crohn's flare, a few extra needle pricks really isn't much, and trains the next generation of nurses and doctors, which is no bad thing.

Here's the reason I'm willing to put up with it: you learn more. when a doctor in training, either in general or on a GI team evaluates you, they then consult with the GI, staff doctor. If you're in the room at the time, and conscious. you can learn a lot about your condition (even if it involves looking up the technical terms later) than you would otherwise.

3) The money is just in case you need some pettycash for whatever... reading material is always useful

4) The credit card is in case you have to make a payment (if you want a more private room without insurance) or if you want anything ordered by phone. Hospital food often gives you no choice or accommodation over dietary concerns. Needless to say this is BAD for a Crohn's patient that has already identified problem foods.

5) A trash can - a place to vomit is never a bad thing. I usually just bring some grocery bags, as it's a little more portable

You need this to dry heave into... Save all of your dry heaving if you can until you ge tinto the ER waiting room... Do not hold back your dry heaving spells... Try to make them sounds as gut wrenching and as painful as you can... (You probably won't have to add to much emphasis on that if your like me when you go to the ER)

The ER gets 3 kinds of patients

A) People that don't have a family doctor, or are just to damned lazy to go to book an appointment. These are non life threatening situations that in 80% of all these cases could be solved at a docs office unless they need an x-ray... Again non life threatening....

B) Crazy's / hypochondriacs / drunks. These are the people the hospital staff know by name, mostly because they are in every other day due to drinking too much, mental illness, wanting a warm place to sleep and a meal. Sometimes life threatening, but mostly they just waste your time, and your ear drums.

C) Actually sick people.... Sometimes these people are more sick and in pain then you sometimes they are not.... The triage nurse will determine which ones should go back first...

If you think this is selfish or wrong then you obviously do not know how an ER works or the patients they receive. I have once waited 11 hours in a triage waiting room with severe pain.

Obviously you wish to be included in the "C" category, but you also want to get to the appropriate place within the triage list. the following are tips you should only use in cases of severe pain.

The Diagnosis: 
Triage nurses are heavily overworked and smart people. if you can cut the BS while speaking in medical terms, they are more likely to place you in the proper triage order. If you have Crohn's, tell them. If your terminal ileum feels like it's about to explode, tell them that too. It is harder for a nurse to reassign your place in a triage list if your condition worsens (think of how many people in A or B will say this after becoming impatient of waiting) than to assign you a high priority right from the start. 

The Pain Scale:
The triage nurse will ask you on a scale of 1 to 10 how bad the pain is. Do not be a hero, as sitting there suffering while some ass from "B" gets treatment faster because they are making a fuss is not going to get you the care you need. Answer 9 or 10.

Sitting or Laying Down:
If you are offered a portable stretcher, take it. If you are in severe pain, laying down is the preferable way to sleep / pass out. You will probably not be offered one again for the duration of the triage period, so I'd highly recommend you take it. Another general hint, laying down on your left side is known to speed bowel movements. 

I may turn this into a wiki post at some point in the future


----------



## lulu2

TerminalIleum said:


> Some tips for Canadians, my experiences are based on south-western Ontario and Toronto over the last four years.
> 
> 
> As for teaching hospitals are guess what? Full of medical and nursing students...
> And yes they will make the same mistakes on you. Mostly this involves IV insertion (it takes time to learn) and with the pain associated with a crohn's flare, a few extra needle pricks really isn't much, and trains the next generation of nurses and doctors, which is no bad thing.
> 
> Here's the reason I'm willing to put up with it: you learn more. when a doctor in training, either in general or on a GI team evaluates you, they then consult with the GI, staff doctor. If you're in the room at the time, and conscious. you can learn a lot about your condition (even if it involves looking up the technical terms later) than you would otherwise.
> 
> 
> I may turn this into a wiki post at some point in the future


Thank you.  It is very important that medical students learn and the best (and really only) way to learn in medicine is to see and do (under close supervision). All the patients who let me examine them, stick needles in them (sometimes successfully, sometimes not), talk to them and review their care with the doctors helping them, I am eternally grateful to, without them I wouldn't be where I am now! 

xxx


----------



## Twila

I got in really quick last time at a Canadian emerg. First of all, make sure your belly is super distended and when they ask why you are there say:"exacerbation of crohn's." I suppose it helps that I am tiny so any distension on me looks quite remarkable... also anemic so very pale... that helps.


----------



## rhosymynydd

*UK hospitals*



GNC Crohn's Man said:


> How to get the best and fastest emergency room care..
> Again bear with my spelling and grammar skills cause they weren't the best to deal with.. Plus when you are taking Valium based meds they have a tendency to decrease a bit...
> 
> This is if you are going to be admitted to the ER the normal way and not by the paramedics...:devil:
> 
> 
> You not a hero... If your going to to the hospital you are sick very sick.. If you are like me you would have been vomiting/dry heaving for about 3+ hours
> before you even leave the house... Maybe even several hours or days... When I dry heave my whole body tightens up and basically goes into convulsions... So by the time my brother (he generally takes me to the hospital) gets me in the truck I am about ready to pass out and I can not walk on my own...
> 
> So get whomever to drive you up to the ER front door.. Get them to help you into a wheel chair... I think being put in a wheelchair and being wheeled in may help the triage nurse decide to send you back into the actual ER for treatment...
> 
> MAKE SURE YOU HAVE THESE THINGS with you or that the person driving and sitting with you at the ER waiting room has these things... (in my case it's generally my brother)... I will go into further detail as to why you need these items and what to do with these items.
> 
> 1) Drivers License
> 2) Insurance Card
> 3) Less than $20 in cash (You need this is $5's and 1's) No $20's
> 4) A credit card or debit card that can act as a debit card
> 5) A trash can
> 6) Small thermal blanket
> 
> 
> 1) Drivers License
> 
> This is standard it does not matter what is on your license just so long as you have one... NEVER EVER EVER EVER EVER GIVE them more than one address... The address you give them is the address all bills will go to...It can be different from the address on the license... They WILL say that it won't be a problem to have a primary address and then a secondary billing address... And that t,hey can do this in the computer but just like anything the more info you give them the more stuff will get screwed up... So only give them the address you want the bill sent too... Phone numbers you can give them... As your primary phone number give them the number of the place you are currently living at or the one you use the most (such as a cell phone)..
> 
> They have about 5 or more different contact numbers for me at every different hospital I have ever been in... Let's see that would about 6 or 7 different ones (hospitals not hospital visits)... But my address is the same for all of them... My insurance is under my dad and my dad pays for my medical bills.. My parents are never going to move away from their house. So I don't ever have to worry about my medical bills, them getting payed, or dealing with the insurance claims... Until I get my own job security, and my own insurance. No I Do not live with my Mom and Dad (they live 180 miles east of here) But, we both use the same credit union so he (my Dad) can transfer money into my account whenever he wants too.
> If you give them two different address then I'm gonna laugh at you and say I told you, so as they combine the two address and then they try to send that off into limbo land to get it paid... You will then get phone calls from collection agencies demanding payments on bills that you never received since the bill got sent off into postal limbo..
> 
> Trust me I've been there all of these things I'm telling you are from 1st hand experience not second or third hand...
> 
> 
> 2) Insurance Card
> 
> (if you don't have insurance I'm sorry but your playing Russian roulette with that hospital) If you do not have insurance you are more likely to get care at a religiously funded hospital. They may even be able to treat you for free or give you a major deduction in your medical costs... Just depends on the hospital... Example where in the south we have "Baptist Health" hospitals that are partial funded by the
> 
> NEVER go to a college hospital and NEVER go to a hospital that is funded by private investors.. They will always charge you full and The hospitals there are there to make money... Not lose it so they will more than likely boot you out the door unless your gonna just die right then and there... They will also NEVER cross off your medical bills even if you can not afford them... Again they are in the business of making money...
> 
> Also college hospitals are guess what? Full of medical and nursing students...
> And yes they will make the same mistakes over and over again on you because every time you go in there will be a new set of student doctors/nurses.. Plus the only nurses/docs with lots of experience are having their hands full teaching the students...
> 
> I had a great doctor that I got along with great at a college hospital... She was in her fellowship though so once she completed that she left... I tried staying with that college hospital some more but it just wasn't worth it...
> 
> In choosing a GI doctor you must choose one that is both competent and experienced AND that is located in a good hospital with a good nursing staff...
> 
> I'm lucky now... I have a a very good experienced Doc now and plus the hospital his patients go to is literally right across the street from where I live... If I got the right room and the trees weren't in the way then I could see my house from one of the windows in the hospital...
> 
> 
> 3)A trash can - with a several plastic trash bags (I just put Wal-Mart bags in mine) covering it... unless you just want to throw away that garbage can.. It's up to you....
> 
> You need this to dry heave into... Save all of your dry heaving if you can until you ge tinto the ER waiting room... Do not hold back your dry heaving spells... Try to make them sounds as gut wrenching and as painful as you can... (You probably won't have to add to much emphasis on that if your like me when you go to the er)
> 
> If you think this is selfish or wrong then you obvisouly do not know how an ER works or the patients they receive there..
> 
> The ER gets 3 kinds of patients
> 
> A) People that don't have insurance or are just to damned lazy to go to the doctor. These are non life threatning situations that in 80% of all these cases could be solved at a docs office unless they neeed an x-ray... Again non life threatning....
> 
> B) Crazy people these people are literally crazy they may seem like they are suffering from physical symptoms they may just look crazy thye may look normal.... Either way the problem is physciatric.... Again non life threatiing...
> Just really damned annoying...
> 
> C) Actual sick people.... Sometimes these people are more sick and in pain then you sometimes they are not.... The triage nurse will determine which ones should go back first...
> 
> 4) A small thermal blanket... Go by Wal-mart or wherever right now if you do not already have one and by a small thermal blanket.. Why a thermal blanket and just a small one? It traps heat very very very well.. Plus you can get a small one... So that way your not luggign around a big blanket from home into the ER waiting room. You can just have a nice small thermal blanket drapper oer the knees of your strether... And sinceit is smalll you can take it on or off as you like. Also since it is thermal it doesn't let loose much body heat at all so if you wan tto get warm you can get warm quick and not have to worry about any kind of eletric device or ice hot patch.. Make sure you have one of these and you know where it is for when you go to the hospital.
> Why? Because hospitals don't give out blankets in the ER waiting room... So you may get very very very cold... Once your inside the actual ER and in a bed you may or may not need it ... But you might be waiting out in the ER waiting room for up to 6+ hours so it is a very very wise invest ment to bring that blanket..
> 
> [5]5) The money is thier just in case you need some pettycash for whatever...
> 
> [6] The credit card is thier in case you have to make a payment or if you want anything ordered by phone (Like me I always order 3 regular breadsticks with just cheese sauce from papa's john's... Thier bread sticks are jus that backed bread no cheese no extra flavor nothing.... So it is a great starter carb fora low residue diet...
> 
> Yahhhh I think I may be able to sleep noe ficing to take 2 more 1 mg adavian and 2 more resterall...
> 
> If not I'll just back here in a few more hours in on even further zombie state than I am nows...
> 
> 
> Okays cya guys later.... And let me know if some of typing is illegable or misleading because again I'm not working at 100% brain poer here...
> 
> Ok cya later
> 
> Daniel
> 
> Just reading this post is giving me a headache; I am gonna polish it up, fix the horrendous grammar mistakes, and cut out the sections that aren't relevant.


