Emergency room / hospital visit

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Polarisjeff
Regular Member


Date Joined Jan 2006
Total Posts : 74
   Posted 1/5/2008 11:11 AM (GMT -6)   
Hey, just wondering what exactly happens when you've reached a point in a flare when you need to got o the ER or be admitted. I'm doing everything I'm supposed to as far as meds, supps, and restricting my diet, and things are still out of control. 15+ times a day, tons of blood, pain. I've lost 30+ pounds. My new GI is gonna flex-sig me Monday (yippee!), but I'm not sure I can make it until then (like that's gonna make me feel better anyway). I do my enema and sleep pretty good at night, so that's keeping me going. I eat maybe a banana, a yogurt, and some rice cereal or rice noodle soup in a day. So, I'm guessing they IV you first to level out your vitamins, but what about the inflammation? I can't do the steroid thing again. No way.
Diagnosed with Ulcerative Proctitis April 2006

Canasa suppositories daily
Hydrocortisone enemas nightly
Flagyl 3/day

Probiotics, fish oil, iodine, Bio-D-mulsion, Ultra InFlamx, sea salt,

Status: 48 hour virus left me with mod to severe flare
12/4/07 - progressed to severe 12/28/07


PSC27
Regular Member


Date Joined Jan 2008
Total Posts : 23
   Posted 1/5/2008 11:14 AM (GMT -6)   
Have you considered Remicade?
That did wonders for me, and I was in the bathroom 25 times per day from my UC...I got off the steroid, I gained 45 pounds it was rediculous!
I'm sorry to hear you are in such pain, I KNOW the feeling just try to hang in there
Diagnosed with Ulcerative Colitis - January 2007
Diagnosed with Primary Scerlosing Cholangitis (Liver Disease) - July 2007
Medications include: Asacol, Remicade, Urso, Neurontin, Prednisone (Just weined off), Imuran, Percocet


PSC27
Regular Member


Date Joined Jan 2008
Total Posts : 23
   Posted 1/5/2008 11:15 AM (GMT -6)   
Usually, to go to ER you have to have FEVER, NAUSEA, VOMITING, SWELLING, etc...In July I had a fever of 105 I did not think I was going to win
Diagnosed with Ulcerative Colitis - January 2007
Diagnosed with Primary Scerlosing Cholangitis (Liver Disease) - July 2007
Medications include: Asacol, Remicade, Urso, Neurontin, Prednisone (Just weined off), Imuran, Percocet


shoegrl2
Veteran Member


Date Joined Nov 2005
Total Posts : 675
   Posted 1/5/2008 11:20 AM (GMT -6)   
When I reached the point that I had to go to the ER I had over 15-20 trips to the bathroom a day and then started vomiting because of dehydration. I was started on fluids via IV, including potassium, and had nothing orally for 9 days. Not a drop of water or an ice chip for that whole time. I recently found my "diary" from my extended stay in the hospital, and after about a week my trips to the bathroom were reduced a little each day. By the time I left I was on a diet of soft foods and had about 5-6 trips to the bathroom a day. My treatment however, included steriods. As much as I hate them, they did their job. I eventually weaned off of the steriods and started Remicade treatments. That was 2 years ago and I am doing really well, thanks to the Remicade.
  My GI always told me not to try to be a hero. Get to the ER if things get too bad. I consider 15+ trips to the bathroom, lots of bleeding and dehydration cause to get to the ER.  Good luck to you and keep us posted!
 
Debbie
pancolitis. Osteopenia. multi-vitamin, calcium, omeprazole, benefiber, boniva. Remicade since Dec. 2005.
 
"The secret to my own happiness, my own good future, is within my own hands, I must not miss that opportunity"
 


TheLori
Regular Member


Date Joined Aug 2007
Total Posts : 277
   Posted 1/5/2008 11:29 AM (GMT -6)   
when i was admitted I called the hospital, got the GI on call to call me, told him what was going on and he said I needed to be admitted.  He had the hospital have my room ready.  It sure beat having to go thru the ER

Lori
38/F
UC diagnosed 1991
Asacal, colazel, zoloft,levoxyl, colocort enemas


Red_34
Forum Moderator


Date Joined Apr 2004
Total Posts : 22057
   Posted 1/5/2008 1:22 PM (GMT -6)   
I learned the hard way because there were soooo many times that I've should've gone to the ER. But I have a stubborn optimistic streak that thinks I can handle it at home - usually my GI will yell at me later for not going! But whenever in doubt, it's best to be seen. From what I've heard, usually steroids is the first line of treatment when you go to an ER but if you really don't want them, you don't have to have them. It is your choice however there is nothing that will get it under control faster (usually). If you do end up going, I wish you good luck.
 @--->--SHERRY--<---@
Moderator for Allergies/Asthma and Co-moderator for UC
~Left sided Uc -'92 - Colazal (9 daily), 6mp (50-100mgs), Prilosec, Biotin, Forvia, Pro-Bio**Unable to tolerate Asacol, Rowasa or Canasa** ~Allergies - Allegra & Singulair
~Secondary Reynauds Syndrome - '04 - Norvasc~Fibromyalgia - '06~No meds
To help Healingwell - click here: DONATE
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"The quality of my life depends on the quality of my thoughts."
 
