When to go to the ER?

[KittyRN]

Hi everyone

I'm a very occasional poster. My husband has Crohns. He had a "flare up" Feb 2009, which ended up being from what he ate and he apparently has a fibrostenotic stricture (from surgery 2001), so basically the Crohns wasnt flaring but what he was eating got "stuck" because of the stricture.

Well he has not been feeling well all day. Had breakfast but that's it. He has not vomited yet but is close I think. I'm pretty sure it's the stricture again as he has been virtually symptom free since last Feb and we had steak last night which is hard to digest. Last time he was in the hospital they put in an nasogastric tube and started him on steroid which they then determined he didnt really need since it wasnt actually a flare.

So when would you go to the ER? Like I said he hasnt puked yet. How long should I let him be miserable? He wont go unless I force him but I hate having him go there when they pretty much dont do anything besides not feed him (though I know I dont want him to get dehydrated). Oh, he's not really in pain just feeling very bloated/backed up/nauseous.

Thanks.

 

[ChefShazzy]

Everyone is different; if he feels like he should go, then he probably should go.

In the past, I have gone when I couldn't hold food down for two days, and lots of pain, cramping, nausea, and blood in the stool. I'm the kind of person who doesn't go until it's really, really necessary... Is it possible to get in touch with his GI and be squeezed in for an appointment in the next day or two?? In the meantime, make sure he is keeping hydrated. And watch what he eats - most Crohnies don't do well with red meat. He may need to change his diet in the future to avoid possible blockages. Again, though... if you think he should go... just go! Hope he feels better soon...

 

[KittyRN]

Thanks for the reply Sharon. He's puking as I type. I guess we'll wait and see how he feels now that he's brought stuff up and if it happens again/if pain starts. I shoudl be able to get in with his GI tomorrow if not our GP for sure. Does it seem irresposible to wait it out??? Like I said, he will pretty much NEVER suggest going in, but if I pressure him he will.

 

[DustyKat]

I agree with Sharon.

IMO if you feel you need to go to the ER and there's nothing much wrong then you're no worse off and you're not left guessing. There's nothing wrong with putting your mind at ease and it is difficult when you have to make the decision for someone else.

Hope things sort out soon.

 

[DustyKat]

No it is not irresponsible to wait it out. If he does not feel any better after vomiting or his condition worsens and you think he needs to go to the ER then go.

 

[KittyRN]

Thanks everyone.

He appears to feel a little better after puking. Just wants to rest right now. By the sounds of it I dont think he brought enough up to make a huge difference but I'm glad he feels a bit better. I guess I'll keep an eye out. I just wish things would start to move in the opposite direction.

 

[HospitalPatient]

June 3, 2010

Kitty:

As you know, we Crohn’s Patients HATE going to the Hospital but I think we all seem to have a built-in barometer which tells us when we MUST GO.

If the Pain is breaking through whatever Pain Meds you have and you think that Vomiting or a Bowel Movement will not relieve the Pain – or you think it would - but you don’t envision one or the other happening any time soon - GO TO THE ER.

If the Pain is SO BAD that your husband might pass out and then won’t be able to tell you what is going on – GO TO THE ER.

Us tough guys think we can take it ALL but if we PERFORATE – that is beyond serious. I totally understand the Stricture aspect and that it might Pass but it also sounds like this could be somewhat of a chronic problem and he probably has to undergo a variety of Tests and if he is ADMITTED to the Hospital he can then have them done much more quickly and depending on your Heath Insurance – probably more affordable.

I hope that helped. Good luck. Lastly – WHEN IN DOUBT – GO TO THE HOSPITAL. Just Call the Doctor ahead of time and see if he or she can make your ER Visit as “Personalized” as possible.

 

[KittyRN]

Thanks Michael. I will definitely force him to the ER if this continues, but as of right now he seems to be settling. I definitely do not want something as severe as a bowel perforation happening! As resistant as he can be, I know he'll give in if I push him. He doesnt want me to worry.

Funny thing is he just saw his GI last week who thought everything sounded great and was scheduling his next appointment with colonoscopy in October!

 

[KittyRN]

Oh just wanted to add, he still doesnt have any pain/has not taken anything for pain. Just bloating/nausea. And some pressure.