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Discussion Starter · #1 ·
Was wondering how others here try to figure the threshold that it takes to go to the hospital. I guess it's relative to the person, but when should someone know when when is when.Over the years the limit for me has gone way up. I ride things out at home where I'd used to go to the ER. I've only been once in the last 2 yrs and that was from a bad reaction to a new medication.Much of that is because I hate the hospital, part because they can't do anything to actually help me, and most is the fact I deal with things better now.But, the question. Is there a pain threshold upon which you should always go? Is there a length of attack? Change in symptoms? Fainting? Anything else that should be a benchmark.I guess I'm asking partly because I want to know if I push it too far sometimes. My rule of thumb is 12 hours WPPI with no end in sight before I'll go in. But recently I had a pretty major attack that lasted for 3 days. It was not WPPI, but was pretty close at times. I was out of town so I really didn't want to go the er, and I actually wanted to semi enjoy myself.It just made me wonder. I'm always told the attacks have no lasting effect (besides emotionally) and I can continue what I'm doing. But, is there a point where I can go too far and cause damage, without experiencing symptoms that are not my normal. And what additional symptoms, which if they occured, would be a sign that one needs the er.
 

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AJ,Hard to say really.. everyone's pain threshold is kinda subjective & unique to that individual. But I see what you are asking and it *is* a good question.Best bet of course is to pose this question to your Doc next time you are in or place a call to ask this.However, I found these guidelines to maybe help one discern when a trip to the ER may be in order:
quote:"If a person has problems that might be IBS, or if a person with IBS has unusual symptoms, a doctor should be consulted. Go to a hospital emergency department if problems are severe and/or come on suddenly. Symptoms not consistent with IBS are fever, blood in stools or urine, vomiting, black or tarry stools, pain or diarrhea severe enough to interrupt sleep, or weight loss. These symptoms require the attention of a doctor."
(bold emphasis is mine.)The above is from this site:http://www.emedicine.com/AAEM/topic274.htmHope this helps.BQ
 

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After several hrs, Mainly, if the pain Increases in severity,abdominal pain, fever, chest pain,rapid heart rate that does not decrease, other additional symptoms, I would go to the doctor. I also tend to stay away from the ER, unless totally necessary and unbearable. I had an attack that started around 4:30am and subsided around 1pm that day. The pain was steady painful cramping w/without diarhea. It intensified briefly at one point, but did subside. If it had continued, and especially got more painful, I would have gone to my doctor that day. Hope your feeling better ArtJunky.
 

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I hate going to the ER. I've never gone for any IBS or other GI illness (although I've had food poisoning bad enough I probably should have at least seen a doctor a couple of times, esp. given BQ's list).Generally I do the ER when something needs to be X-rayed. I would if I really felt I got to the point I needed IV fluids or was losing a lot of blood out the GI tract (and I've always managed to keep enough fluids in when vomiting and pooping excessively to keep out of the ER) . I also went recently when I couldn't get my heart rate under control on my own. Also would go from symptoms of heart attack or stroke.Pain, I don't go just for pain, but then I've never had pain so bad I couldn't just tough it out. Now sit in fetal position and not move because moving hurt like I was gonna die I have had, but I never felt the pain was bad enough to spend the money on an ER or other urgent care type place visit. Especially since I figured there wasn't much they could do for the IBS pain there that was significantly different from home care and I'd rather be at home when I feel like that.Pain intenstity isn't that good way a lot of times to decide how severe a problem is and how much you need immediate attention. Some things that hurt like heck aren't medical emergencies.But then I am one of those I will avoid the ER at all costs, so I probably wouldn't go when it was wise to do so.I would add if you haven't had a bowel movement in over a week or longer than is normal for you to not go you probably need to be seen at least by urgent care/walk in type of thing if not the ER. If it is an intestinal blockage that needs to be taken care of.K.
 

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For me to go to the ER I have to be in pain so bad I can't be touched and my pain meds aren't making a dent. I have to be having either severe D to the point of passing nothing but water. The main reason I go in is because I have problems with becoming severely dehydrated. When I get bad flare ups I can't drink anything. Anything getting put into my stomach at that point only multiplies the pain. I'm a huge baby when it comes to pain so my husband really decides when it's time for me to go in. He knows what I can actually handle ( vs what I think I can handle which is much less) and if it gets too bad he'll suggest it. More then once he's suggested it but I never went in because either a. pain was so bad I couldn't be picked up to be put in the car or b. I was having such severe D I couldn't leave the bathroom. Other then that I would say head in if there is blood present, your passing out, or if it's lasted longer then normal and you can't eat or drink. For those things if you won't head into the ER at least call your doc.
 