 
 
 

 
 


julee70
Regular Member


Date Joined Oct 2007
Total Posts : 475
   Posted 1/5/2008 1:59 PM (GMT -6)   
Personally, I avoid hospitals if I can because I don't want to risk picking up an infection or something. But I'm on an immunosuppressor, so I worry more about that than most people.

I would suggest talking to the doctor on-call at your doctor's office. It's when you say "lots of blood" that makes it sound like, gee, you really shouldn't wait until Monday to talk to the doctor.

My treatment for stopping the 20 trips to the bathroom: take tylenol/codeine. It has the great side effect of constipation. Works really well and pretty fast. I've posted about this before. There are a lot of considerations since codeine can be addictive. But when I've reached the end of my rope, the codeine is the miracle drug I need. Ask your doctor about it if you feel comfortable with the idea of it. It's not for maintenance, but if you're ready to check in to the hospital, it could get you back on your feet short-term.

Do 5ASA drugs (Asacol, Colazal, etc.) work for you?

Also, one thing... are you sure that the Canasa suppositories work for you? I'm pretty sure they made me worse or had no effect on my D. You could try Cortifoam in the AM (instead of Canasa) and continue with the cortenema at night. Or try the cortenema twice a day. That would be a more aggressive way to deal with this bad flare without resorting to oral steroids.

Hang in. I hope that this gets under control soon and then you'll quickly be on the mend.
Definitely go to the hospital if you want. Do you live alone? If you do and you decide not to go to the hospital, maybe you can arrange to have people call and check in on you this weekend.
-------
UC for the last ten years
Current Meds: 6MP
Past Meds: You name it; I've tried it.


quincy
Elite Member


Date Joined May 2003
Total Posts : 25764
   Posted 1/5/2008 3:30 PM (GMT -6)   
Hi Jeff...Oral 5ASA meds should be a consideration and maybe a 5ASA retention enema rather than the steroid one...or have the steroid one in foam form during the day and a 5ASA one at night.

The fact that nights are good is a huge plus....

Whan was your last colonoscopy?

Are you having diarrhea or somewhat formed bms or mostly bloody/mucus bms?

Ask the doctor for an antispasmodic...it will help.

You need to get more proteins into your body.

I feel or you...but I think you should hang tough for another day before you see the doc. Set up a plan with him..

quincy
*Heather*Status: mini flare Dec 28... increased enemas to nightly
~diagnosed January 1989 UC (proctosigmoiditis)
~5ASA: Asacol (6 daily) + Salofalk enemas (increase for flares tapered to maintenance)
~Bentylol (dicyclomine) 20mg as needed
~vitamins/minerals/supplements 
~Probiotic 3(Natural Factors Protec) bedtime + 1 (Primadophilus Reuteri) occasionally
~multi-digestive enzymes as needed ....bromelain 1 - 2x daily
~Ranitidine,Pariet (reflux) Effexor XR 75mg;  Pulmicort/Airomir (asthma)
~URSO for PSC (or PBC) 500mg X 2 daily (LFTs back to NORMAL!!)
My doc's logic.. "TREAT (FROM)BOTH ENDS"  worth it !!!


princesscolon
Veteran Member


Date Joined Apr 2006
Total Posts : 733
   Posted 1/5/2008 6:52 PM (GMT -6)   
Are you sure the fish oil and or probiotics aren't making you worse? They seemed to make me worse, especially the fish oil. My D slowed down when I quit the fish oil. Lomotil helps stop my D too. It's up to you if you want to go to the hospital or not, I broke down and went for the first time in Nov. The fluids helped me feel so great, and I think the Flagyl IV helped too. I got nervous, though, and checked out after I got those. They were doing unnecessary xrays and wanted to do a colonoscopy even though I had had one 6 days prior, and were insisting I give them a stool sample but I was empty, oh yeah, and they said no water or anything and I was soo thirsty. If I was in your shoes and about to get a flex-sig anyways, maybe being in the hospital would be best, though. They might pressure you into the steroids. Sorry you are flaring so badly, I know how painful and exhausting it is.
Diagnosed with Left-sided Ulcerative Colitis 1995 at 15
Tried: Prednisone, Rowasa & Hydrocortisone Enemas, Proctofoam, Sulfasalazine, Asacol, Probiotics, Fish Oil, Canasa, Enotcourt, Colazol, Proctocort, Anamantle, etc...
Diagnosed with Ulcerative Proctitis with almost rectovaginal fistula in 2004, put on Remicade, August 2007:Increased Remicade dosage-700mg every 6 weeks,diagnosed with Psoriatic Arthritis & Fibromyalgia Current meds: Remicade 700mgs every 6 wks (had reaction, will start Humira in 6 weeks) Lomotil, Darvocet, Clorazepate, Proctofoam HC, Tapering Prednisone again :( for joint pain, Glucosamine 500 mgs, Vitamin B


