noblebaron; I hope you get the treatment you need, and heal up well. I don’t have anything to add as to ER treatment. But, your quesion made me wonder, and pertinent, really: do ER visits for less than life-threatening conditions make a difference to the patient’s future insurance rates? Do insurance companies consider that at all, and does it have an effect in charging customers?
Not meant as a hijack, but, if there is an effect, certainly worth considering to decide to go to the ER or not.
I went to the ER twice last year for sports injuries (non-life threatening, two weeks in a row strangely enough). My insurance rates didn’t change, as everyone in the company pays the same rate as everyone else.
Both time were relatively quick. I can’t really add anything, everything I experienced was nailed down pretty well by the previous posters.
Did ya get there yet?
In my ED we’d put you at the front of the line if we knew you were a Doper… 
If you have pus trapped under the skin, say from an infection that started at the margin of the nail it might need to be opened up. We usually will numb the finger down at the base where the nerves come in on each side, and it actually doesn’t hurt to much to get a digital block like that. We also worry about any infection near a joint to make sure it’s not in the joint itself, which is a bigger deal.
Impossible to say what the experience itself is like. Every ED is different. Mine is a lovely suburban ED with highly qualified and courteous personnel and competent care. Also free wireless. And a TV in every room. Seriously. There is a fast track area for minor care but still no guarantees on wait times.
Best wishes.
In your case, you might expect to learn how to spell paronychia. 
If you have insurance through an employer or other group plan, absolutely not. As mentioned before, everyone similarly situated pays the same premium regardless of claims history. (Similarly situated refers to things like PT vs. FT, hired at same time, active employee vs. retiree). Very broadly and in the aggregate, if a group of employees use the ER a lot, it will increase the employer’s claims history, and may increase everyone’s premium overall. Alternatively, the insurance company might tweak the policy so patients bear more of the cost of an ER visit.
If you buy the insurance yourself, not through a group, an ER visit will be a bigger claim than an urgent care or office visit, just because it’s more expensive. I’m not sure exactly to what extent those companies can take claims history into account when setting a premium, but it wouldn’t surprise me if they did. This probably varies with state law. The employer policies are largely governed by a federal law, ERISA.
What should I expect at the ER? Going there shortly.
Don’t fall asleep while you’re there or you may be awoken by security guards triyng to beat you up. (At least according to lee)
Expect to be ignored for a few hours.
Let us know what happened, eh?
For your ailment, Urgent Care is likely better than the ER.
Its good if you have the type of problem you have, if you DON’T go to a hospital that is a noted trauma center. For example, I mostly tried to avoid the University of Michigan ER, because truly horrible shit is being medi-vaced there all the time. Your basic “I fell of my horse and now I can’t walk” took about 8 hours to process… once they got over the excitment of thinking my pelvis was broken I sort of languished. I was in a morphine-induced haze so the time fairly flew by but my SO was pretty bored.
My SO went in for your basic “I fell playing hockey and fractured my spine” and that took about 12 hours which was pretty outrageous.
In their defense, the other patients, were for example, a homicidal/suicidal with ?stab wounds? that got helicoptered in as a danger to self/others (psych wouldn’t take him till neurology saw him first, etc etc.), and a bipolar guy off his meds with burns on 70% of his body.
So, our problems were somewhat trifling comparatively. We were of clear mind, and no organs were hanging out. Hence the low priority.
Hi all,
Thanks very much for your replies. Sorry if anyone’s been worried while I’ve been able to update.
Warning: My reply might contain too much information.
I went to the ER that night and was diagnosed with a ‘felon’ or possible ‘cellulitis’.
The doctor froze the finger on both sides above the middle knuckle and then made a 1/4" incision on the side near the nail to try to release any pus. My fiancee was watching the procedure and apparently they dug around searching for the puss ball with forceps or something similar. However, none came out.
