Emergency Room or Urgent Care?

[drewtwo99]

I am sorry if this kind of is breaking the rules, I know that asking for medical advice on here is kind of frowned upon. Feel free to close the thread if it's a violation, and I apologize in advance if so.

I have some sort of terrible flu, and haven't been able to hold down any water whatsoever for several hours now. I try drinking even the smallest amount and it either comes back up out my mouth or out my ass. Pretty terrible and gross. I'm worried about dehydrating, so I need to go see a doctor, and I'll be leaving here soon to do just that.

I was just wondering how serious it is. I don't feel like my life is in danger immediately, because I don't know how likely it is I could dehydrate to the point of passing out/death, etc. It has only been going on for about 5 hours now or so. I feel very, very thirsty, light headed, kind of dizzy, very weak... but I can get up and walk around and I'm aware of what's going on.

That being said, do any of you have an opinion on whether I should go to urgent care or to an ER? Money doesn't really matter to me unless it's obscenely more expensive. Will they be able to help me at an urgent care facility?

Thanks so much.

[Alice The Goon]

If you feel that you may need IV hydration, an ER would be the way to go. Most urgent care centers don't do that. The only thing an urgent care would be able to do for you is collect a stool sample to send to the lab to see if you have food poisoning or other infection, and to give you a prescription for diarrhea/vomiting.

ETA: I, personally, would not seek medical attention for this unless I were very old, very young, or immunocompromised, unless it lasted for more than 24 hours. But your MMV.

[Ethilrist]

I'd say go to the ER and take a cab. If you're light-headed, dizzy and think you need medical care, you probably shouldn't be driving. And, if they hang onto you for a while, you don't want to have to deal with wherever your car's parked.

Speaking as a guy who drove himself to the ER once and ended up spending a day in the ICU with diabetic ketoacidosis... they were kinda surprised, because most people who show up with that are in a coma.

[Colibri]

Originally Posted by drewtwo99

I am sorry if this kind of is breaking the rules, I know that asking for medical advice on here is kind of frowned upon. Feel free to close the thread if it's a violation, and I apologize in advance if so.

We relaxed the rules on medical and legal advice some time ago. Now they're OK in IMHO (but not in GQ). We just want to emphasize that free advice is only worth what you pay for it.

[KneadToKnow]

Originally Posted by Ethilrist

I'd say go to the ER and take a cab. If you're light-headed, dizzy and think you need medical care, you probably shouldn't be driving. And, if they hang onto you for a while, you don't want to have to deal with wherever your car's parked.

Speaking as a guy who drove himself to the ER once and ended up spending a day in the ICU with diabetic ketoacidosis... they were kinda surprised, because most people who show up with that are in a coma.

Concur. With bells on.

[peedin]

We just had this discussion at lunch. At the hospital where I work. The consensus was "if you need an ambulance to get there, go to the ER. If you can drive yourself, go to convenient care."

[Amasia]

The emergency room will be obscenely more expensive. Do you have health insurance or any sort of primary care MD? If so, can you call them and ask for a recommendation?

[Alice The Goon]

Originally Posted by peedin

We just had this discussion at lunch. At the hospital where I work. The consensus was "if you need an ambulance to get there, go to the ER. If you can drive yourself, go to convenient care."

Not necessarily. There are quite a few scenarios where you could drive yourself and still should go to a hospital instead of urgent care. One example would be if you had a facial laceration- you could drive yourself, yet an urgent care would send you to an ER because you'd need a plastic surgery consult.

[lavenderviolet]

If you go to the ER, they will probably give you an IV so they can give you some fluid and some medication to stop the vomiting (likely zofran). You'll probably be more comfortable that way, so nobody would blame you for going to the ER for this even though it may not be strictly an "emergency".

[Omar Little]

Originally Posted by Amasia

primary care MD?

+1 You just sound sick. ER is for emergencies, which your situation does not sound like.

Eat bananas, rice, applesauce and toast, in small amounts to start off. You might also want to get some pedialyte to drink. The electrolytes will be good for you. If it's your symptoms are continuing for 24 hours, then go to the quack shack.

[runner pat]

Originally Posted by Omar Little

+1 You just sound sick. ER is for emergencies, which your situation does not sound like.

