When do you make the hosptial decision?

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MathGeek
Regular Member


Date Joined Feb 2008
Total Posts : 23
   Posted 4/1/2008 4:30 AM (GMT -6)   
What is your "limit" at which point you decide a trip to the ER is going to help? and what do they do for you?

I'm in a lot of pain and nauseous and no sleep but feel like if I go, they'll give me a sad pity face and send me home. I'm also noticing the blood back, and i'm on 40 mg of prednisone right now. I also have wicked headaches and sharp lower back pain.

Do I stay or do I go?
31 yr old female
Dx'd in 2/2008 UC (not sure how much, or where, LOONG story there, i'm sure i'm getting another scope soon)
Asacol 12xday, Rowasa 2xday (off these for now waiting for pred to work)
Prednisone 40 mg/day


jujub
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Date Joined Mar 2003
Total Posts : 10407
   Posted 4/1/2008 6:11 AM (GMT -6)   
Go to the ER when your life is in danger or the pain is completely intolerable. Otherwise, you're better off to see your own doctor - pc or GI. The ER docs don't know you, don't know your history, and probably treat UC flares infrequently enough that it's not their strength. They'll give you fluids, maybe a suppository for the nausea, maybe IV steroids and tell you to follow up with your own doctor. You'll likely wait a while to be seen (here you'd wait 2-15 hours depending on which hospital you go to) and it will cost a lot more than a doctor's office visit.
Judy
 
Moderate to severe left-sided UC (21 cm) diagnosed 2001.
Asacol, Rowasa, Pentasa, Prednisone, Entocort, Azathioprine
Colazal,  Remicade, Nature's Way Primadophilus Reuteri.
In remission since April, 2006. Remicade has been my wonder drug.
 
Co-Moderator UC Forum


tjf
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Date Joined Dec 2005
Total Posts : 3238
   Posted 4/1/2008 6:55 AM (GMT -6)   
I would say call your GI. Express how sick you are and need to be seen immediately. I have never had good ER experiences in general. Keep us posted!
Tabitha (Tab)

100mg Azathioprine, 2 Fibercon, Colazal-9 a day, Acidopholis Pearls, Nexium

http://www.healingwell.com/donate
Co-Moderator UC Forum


Katmom
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Date Joined Mar 2008
Total Posts : 1202
   Posted 4/1/2008 7:49 AM (GMT -6)   
Sounds like you need to be admitted to the hospital, though avoiding the ER is advisable. When admitted, they will up your steroids. Even 50 mg of prednisone is stronger than 50mg given orally. It should knock you into remission, if you also give your bowels a rest. They'll IV you, and put you on a liquid diet. You will probably respond quickly, and feel better soon. They should also do the blood work needed to see if you can go on the 6mp.s. They take a week to get back, but better sooner than later. If the new Pred. doesn't work,it's your next drug.
Goodluck

MathGeek
Regular Member


Date Joined Feb 2008
Total Posts : 23
   Posted 4/1/2008 8:06 AM (GMT -6)   
Well, i put in a call to the GI, waiting to hear back. I'll post as soon as I talk to him. Thank you all for your replies, for some reason the pain always seems worse in the middle of night/early morning. \\
31 yr old female
Dx'd in 2/2008 UC (not sure how much, or where, LOONG story there, i'm sure i'm getting another scope soon)
Asacol 12xday, Rowasa 2xday (off these for now waiting for pred to work)
Prednisone 40 mg/day


Another UC wife
Veteran Member


Date Joined Jun 2007
Total Posts : 2111
   Posted 4/1/2008 10:04 AM (GMT -6)   
After a few months of seeing DH in wicked pain I could not stand it any longer. Called his Dr who got right back to me on a Sat. night. We discussed what was going on and she agreed. We used the emergency room at the hospital nearby that she has privileges at. I brought with me a total typed list of meds, dose, strength etc. A typed summary of his condition and what has been going on up to this point so when the Dr interviewed him he asked relevant questions and not a bunch of unnecessary ones. And finally I asked his Dr. to give me "a plan" for the ER Doctor that she wanted to see followed as she would be in later that night (actually her partner) which I also typed up.

We went in at 7am on a Sunday morning and had no wait at all as luck would have it. It is better to try to go very late at night or very early to avoid an extra long wait in the waiting room which is no fun if you are in extreme pain, urgency etc.

He was admitted for a total of 5 1/2 days - pain management - started Imuran along with prednisone to help "jump start" it. In his case going to the hospital (with a plan) worked out well for us both as I was out of my mind watching all this going on at home here.