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Discussion Starter · #6 ·
quote:Originally posted by BQ:AJ,
quote:"If a person has problems that might be IBS, or if a person with IBS has unusual symptoms, a doctor should be consulted. Go to a hospital emergency department if problems are severe and/or come on suddenly. Symptoms not consistent with IBS are fever, blood in stools or urine, vomiting, black or tarry stools, pain or diarrhea severe enough to interrupt sleep, or weight loss. These symptoms require the attention of a doctor."
BQ
Minus the tarry stools, those are my normal symptoms. No blood in the urine either. Blood in stool is intermittent and usually from a hemm. I wake up from pain a couple times a week, a couple times a night when things are bad. When I finally get good rest I usually will pass out for 12 hours or more.I, too, rely on my wife to help determine. She never wants me away from her, though, so she normally would like to keep me at home. But, lately, even she's been saying I should go at times. She's saying it's happening too often, even if the attacks are a little more mild than my big ones.My other main concern is the fainting. I have to stop and pause at times when I feel close. And I've fallen down stairs twice this year from fainting, luckily didn't injure myself badly either time. Both times I was near the bottom of the stairs so I didn't fall too far.
 

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I know you have probably been to different doctors, and your also on different meds for this. But I would try another doctor, GI, to see if someone else can help you with this, since you are having severe problems and should not have to continuely suffer from this. I know I have been to different GI, Internal, Primary, etc for my IBS and Barretts, and get tired of going to different docs. I may one day try another Doctor. Maybe they can try another med for you, change what your on now, or help you in other ways. The way you are living is not living, and there must be someone who can do more for you.
 

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Discussion Starter · #8 ·
I know about the quality of life thing. I shouldn't have to live like this. I deal remarkably well, considering, mainly due to therapy. But, as hard as I try, the pain has definitely altered my life and quality of living.I've found over time the mental trauma ends up being worse than anything physical. I was really having problems because I was suppressing attacks altogether to the point where I would not remember I had one. But all the raw emotion would bubble up and burst out at innorportune times. I still repress a lot of pain daily. I guess I'm so used to it my body has found a way to do it.About doctors, it's a tough thing. I go to a medical school's hospital for my general stuff, which means I see a lot of doctors. I'm also made privy, usually, to any specialists that fly in to speak or for other business. There I have a team of 20 or so doctors who review my stuff. I really see a lot of perspectives. The flip side is sometimes they want to go in a million different directions.My GI I've had for a while, and like him. But I've had many GI's over the years. Usually goes like this. They review all my medical history, say if the treatment isn't working than it's becuase they are treating the wrong thing.My treatment regimen then changes, which invariably ends in some sort of nasty reaction or side effect. That treatment is then stopped and they continue to tweak little things and put my body through the ringer. Eventually, I enter the office one day and see "the look". The good thing about it is you can tell they feel bad about it, but that's about where they tell me they don't know how to help me.Repeat that a whole bunch of times and here I am. I've refused any medical testing for 2 yrs because it was all too much, and it wasn't getting me anywhere. Even when they see something in a test, it just goes down to non-specific findings. Not that I've ever still gotten a decent answer on what the heck that means exactly.
 

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Artjunky;The passing out thing should definitely be cause for concern. That is NOT normal. There is a multitiude of things that could attribute to a fainting spell. Sometimes, it can be found in a simple blood test. I know the "medical mill", as my mom calls it, can be a pain in the you know what! No pun intended
, but you might want to consider going to the dr. with a list of your symptoms again, including the recent attack you had, and see if they can offer something new for you. If nothing more, to find out about the fainting spells. I think sometimes it is easy for us to put our symptoms on the IBS, and it could be something else. I don't run to the dr with every little thing either, cause I hate the whole testing, etc. but sometimes we gotta do what we gotta do. Good luck to you and take care of yourself.
 

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I guess the ER is A+E here in UK. I would be way too embarassed ever to go to A+E for IBS, unless I thought it was something else and my life was in danger.A+E/ER is supposed to be for life-threatening illnesses, or accidents that involve heavy blood loss/broken bones/head injuries. If you go for things like IBS, you take up resources someone else might urgently need.When I have severe IBS pain I take 60mg codeine, aspirin and benzos, and wait it out.
 

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Quality of life is everything ArtJunky. I really hope someone can help you eventually,to help make this illnesss tolerable, even if it takes you in a different direction. Blood work can reveal many other things, and I'm sure you've had plenty of that, but the fainting and 3 days of sickness needs to be addressed so that you are living and not just existing.
 
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