(Interestingly, he said that he shouldn’t really be cutting until tomorrow, or until “the infected area started pointing to a head”. Nevertheless, he did anyhow. He did have a female med-student with him and I couldn’t help but wonder if this ‘exploratory surgery’ was used as a teaching tool?? Hmm… :dubious: )
I was told to continue the antibiotic I was already on (Cefuroxime Axetil) and was given a prescription of more of the same plus a second, backup prescription for another antibiotic. The first was to be used if the finger got better. Second was to be taken in the event the swelling got worse. Also, in the morning I was supposed to soak it in warm salt water and try to ‘milk’ it to see if any pus could be extracted.
In the morning there was no way I was going to be ‘milking’ that finger through the incision made the night before. It was throbbing, hurt like hell, plus the swelling was increasing.
Furthermore, in the stress of the night before, I had put my prescriptions through the wash.
So I went to the walk-in clinic in the morning and a doctor put me on another type of anitbiotic completely: Novo-Trimel (trimethoprim and sulfamethoxazole.) She was about 70 and said that ‘a lot of the younger doctors are prescribing these new antibiotics and they’re not working for the newer bacterial strains’, so she wanted to try me on one of the old ones.
(I should also mention that I’m allergic to penicillin, so this factors into things.)
Well, I watched my finger continue to swell throughout the afternoon, with the pain creeping down my finger past the first joint and swelling into my third. I started to get a bit of a fever and decided to make another visit to the walk-in clinic.
Another doctor assessed the situation and told me to get to ER right away. Considering that I had been on antibiotics for five days, with the situation getting worse, we were both concerned about methicillin-resistant staphylococcus aureus (MRSA) aka ‘superbug.’
When I got to the hospital, I was re-assesed and immediately put on IV antibiotics (vancomycin). Interestingly, the doctor that made the incision didn’t take a swab of the incision site even though he (apparently) should have. Even though I was on antibiotics, it might have made a specific treatment more appropriate vs. another if we knew what we were dealing with.
I have subsequently been ordered to have a home-IV situation where I keep the IV in my arm and must return to the hospital every 12 hours to be hooked up for liquid antibiotics for 4 days.
The good news is that that the swelling and pain is decreasing, so the new antibiotic appears to be working!
A few points to mention:
Thanks everyone for the book suggestion… great advice!!
Also, since I live in Canada, the doctor visits were free, and so were the ER visits. Hospital IV antibiotics are free (take home prescriptions are not free, but can be subsidized based on income level/family size.)
On top of all this, I got stung by a bee today in the mall parking lot. I am allergic to wasps and hornets, so I figured I might have an anaphylactic reaction. My finacee went rushing into the pharmacy to buy a $110 Epipen. I asked her to “calm down, please” since frantic worry never helped any medical emergency. Right next door was a walk-in clinic where an epinephrine shot could be obtained for free, if necessary. So she gave the Epipen back and we went next door where I was admitted within 60 seconds after describing the situation. I was observed and, fortunately, had no allergic reaction to the bee sting.
I live in a small town, so the wait times in the walk-in clinics were generally less than ten minutes. The ER wait times were no longer than 20 mins.
Yes, I am extolling the virtues of the Canadian medical system.
A few related questions for medical professionals:
I understand that vancomycin is a last-line defence. Hypothetically, if I had MRSA that was also vancomycin-resistant, what are then are the treatment options?
What happens to the body if no drugs are working? Briefly, in what stages does the body shut down, and how long does it take to die?
If a person has an MRSA infection, does this increase the likelihood of one occuring again in the future?
According to this article: Existing drug will cure hospital superbug MRSA, say scientists | NHS | The Guardian there is a compound that kills antibiotic-resistant MRSA. Apparently, it is an existing drug, but
“The brand name of the drug, ETS 1153, which is currently prescribed for another condition, has not been revealed for commercial reasons.”
Does this mean, simply, that if a person were dying of an antibiotic-resitant MRSA infection that – even though a possible cure has reputedly been found – a person might die because a company is in the process of patenting the drug? Am I naive to think the people who discovered the alleged cure would not ship the drug with, say, some kind of non-disclosure agreement?
Thanks for your support,
-NobleBaron