Good luck.

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


Pooie1981
Regular Member


Date Joined Mar 2008
Total Posts : 274
   Posted 4/1/2008 10:27 AM (GMT -6)   
I went thru this same thing a few weeks ago. I didn't want to go to the ER and get that "sad" face look but the pain was BEYOND and I could barely walk. I was thinking that just maybe it was real bad gas but nothing happened and I ended up going to the ER anyway. Long story short... after about a 3 hour wait and 2 x-rays the Doctor there told me I was constipated and should go for a brisk walk to "walk it off." Yea.. I coudnt even stand up straight let alone go for a brisk walk. And how could they say I was constipated when I had 2 bms that day and the day before !? I was angry. Anyways, I made an appt with my regular doctor and he later told me that I was having a flare up and we went from there............

Basically... I think ERs are for emergencies only.. maybe go if you have fear of being dehydrated, etc from all the bms. Otherwise.. go to who knows you best.. your Family Dr.
Ulcerative Colitis Diagnosed May 2004
400mg Asacol 3 times per day.... increased to 6 400mg per day Mar.11
Entocort 3 pills once a day
Daily Vitamin for Women


MathGeek
Regular Member


Date Joined Feb 2008
Total Posts : 23
   Posted 4/1/2008 12:00 PM (GMT -6)   
Ok, heard from my GI. At first was not going to do much until I started crying and explained how much pain I was in. They are still waiting for samples to come back,etc and I understand that but sheesh do i just sit around in agony until then? So i got really upset and they rescheduled me for tomorrow instead of on the 10th. I mean, when I look in the mirror I look like death warmed over. And doesn't it seem odd that the prednisone is doing NOTHING? ugh. So at least I got in earlier.

eyes

I just want to be able to work. I'm a single mom, and this job is our life.
31 yr old female
Dx'd in 2/2008 UC (not sure how much, or where, LOONG story there, i'm sure i'm getting another scope soon)
Asacol 12xday, Rowasa 2xday (off these for now waiting for pred to work)
Prednisone 40 mg/day


Red_34
Forum Moderator


Date Joined Apr 2004
Total Posts : 23551
   Posted 4/1/2008 2:01 PM (GMT -6)   
I'm suprised that your GI didn't at least call in a script for pain medication. I'm glad you're being seen though. Let us know how it goes ok?
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~Left sided Uc-'92-Colazal(9 daily),6mp(50-100mgs),Prilosec,Biotin,Forvia,Pro-Bio**Unable to tolerate Asacol, Rowasa or Canasa**~Allergies-Singulair
~Secondary Reynauds Syndrome-'04-Norvasc~Fibromyalgia-'06~Sacroiliitis-epidural injections
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princesscolon
Veteran Member


Date Joined Apr 2006
Total Posts : 733
   Posted 4/1/2008 5:23 PM (GMT -6)   
I went to the ER last Nov when I was so weak from non-stop bms for a week straight. They gave me an IV of fluids, man, I wish I could have those here at home for when I need it! It helped me feel soo much better. Then they gave me an IV of Flagyl and another antibiotic (my blood tests showed signs of infection as usual). I told them my pain level was a 10 because my rectum was soooo sore and they wouldnt give me any pain meds. Then they took pointless xrays and the doctors attacked me about my diet and the fact I wasnt taking hydrocortisone enemas. My GI let me be released that day so I went home and took it easy and the flare-up stopped. Was it worth $2,000? At the time, yes, because I was so weak and I couldn't get the D to stop. The most frustrating thing is the ER doctors acting like they are UC experts, or at least the 2 I met were. That was my experience... I would say it's all up to you and how bad you are feeling.
Diagnosed with Left-sided UC in 1995 at age 15, Prednisone, Rowasa & Hydrocort. Enemas, Proctofoam, Sulfasalazine, Asacol, Probiotics, Fish Oil, Aloe Juice, Canasa, Enotcort, Colazol, Anamantle, Remicade, etc... had almost recto-vaginal fistula in 2004, put on Remicade, August 2007:Increased Remicade dosage-700mg every 6 weeks,diagnosed w/ Psoriatic Arthritis & Fibromyalgia Current meds: Clorazepate, Proctofoam HC, Glucosamine 500, Vitamin B, Lomotil,  Tylenol pm, Lyrica started 1/17/08


Another UC wife
Veteran Member


Date Joined Jun 2007
Total Posts : 2111
   Posted 4/1/2008 8:26 PM (GMT -6)   
I didn't mention in my response above also how weak he was at the time from all the BMs....he also had several IVs, 3 units of blood, private room/ isolated due to stool testing (c diff testing?) in addition to starting the Imuran and prednisone. So the hospital admittance in his case was definitely needed.