For UK - as has happened to me, if your regular hospital is shit down (due to c-diff or winter vomiting disease. try and get the ambulance take you to a preferred hospital rather than just any old one. Calling ahead, whether or not it is to your own hospital is really recommended and if you have a favourite ward, get them to ring down with an empty bed and ask for your admission rather than be desginated to the admissions ward who for some strange reason will insist on a chest x-ray (we re still trying to work this out (Morriston & Singleton in Swansea both insist). Play near dead, even if you are feeling slightly better on arrival (its the relief that gives adrenlin a quick spurt but you will be feeling it like it again so make it so. Always attend with a concerned relative, preferably hysterical. The more drama the quicker they want you out of A&E and you need to get to a gastroenterologist not an intern.


----------



## rhosymynydd

*anyone with needle problems?*

I hate hospital admissions because I always have to go through junior doctors or interns fishing for a vein, which they can't find. I always plead, beg etc. for a nurse practicioner or an anaethetist to get the IV in, because crohn's veins are so battered and bruised it really adds to the pain to have someone try "in vein" 8 times. They are on my feet now having given up on my arms and hands but this is not a good option so only take it when all else has collapsed.:hallo3:


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## Mountaingem

I hear you rhosymyndd. The last thing you need when you're seriously ill is to have a bunch of interns treat you like a pin cushion. I don't even deal with them. I tell them "I'm sorry, but I'm already going through enough and don't want someone practicing on me." 

Of course they never want to listen to me either but then my husband gets into it-It doesn't hurt that he's is a 6 foot plus construction worker lol!


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## Leebie3

WOW!  Australia and New Zealands health systems ROCK!  NZ is WAY better than Aussie though.. In Aussie they have medicare and some things you still have to pay for (ie my faecal calprotectin test cost me $80 :-s)  yet in NZ everything is paid for by the government or ACC (accident cover and compensation).

I have NEVER waited more than a few hours at the A&E.. and have spent just as long waiting at the GP's LOL


----------



## annawato

Cara Fusinato said:


> .  Then I turn on the charm and joke with the staff and express concerns about other people -- it wins them over and they help me 'cause they like me.  I mean, I'm not lying, I have a sense of humor and I do feel pity for others, genuinely.  They are just so used to being yelled at, that they appreciate the difference.  That's how I get the best and fastest care.


i find this helps a lot when you eventually get to a ward/ room too. Amazing what just being nice and pleasant and understanding can achieve.
GNC Crohns man, loved your post, so very true and unfortunately so very often necessary. Why do all those idiots go to emergency for minor problems? have they not heard of general practioners? (which is aussie for family doctor). Once had to wait, in agony, while someone showed the nurse a splinter in their finger. For heavens sake just cut the damn thing out yourself! Note to self - don't be stoic, tears help.


----------



## Kendra

GNC Crohn's Man said:


> Next is part two... You are now in the real ER... First thing you do is as ask if you can get the ER doc to go ahead and right you up orders for pain and nausea meds... Try dry heaving a few times while doing this.. It speads up the process... They will say they can't give you anything until they get an I.V. in you and start you on a saline solution.... You say you can give me all of that together (iv. started and in, pain meds, nausa meds, and a saline drip) if the doc writes those orders while they are gettign you preped... The nurse should come back with the iv kit and a bag of saline... After they hoook that up ask them if that order for pain and naueas meds is up... It should be if you did this right... Now you should be free
> 
> 
> Also when they say to rate your pain scale never say anything other than 10...
> Also tell them your pain and nausea comes in waves so even if you don't look that bad right nown 5 minutes you may be biting through the sheets and in tears.
> 
> I'll finish this later... Gotta drug myself up nice and good if I plan on sleeping


They always tell me no pain or nausea meds until blood work comes back...totally sucks. I usually have to have IV`s in my feet or the side of my neck. I Stay so dehydrated they have to stick me several times, & the kicker is they charge me for every time they do, even if they miss! I feel I shouldnt have to pay but for the one iv that works. They usually dnt last long before they blow, then they have to get an Anesthesiologist to put them in my neck! Then i am charged with his bill! I have no insurance, working on getting Disability Gonna go Bankrupt soon! Credit crds are maxed! So frustrating.Thanks for your post though, I could use that info so I dnt sit there for hrs waiting to be seen. :thumright:


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## annawato

Kendra, wow, I cannot believe they would charge you for each iv whether they are successful or not - the US health system really sucks doesn't it? We are very fortunate in Australia that you basically get the same treatment whether privately insured or not, only diff is choice of doctor and hospital. This is important if you have a chronic illness but if not there is not much reason to be insured if you don't mind being treated by whoever is on call.


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## sullivan777

Hi Daniel,
Great post, I love a sense of humor and am always ok with spelling and grammar problems as I have a lot myself.
I live in Australia, Queensland.
We have public health here which means no payment for any services at all if you go to hospital or are hospitalised.
We then have private health which we have a private insurance policy for and it can cover most of the costs but certainly not all.
Public hospital is certainly the best place for any emergencies. E.g. heart attacks, car accidents etc. but non urgent surgery people can wait five years so so for a hip replacement.
Also here our ambulance service is free.  So in January when I was very ill I call an ambulance, I had chest pain and diarrhoea and vomiting and not keeping water down.  Any emergency centre will always see chest pain asap as it could be a heart attack.  But I guess you wouldnt want to put it on but I guess if you have mild chest pain its best to say.  Yes and screaming in pain is a good idea as no dr. wants people screaming in their emergency room.  The bucket and the vomiting and all your ideas were excellent.  
Its great to keep a sense of humor about these terrible illnesses.
You are so young to be so sick I hope you can stay well for a long time.
Sullivan777


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## LivinglifewithCrohn's

More and more hospitals in the US are offering online ER sign-up with time slots that can be chosen and many are also offering realtime wait times online. If you don't have a computer you can always call the ER and ask what the projected wait time is. We even have billboards in my area that show ER wait times for various hospitals.

