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Flare up, Emergency room??

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Flare up, Emergency room??  
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Posted 10/28/2007 8:50 PM (GMT -6)
wow.. I've tried twice to post this.. first time I wrote like an essay.. it got erased right before I was going to submit it to you guys and second time my computer restarted itself.
 
 
 
My third attempt.. I'll try to make it as short story form as possible:
 
                  For the past week and a half I've been going through what I think is a flare up. I've been having frequent and extremely bloody BMs.. anywhere from pebbly to bloody diahrea. I'm still new to the disease so I don't exactly know what the true definition of a flare up is because my symptoms have never really gone down. The only med I take is Colazal, which I sorta stopped because I don't think it works. On wed. I had to go home early from work because after I spent 15 mins in the bathroom and looking down to a toilet of almost all red blood I was in so much pain I was crying and cried all the way home. I tried to take 3 colazal (used to take 3 3x a day) to see if it would help. I puked it up immediately. I had horrible pain the next day also when I tried to eat mac and cheese...I ended up puking it all up..and havin bloody bms all through the night... every time i went to lay down I had to get up again. Next day I got chicken noodle soup down.. not too much pain at all, bloody bms still... today is bloody also...but ive been able to eat.
 
 
Once my pain subsided somewhat on wednesday though.... I called my dr up in atlanta..(I just got married and moved to Perry, Ga from atl) She said that I had no choice but to go to the ER. When i got married I didn't have insurance w/ my parents anymore and hadn't been added to my husband's yet (I should be added tomorrow) It was 5000 w/o insurance for an ER visit. My GI also said that because I couldn't hold down my medicine and got nauseaus from it...I seriously had to go to the ER. She said once it was over I'd prob also have to get another colonoscopy.
 
 
My questions are: 1. What defines a flare up?
                         2. How do you know when you HAVE to go to the ER? Have you gone to the ER and if so.. why? What does the ER do to help a flare up??
                         3. Is what I'm going through a flare up?
                         4. I'm not crazy for not goin to the ER and sticking it out when I don't have 5000 to pay on a trip there right now am I??? lol
 
 
sorry for your trouble to read that
Posted 10/28/2007 9:00 PM (GMT -6)
You definitely need to see a doctor! Do you have a new PCP?

Is there an urgent care clinic that you can go to? You definitely need some meds and a visit to the GI.

Have you tried the colazal again? Is it possible that you threw it up because you were in pain and anxious? Have you been able to eat lately? What has this weekend been like?

1, Flare - any symptoms other than "normal" bms. Any feelings of cramping, any bleeding, etc.
2. Go to the ER if you're unable to hold down fluids for more than 24 hours - or less if you need it. Go to the ER if you are loosing a lot of blood and are feeling light headed, dizzy, and are very pale.
3. You are flaring.
4. Although it's probably not best, I would have avoided the $5000 ER bill too. I would have done whatever I needed to to avoid it.

Get yourself into a doctor the second you are on the insurance!

I hope you get some help soon and can start to feel better!
Pan-colitis and GERD diagnosed May 2003
 
Asacol 12 per day,  Azathioprine 75mg, Rowasa and Canasa as needed
Aciphex, Effexor XR, BCP, Rhinocort nasal spray
Forvia and a Probiotic
 
Osteopenia (hip and spine) from prednisone use.  Started Azathioprine because I was steroid dependent.
 
Co-Mod for the UC forum
Keep HealingWell running smoothly:  www.healingwell.com/donate

Posted 10/28/2007 9:30 PM (GMT -6)

The previous poster addressed most of the questions, so I'm not going to double up on those responses. However, if you are not holding down fluids or solids and you're bleeding to the degree you are, a visit to the ER may end up with you being admited to the hospital. At the hosiptal, they can give you IV fluids to keep you hydrated. I'm no expert, but I'm sure they can get you some meds to make you feel better. Something is definately wrong. You sound like you are in rough shape. I know $5000 is a lot of money for an ER visit, but my personal thoughts are that this is your health. To me, my health means everything. You can always go on payment plans. Most hospitals will accept whatever payment you can afford. When I first moved off my parents insurance and had my own, I had a c-scope and an upper and a few visits to the ER - payment plans were my friend. And the hospital didn't charge interest.