Eat bananas, rice, applesauce and toast, in small amounts to start off. You might also want to get some pedialyte to drink. The electrolytes will be good for you. If it's your symptoms are continuing for 24 hours, then go to the quack shack.

The OP can't even keep water down.
I would also go to the ER.

[Living Well Is Best Revenge]

This doesn't sound like an emergency to me. I'd wait and see a little while longer. Try to drink a gatorade or something like to get yourself hydrated when you feel you can keep something down.

[Omar Little]

Originally Posted by runner pat

The OP can't even keep water down.
I would also go to the ER.

Water is harder to keep down when you're sick, than the items I listed.

[Lasciel]

If you can't even keep down water right now, you're pretty bad off, but it's not immediately fatal.

If you're willing to wait for a bit, I'd try the following: swish your mouth out with fresh water every 5 or so minutes. Don't actively try to swallow any, but don't forcefully spit it out either, just let it sort of dribble back out (being in the shower or bath is useful for this). Afterwards, when you swallow normally, there will be just a teency bit of water getting into your system.

If you keep that down, do it again in 5 minutes. If you keep both of those down, switch to about 1/3 gatorade to 2/3 water, and go again. If you keep that down, go again. Then slowly work the percentages of gatorade up, and keep "not drinking" every 5 minutes.

Once you've gone about an hour after you started the gatorade without puking, then try a single small swallow of plain water again. (you wanna wait so long so if you puke up the swallow of water, you've had a chance to get some of the electrolytes from the gatorade into your system.)

If you keep that down, you should be on the mend - switch to straight gatorade and take very small sips every 10 minutes or so. I wouldn't try any food at all until tomorrow if it were me.

If instead that first real swallow makes you puke again, or you're still dizzy, call your GP and get him to officially tell you to go to the ER. Better chance of insurance coverage that way.


If it were me, I'd tough it out for a half-day - try to sleep through the worst and hope that it was more settled when I woke up, but then it's going on to the weekend, and there's no guarantee that you'll feel better later on.

Sorry to hear that - stomach problems suck ass.

[Lasciel]

Originally Posted by Omar Little

Water is harder to keep down when you're sick, than the items I listed.

Maybe just an anecdote, but I didn't find that ANYTHING solid was keep-downable when I was in the throes of puking my guts up. The only thing that really worked was diluted gatorade, and sucking on (but not swallowing) saltine crackers.

[Farmer Jane]

Check for an urgent care that has IVs.

[Duckster]

I know you really don't want to hear a paperwork/bureaucratic answer, but it is something that may impact your decision.

Do you have medical insurance? If so, does it cover an urgent care visit? Anyone have an idea what an urgent care visit might cost with an uninsured (or the insurance won't cover it) visit?

I know, I know. But at the same time, the OP might have financial concerns that are impacting the decision to seek help, let alone choosing between urgent care and and ER visit.

[Omar Little]

Originally Posted by Duckster

But at the same time, the OP might have financial concerns that are impacting the decision to seek help, let alone choosing between urgent care and and ER visit.

Originally Posted by drewtwo99

Money doesn't really matter to me unless it's obscenely more expensive.

...

[Becky2844]

I'm with Omar Little; water is the hardest thing to keep down when you're sick. Our household magic potion is flat 7UP. But if you're feeling bad enough to consider medical help I think I'd go to the ER.
My husband drove himself to the hospital while having what turned out to be a very bad heart attack. Stupid, stupid man. I almost had one myself when they called me. I told him later that if he didn't care about himself, at least think about the people he could have killed while he died on the highway and took out another car or two along with him.

[not what you'd expect]

Let us know how you're doing Drew. Being sick is the pits.

[Erdosain]

I assume the OP is by now either dead or asleep, so this is probably moot. However...

If you go to the ER, they'll give you a $1,200 IV and park you in a hallway while they tend to the real sick people. And you'd better hope everything is out of your system or you'll soon learn the fine art of crapping/puking your guts out in a nasty ER bathroom with your buttless gown garthered in one hand, IV pole clutched in the other. Which hand do you clean up with? Not the one with a needle in it.

Unless you have underlying medical conditions, you might as well crap yourself in the comfort of your own home.