I also wanted to share that in the US it is against the law to ask any patient who comes to the ER for payment prior to being seen by a healthcare provider. The law is called EMTALA. EMTALA violations/fines can be quite costly to a hospital. It is my understanding that this law is applicable to all hospitals that receive reimbursement from the federal government, ex., Medicaid/Medicare. 

Nearly all hospitals in the US have what is called a financial counseling department where representatives work with people to set up payment arrangements or even in some cases assist patients where financial criteria is met patients' account balances may be written off completely. If you need financial assistance do not be afraid to ask for it. I think you might be surprised at the options that are available.


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## sullivan777

Hi,
Yes, that is good  that people after they have been seen in an emergency centre in the US may not have to pay or may pay off the costs for many months or go bankrupt through medical bills.
Our system of medicare where our public hospitals are free to absoslutely everyone with no charge ever is a great system.  They are not volonterrs who work in these hospitals, they are all paid by medicare.
As well as our public system we have a private system as well and people who are financially able to usually have private health insurance and may choose to use the private system.  So I could go to a public hospital and pay no money at all for anything or I may choose to go to a private hospital and pay to see a Dr in the ER and pay for every service.  Approx $250 to see the Dr in the ER and you are told of this fee prior to seeing the Dr and you would be expected to pay on that day to see the Dr.  You would also pay for x-rays, bloodtests etc.
The advantage of going to the private ER is that you are usually seen within 1/2 hour, as all major emergencies, road accidents etc go to the public hospitals, so public hospitals have long delays and you could wait for say tummy pain for 4hrs or maybe even 8 hrs.  but of course this treatment will be at no charge.  
I had a major car accident some years back and was taken to a public hospital and the treatment, operations, physio etc was excellent and no charge.
We have an excellent system however for non urgent surgery if one does not have private health insurance you could wait maybe 3 years for a hip replacement.
Going private of course you could get it done maybe in a month or so but it could cost $2,000 over and above your insurance and that is with the top insurance.  It seems to be a good system and free from financial worry if you go to the publiv hospital.


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## Z_Ghost

Last time I went I told them I have Chron's and that I felt like I had been gut shot.
They pulled a guy out of the way with a broken are to get me A CT scan.
Poor guy, I know he was in pain but my guts were on fire.


----------



## Crohnie86

GNC Crohn's Man said:


> You not a hero... If your going to to the hospital you are sick very sick.. If you are like me you would have been vomiting/dry heaving for about 3+ hours before you even leave the house...


Not necessarily. Not all of us experience vomiting as our main symptom. I've only been rushed to the ER for vomiting once. All other times were due to severe abdominal pain.




> (if you don't have insurance I'm sorry but your playing Russian roulette with that hospital) If you do not have insurance you are more likely to get care at a religiously funded hospital.


I agree with this to an extent. However, Emergency Rooms in the US are required to see each and every person who walks in the door, regardless of whether they have insurance or not. They are not allowed to turn anyone away, for any reason. The quality of care you receive, however, is a different story. 




> NEVER go to a college hospital and NEVER go to a hospital that is funded by private investors.. They will always charge you full and The hospitals there are there to make money...


I've personally been to probably 10 hospitals, only 3 of which were Religiously affiliated. They _all_ offered Financial Assistance programs. Those programs can usually be found on their web site. This isnt something they will openly tell you about during your visit, but if you inquire about it, they will.




> Also college hospitals are guess what? Full of medical and nursing students...


Everyone has to start somewhere :smile:  I've found that one of the best ER Docs I ever had was a young man. He took me seriously for the first time in years. 




> 3)A trash can


Again, not all of us have this problem, and acting like you have a symptom that you really don't have, is not the way to gain a Doctor's respect. However, if you are vomiting, I can see how this would be useful :smile:




> The ER gets 3 kinds of patients
> 
> A) People that don't have insurance or are just to damned lazy to go to the doctor. These are non life threatning situations that in 80% of all these cases could be solved at a docs office unless they neeed an x-ray... Again non life threatning....
> 
> B) Crazy people these people are literally crazy they may seem like they are suffering from physical symptoms they may just look crazy thye may look normal.... Either way the problem is physciatric.... Again non life threatiing...
> Just really damned annoying...
> 
> C) Actual sick people.... Sometimes these people are more sick and in pain then you sometimes they are not.... The triage nurse will determine which ones should go back first...



In response to A. I have to disagree with you. Not all people who don't have insurance are lazy, and not all are non-life threatening. There are some people out there who (like me) don't have a family to help support them, arent married, dont have children, and dont have anyone to mooch off of. People who work incredibly hard just to make ends meet often can't afford the $200-$300/month insurance bill. I finally now have insurance, but only because I was laid-off from my job due to my health, and can now afford the premium with Unemployment Insurance. Many people who seek Emergency Care are doing so out of fear that something terrible is happening within our body. Since we dont all have our own CT machines, and waiting a week-a month for a Doctor's appointment isnt an option at the moment, the ER is the only option.


You also mentioned the long wait time. We have a hospital here that has a No-Wait ER. You pay $25 to make an appointment that is usually an hour and a half out, and arrive at the time of your appointment. Completely worth it.



> Next is part two... You are now in the real ER... First thing you do is as ask if you can get the ER doc to go ahead and right you up orders for pain and nausea meds...


In my opinion, this is a terrible idea. As you mentioned earlier, the ER sees a variety of patients, unfortunately some who are seeking out pain medications due to addiction. The best thing to do is never mention these medications at all. They even have the right to add it onto your file for future visits, as a red flag. When the triage nurse asks how much pain you're in, they'll know then what needs to be done. 

I think the best approach for ER visits is to be honest and thorough with your Doctor. They will know based on tests whether or not you are being honest, or if you are exaggerating. If they find that you aren't being up-front with them, they are less likely to take your claims seriously. 

Also, giving them a health history can be beneficial. 

 :smile:


----------



## Dawnmg

I really thought the hospital I went to was bad, but hearing from others its not as bad as I thought.  However, it is a pretty bad experience due to the wait time.  I have learned not to wait until I am in dire pain to go to the ER, I will go right when my flare-up starts.  Also if I can wait until 4 or 5 in the morning I can usually get in.  There was one instance where I had to go in on a friday night and the flare up was so bad I couldn't even sit up.  I actually was sliding out of the wheelchair due to the intense pain and discomfort.  That made them move a lot faster and at least got me to a bed.  It took what seemed to forever to get a doctor in, then the meds order.  All in all it takes about 4 hours for treatment, which as you all know can suck when your in pain and throwing up.  
Our biggest problem is that the people who don't have insurance just go to the ER for a common cold or something very minor and that is why it gets so backed up.


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## Ihurt

In my opinion, ER's are pretty useless when it comes to any chronic disease. I am undiagnosed but went to the ER the last Saturday in the middle of the night. I woke up in severe pain in my lower abdomin and plevic area. They did NOTHING for me in the ER.. They did blood work and a urine test and said that since everything was normal, that there was nothing dire going on!!! Well my hubby and I had to beg for a CT scan. Well I did the CT with the IV contrast and the ER doc said it was normal. Mind you, I also complained that I was having some vaginal pinkish discharge and was not sure where my pain was originating from. I found out after they discharged me (I asked to have a copy of the CT report) that they sae uterine fibroids on my scan! Umm hello, that is NOT normal!!!

Anyhow, I went home, still in pain with NO help and told to just follow up with my GI doc. The ER doc even so much as told me that they do not usually deal with people with Chronic illnesses, it is better to see your regular doctor or GI doc for these issues. He said the ER is not really equipped for that. So, in my opinion, I think you should only go to the ER if it is a real serious emergency. I mean for myself, next time I go, I will have to be next to dead because otherwise they are just going to send you home anyhow and with a Whopping Bill!!! I would like to know how these other people that go in for just a cold pay for the expense of the ER, that is what I would like to know...


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## partlycloudy

I was in the ER once, writhing in pain in the waiting room, when a teeny bopper girl arrived after I'd been there an hour, went right in TO GET HER STITCHES OUT then left. Yah, I'm still mad and that was two years ago.


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## Susan2

You get the best and fastest emergency room care by arriving with your GI! 

I had a regular appointment with mine, but I was in a fairly bad way (had to stop on the side of the road to throw up because of the pain). I walked into the consulting rooms, said to the receptionist that I needed to use the toilet, walked down the corridor and collapsed right outside the door of my GI's room. He was - and is, although much older - a charming young man and he bundled me into his own car and drove me around to the hospital. 

