Trying to decide if I should be patient or go to urgent care...

I think the urgent care (as opposed to the ER) would be a good starting place. I would do it. They can do a UA and get results right then without the expense of the ER.

I know what you mean - I feel like if I go too much and it's nothing, I lose credibility. I know that for me, one common place for Crohn's pain is in my back where my kidneys are. It actually isn't my kidneys, but since the intestines go everywhere, that's just a tender spot for me. Not sure if that makes sense or not. But they could do a scan or an ultrasound. If the urgent care dr said to go to the ER, that is worth something at least. 120 is a bit high, even with pred. Pain will make your heart rate be elevated.

I totally get it. I've gone in for things I've been worried about, only to find out it wasn't anything. A lot of that happened when I was figuring out I had fibromyalgia. My rule of thumb has become if it's pain, fever, or dehydration/blood, and it's extremely concerning, then it's worth getting looked at, and the sooner the better. I would call the Urgent Care and ask the doctor there who told you to go to the ER if they could call the ER and let them know they were sending you over. That helps me feel a bit more credible. And honestly, at the end of the day, it really is much better safe than sorry. One time I didn't go in (actually, my PCP told me NOT to go, that I was being overdramatic) and I went septic from an abscess (the PCP insisted it was just a swollen gland) and almost died. And in that case there was no fever, no D, just a painful lump that had formed that morning. The problem with CD is that when things go bad, they go bad fast. Even if your GI orders scans, you won't get that appt for a few days and then you won't get results for a few days after that, when you're out of town. Better to get it resolved now. I know it's scary to go in when you feel like you're losing credibility, and yes some ER doctors and nurses can be jerks about it (been there, done that), but the majority are understanding.

Hi MoShip,
I'm chiming in here. I think most of us have struggled with this issue of knowing when to go to the ER, when to call the doctor, etc. We put up with so much discomfort and pain on a regular basis, and it becomes really hard to know when to take things seriously.

My heart races whenever I'm anemic. Did your GI or the urgent care take any blood tests? And yes, the prednisone can make your heart race, as well as pain, and anxiety....so the racing heart symptom by itself is hard to figure out. If you have decent insurance, I think you should just go to the ER and see what's up. I do understand about your CT and radiation concern. I wish the ER would do MRI's instead, but they don't. But if you are very ill, maybe you need to be admitted for hydration, pain control, diagnostics, etc. We deal with so much that it's easy to forget that Crohn's can get life threatening and serious.....if it turns out to be anxiety, then so what....you wouldn't be the first one of us to worry unnecessarily, and at least you will be re-assured.

Well, hopefully you'll either hear from your GI or the ER will be helpful. Let us know how it goes!

Oh wow, a fistula is no fun at all. I am so sorry. :( I think a scan of that area would be a good idea.

Oh MoShip!
Don't feel bad for asking questions!
Many, myself included, made a similar decision to just deal with their Crohns on their own and not see it for the danger that it was.
I was diagnosed in high school and was treated until I graduated and then I was done with it all for almost 10 years and got rectal pain, an abscess, and then a fistula in August 2009.
Sometimes we just don't want to acknowledge the warning signs until we're really sick.
I first got sick with a fissure and didn't know what a sitz bath was. I did realize that exercise seemed to relieve some of the fissure pain, as did super hot showers. At one point, I was in a shower so long that I felt faint when I was getting out. Hot water is great even if you can't sit in it.
I really hope your ER doctor was wrong and that it's not a fistula. They are nearly impossible to be rid of for good, but at least you'll be put on some strong drugs that will make you feel better.
Feel free to post more on this forum!

You could try Tramadol. Doctors aren't as hesitant to prescribe it as they are with oxycodone or other opioids. Tramadol didn't work for me (nausea and headache), however I know it has helped a lot of others.

He has given me tramadol before, but I asked for it about a month ago after an allergic reaction to pentasa, and he said absolutely no NSAIDs. It did make me nauseous, but I found if I take half, and then in thirty minutes if I'm still in a lot of pain take another half it helps, I have no idea why.

I was on humira in 2012 after I was diagnosed, I had a different doctor at the time and he was all about starting with the big guns, but after the 4th time being injected I had a really bad reaction. (Now I'm thinking it was more in my head.) The injection site became really red and painful, and it felt like I was being stabbed. I would be willing to try remicaide, but the doctor I have now sees those as almost the last resort. You are very tough! I don't know how you do it without anythin! I don't handle pain very well at all.

I think you need a new GI doctor. The "big guns" like the biologics are being viewed as the first line of treatment as opposed to last resort nowadays. Doctors who hold back on them are not keeping current with the most recent research.

And I don't know why he said no to tramadol then because when his nurse called me back she said no because he said no NSAIDs. I just think he doesn't like prescribing things, the prednisone has caused severe anxiety and he still refused to give me something for that. I need to get a primary care, but living in a small town on medicade it's not the easiest thing to do, and I am picky because my last primary care told my mom when she asked if I could have crohns that there is no way and didn't once send me to a GI even though I was in her office at least once a month with stomach pain and blood in my stool. I didn't even know there was such a doctor (I was in high school at the time)

I'm going to start looking for a PCP close to where I live today. I have been picky in wanting a female doctor, but closeness is more important to me. I will have to find a PCP before I can switch GIs though because I have to have a referral. I don't need one with the GI I have now because I have established care with him already (as far as I understand.) I'm curious if they are going to call me today, I left a voicemail Thursday asking if they think I should go to ER or no and never heard back, and the ER doctor called the office and spoke to the on call doctor. I know I should probably call them and not wait, but I don't think I will out of curiosity, and my mom doesn't think there is anything they will do for me. I couldn't go see them today even if they could get me in due to distance and weather.