Please take care of yourself!

Diagnosed with UC January 2007
Responding well to Asacol 2 pills 3 times per day
Asacol upped to 12 per day until the flare is under control - starting to tapper 1 pill per week
Canasa added nightly until the flare is under control

Posted 10/29/2007 5:22 AM (GMT -6)
I agree with the above two posters. You need to get to the ER now or at least as soon as your health insurance kicks in (which is tomorrow, right?). I can understand waiting a little time to avoid the $5,000 but only if you can keep your fluids up. If you can't keep for fluids up then just go to ER - your health is the most important thing. From the symptoms you describe I would imagine they'll admit you to the hospital, get you on a drip to keep your fluids up and put you on IV steroids and probably flagyl. I once was admitted to hopsital in a similar state and they were testing me for toxic megacolon - it wasn't, but you don't want to stuff around with your health. Not to be negative or scare you but you could find that, because you were able to eat today, tomorrow you'll feel worse as that food comes out over the bleeding ulcers in your colon. I did that for a few days and my Dr said it was a common thing with bad flares. You eat, so the next day is bad because that food has to come out over the ulcers. You are then in pain so you don't eat that day. Then the next day is actually not so bad because no food is coming out. So you eat - repeat cycle. Things for me that time went downhill fast. On the Monday I happily drove myself in to see my GP to say "I have an annoying tummy bug of some kind", on the Friday morning I was admitted to hospital as an emergency patient - dehydrated and feeling like I was on death's door. Please look after your health.
UC since 2001, diagnosed May 2005
Salofalk tablets (Asacol) 2 tablets 4 times daily (4gm total) for maintenance, Salofalk enemas and/or Colifoam for flares
Oat bran 60grams daily, Metamuscil and multivitamins

Currently using Colifoam (steroid foam) nightly to clear up a stubborn flare.

Posted 10/29/2007 8:49 AM (GMT -6)
It is so sad in a country like ours that insurance or lack thereof is such a bottom line and interferes with important health decisions. It is easy to say get immediate medical attention and you definitely do need it for sure but I can sympathize with the worry about the financial end of things too. I hope you can get the help you need and it all works out for you. Definitely get signed up on your husband's insurance as their may be a "waiting period" you may need to go through as well.

All the advice above is great....my husband was in so much pain and a lot of what you are describing that I couldn't stand it any longer and insisted he go to the ER. He was admitted and kept for 5 1/2 days. Needed IVs and almost 3 units of blood. He was given pain medication in the IVs to quiet things down and slowed down the colon too and the frequency and urgency was a lot less. He was put on a pain management program and is still on it. He is starting to show signs that we should be able to think about tapering off the pain medications -- these meds seem to work very well for him - he is not in a stupor and "out of it" as they are timed released. I am not happy that he is still on them but it has made the difference in him getting his life back.

He sees his local GI tomorrow and the Mayo Clinic again on 11/19th which I am sure may want to start to get him off these pain meds and see how things go from there.

I hope you can get some relief fast. I'll be praying for you.

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 15 mg prednisone & tapering, 12 Asacol, Lidocaine Hydrochloride Jelly 2%,multi vitamin, iron 1X day, DanActive, chewable calcium, Prilosec 20mg, enalapril 10mg, glipizide 5 mg, zocor 20 mg, baby aspirin, (Fentanyl pain patch 50mg 72 hrs  Morphine Sulf 15 mg twice daily)Cortifoam enemas AM & PM, folic acid 1mg, Fosamax 1x month

Posted 10/29/2007 1:17 PM (GMT -6)
As far as I can tell, an emergency room facility is required to treat you, regardless of ability to pay. If you're nauseated, getting dehydrated, losing a lot of blood and are in pain, you need to go.

http://en.wikipedia.org/wiki/Emergency_Medical_Treatment_and_Active_Labor_Act
Diagnosed with ulcerative colitis spring 1999
C-scope confirmed UC diagnosis 9/18/2007
No explanation for right side pain and thickening of bowel wall
 
Therapeutic dose sulfasalazine, back on a pred taper for first flare in years
Probiotics, l-glutamine and fish oil caps. George's aloe vera juice and Mucosaheal.
 