It was amazing how quickly we completed the ER formalities and had me installed on the ward. :ylol:


----------



## lsgs

I've been to A&E once and didn't have to wait at all. The place was packed too. My boss at the time was a doctor and he wanted me to go in an ambulance and I said no, so he put me in a taxi and my mum met me there. I was sitting outside and couldn't stand up. My mum helped me in and we sat in the waiting room, I kept seeing stars and feeling faint. Then I was called to triage and couldn't walk, had to be wheeled in. My BP was through the roof and my pulse rate was 120. I was admitted right away and then when they asked me to change into a gown I just became hysterical with crying because the pain was so bad I couldn't do it. The nurses had to change me I was so embarrassed. Then they did some bloods, saw they were normal (was on a DMARD at the time so of course they were normal!!) and gave me two paracetamol (yes, paracetamol!!) Later they came back said nothing was wrong and I was stressed! Looking back it's so ridiculous. So that's my guide to a wait-free A&E visit in the UK 

Oh and I also turned up in scrubs since that's my uniform!!


----------



## UnXmas

The original post (which this is mainly in response to) is US-centric, but I think my post applies to ERs/A&Es in many countries.

It is not a good thing to fake symptoms! Or even exaggerate.  Moral arguments aside, the staff are going to work out how sick you really are sooner or later anyway. They’ll go by their assessments – blood pressure, temperature, blood tests, etc. 

The pain scale is mostly used to determine whether you are getting worse or better more than to determine whether you should be seen before someone else or not. If you state your pain is 5 and then an hour later say 10, they can see you’re deteriorating. They know that everyone interprets pain differently, so if you give your pain as an 8 and the patient next to you gives his a 7, it doesn’t mean you’ll get treated before him. They’ll go by the overall assessment.

An alcoholic deserves to have his life saved or his pain treated as much as anyone else. No one sets out to become an alcoholic/drug user/etc. I’ve seen some homeless people use the A&E as a place to get warm at night. It’s highly unlikely the emergency staff are going to rush a homeless but healthy person into treatment. If they sit in the waiting area and are not disruptive, I can’t help but think they’re better off there than out in the cold. And if you resent an alcoholic for getting seen before you, how would the patient behind you in the queue feel if they knew you were faking dry heaves to speed up your own treatment?

There are times when staff make mistakes or are incompetent. There are problems with the system that can cause unbearable waiting times and disorganisation. Sometimes you will have to stand up for yourself or have someone else assert for you that you need help sooner.  But I don’t think you should go to an emergency department as if it’s a competition to look as sick as you can.


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## Kinsey

Great topic and really helpful info, thank you all so much for all the post, I can help my son much better armed with this information.  Kinsey


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## carlysy

The sad truth of my experiences in the emergency department closest to where I live is that if you want to be let in the door or looked at by a triage nurse you need to make it bloody obvious how sick you are, aka cry loudly, groan loudly in pain, if you are throwing up into a bucket/vomit bag don't hide it. It might help that I am a girl and I look much younger than I am, but this seemed to get me in quicker than other patients. Unpleasant but true

Btw I know this seems like the wrong thing to do but I was genuinely in 10/10 pain. My symptoms were not faked at all, I just needed to somehow get their attention in the always very crowded room so they knew how desperately I needed pain relief!


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## TheyCallMeRC

I read some of the first posts and great info from what I read. 

One thing I can say for certain and least in the United States and in Georgia.... I have been to ER's in 4 different counties around me and they all say Monday nights are the absolute busiest night of the week.

I have gone in with severe abdominal pain, fever of 103 degrees and pain level 10 and it still take 7-8 hours from triage to get back to the ER.

One thing a lot of people dont take into consideration is not only a packed full waiting room, but most of the time you don't see the ambulances bringing people in.

That is something else.... I was in bad shape one night and knew it was going to take a while because it was 10 pm so I called the ambulance thinking at least I would get right back to the ER... Wrong!!!! They got me right back to triage but then they put me in a wheelchair and rolled me out to the waiting room and still took another 3-4 hours. So don't assume that an ambulance ride will ensure a straight shot to the doctor. But don't be afraid to call the ambulance if necess. they can start an IV on you and start fluids and sometimes get you a little morphine to take the edge off until you can be seen.


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## alouise09

Great post! I have been to the ER a million times! My GI doctors are pretty awesome! I just call them on the way, and they set me up for an admit right away with pain and nausea meds ready. Most of the time I get to bypass the ER! When I do have to go through the dreaded ER process, crying almost always helps! As long as I throw out the name of my stomach issues, pain and nausea meds are always ordered without question!


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## Johnnysmom

Two things I would add...

The ER doctors are there just to make sure you don't die.  They will have no knowledge or experience (usually) with an illness like crohns.  So I would call my son's GI before I leave the house and talk to the DR on call to make them aware of what is happening and hopefully get them involved that night or the next day.  

Also, if you are immunocompromised due to crohns meds, let them know immediately.  I usually say, my son's White Blood Cell count is about a 3.7 right now.  They will get you back to a private room pretty quickly if they can or give you a mask.  

It doesn't hurt to have a copy of current meds and labs too.


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## Dragonfly72

I just worry if you say your pain level is a "10" and it is not.  You never want the risk of receiving too much pain med as it can be so dangerous. I would never  Want  any one get worse or create further issues~~
Good advice on the bucket and a blanket   here's to all of us feeling bett
er!  God bless


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## UnXmas

Dragonfly72 said:


> I just worry if you say your pain level is a "10" and it is not.  You never want the risk of receiving too much pain med as it can be so dangerous. I would never  Want  any one get worse or create further issues~~


This is true - but also, when someone is genuinely in unbearable pain it's pretty obvious. I don't think people should be exaggerating their pain in order to be seen before other patients anyway, but if you do give your pain level as 10 when it's really not, you'd have to be a very good actor to keep giving the impression that you have level 10 pain for hours, or for however long you're in the emergency room. If staff catch you when you're obviously not in really severe pain after you've told them you are, you're not going to do yourself any favours if you want the staff to take you seriously and believe you. Also if you say you have level 10 pain and then they give you a whole load of morphine and you still keep saying your pain's a 10 to make sure you're seen before other patients, they're going to get suspicious.

There are so many posts on this forum from people who are upset because their doctors don't believe them or don't take their symptoms serious enough. Every time a doctor discovers a patient hasn't been honest, it's going to make it more likely that they will start doubting other patients - including the ones who honestly do need much more help than they are getting. No, doctors shouldn't treat all their patients as if they exaggerate just because some other patients do, but it's often human nature to make this kind of generalisation and a lot of doctors are going to do so.

Anyone who thinks about giving their pain a 10 in order to get faster Emergency Room care: think of the patients who are having to wait longer because you've exaggerated your symptoms and the possible consequences of doing so. You should never lie about or exaggerate your symptoms to doctors.

I know I posted my problems with the advice given in the main posts of this thread already, but it just seems wrong to me that this thread is a sticky in this forum when there are serious problems with the advice which it is giving.


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## UnXmas

Ok, so since I have problems with some of the advice in this thread, here’s my own:

1. Make sure you know what counts as an emergency and only go to the A&E (ER) if you really do think it’s an emergency. Not if you’re just feeling bad, not because you’ve a long wait to see your consultant, not because you want a diagnosis for your chronic symptoms. Go because you’re concerned you will die or become severely ill if you don’t get treated right away.

2.  If staff at the A&E tell you your condition is not an emergency, accept that advice unless you seriously think they’re completely wrong, in which case ask for a second opinion. Explain why you think it’s an emergency and ask them to explain why they think it isn’t. Make sure they have all their facts about your condition correct. But if you are conscious, not bleeding to death, and if they’ve gone through all the basic checks – blood pressure, blood tests, heart rate, temperature – and the results don’t indicate anything immediately serious,  then realise it may be that you are fine to wait for a regular doctor appointment. Don’t feel bad if they tell you you’re not actually an emergency case at all. While you should only go to the A&E if you think you are an emergency case, part of their job is to assess whether you are or aren’t. 

3. Take any relevant information – consultant’s contact details, test results, a summary of your medical history, list of allergies, list of medications, etc.

4. Do no drive yourself. If you are in immediate need of medical care, you are not fit to drive. Do not have a friend or family member drive you unless they are definite they are calm. You don’t want your mum crashing the car because she’s so worried about you she has a panic attack at the wheel, or your spouse crashing the car because she/he’s trying to get you to the hospital so quickly she/he loses control of the car. If there’s any uncertainty about the safety of the journey, call an ambulance. Keep in mind that an ambulance will usually take you to the closest hospital. If you know that standards and expertise are better at a different hospital, and if you are sure you can make a longer journey without a negative effect on your health, you may have to find someone to take you rather than calling an ambulance.