[drewtwo99]

Hi all. Just wanted to come back and give you an update.

I did end up going to an ER, because of some confusion over whether or not a place at the hospital was urgent care (Cigna was basically wrong when they said there was a department at the hospital that acted as an urgent care facility, and by that point, I was having trouble even walking around. Almost blacked out getting out of the car in fact). So I decided just to go to the ER since I was there and didn't feel like hunting down another urgent care place. My wonderful boyfriend was doing all the driving and walking me around, making sure I didn't fall over, etc.

I was running a fever of 100+, and my blood pressure was really wonky when I stood up, so they determined I was dehydrated and hooked me up to an IV for several hours to replenish my fluids. In the end, I'm glad I ended up going to the ER because it felt like I could have passed out at any time. (The weather in houston is pretty hot and humid nowadays so that probably added to my light-headedness).

Anyway, I'm home now and been sleeping the day away. Doctor's orders were NO SOLID FOOD whatsoever, and I did get a perscription for anti-nausea. Luckily I haven't thrown up again since I posted this morning, or shortly thereafter, but I'm still losing a lot of water due to loose stool (which calling it stool is generous, considering there's not a speck of solid shit in there, literally... all water).

My boyfriend has been playing nurse and taking good care of me, making sure I drink a little water occaisionally (that's the doctor's orders, he said to avoid anything with sugar so gatorade or soda is out). I have no appetite but he also bought me some clear soup to try to eat when I feel up to it, but the doctor seemed to urge me not to eat anything today, which is fine with me because of the lack of appetite.

Anyhow, thanks all for the advice, everything seemed to work out in the end. I asked one of the nurses or orderlies or whatever she was who was doing most of the stuff with me if I was right to come to the ER, and she seemed to think I didn't make a bad decision. She said anytime you're feeling pretty dizzy or light headed the ER is not a bad choice.


Now... I just gotta wait for the bill. Ugh. Probably going to kill me! Anyone want to hazard a guess how much an IV treatment, a blood and a urine test at an ER is going to cost me? I had a 100 dollar co-pay with my insurance, so that's all I payed today... but who knows what my ER deductible is and how much the bill is going to be...

ETA: Just looked up my insurance info, and it looks like I have a 300 yearly deductible, so I think the max I'll owe is 300 bucks. That's not too bad, assuming I'm understanding my coverage correctly.

[needscoffee]

Originally Posted by drewtwo99

ETA: Just looked up my insurance info, and it looks like I have a 300 yearly deductible, so I think the max I'll owe is 300 bucks. That's not too bad, assuming I'm understanding my coverage correctly.

Often there will also be a fee for using the ER in addition to the deductible, like $50 or $75 or so.

[Taomist]

I sure hope you're feeling better soon, Drew*. Did the hospital seem to think it was 'just the flu' or...? Either way it sucks; glad you have such a nice boyfriend to help take care of you, it really sounds like the pits. Feel better soon!

[Becky2844]

Glad you're feeling better! Take it easy till you feel like yourself again.

My guess on the bill is: $1,475.00.

[NinjaChick]

Originally Posted by Taomist

I sure hope you're feeling better soon, Drew*. Did the hospital seem to think it was 'just the flu' or...? Either way it sucks; glad you have such a nice boyfriend to help take care of you, it really sounds like the pits. Feel better soon!

*twitch* Pet peeve - if someone in an ER told him it was "just the flu" they should have whatever medical license they hold revoked.

The flu is the influenza virus, which can cause nausea and vomiting, but those symptoms are generally far more pronounced in children. Influenza is usually characterized by fever, body aches, congestion and cough, and fatigue. It is caused by the influenza virus, and most commonly spread by either inhaling aerosols produced by an infected individual sneezing/coughing, or hand-to-mucous-membrane contact.

Symptoms like the OP had come from gastroenteritis (an irritation of the gastrointestinal tract). This was most likely caused by one of a few viruses or bacteria - none of which are the influenza virus. It was most likely caused either by consumption of contaminated food (cross-contamination of raw produce, improperly cooked meat), or via the fecal-oral route (and that's why you always wash your hands well after using the bathroom).

There is no such thing as "stomach flu".

Glad you're feeling better, OP!

[yams!!]