 

Posted 10/29/2007 3:36 PM (GMT -6)
Definetley go to the ER. If youcan wait another day for your insurance to kick in and I am assuming that is 12:01 midnight then I would go then. Are you running a fever?

Stacy
Current meds are:
 
Asacol 6 pills a day
Lexapro 20 mg once a day
Ativan .5 mg when needed
 
 
 

Posted 10/31/2007 10:59 AM (GMT -6)
Good news...

Ok so I didn't exactly go to the Emergency room because it would just have cost way too much. For a day or two it seemed to be okay... like I could keep things down and my stomach wasn't cramping and goin insane. I still bled, but not as much. Then yesterday I got to work at 9am and in minutes I went into the bathroom and didn't come out until 30 mins later... and my boss was like take the rest of the week off because you can't work like this. I called my husband crying about needing my darn insurance. The great man that he is... he made it happen and we went to the dr at like 2:45 and he gave me prednisone and a new drug called lialda. I told him the only drug i'd been on was colazal and i didn't think it worked. So he said to try that.

Took the pred this morning.. 40mg. I feel sooooooooooo much better. And the lialda seems to help too. But I feel like I dont have to run to the bathroom and i'm eating again and keeping things down.

Hopefully prednisone will get me into remission.
Posted 10/31/2007 11:16 AM (GMT -6)
sweetmelody,

Something that "may" help would be to avoid sugars & milk and eat smaller amounts of carbohydrates. This may or may not help you feel better, but try it for a week and see what happens.

ps.
No sugar means, no cakes, candies, sodas, fruit punch, maple syrup, etc...try using honey instead.

NBT
Diagnosed with Ulcerative Colitis January 2007
Meds: Remicade, Primal Defense Ultra, Multi-vitamins (also iron, B12, Magnesium and Zinc), Flaxseed/Natures Bounty Fish Oil
Swanson Ultra Caprylic Acid (natural anti-fungal) 600mg x2 daily
Carrot & Garlic supplements (natural anti-fungal) x2 daily
 

Posted 10/31/2007 11:25 AM (GMT -6)
ah I don't really eat that stuff anyways. The only one I'd have real trouble with is the fruit punch.. mmm.
Diagnosed March 07
 
Medications: Colazal 3 3x a day
                  Prednizone- 40mg
                  Lialda- 2 a day

Posted 10/31/2007 12:08 PM (GMT -6)
glad you are doing better, not sure where the $5k came in for an ER visit......my husband nearly sawed off his hand (prior to his being on my insurance) and that whole thing was only $1,500 for the ER visit, surgery, x-rays etc.

When I was first dx'd I had just quit my job for another and had to wait 90 days for insurance but that job was so horrible, I found another job and had to wait another 90 days for my insurance (have been at that co for almost 8 years now) and I racked up over $2k in medical bills Doctor visits, some kind of oscopy (not a colonoscopy) and prescriptions, I remember going to see my specialist for 5 minutes and he poked me in the stomach and sent me on my way.......the bill was $300. Anyhow, it took me almost a year to pay it off but I was glad I did not wait......your life is worth it!!!
Beth, 32
UC Diagnosed March 2000
Azathioprine 100mg 1xday;Remicade tests pending;Hydrocortisone enemas 1xday;Calcium and Vit D 500mg 3xday, Multi Vit, Folic Acid 400mg 2xday, Potassium 600mg 1xday, Probiotics.
Minimal Change Disease (Kidney Disorder) Diagnosed Sept 2007
Prednisone 60mg 1xday, Simvastatin 20mg 1xday, Diovan 80mg 1xday. Fosomax 70mg 1xweek. MCD may be from hypersensitivty to 5ASA drugs.