5. If you end up in the A&E fairly regularly, keep an overnight bag packed and ready – toiletries, medications, night clothes, money, etc. etc.

6. It may be that while you can’t be seen right away, the staff may be able to make things more comfortable while you wait – pain meds, sick bowl, a drink (if you know you won’t need surgery – don’t drink and definitely don’t eat if there’s a possibility you may need surgery), anti-nausea meds, etc., etc.

7. If you feel you've been waiting too long, do NOT fake or exaggerate your condition. Remember that while doctors do make mistakes, most A&E staff will recognise when fast treatment is needed. Do not get angry. If you feel angry, if possible try to get someone else to talk to staff on your behalf. It’s natural to get frustrated when you feel awful and are kept waiting a long time – but even if you do need faster treatment, getting angry won’t help. Be persistent, be clear about your concerns, and be nice to the staff because usually the only reason they cannot see you faster is because they are caring for other patients.


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## Nuclearfueled

Hey guys,

I don't mean to rain on this ER parade but...

As a former Provider in a big city Hospital I will say that there is no need to 'game' the system.  No need to pull out the theatrics; it just upsets the other sick patients and creates an environment that promotes acting out to gain advantage.  The Triage nurses are very-very good at determining the order of service etc...  I just really get a bit UPSET when I read some of these posts.  There are MANY OTHER sick people in ER also.  Many are elderly and very sick and they do not yell and scream for service; they usually sit there and quietly suffer like everyone else.  

In the United States, being served in the ER is a hideously expensive route to take just to be parked for fluids and narcotics.   The job of the ER Docs is to stabilize people and either get them out or put them up on the floor, that's all.  Don't wait through 3 weeks of vomiting, that is your own personal incompetence.  Get with your Primary Care Doc and order up outpatient imaging and blood work.  

Honestly, when I worked with ER patients I had much less sympathy for the 20 year old acting out than I had for the 80 year old guy waiting his turn patiently.  You'll find that most Providers have seen it all, so, you won't be fooling them....  Just sayin'....:ybatty:


PS-  Telling an ER staff member that your pain is a '10' will work against you.  There are no '10's' that are still conscious.  Unless you have a clear record that you are not Opiate Naive, you will be Titrated up gradually with IV Morphine if your pain is moderate, and IV Dilaudid if your pain is more severe.  Again, the ER staff are highly skilled, they do not over-medicate patients based on their stated pain scale.  Younger patients tend to over estimate their pain while older patients tend to underestimate their pain.

Ex:  I saw an older woman with only a vague complaint of hip pain.  Her left leg had four compound fractures of the lower leg and a spiral Trochanter Fx of the hip.  She had been walking on it for weeks which is virtually impossible.  This is a common scenario with the elderly.  

Yet, on the other hand I've seen huge football players in tears who claim that they are certain they have broken their leg 'really bad' who come back from Radiology with no pathology at all but for some minor swelling.

Bottom Line for IBD, Crohn's, UC patients.  If you look like you are toughing it out the best you can, if you are considerate of the other sick people in your midst, and if you do not use a pain number above an '8', you will get the best service.  

I always respected those that were tough, those that were aware of their communal surroundings, maybe even got up to grab an Emesis bag for someone else or helped someone else with their wheelchair, pure gold those patients.  I was also keenly aware of those who felt fortunate to be able to get some care at all, and were grateful for the time spent by the staff.  

I fast tracked those patients.  Just sayin, again....

Don't bring trash cans to ER.  They are equipped with plenty of Emesis (Vomit) bags that are hanging from several locations in the waiting room.  Bringing your own trash can will not make you look sicker.


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## Nuclearfueled

*Protocols and Perspectives*

Friends,

Also keep in mind.  In the old days medical records were all paper and usually stored at a distance therefore info was not so immediately available.

In the computer age now we have EMR's, Electronic Medical Records that are intensely detailed.  Triage nurses can immediately see every detail of your last visit, and every visit where EMR's were used.  Those records have copious notes from the nurses and attending physicians.  

So, If you pulled a bunch of nonsense on the staff on your last visit, threw a fit in the waiting room etc....  They know that right off the bat and unfortunately you will not benefit from that information on your current visit.  You are treated in large part based on your prior history.  You may be able to jump to the front of the line this visit but you will pay for that on your next visit.  The staff can be a harsh bunch too -labeling patients 'frequent flyers', 'Seekers', 'Stinkers', 'Whiners', and on and on....  I had many frequent flyers that were great and I really wanted to treat and I also had 'Whiners' that I dreaded dealing with and If I could  -pass them off another staff member.  We know alot about you when you are sitting with your Emesis bag and Blanky.  We go over your case long after your visit and we remember you next time.  You'd be shocked to know that some of what you say during your visit is added to your medical record verbatim.  

I just want to stress, it's not a game for ER staff.  They have an obligation to treat everyone equally and with dignity.  There is also a rigorous protocol of steps that are followed that are rarely strayed from too far as many of you know.  Narcotics rarely come first unless your pain is severe due to trauma, and on and on.

So, if you want to have an ER visit that is successful and also helps build your record as someone who is 'credible' and desirable to work with in the future -here are a few tips.

1) Answer the questions that you are asked.  Believe it or not, people don't answer the questions asked, instead preferring to tell their prepared speech.  Throw away the speech, be in the moment.  When asked, describe your condition calmly in a condensed format that details your actual symptoms.  

2)  Save any past horror stories or failed procedures for for later if it become relevant. You will likely only have brief periods of time with the staff where you can convey your information.  Don't waste it with non-relevant information, drama, or exaggerations.  Filter out all extraneous speech making and get to the exact nature of your problem quickly.

3)  Read up on your condition and the associated medical terminology and you will be able to converse with the attending Physician on a higher level.  Patients that show an understanding of their condition in medical terms are often rewarded with more candid speak from staff regarding their labs, XR's or CT.  If you show genuine interest and appreciation for the details of your imaging study you may be rewarded with an actual printed copy of the Radiologist 'wet read' which is pure gold.  I have all of my Rad reports in a file.  Turns out I have cyst in my left kidney that I was not informed about but I can run my disc and see it myself on my computer.  So, be involved in your care!  Be interested, be curious, get smart!

4)  An AB/Pelvis CT w/wo Contrast is a REALLY valuable study to have performed.  It is a high dollar study that will contain information about every organ that is readable to the Rad.  Heart size, Liver, Spleen, Kidneys, Pancreas, Bowel loops, Spine, Air/Fluid levels, Lungs etc... That means that an entire spectrum of illnesses CAN potentially be ruled out (for the moment) which can be very comforting and valuable information.  

5) If your condition is dire, limit your oral fluid intake in the event that a stat surgery is needed. Inform someone of where you are.  Expect to wait, be grateful if that wait is short.

Nuc~


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## UnXmas

Nuclearfuled - I agree with many of your points; I've already written quite a few posts on this thread about the problems of exaggerating your pain, giving it a "10", etc.

I'm not sure if your point about records applies in the UK though. There is going to be a new system in the UK very soon about making your medical records available whichever hospital you are in, but for the time being people here will probably find a hospital A&E has no records readily available - even if you've been to that hospital before.

The only other thing I wondered about reading your posts it this one:



> 3) Read up on your condition and the associated medical terminology and you will be able to converse with the attending Physician on a higher level. Patients that show an understanding of their condition in medical terms are often rewarded with more candid speak from staff regarding their labs, XR's or CT. If you show genuine interest and appreciation for the details of your imaging study you may be rewarded with an actual printed copy of the Radiologist 'wet read' which is pure gold. I have all of my Rad reports in a file. Turns out I have cyst in my left kidney that I was not informed about but I can run my disc and see it myself on my computer. So, be involved in your care! Be interested, be curious, get smart!


I've found that using a lot of medical terminology makes a bad impression on doctors. They associate it with patients who spend too much time online self-diagnosing (associated with hypochondria) and resent patients who come across as if they know more than doctors do. Maybe it's different for you being a medical professional?

Also, perhaps this is just me, but the times I end up in the Accident & Emergency room, I'm barely capable of speaking let alone conversing on a higher level!


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## Nuclearfueled

UnXmas,

In the states here EMR's apply to all modalities. For example: Through the Diagnostic imaging side of the Hospital which is all digital (no film) I was able to see all imaging studies and Rad reports on any patient on my computer. I could also access the MAR where all Providers, ER and nursing staff enter their patient information. Essentially I was able to follow a patient through their entire visit from their intake in ER, what drugs were given and in what doses etc... through their discharge, every note, every scribble. Height, Weight, Temp on arrival, primary complaints, all Labs past and present, home address, insurance, prescribed meds, drug screens and any illegal meds and on and on. Really comprehensive information is available now and it applies across the spectrum of hospitals, clinics and any private practice providers that sign up with the required software packages. The UK will really need to get on board with this as it has proven to be essential and has saved billions of dollars and is now considered indispensable.