chili123
Regular Member


Date Joined Jan 2007
Total Posts : 300
   Posted 1/5/2008 7:03 PM (GMT -6)   
I just want to say that I understand............like many people here. It is terrible to not feel good and not know what to do to fix it and whether you are "sick enough" to actully go to ER. I ended up in the hospital 4 times last year. My family told me that if I go to the ER and they admitted me then I needed to be there. So, I think if you feel at a loss at home and you are scared then you should go - I think that you have to listen to your instincts. Worse case is they check you out and they send you home. I also agree with one of the other members that warned that they may push steriods. That I would agree with. With any hospital visit, you do have to be prepared for the medication that they give you to stabilize you.

My thoughts are with you and I hope you are feeling better really soon!!
Pancolitis - July 2006
Medications:  Predisone - 5mg ,asacol - 12 tablets per day
Supplements:  multi-vit, calcium, folic acid
My wish:  get off prednsione....been on straight since 8/2006


Another UC wife
Veteran Member


Date Joined Jun 2007
Total Posts : 2111
   Posted 1/5/2008 7:57 PM (GMT -6)   

Hi there -- when we were at the end of our rope I called and left a message with the answering service on a Sat.night.  His Dr knew for me to call something was not good.  We spoke and developed a plan.  I brought him to the hospital that she and her associates have privileges at early the next morning.  

I had all the meds typed up insofar as dose, Mgs, time of day taken etc.  I also typed up an overall summary of what had been going on for the past year and the reason for bringing him to the ER.  I typed in red what his Dr.told me to indicate for a current diagnosis, what she felt needed to be done and wished to be done as she and her associates would be in to also monitor his care along with her telephone # if the ER doctor had any questions.   

When the Dr on call came in to examine and ask his questions -- the piece of paper I had for him to read first channeled his thoughts and he wasn't asking all these unnecessary questions that my husband was in too much pain to be bothered answering. (As it turned out the pain meds had him so comfortable he was finally sleeping for the first time in many weeks.)  It really helped to streamline things going in with a plan.  The typed listing of meds was a help for the nurse for the chart notes she needed to make.

Also if you call ahead to see how busy the ER is so you don't have to wait an unbearable amount of time before you are seen & triaged by the nurse etc. you won't have to deal with that aggravation.

His ER visit and subsequent admittance went very smoothly.  Due to his pain level and constant bathroom trips he was given an IV quickly along with pain medication in the IV.  Within minutes he was pain free and comfortable which was not the case for several months.  It also did slow things way down and he wasn't going to the bathroom often at all. It was Mother's Day and the ER got very hectic not long after he was taken into an ER room of his own.  He was admitted early evening and stayed in the hospital for 5 1/2 days total.  He needed the pain meds every 3-4 hrs to keep the spasming at bay which is why he was admitted.

The imuran (azathioprine) was started then along with meds for pain management.  Things are much improved - but not a full remission yet as he still has multiple BMs each day and needs the pain meds still.  However, he is quite functional and finally off the prednisone.  He was on and off the prednisone for a year 1/2 and hopefully not be back on it for a long while we hope.  Daily life is still a challenge for him but considering where he was he is grateful to have some kind of functionality even though it isn't the greatest sometimes.  Some days are better than others but going to the hospital was a turning point for him in addition to signing on with the Mayo Clinic in Jacksonville who are also involved in his current care.

Good Luck -- I hope things turn around soon for you and your pain is greatly diminished as that is so debilitating and gets in the way of so many things. 


