Emergency room / hospital visit

Hey, just wondering what exactly happens when you've reached a point in a flare when you need to got o the ER or be admitted. I'm doing everything I'm supposed to as far as meds, supps, and restricting my diet, and things are still out of control. 15+ times a day, tons of blood, pain. I've lost 30+ pounds. My new GI is gonna flex-sig me Monday (yippee!), but I'm not sure I can make it until then (like that's gonna make me feel better anyway). I do my enema and sleep pretty good at night, so that's keeping me going. I eat maybe a banana, a yogurt, and some rice cereal or rice noodle soup in a day. So, I'm guessing they IV you first to level out your vitamins, but what about the inflammation? I can't do the steroid thing again. No way.

Usually, to go to ER you have to have FEVER, NAUSEA, VOMITING, SWELLING, etc...In July I had a fever of 105 I did not think I was going to win

when i was admitted I called the hospital, got the GI on call to call me, told him what was going on and he said I needed to be admitted.  He had the hospital have my room ready.  It sure beat having to go thru the ER

Personally, I avoid hospitals if I can because I don't want to risk picking up an infection or something. But I'm on an immunosuppressor, so I worry more about that than most people.

I would suggest talking to the doctor on-call at your doctor's office. It's when you say "lots of blood" that makes it sound like, gee, you really shouldn't wait until Monday to talk to the doctor.

My treatment for stopping the 20 trips to the bathroom: take tylenol/codeine. It has the great side effect of constipation. Works really well and pretty fast. I've posted about this before. There are a lot of considerations since codeine can be addictive. But when I've reached the end of my rope, the codeine is the miracle drug I need. Ask your doctor about it if you feel comfortable with the idea of it. It's not for maintenance, but if you're ready to check in to the hospital, it could get you back on your feet short-term.

Do 5ASA drugs (Asacol, Colazal, etc.) work for you?

Also, one thing... are you sure that the Canasa suppositories work for you? I'm pretty sure they made me worse or had no effect on my D. You could try Cortifoam in the AM (instead of Canasa) and continue with the cortenema at night. Or try the cortenema twice a day. That would be a more aggressive way to deal with this bad flare without resorting to oral steroids.

Hang in. I hope that this gets under control soon and then you'll quickly be on the mend.
Definitely go to the hospital if you want. Do you live alone? If you do and you decide not to go to the hospital, maybe you can arrange to have people call and check in on you this weekend.

Are you sure the fish oil and or probiotics aren't making you worse? They seemed to make me worse, especially the fish oil. My D slowed down when I quit the fish oil. Lomotil helps stop my D too. It's up to you if you want to go to the hospital or not, I broke down and went for the first time in Nov. The fluids helped me feel so great, and I think the Flagyl IV helped too. I got nervous, though, and checked out after I got those. They were doing unnecessary xrays and wanted to do a colonoscopy even though I had had one 6 days prior, and were insisting I give them a stool sample but I was empty, oh yeah, and they said no water or anything and I was soo thirsty. If I was in your shoes and about to get a flex-sig anyways, maybe being in the hospital would be best, though. They might pressure you into the steroids. Sorry you are flaring so badly, I know how painful and exhausting it is.

Hi there -- when we were at the end of our rope I called and left a message with the answering service on a Sat.night.  His Dr knew for me to call something was not good.  We spoke and developed a plan.  I brought him to the hospital that she and her associates have privileges at early the next morning.  

I had all the meds typed up insofar as dose, Mgs, time of day taken etc.  I also typed up an overall summary of what had been going on for the past year and the reason for bringing him to the ER.  I typed in red what his Dr.told me to indicate for a current diagnosis, what she felt needed to be done and wished to be done as she and her associates would be in to also monitor his care along with her telephone # if the ER doctor had any questions.   

When the Dr on call came in to examine and ask his questions -- the piece of paper I had for him to read first channeled his thoughts and he wasn't asking all these unnecessary questions that my husband was in too much pain to be bothered answering. (As it turned out the pain meds had him so comfortable he was finally sleeping for the first time in many weeks.)  It really helped to streamline things going in with a plan.  The typed listing of meds was a help for the nurse for the chart notes she needed to make.

Also if you call ahead to see how busy the ER is so you don't have to wait an unbearable amount of time before you are seen & triaged by the nurse etc. you won't have to deal with that aggravation.

His ER visit and subsequent admittance went very smoothly.  Due to his pain level and constant bathroom trips he was given an IV quickly along with pain medication in the IV.  Within minutes he was pain free and comfortable which was not the case for several months.  It also did slow things way down and he wasn't going to the bathroom often at all. It was Mother's Day and the ER got very hectic not long after he was taken into an ER room of his own.  He was admitted early evening and stayed in the hospital for 5 1/2 days total.  He needed the pain meds every 3-4 hrs to keep the spasming at bay which is why he was admitted.

The imuran (azathioprine) was started then along with meds for pain management.  Things are much improved - but not a full remission yet as he still has multiple BMs each day and needs the pain meds still.  However, he is quite functional and finally off the prednisone.  He was on and off the prednisone for a year 1/2 and hopefully not be back on it for a long while we hope.  Daily life is still a challenge for him but considering where he was he is grateful to have some kind of functionality even though it isn't the greatest sometimes.  Some days are better than others but going to the hospital was a turning point for him in addition to signing on with the Mayo Clinic in Jacksonville who are also involved in his current care.

Good Luck -- I hope things turn around soon for you and your pain is greatly diminished as that is so debilitating and gets in the way of so many things. 

I had the worst flare of my life late october,  which included 3 ER visits and an admission to the hospital x 6 days.  The first ER visit ,  they  talked to my GI doc, and offered to admit me, or to continue to manage at home.  So, they started me on potassium because my levels were low gave me pain meds,   and checked to make sure I didn't need to be transfused and home I went.  I was on the highest prednisone dose I could  be on I think.   then about a week later,  with no relief in symptoms,  I had new symptoms,  a severe upper abdominal pain (on the weekend) So off to the ER I went again.  This time I had a gastritis,  because of the high dose of steroids while eating very little.  So started on Nexium.    The 3rd ER visit was because my primary doctor wanted to admit me from his office,  but there were no beds.  So he said the only way would be to go through the ER, and he called the ER doc and talked with him.   I got an IV started in ER and some good IV pain meds,  and waited for my bed to open up.   Then, the next day,  I got a flex sig,  and was on IV steroids.  They helped but I kept backsliding in my symptoms.  Finally my GI wanted to start the remicade.  I guess that helped, because I was able to go home after 6 days.  I hated being there,  but it was the best place for me at the time.  At home I was able to taper off prednisone, and now doing pretty good.     There is no good time  to tell ya when to go.  If you are bleeding alot,  and dehydrated,  and in pain,  those sound like good enough reasons to me.  Good luck! I"m sorry you're going through this!!