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Thread: Should I Just Go to the ER?

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    Default Should I Just Go to the ER?

    I haven't been diagnosed with anything, but my nose is so blocked up, and I'm so blah feeling. It's mainly my nose being so blocked -- I can't take it. I'm not sure if that's silly, but I can't comfortably breathe through my mouth or sleep, and I'm so, so tired.

    I can't get in with a Rheumatologist until Friday (which was moved from Monday), but I don't know if I can hold on that long. Obviously I can if I have to, but what are everyone's thoughts on going to the emergency room with these symptoms and making them do a blood work up there? Or even a nasal biopsy. I just want to be on something that will let me breathe!!

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    If you feel that badly, you should go to the ER. Make sure you clearly communicate the severity and duration of all your symptoms. A complete blood work up would be appropriate. They may want to do additional tests to see if they can return a diagnosis. I'd also mention that you suspect wegs and why.

    Good luck!! Hoping that whatever is ailing you is treatable.
    Pete
    dx 1/11

    "Every day is a good day. Some are better than others." - unknown

    "Take your meds as directed and live your life as fully as you can." - Michael Chacey, MD

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    I'm having a hard time deciding to go. I don't know if this is looked at as an emergency. You say feel that badly, but I look at things others have/are going through and it's not at that level. I'm just super uncomfortable. Is that enough? I'm afraid to be looked at like a moron/not be taken seriously.

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    I wouldn't worry about appearances. Super uncomfortable or not, if you have undiagnosed Vasculitis, you're sick and won't get better without a diagnosis and appropriate treatment.
    Pete
    dx 1/11

    "Every day is a good day. Some are better than others." - unknown

    "Take your meds as directed and live your life as fully as you can." - Michael Chacey, MD

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    If I were in your place, I'd probably wait for the rheumy's appt. on Fri. and try inhaling some steam and a series of sinus rinses to get things loosened up and out of there. But that is assuming it is mucus causing the problem, which may not be the entire case... if you feel there is a physical blockage there beyond just mucus, then maybe going to the ER would be a good idea. You also need to see a good ENT, and maybe your rheumy can suggest one.
    Anne, dx'ed April 2011

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    I just spoke with the Rheumatology office's on call doctor. Since they haven't seen me yet/don't know my history, it seemed like he was being very reserved with advice. He said I could wait for my appointment or go to the ER (duh). After going into a little more detail, he advised that the ER wouldn't really be able to help me tonight because they can't call the office and get direction, so wouldn't be able to test me for anything specific. He also said that if I really needed relief, he didn't think being on steroids would mess with any of the testing they would order -- that is why I haven't been given steroids, and am trying not to run somewhere begging for them. I've been using Afrin every night instead, but I'm on my third day, you're not supposed to do it after that, so I really don't know how much longer I can hold out. Friday is far away.

    I did mention the Wegener's -- called it Wegman's *face palm*. He said I "could" have it. I just stated it in a way like, "I have reason to believe this is what is going on." I also asked if they've seen patients with that, and he said yes. I also saw that the doctor I was referred to, though she doesn't have many good reviews, diagnosed someone with vasculitis. That seems like a good thing.

    He also said that Wegener's is really hard to diagnose and there's a lot of testing involved - is that true, though? I see here that people had that specific marker tested, ANCA or something. Is that not going to be enough? If they took a biopsy from my nose, is it possible it won't show up on there? My worst nightmare, besides having WG, would be furthering the process of being diagnosed and continuing to fight for air through my nose. Is it really so hard?

    He also mentioned that I could go to the ER tomorrow and they might be able to correlate with them then.

    I have to say, it's really hard because I have such trust issues with doctors now. I've been diagnosed with some dumb crap and suffered for so long (not nearly as bad as some), it's just so hard to know if I'm going to someone who has my best interest at heart, and will take care of me as a person who doesn't want to suffer or die sooner than need be. Is there any advice on dealing with this possible poor treatment anxiety better?

    @anne -- it's not mucous and yucks up there that need loosening, though there's a ton of it. It's mostly just inflamed.
    Last edited by Sunrise; 04-12-2016 at 02:02 PM.

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    Do you have a walk in clinic nearby? They might not be able to help much but might have some thing to help you feel more comfortable and might be able to rule out some things too. Once I went there thinking I had bronchitis and needed an antibiotic and their exam indicate I had the flu and they gave me the correct meds to help me feel better.
    Knowledge is power! Wisdom is using it to make good decisions!

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    @drz -- It's late by me, urgent care isn't open anymore. I'm not sick, in a virus sense, just have really inflamed nasal passages. I'm actually on an antibiotic right now. I was given some because they seemed to help me last time I was on them, but they're doing nothing now, just super blocked up nose. It's extremely uncomfortable.

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    It seems like you should be on prednisone or at least a steroid nasal spray instead of the Afrin. That stuff can have a nasty rebound effect and make things worse, which is why they say only to use it for 3 days. I stay away from it. I have had my ENT give me a steroid shot in the back of my nasal cavity which really helped a lot and lasted about a month. That was before anyone got the idea I might have Wegs and it was just being called severe allergies and sinus infections. I'm not sure that pred will affect any tests all that much, but could be wrong. The anca test is not always a good indicator, the reading can be very low or negative and you can still have Wegs. Biopsies are considered the best indicator, but the nasal ones are considered least reliable and if that's your only involvement, there'd be no other place to biopsy, except maybe your gums, if they are red and inflamed at all. But expert docs have diagnosed and treated people based on symptoms alone, in the absence of reliable tests. And I did get a positive nasal biopsy, so it is worth a try. If your nasal passages are that inflamed and you are that uncomfortable, I wouldn't hesitate to go to the ER and see if they can give you any relief. Seeing the rheumy is important, for sure, but he is not an ENT and you will need some help in that area, too. Best of luck and I hope you can get some relief soon!
    Anne, dx'ed April 2011

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    If you have any doubt go and get checked out. 4 years ago this month I was having trouble breathing and had3 trips to the er in 5 days. They couldn't find anything wrong and when I saw my ENT he scoped up my nose into my throat and my airway was totally obstructed. I was rushed to the university hospital 2 hours away for an emergency tracheotomy. If you have any doubt be safe and get checked out. It was after that I was diagnosed with Wegeners and subglotic stenosis

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