I ADAMANTLY disagree with the argument that ignorance is bliss. Ignorance is ignorance and you will be treated as such (unfortunately). I've heard this 'ignorance' tact many many times, usually regarding Narcotics. People are warned to never use drug names or ask for a drug by name. Wrong again. Ask all you want, use names and dosages all day long. If the drug you suggest is the correct one you will get it, if it is not the correct drug you will not get it.

So many people highly over estimate their ability to overcome a physicians training. Like the pain scale; say your pain is a '10' all day long, you will still be Titrated up slowly from a standard dosing schedule of 1-5mg of IV narcotics, usually Morphine. If you are wearing a Fentanyl Patch that is legitimately prescribed to you then your tolerance is high and you may get Titrated up from 10mg of IV Dilaudid.  Most Opiate Naive patients are asleep after the intial dose.

Again, being ignorant and uninformed, or pretending to be ignorant is wrong headed thinking that will NOT get you the best care. We want patients that are educated about their illness so that they can participate in the details of their care.  Yes there are smarty's that think they know everything; they just get gently corrected.  better that they think they know something so that it can be discussed and corrected if needed.

Yes, when patients are in acute crisis they are not expected to carry on detailed conversations, however, once they are stabilized they are expected to answer some questions. Trying to explain a complex problem to an uninformed patient, especially one that requires a decision be made by them immediately is frustrating. Providers know and expect that patients with chronic illnesses are obsessed about it and crazy from their malady and that most will hopefully be reading everything they can get their hands on related to their illness. Others prefer not to know, too scared or just not interested in things medical.  Diabetics absolutely need to become knowledgable because it is so essential that they know how to manage it.

I find that conversations with well informed patients is much more productive, they 'get it', and we can move on quickly to any complications or other matters. On the other hand, talking to a blank stare that asks no questions and has little knowledge of even their most basic anatomy is a patient that won't be participating in their care, unfortunately.

If you subscribe to the ignorance is bliss philosophy you will be treated with less information and since there are so many measures of healing that patients need to take upon themselves, you may be told to get more educated about your condition.

I really hope some of these myths go away because they just continue to proliferate and they are wrong.

Another example is Prednisone. Sometimes people educate themselves but they seek out incorrect information. They will fight their Doctor saying 'I heard that Prednisone was bad so I won't take it'. That patient got educated with the wrong information and the physician will need to expend even more time explaining why in their case Prednisone is the correct treatment. That is the most frustrating type of patient there is... They got smart on incorrect information.

I've read so many threads in many forums where someone is telling another forum member definitely 'Don't take Prednisone!', 'Prednisone is Awful and horrible, the devil drug' etc.... I just fume over those threads.  Prednisone helps millions and millions of people with all sorts of immune related illnesses. Without Prednisone I would be dead several times over. Actually I would have died in 1979 if I didn't have Prednisone, and again in 1991. Most UC patients would lose their Colons very quickly without Prednisone.  In short runs of a few weeks followed by a gradual taper, Prednisone is a great way to turn around a flare that isn't responding to lesser treatments. More importantly, one forum member should not be telling another NOT to take a medication that their Doctor is prescribing. That is a serious discussion between patient and Doctor that the patient needs to be open to having.  Again, more ignorance. If you don't know much about Prednisone ask your Doctor about it and read about it from some credible sources. In nearly all cases where Prednisone is used in short runs the positives outweigh the negatives. Some illnesses require chronic Prednisone therapy for years or even decades. In those cases of long term Prednisone use serious side effects do come into play and patients need to weigh those risks.  Those are tough choices.

Sorry for such a ramble but some of these myths and counter intuitive suggestions that circulate the internet really need to be crushed.

Nuc~


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## Ihurt

I kind of get what Unxmas is saying regarding doctors Not liking patients who are educated and knowledgeable. I will say that I have come across quite a few doctors who seemed to get a very arrogant attitude with me because I am so informed about my health and pro-active. Honestly, I think a lot of doctors  prefer the ignorant patients. They don't seem to like when you question them or their ideas. Not all doctors are like this though. I have a couple who absolutely LOVE that I am knowledgeable about my illnesses and proactive. 

But yes, I can say that it is best to NEVER tell a doctor you have been doing research online about your health. You will get slapped with that hypochondriac label and then the doctor will likely tell you that you cannot believe anything you read online. In some cases, yes, there is a lot of crap online that is garbage. But when you go to reputable sites, then you are getting good data. But again, some doctors I think feel inferior when you come off as being knowledgeable about things. I think being proactive and knowledgeable is an absolute must when you are sick with any kind of illness. Bottom line is, if you are not proactive, you are not going to get the best care, period. Doctors are not going to put too much time into really trying to help a person. Sometimes we as patients have to guide the doctors. I mean we know our bodies best most of the time. 

One other thing I noticed is that women generally do NOT get the respect the deserve when seeing doctors a lot of the time. I will say, and my husband even has seen it for himself, that if he goes with me to my appointments, I am 50% more likely to be taken serious. That is sad, but it is true. Every appointment I go to when I bring my husband, we notice that I am listened to  more so. When I am alone, it is kind like I am pushed off. This is terrible, but it is true. I know a lot of friends who have experienced the same exact thing as well. So if possible, try and bring a spouse, friend, or other family member with you if at all possible. You are likely to get somewhere and get more respect with someone there backing you up. That way the doctor cannot dismiss you concerns so easily.....


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## Nuclearfueled

Ihurt,

Good points.  The attitudes and the 'who's the boss' challenges and all of those stilted exchanges do lead to Doctors becoming arrogant and asserting their authority and knowledge.  When patients get knowledgeable they need to remember that knowledge is just the basics for a discussion.  It's not a black and white stamp that you lay down at the feet of your Doctor as a take it or leave it.  If you have knowledge don't undermine it by using it incorrectly.  All it means is, you can speak the language, now have the discussion, and it has to be civil or all is lost. 

I have doctors too, I don't self care my Crohn's.  I have medical knowledge which means I can speak the language with my Doctor, that's all.  I speak to them with respectful inquiry as I expect them to speak to me.

*Positive exchange:
*
"Doc, what is with this fatigue, it's killing me.  I read that it was related to the Crohn's disease itself in combination with an immune response?  Is that how you see it?  Are their treatments for this?"

*Negative exchange:
*
"Doc, I know for a fact that my fatigue is caused by a radioactive process in the lining of a goats Anus.  And don't you dare try to put me on Prednisone either because I know for a fact that Prednisone is a killer.  And by the way, I hate Doctors!"

Lol, I think it's all a matter of perspective.  Doctors rarely feel inferior (we may think they do, they don't), by nature they are type-A's that have gone through a really rigorous program over a dozen years of challenges.  I think they get frustrated, no doubt there.  Doctors strive to remain unruffled in the face of all sorts of patients, but sometimes they react when some patients are on the fringes of the norm.  They see such a wide variety of people that I think they struggle to keep everyone on the same page.  In some parts of the country women are still treated poorly and that's a scourge that stains the social progress that we all deserve.  I'm sorry that it requires your husband be in attendance to get proper treatment.

Nuc~

People of all professions find the same issues when it comes to dealing with other people.  Say you trained extensively for many years to operate a very complex machine that laser drills precise holes into silicon wafers.  Imagine someone who knows very little about the machine or the process comes across you and laughs and says "Ha, anyone could operate that dumb machine".  It would likely take all of your reserves to calmly say "That's not true, this machine is very complex and it took me 6 years to learn how to operate it".  That is the position that Doctors find themselves.  people just haul off and say whatever comes into their head to Doctors.  Now, say a second person comes across you and your machine and says "Wow, I've never seen one of those macines in operation but I've read that they can take yer arm right off in a second, is that true?"  That is a bit better.  At least that person has an inkling about the machine and its potential dangers.  They may be wrong in that it doesn't take arms off but at least they have a basic respect for it and you as its operator.  

So, obviously you can more easily have a constructive exchange with the second person.  The first person not so much, you just want slap that person.  That's how Doctors feel from what they've told me.  They just want some basic respect for the years that they put in but they always risk headbutting with someone that wants to challenge them, and knowing nothing of what they do.