61 yr old male~Colitis 1st diagnosed Jan '05-cleared up within a few wks. Flared again in May '06 (now UC) & hospitalized 5/07-currently heading towards a remission. Osteopena of spine from prednisone DX 8/07  Oct 07 feeling quite normal most days.  150mg Imuran  Zero mg prednisone   12 Asacol, Lidocaine Hydrochloride Jelly 2%,multi vitamin, iron 1X day, DanActive, chewable calcium, fiber capsule 1x day, Prilosec 20mg, enalapril 10mg, glipizide 5 mg, zocor 40 mg, baby aspirin, (Fentanyl pain patch 50mg 72 hrs  Morphine Sulf 15 mg twice daily)Cortifoam enema PM, Canasa suppositiry AM, folic acid 1mg, Fosamax 1x month


MitzMN
Veteran Member


Date Joined Feb 2007
Total Posts : 594
   Posted 1/6/2008 11:20 AM (GMT -6)   
Be sure to not let yourself get dehydrated. That's a problem with all those BMs every day. Get some Pedialyte or whatever to restore electrolytes.

Don't wait till you're so sick you can't function. That just might mean the difference between an ER visit and hospitalization.

Good luck!

Mitz
Sporadic proctitis since about 1985. Mother had J-pouch surgery 1983.
DX'd with clostridium difficile in 2000. Pred, two courses of Flagyl, then Vancomycin finally got rid of it. 2001 colonoscopy dx'd left-sided UC. . Treated with prednisone, Rowasa, Asacol. Asacol not working, switched to Imuran. Three small flares since in 2002, 2005, and 2007, brought under control with steroid and Rowasa enemas. Lap Chole performed October 26, 2007, after gall bladder attack in June, '07.
Daily meds: 100 mg Azathioprine and 225 mg Effexor XR (for chronic, longstanding depression), many vitamins and Primadophilus Reuteri


~ChristieAnn67~
Regular Member


Date Joined Dec 2007
Total Posts : 151
   Posted 1/6/2008 6:32 PM (GMT -6)   
I had the worst flare of my life late october,  which included 3 ER visits and an admission to the hospital x 6 days.  The first ER visit ,  they  talked to my GI doc, and offered to admit me, or to continue to manage at home.  So, they started me on potassium because my levels were low gave me pain meds,   and checked to make sure I didn't need to be transfused and home I went.  I was on the highest prednisone dose I could  be on I think.   then about a week later,  with no relief in symptoms,  I had new symptoms,  a severe upper abdominal pain (on the weekend) So off to the ER I went again.  This time I had a gastritis,  because of the high dose of steroids while eating very little.  So started on Nexium.    The 3rd ER visit was because my primary doctor wanted to admit me from his office,  but there were no beds.  So he said the only way would be to go through the ER, and he called the ER doc and talked with him.   I got an IV started in ER and some good IV pain meds,  and waited for my bed to open up.   Then, the next day,  I got a flex sig,  and was on IV steroids.  They helped but I kept backsliding in my symptoms.  Finally my GI wanted to start the remicade.  I guess that helped, because I was able to go home after 6 days.  I hated being there,  but it was the best place for me at the time.  At home I was able to taper off prednisone, and now doing pretty good.     There is no good time  to tell ya when to go.  If you are bleeding alot,  and dehydrated,  and in pain,  those sound like good enough reasons to me.  Good luck! I"m sorry you're going through this!! 
                                          ~Christie
40 yo RN, happily married, with 2 beautiful daughters, Tianna(14 yo) and Alyssa(10 yo).   Diagnosed L sided Ulcerative Colitis in Jan '04 and Diabetes type 2 in June '05.
                                         Medications
Remicade infusions ~ 11/6/07, 12/6/07, 12/20/07,  6-MP 100mg daily, Pentasa 500mg twice a day, prednisone 20mg 10mg 5mg daily, Nexium 40mg twice a day, Lantus insulin 45 35 units daily, Novolog 10 8 units with sliding scale at meals, Amaryl 2mg daily, multi-vitamin daily, Calcium daily, B complex vit daily,  and pro-biotics daily.


UCinNC
Veteran Member


Date Joined May 2007
Total Posts : 526
   Posted 1/6/2008 7:13 PM (GMT -6)   
Hi. I see your posted is from yesterday AM, so maybe you have made a decision by now. But, just in case.... my Gi says that hospitals are the place to be if there is ever any question of serious dehydration. a hopsital will be very honest. if you don't need to be admitted, they'll IV you some fluids and send you home, and if you do need to be admitted, you'll probably be relieved to be in the care of professionals who can help you so that you don't have to monitor yourself so much, which I, personally, find very stressful.

by the way, why are you getting a sigmoid and not a full colonoscopy? you sound like you feel pretty lousy. might be worth a full scope to confirm that the disease hasn't spread....

i hope you're feeling better by now or very soon.
29/Female/NC
Pancolitis dx 3/07
12 Asacol/day
150mg Imuran/day (steroid dependent, reached this dose 9/07)
Various vitamins, a probiotic.

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