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Temperature - when to go to the ER

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Crohn's Disease
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Posted 7/28/2010 1:20 AM (GMT 0)
I apologize if this question has been posted on this site before. I can't find an answer that relates closely enough to my problem.

I have Crohn's Disease. Stopped taking Humira over 6 weeks ago because it wasn't helping - my rectum was/is inflamed, had 4 abscesses in 8 months. Had my last one 2 weeks ago. My doctor replaced the Humira with Prednisone, with the idea to discuss options like Remicade and a possible surgery once the Humira was out of my system.

Seeing the surgeon tomorrow. But this evening I bled into the toilet and now I've got a fever of 104F.

I don't want to go to the ER! It's the worst place in the world.

Do you think I can wait until I see my surgeon tomorrow? Took Tylenol about an hour ago.
Posted 7/28/2010 1:24 AM (GMT 0)
My AMA family medical book says to go to the ER when you fever goes above 102.
Posted 7/28/2010 1:30 AM (GMT 0)
Thank you so much for your reply. I couldn't find anything on the web or here.

Temp is coming down...
Posted 7/28/2010 1:34 AM (GMT 0)
Minou,
I still wonder if going to the ER might be a good idea. Some people start seizing at 104.
Take care,
Navy
Posted 7/28/2010 1:38 AM (GMT 0)
I was thinking the same thing.

The very fact that you got that high at all is concerning, and should probably be investigated...
Posted 7/28/2010 1:40 AM (GMT 0)
You don't think I can wait until I see the doc tomorrow morning?
Posted 7/28/2010 1:41 AM (GMT 0)
A fever that high can quickly lead to dehydration, which can get out of control very quickly. I once put off going to the ER only to find myself so weak and dehydrated that I was shaking uncontrollably and had to call an ambulance and was admitted into ICU. Your history, along with the fever and the blood would make me think that it is better to be safe and go on into the ER.

I hope you feel better soon,

Glori
Posted 7/28/2010 1:45 AM (GMT 0)
What if you call ahead, Minou, and ask the triage nurse's advice?

I know the ER is horrible, but a few hours there now might be better than a few days in hosp later...
Posted 7/28/2010 2:28 AM (GMT 0)
You can also call your doctor's office...and get the off hours office to page him (or whomever is on call at that practice)...that way your doctor can advise you even better...
Posted 7/30/2010 3:37 PM (GMT 0)
Thought I might give an update to this story for anyone who might find themselves in my situation.

My temperature went down to 99F with the Tylenol but shot right back up to 103F a few hours later. I decided to wait until my appointment with my surgeon before heading to the dreaded ER.

She gave me a note and sent me down there after my appointment. My temperature was still 103F and my blood pressure was 90 over 58, or so. They started an IV, gave me a CT scan, blood culture tests, urine tests, stool tests, chest X-ray, more urine tests, more stool tests.

It was a 2-day nightmare. I mean, how many doctors have to stick a finger in your anus before you can get some help? I HAVE CROHN'S! It's in my rectum, and it hurts like hell. It was as if they didn't believe me... "you might have C-Difficile", "are you sure you don't just have a virus?". I had to tell my story a thousand times and every time I got the same confused look.

Anyway, I finally busted out of there with a promise of Remicade and a script for more prednisone.

If I had to do it all again, I would have tried to reach my GI first. But then again, maybe it was inevitable.
Posted 7/30/2010 8:05 PM (GMT 0)
yeah, I think your right, none of the specialists like to deal with emergencies in their offices.  Even urgent care facilities don't want to deal with a true potential emergency, and you probably really wouldnt want to be there either.  But after the first rectal exam, why more?  Practice?  you always have a right to say no - tell them to see the other dudes statement (unless you landed in a teaching facility's ER then all the students line up at the door . . .)  But glad your on the mend. 
Posted 7/31/2010 12:23 AM (GMT 0)
I always forget about my rights when I'm in the hospital. It's a weird place, another dimension. At one point while the nurses were doing their rounds a patient started yelling "Who are you? The Gestapo?" Everyone thought she was crazy, but I think she made a good point.

Thanks for the humour grumpygi
Posted 7/31/2010 4:50 PM (GMT 0)
Much as I hate rectals the very MINUTE a rectal exam was mentioned I would first ask WHO the doctor was, just a resident, intern OR the full-fledged doctor who was going to be managing my treatment and discharge or admittance - 'cause NO ONE ELSE is doing a rectal exam! NO ONE ELSE. He who has the final decision and say on my treatment is the ONLY one who gets to do a rectal and he only gets ONE SHOT at it.
Posted 7/31/2010 8:53 PM (GMT 0)
I LIKE that policy C-too!
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