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## Ihurt

Nuc, I totally see what you are saying in regards to how you present yourself and information when speaking with a doctor. That does matter of course. I have always been very diplomatic when I talk to my doctors, very respectful. But I have still had issues with doctors having this ultra Ego thing going on. I still remember one gastroenterologist( a professor of medicine in his field) I went to see years ago when I was having this very odd throat burning issue that developed after I got sick with a very bad cold virus. I also was having other issues as well. I was pretty sick. Anyhow, I went to my appointment and explained to him all that was happening. When I had finished telling him of everything I had went through, he just smirked. Then he turns to me and says, " you know, I really do not think you have any issue here.", Then he goes on to say," What I see is a woman making a mountain out of a mole hill. I see this a lot with woman your age"!! Needless to say I never wanted to slap someone more in my life than I had at that moment. I was appalled at his attitude. After the appointment his personal assistant nurse came up to me( since she heard what he said), and apologized for him. She could tell I was very upset at how I was treated. She said if she were me, she would seek out another opinion( which of course I did). But that is just one example of how some doctors can be unreal.  I also use to see a urogynecologist for my Interstitial cystitis issues of the bladder. I developed a UTI and was put on cipro antibiotic. Well after the second dose I had woke up in the middle of the night with my arm just throbbing. Well I researched the drug and saw that it could cause tendon issues. I called him right away the next morning and told him that I needed him to switch my medication that I was having a very bad side effect. He told me that this was NOT a side effect of cipro and that I should keep taking it!! Well I called my pharmacist and talked to her about it. She told me to stop in immediately as it can cause spontaneous tendon ruptures and tendon problems in some people. Well I called the doctor back and explained what the pharmacist said( and I do believe that they are more knowledgeable about drugs than a doctor is) and he got all irate with me. It was like he did not want me to call the shots at all or have an opinion on this. I was so mad. I told him I was not taking anymore of the drug as I did not want to get worse. Well needless to say he begrudgingly called me in something else. My whole point being is that sometimes it seems like doctors do not "Listen" to their patients. Granted, I understand they went through 6 years of school, and I respect that, I do. But at the same time, just because you are a doctor and went to school does not make you great at your job. I have had car mechanics who are certified mess up my car. I have had certified plumbers do a horrible job an make a situation worse. These are things patients have to be aware of. I mean just because a person had MD in front of their name does not mean you can put your 100% trust in that person. I trust only one person, and that is myself. Not to say I have no trust in my doctors, I do. I have a couple doctors who are great, the both work with me on my issues. That is the key word, "work WITH me". Most doctors like to call all the shots and usually do not want to have the patient making decisions or be involved in deciding treatments. They would much rather the patient just go along with them. And there is always that one thing that still stands, I mean who knows a body better than the person living in that body????


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## UnXmas

Nuc - but many the doctors I've seen are nothing like yours!

For one thing, your post kind of assumes that the medical professional is knowledgeable. I have lost count of the number of times a doctor has told me something that is completely wrong, or given me inappropriate treatment. Conversations between doctor and patient can mean very different things if the doctor is incorrect. Just as for some people, whose doctors may have told them prednisone is the best choice of treatment for them, will end up with permanent health issues as a result and wish they'd never taken it.

I learn about my condition and about drugs, but I never suggest to doctors what's wrong with me or what tests I need or what my treatment should be anymore. I let the doctor decide, and then I either accept their choice or find a different doctor. But I think owning up to reading about medical conditions online never makes a good impression on doctors, at least not the doctors I know.

I actually have found some benefit in doing less research and remaining ignorant - to an extent. I am the sort of person who can get neurotic about things, and now that I have doctors who I trust, I do feel some relief that I can turn over a lot of the decision making to them. 

Perhaps what I mean is that the extent of patient involvement should vary depending on the specifics of each given individual situation.

To be honest I'd be a bit worried if doctors give inferior treatment to patients who don't understand their condition and don't know the terminology. A lot of people do not have the ability - or have not had the necessary education - to acquire that sort of knowledge. Some are just too overwhelmed with being ill. A good doctor should tailor their language to the patient's abilities.


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## Nuclearfueled

Good points all 

Ihurt, I hear you.  Sorry you've had those bad experiences.  I try not to make my bad experiences poison the entire Well.  Clearly you've had issues with your Doctor that were not good.  I also take Cipro and I believe the tendon rupture issue is a rare one but something that patients and their Doctors need to discuss.  The point that not all Doctors are even good at their jobs, like the lousy Auto Mechanic analogy, is a really good one.  All we can do is go into these interactions with our best foot forward, and OUR civility intact etc...  We can only control what happens on our end of the discussion.  

And you are right, I did not account for the incompetent providers out there and the ones that have poor patient care skills.  Many Docs are a bit challenged in the patient care area due to the mountains of medical information that they are required to know. The AMA has periodically updated protocols in an effort to teach Doctors how to be human beings by training them to have more compassion, and especially how to interact with diverse populations.

I've only had one Doctor that I felt was borderline incompetent, well 2 doctors actually.  The first Doctor had me up on my knees in his office, door wide open, yelling down the hall asking for an extension cord so that he could get a better look up my rear end with his table lamp!  His 19 year old PT female office assistant was going through drawers looking for cords, meanwhile the Doctor was asking me how much Anal sex I had been having.... Just crazy.  I was a young guy, having my first UC symptoms.  I was so mortified and traumatized by that guy, but I was too shocked to complain and didn't seek any further treatment for many months which just made my condition worse.  

The 2nd incompetent Doc was my GI Doc years later in the middle of the UC battle.  I was parked up on the floor at his hospital and for some reason instead of calling in the highly skilled infusion nurse (The one that places PICC lines), my Doctor decided he wanted to place my port himself, so with no Anesthesia of any kind not even a stab of local Lidocaine he proceeded to investigate with a large gauge 4" needle under my Collar bone (the location of the big deep veins used for ports). For over 15 minutes he just kept stabbing and missing and stabbing.... I was holding a male nurses hand and I was crushing it so bad that he was also crying out in pain.  The most absurd, painful, abusive and stupid thing I had ever experienced from a Doctor.  When he was done I was drenched in sweat and crying.  I had a shunt with 4 ports.  When my regular nurse came in and tried to flush it she found that 2 of the ports were dead and needed to be capped off since they were not functioning.  Several hours later my nurse noticed that my entire chest was turning purple from blood infiltrating my tissues and the port was removed and replaced by the Infusion Nurse.

As you say UnXmas, Doctors do tailor the information (not the care) that they give patients based on that patients knowledge base, but it's not out of favoritism.  I tend to get much more information out of my doctors because I have some medical knowledge and I can ask some of the right questions.  And when a Doctor is flexing his brain and rattling off some good stuff, I'm into that.  I like when they get a chance to show off some of their expertise or share a latest finding.  I'm not put off or threatened by that at all.  I want to hear it, that's what I'm paying them for, show me your stuff, ya!  Teach me a few things.  

There is good online information at the Mayo Clinic website, Johns Hopkins University, PubMed, the Cleveland Clinic, The Oregon Health Sciences University (OHSU) and many many others.  There is excellent information out there that is highly credible.  People should use those resources.  

We will have to agree to disagree on the point of patient knowledge about their illness. I've never heard of anyone endorsing ignorance.  It goes against everything our representatives (some of them) and educators are fighting for every day; raising our awareness, personal empowerment etc...To endorse ignorance as a strategy for anything boggles my mind, but so be it.  If, for personal reasons it helps you to be a bit on the clueless side about your illness then that is your prerogative to do that.  Early in this thread, many pages back... Wow, there is just bad some information there... and this is a 'Sticky'?

To be more accurate about a specific drug or therapy one shouldn't pluck out the anomalies and rare occurrences and hold them up as representative examples of a norm.  Of the millions of people that are helped everyday by Prednisone or Cipro or some other drug; there will always be instances of bad outcomes.  If you base your care on out-lier bad outcomes then there will be no drugs or therapies that are safe enough or effective enough to use.  



Okay, the horse has no heartbeat.

Nuc~


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## Ihurt

Hey Nuc,

Wow, sorry you also had those bad experiences as well, that is awful. I can understand your reluctance to ever go back! That is kind of what I have been going through. I have learned that if your issues are not clear cut, or black and white, then doctors just do not seem to want to deal with it or they just shrug it off as being IBS or whatever. Absolutely, not all doctors are bad, that is true. I have a very good primary care doctor who is very compassionate and always willing to work with me. I think a good bedside manner and compassion is very important to have which many doctors seem to lack it seems. I went through about 5 primary care doctors before I found the one I have now. My gastro doc is ok, he has a very good bedside manner and I like that. But I think he is limited. I think since I have other health issues, he kind of just wants to place any new issues I am having into saying it is all connected with my other health issues. I mean honestly, I could go get a second opinion, but I am so tired of going to doctors ( I am sure you know what I mean). Besides, I am already in the best hospital in Chicago already supposedly with a top GI. It really gets frustrating though. 