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 every other PM, Canasa suppositiry AM, folic acid 1mg, Fosamax 1x month


MathGeek
Regular Member


Date Joined Feb 2008
Total Posts : 23
   Posted 4/2/2008 3:38 PM (GMT -6)   
Ok. So went this morn, and she upped my pred to 60 mg for 2-3 days and then wants me back down to 40 mg. Also sent me for an abdominal CT scan (which I did right after I left the clinic) and so we're waiting to here the results on that. She also gave me a script for Ambien becuz she wants me to do 30 mg of pred in the morn and 30 at night. So, still no answers for sure, but at least I feel heard, ya know? And i'm really looking forward to some sleep!! smurf


She also mentioned that if in one week i'm worse or showing no improvement she wants to admit me to the hospital to get some IV steriods. So we shall see!
31 yr old female
Dx'd in 2/2008 UC (not sure how much, or where, LOONG story there, i'm sure i'm getting another scope soon)
Asacol 12xday, Rowasa 2xday (off these for now waiting for pred to work)
Prednisone 40 mg/day


tjf
Veteran Member


Date Joined Dec 2005
Total Posts : 3238
   Posted 4/2/2008 5:21 PM (GMT -6)   
I was wondering how you were doing. Thanks for posting an update. You hang in there...hopefully you will get some relief soon.
Tabitha (Tab)

100mg Azathioprine, 2 Fibercon, Colazal-9 a day, Acidopholis Pearls, Nexium

http://www.healingwell.com/donate
Co-Moderator UC Forum


Another UC wife
Veteran Member


Date Joined Jun 2007
Total Posts : 2111
   Posted 4/2/2008 10:15 PM (GMT -6)   
Going from 60mg to 40mg in a few days seems a fast decrease for prednisone. Maybe others have experience with this and it is ok - just sounded not right.

Hope you can get some well deserved and much needed sleep. That is so tough when you want to sleep and the body doesn't let you. Hubby needed Ambien for a few nights and it did help.

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 every other PM, Canasa suppositiry AM, folic acid 1mg, Fosamax 1x month


jamo0001
Regular Member


Date Joined Apr 2007
Total Posts : 75
   Posted 4/3/2008 1:04 AM (GMT -6)   
They finally put me in the hospital when I could no longer hold down food. I had been in a bad flare for about two months, but it took the non-stop vomiting for them to finally send me to the ER.
James

21 yrs old, diagnosed severe pan ulcerative colitis 2 Mar 2007
Hospitalized 27 Apr-5 May 2007
Remission since 4 July 2007
Asacol (mesalamine) 400 mg x 12 daily
Remicade <--first infusion on 3 May 2007; currently once every 8 weeks
Imuran (azathioprine) 50 mg x 2 daily
Eating fruits and vegetables like there is no tomorrow...
"God bless Remicade!"


MathGeek
Regular Member


Date Joined Feb 2008
Total Posts : 23
   Posted 4/3/2008 11:42 AM (GMT -6)   
Well, i thought that about the 60 mg too, I'm not sure... she didn't want me on it for more than 2 days... So what I did, was take my reg 40 in the morn and added 20 at night....

So last night was day 1.

Was still up 3-4 times that night on the toliet, even with the ambien I didn't sleep well. *sigh*
31 yr old female
Dx'd in 2/2008 UC (not sure how much, or where, LOONG story there, i'm sure i'm getting another scope soon)
Asacol 12xday, Rowasa 2xday (off these for now waiting for pred to work)
Prednisone 40 mg/day


princesscolon
Veteran Member


Date Joined Apr 2006
Total Posts : 733
   Posted 4/3/2008 1:05 PM (GMT -6)   
Sorry to hear that.  If you continue to do bad, I would go to the hospital.

Diagnosed with Left-sided UC in 1995 at age 15, Prednisone, Rowasa & Hydrocort. Enemas, Proctofoam, Sulfasalazine, Asacol, Probiotics, Fish Oil, Aloe Juice, Canasa, Enotcort, Colazol, Anamantle, Remicade, etc... had almost recto-vaginal fistula in 2004, put on Remicade, August 2007:Increased Remicade dosage-700mg every 6 weeks,diagnosed w/ Psoriatic Arthritis & Fibromyalgia Current meds: Clorazepate, Proctofoam HC, Glucosamine 500, Vitamin B, Lomotil,  Tylenol pm, Lyrica started 1/17/08

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