Originally Posted by NinjaChick

*twitch* Pet peeve - if someone in an ER told him it was "just the flu" they should have whatever medical license they hold revoked.

The flu is the influenza virus, which can cause nausea and vomiting, but those symptoms are generally far more pronounced in children. Influenza is usually characterized by fever, body aches, congestion and cough, and fatigue. It is caused by the influenza virus, and most commonly spread by either inhaling aerosols produced by an infected individual sneezing/coughing, or hand-to-mucous-membrane contact.

Symptoms like the OP had come from gastroenteritis (an irritation of the gastrointestinal tract). This was most likely caused by one of a few viruses or bacteria - none of which are the influenza virus. It was most likely caused either by consumption of contaminated food (cross-contamination of raw produce, improperly cooked meat), or via the fecal-oral route (and that's why you always wash your hands well after using the bathroom).

There is no such thing as "stomach flu".

Glad you're feeling better, OP!

Sigh... you are right in that, until influenza and rotavirus decide to start a family, there is no such thing as an influenza virus that focuses on the GI tract, but I would argue that "stomach flu," as the layman's term for "gastroenteritis," certainly exists. If I told a friend I had to cancel plans due to a bout of stomach flu, they would know exactly what I meant, but if I blamed my absence on gastroenteritis, people would wonder what exactly I had, and if one of the symptoms was being overly pedantic.

love
yams!!

[drewtwo99]

Originally Posted by yams!!

Sigh... you are right in that, until influenza and rotavirus decide to start a family, there is no such thing as an influenza virus that focuses on the GI tract, but I would argue that "stomach flu," as the layman's term for "gastroenteritis," certainly exists. If I told a friend I had to cancel plans due to a bout of stomach flu, they would know exactly what I meant, but if I blamed my absence on gastroenteritis, people would wonder what exactly I had, and if one of the symptoms was being overly pedantic.

love
yams!!

Yes, the printout on gastroenteritis said it was commonly known as stomach flu, and that's what the doctor diagnosed me with.

I'm feeling almost back up to 100% tonight, to all of you who may be concerned!

After doing more research on my insurance, it looks like the most I will pay will be 300 dollars... I am very fortunate to have good insurance supplied by my employer. I feel so bad for people who have to go to the ER for something actually very serious, and don't have insurance or very good insurance.

[outlierrn]

Originally Posted by Alice The Goon

Not necessarily. There are quite a few scenarios where you could drive yourself and still should go to a hospital instead of urgent care. One example would be if you had a facial laceration- you could drive yourself, yet an urgent care would send you to an ER because you'd need a plastic surgery consult.

Most facial lacs do not require a plastics consult.

[Alice The Goon]

Originally Posted by outlierrn

Most facial lacs do not require a plastics consult.

The urgent care centers I have worked in wouldn't touch a facial laceration, and would send those patients on to a hospital for suture.

[SCSimmons]

Originally Posted by Alice The Goon

The urgent care centers I have worked in wouldn't touch a facial laceration, and would send those patients on to a hospital for suture.

My local urgent care was happy to stitch up my son's face when he barely failed at putting his eye out with a bungee cord. I don't think plastic surgery was ever even discussed. Years later, he still has a little scar and only two-thirds of an eyebrow. (I always instruct him to tell the girls that one of the ninjas just managed to slip past his guard before he finished them off.)

OTOH, when I dislocated my pinky finger at the second knuckle, another location of the same chain wouldn't help me & sent me to the ER. The story was I needed X-rays to verify it wasn't broken, and they had no X-ray machine. I was pretty sure it would have hurt more if it was broken, but that doesn't qualify as a diagnosis I spent nearly four hours at the hospital in the middle of the night just verifying that it wasn't broken. Actual treatment took about five seconds. (Passing MD walking by: "Want me to reduce that for you?" "Um, sure ..." YANK. I think that must have been Dr. Hank from Royal Pains.)

[outlierrn]

Originally Posted by Alice The Goon

The urgent care centers I have worked in wouldn't touch a facial laceration, and would send those patients on to a hospital for suture.

Usually done by the ER doc without a plastics consult.

[Sister Vigilante]

You are so lucky that flu is all it was. I spent a day hugging (literally, yes literally) the toilet three times last year. First time, went to ER, had CAT scans, MRI, end result: no more gall bladder.