Oh, actually the tendon issues believe it or not, are not Rare at all. I ended up having to go to an urgent care due to the pain I was having in my arm after I took the cipro. I went in there thinking the doctor was going to be just like the uro, and tell me that the cipro was not causing the issue. Well I was shocked because when I told the Dr. about my symptoms and that the pharmacist said it could cause tendon issues she said I was smart to stop taking it. She then told me that she had taken levaquin ( a sister antibiotic of cipro, same family) and her Achilles tendon nearly ruptured! She said she has seen quite a few people who have had injuries due to cirpo and drugs in that family. She said unfortunately, most do not even put two and two together. I guess it is Not that rare really.


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## Nuclearfueled

Ihurt,

What is your primary complaint?  What is your current condition?  Was the issue with your arm a ruptured tendon?

All The Best,

Nuc~

I just looked up the risk of tendon rupture and  Cipro> 15 in 100,000 patients.  Usually other issues in play also related to vascular health in that area, age and numerous other issues.  Point taken though.  It is a concern.  If at risk or just worried or having symptoms definitely switch Antibiotics with the guidance of your Dr.  I try to limit my Cipro since it seems to just make me feel like crap :ybatty:


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## Ihurt

Nuc,

Well for the last two years I have had moderate to severe intestinal pain. I get pain and cramps and that feeling like I always gotta go. But usually I go once a day( it is usually always formed, but sometimes on the softer side where the stool is formed but when it hits the water it kind of disintegrates). Sorry if that was too much information. But my main issue is bad pain all throughout my intestines and sometimes I get times where it hurts on the right lower side. I have had the following tests thus far in the last year and half; I had stool tests checking for parasites and calprotectin levels, blood work, abdominal ultrasound, MRE of small bowel last October and it was normal. I also had a colonoscopy this past April and that was normal. I had one episode where I had severe lower abdominal pain that sent me to the ER and they did a CT scan with only the IV contrast since I cannot tolerate the drink one. That one came back normal as well. So my GI keeps thinking I have IBS. Just that my symptoms do not fit IBS at all. I feel like I am getting worse as time goes by. I know a lot of people on the crohns board say that getting a diagnosis can be hard. I wonder if they could have missed it with the tests I have had, or maybe it takes time for the inflammation to surface with crohns? I just do not know. I am seeing a rheumatologist soon to see if he can offer any help. 

No, I thankfully did not have my tendon rupture. I had tendonitis though In the arm where it was throbbing. I had issues for about a good year after taking that cipro. It took awhile to fully heal. I think had I not stopped taking it I may have ruptured , who knows. :eek2:


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## ce1210

I would say getting the best ER care would be dependent upon which hospital you went to, I know in TN there are vast differences from hospital to hospital. ER docs at Sumner Regional Hospital in Gallatin, TN turned my grandfather away told him to go home there was nothing wrong with him, and he was in the middle of having a stroke right in front of them. As we were walking out a nurse came running outside and told us that we needed to take him to another hospital because something was wrong? A doc at the same hospital attempted to begin taking the pins out of my dad's broken wrist before he was given any anesthesia (he actually stuck the knife in and my dad started screaming),and left pins in my dad's broken wrist to long and he had to have major orthopedic surgery to reroute tendons in his right arm. And I crushed 2 fingers on my left hand pulling my fingernails out in the process, well they cleaned the fingernails and shoved them back into my fingers and put 2 stitches thru each so that my fingers would heal in the correct shape. When it was time to have them removed, I went back to that hospital and the doc that was pulling them couldn't get them to come out. He said it was my fault because I wasn't holding still so he called in 2 nurses (both about 5' 100lbs, I was 6'4 215lbs) to "hold me down". He then tried to yank one out very quickly and it ripped in half and when this happened I jerked really hard (not on purpose, but having someone yank on a finger that is dislocated and broken in 3 places is NOT pleasant) and knocked one of the nurses down. He got all flustered and told me he couldn't get them out, so just wait till they fall out on their own. Why he didn't just numb the fingers I'll never know...

So emergency rooms and doctors are hit or miss, 50/50 in my experience...but I will never take any drug my doc prescribes without knowing its mechanism of action, its full side effect profile, who stands to profit off of my prescription, pharmacodynamics/pharmacokinetics, etc. I will also never have any more tests or imaging done without physically seeing the results (I just now got the results from my CT w/ contrast they used as initial diagnosis for crohn's in june and have had to fight docs, nurses, the hospital, and my insurance company to get it). I can tell that my GI doctor finds me annoying, but I think he is starting to become intrigued by my "hypochondria" and hatred of pharmaceuticals. He told me I may want to consider seeing a therapist to deal with starting 6-mp or something since I was afraid to...I told him I would prob cause a therapist to commit suicide and he laughed for like 10 minutes but he def thinks I'm crazy. a

I really have a problem with the way society looks at doctors, like they are practicing some kind of black magic. All they are doing is becoming extremely informed on the anatomy and physiology of the human being, then making educated guesses about what medication, surgery, or therapy will help (do more good than harm to) each individual they see. Anybody that wanted to be a doctor badly enough, could be a doctor.


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## optimusmog

ce1210 said:


> I would say getting the best ER care would be dependent upon which hospital you went to, I know in TN there are vast differences from hospital to hospital...


I agree 100%, it's not just in Tennessee but I've experienced these variations in NE, PA, NJ, IL, NY... Living in Chicago I had one hospital admit me at the triage desk, before I could sit down and before they got my insurance info, because I had a fever of 104. I presented with the exact same symptoms at another hospital in Chicago later that year and sat in the waiting room for god knows how long (I don't know! I was delirious with a fever!). In NYC it's one hell of a crapshoot. I've had experiences all across the spectrum, from "could you make an appointment to see your gastroenterologist in the next 24 hours?" (as I'm actively dry-heaving) to "don't move, we'll bring the gurney out and you can relax" (when I wasn't even puking!).

I think it comes down to doing your research beforehand - yes, after some amazing hospital horrorshows, I have become that crazy person who quickly hops on google and looks into the local ERs before I travel. And THANK GOD because when I'm having a flare, I don't want to be simultaneously freaking out that I'm about to wind up in Our Lady of MRSA Hospital or something. A little bit of preparation can make such a difference.

Also, I have found that calling my doctor and having them contact the ER (whether or not it's in-state or an affiliate or whatever) so they know I'm coming in is HUGE. We're talking the difference between a 3 hour wait and a 20 minute wait.

I find it most useful to be as straight as possible, like "I have Crohn's disease, I take (whatever) maintenance medicine, but this (blood everywhere, high fever, inability to keep food down, etc.) symptom is unusual for me and I am worried my disease is flaring." My Mom's a doctor and I've noticed that, even if she doesn't pull the "I'm a doctor" card, this is how SHE talks to the people in the ER when I'm flaring, and it works.

...Which brings up the point of how incredibly valuable it is to have an advocate with you if at all possible. I know when I am in searing pain and can't think straight from the fever/dehydration/PAAAIIINNNN, it's a relief to have someone with me who can speak clearly and answer questions with a working brain. My husband and Mom know when I'm downplaying my pain or being non-chalant about my symptoms and they often have a more realistic viewpoint than mine. Plus, it never hurts to have an extra voice backing up why this is serious shit and not just a fun jaunt to the ER for a silly tummyache from eating too many gummybears. :kello:


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## UnXmas

I've found the secret to getting the best and fastest emergency room care. The hospital I went to isn't known for having a great A&E. When I got there, the waiting time given on the sign was four hours. I was seen in less than two minutes, then went from doctor to bed to pain killers to scan to surgeon... etc. My intestine had perforated. So I've concluded you get the best care when you're really sick, and if you want to be seen quickly, go to A&E when you're very ill. If you're having to fake sickness to try and be seen quicker, you're probably not sick enough to need to be seen quickly, and shouldn't be trying to jump ahead of people who need help more urgently than you do.


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## Axelfl3333

Hi nuc,I agree with a large part of what you say but like many on here I,ve ran across many doctors who have the customer care skills of a dead fish!sorry to insult you dead fish!i,ve just came back from one who was like that it's very frustrating.conversation went this way your blood work came with great results,stool sample the same,that's good I say,why do I go to the toilet 6/8 times a day!don,t know is the reply,any ideas?no.see you in 4 weeks for a check-up.mentioned pretty bad joint pain especially my shoulder,physiotherapy might help,I,ve had it suggested cortisone injection,fine want to do it just now?see what physiotherapy say,reply I,ve been,ok see you in 4weeks,bye.this happens on a regular basis bye the bye,no eye contact just the blank stare into the computer monitor.this probably explains the rise of alternative holistic healing at least theypretend there interested.I know all drs aren,t this way.


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## apl2018

go in screaming in pain


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