Posted 10/31/2007 12:44 PM (GMT -6)
my dr in atl said it would be like 5000 dollars to go to the ER without insurance. I just got married and we bought a new house... we don't have that kind of money. I guess I thought I could endure the yuckiness until I got added because I knew it would be soon. I'm glad it all worked out though and that now I'm on prednisone... i swear it stopped my flare immediately.
Diagnosed with UC March 07
 
Medications: Colazal 3 3x a day
                  Prednisone- 40mg
                  Lialda- 2 a day

Posted 10/31/2007 1:00 PM (GMT -6)
I'm pretty sure the pred nipped that flare in the bud. Unfortunately, you need to address it by keeping the flares down. Do you have a GI or a PCP that you can go to who can refer you to a GI?

Like you, when I was first diagnosed, I was so sick. I kept calling my doctor, I remember, but I only got a c-scope scheduled. I really needed to be on pred or enemas to stop the flare. Instead, I just got sicker and sicker, and the day before my scope, I ended up in the emergency room, gettings bags full of fluids. I could hardly get up long enough to go to the ER, I was so weak and dehydrated, but once I had fluids, I felt like a new person. By the next morning, however, I was again just about unable to function. They left the IV in my hand in anticipation of the scope the next day, so they gave me fluids during the process and I felt better afterwards. I was immediately put on pred and started the treatment regimen I'm on now for my UC.

My emergency room visit was only like $800, and that was about six years ago. My scope was much more. Be sure to do what I didn't do, and ask for an insured price on your bills. I was shocked to see since I now have insurance how much cheaper things are for insured patients. I thought I was getting a great deal with payments and no interest for my $2300 or so, till I recognized later on that billings by clinics and hospitals are routinely discounted 20, 30, 40 even 50 percent and more by insurance companies.

I hope you stay on the well side!

Mitz
Sporadic proctitis since about 1985. Mother had UC, then J-pouch surgery 1983.
DX'd with clostridium difficile in 2000. Prednisone, two courses of Flagyl, then Vancomycin finally got rid of it. Symptomatic with UC after that.
Colonoscopy in 2001 dx'd left-sided UC. Was pretty darn ill at that time, dehydrated, weak, unable to work. Treated with prednisone, Rowasa, Asacol. Asacol not working so switched to Imuran. Three small flares since in 2002, 2005, and 2007, brought under control with enemas, steroid and Rowasa.
Gall bladder attack 6/13; ultrasound showed stones; Lap chole performed October 26, 2007.
100 mg Azathioprine and 225 mg Effexor XR (for chronic, longstanding depression) daily.

Posted 10/31/2007 1:35 PM (GMT -6)
wow i guess ER isn't that much... but even 800 is too much for us to spend right now haha. I do have a GI down here now thank God. But we waited till the insurance kicked in. That's how I was prescribed the pred and lialda. It seems to have nipped everything in bud and i couldn't be any more thankful because I was in a bad place for like a week and a half. unbearable pain sheesh.
Diagnosed with UC March 07
 
Medications: Colazal 3 3x a day
                  Prednisone- 40mg
                  Lialda- 2 a day

Posted 11/1/2007 8:42 AM (GMT -6)
I'm SO glad to hear that you got some help! What miserable time for you :(
Pred is that drug we love to hate - but at certain times it works like a charm!
Take care and keep us updated!
Pan-colitis and GERD diagnosed May 2003
 
Asacol 12 per day,  Azathioprine 75mg, Rowasa and Canasa as needed
Aciphex, Effexor XR, BCP, Rhinocort nasal spray
Forvia and a Probiotic
 
Osteopenia (hip and spine) from prednisone use.  Started Azathioprine because I was steroid dependent.
 
Co-Mod for the UC forum
Keep HealingWell running smoothly:  www.healingwell.com/donate

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