Second time, ER, admitted, held for a few days CAT scanned again, rehydrated, flooded with potassium, released.

Third time I went to urgent care instead (I had called ahead and asked if they give rehydrating IVs and meds for nausea, which they said they did). But hey decided my heart rate and blood pressure were "stroke out" high and sent me in an ambulance to the ER where I was admitted yet again, tested, and released after a few days.

When you're dry heaving into a bag in the ER waiting room they sure triage you pretty fast. When they discover your BP is 180 over something, you get the special wristband that lets you out of the waiting room and into the ER proper. Where they somehow have cameras that can see and hear you, I learned. I spent 10 hours in that ER room before getting a real bed.

Anyway, glad you're better and that they were able to diagnose you.

(And boy howdy do I know what it's like to go to the bathroom with an IV and heart monitor attached to your body. They had to replace my IV 3 times; I looked like Bane.

[Arabella Flynn]

As a matter of policy, I tell people that if they can't keep anything solid down for more than three days, or can't keep any liquids down for more than 12 hours, they should seriously think about the ER. I developed this policy after acquiring a roommate who had a tendency to not tell anyone when she was really sick, and not go to a doctor for anything short of rapid exsanguination -- and even then she'd probably wait a while to see if maybe she'd get better. I discovered this idiocy one day when I came home from the night shift when she was getting ready for her morning shift, and watched her conk out and have what later turned out to be a dehydration-induced blackout and syncopal seizure right in front of me. Twice.

After the first one, I took her shoes away from her and called her out sick from work. (They weren't supposed to let me do that, but such policies tend to get bent when you tell them, "You can talk to her yourself if you want, but she's still lying on the bathroom floor.") After the second one, I told her she could put on some pants, get her purse, and call someone for a ride to the ER, or I would just wait until she did it a third time and call 911 while she was out and couldn't stop me.

It turns out that if you tell the desk nurse that your roommate is very ill, not keeping anything down, and passing out and seizing on the floor, they come out to the parking lot with a gurney to get you. We did not stop in the waiting room. I did her intake for her. Which was good, because she also wanted to lie to the doctor about some of her chronic medical problems and whether there was a non-zero chance she was pregnant.

The moral of this story is that severe dehydration is very easy to fix when you're in the ER where they have doctors and IVs, but that the aforementioned ER people take it very seriously, because it can in fact kill you if you let it go on too long.

[handsomeharry]

Not a lot to add, except: Yesterday, I went to an "Urgent Care" facility. Something tells me that they weren't really equipped for anything urgent. More like, a Dr's. office with a sign that said "Urgent Care." i.e., if you think you need something that a Dr.s office won't give you, don't bother with the UC.

[Hello Again]

Originally Posted by handsomeharry

Not a lot to add, except: Yesterday, I went to an "Urgent Care" facility. Something tells me that they weren't really equipped for anything urgent. More like, a Dr's. office with a sign that said "Urgent Care." i.e., if you think you need something that a Dr.s office won't give you, don't bother with the UC.

Urgent Care varies. Varies A LOT. Mine is just a couple of docs who only take walk-ins, but they are Board Certified in Emergency medicine and they do IV hydration and X-rays on site (which a lot of the posters on this thread have said theirs doesn't do).

But the larger point is, many people don't have a regular doctor, or can't get to their regular doctor when they are vomiting uncontrollably at 1am on Memorial Day. Your local office may be no more than a doctor who happens to be open till midnigh, but that's good enough for an awful lot of low-priority situations that might otherwise end up with you cooling your heels in the ER for 12 hours or so.

[drewtwo99]

Just got the information from the insurance company. I will only pay 300 to the hospital. The hospital billed for about $3,300, the insurance payed about $1,300.

Overall I'd say it was worth it.

[Nawth Chucka]

Originally Posted by drewtwo99

Just got the information from the insurance company. I will only pay 300 to the hospital. The hospital billed for about $3,300, the insurance payed about $1,300.

Overall I'd say it was worth it.

Wow, I'll say! It can't hurt (if you can pay it all at once) to call them up w/ your credit card # and ask for a cash discount if you pay the full amount right now.