Blackjack's Thread of Illness and Ailments

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Blackjack's Thread of Illness and Ailments

Postby willeyeam » Sun Feb 10, 2019 7:16 pm

My friend is a PA at an urgent care and we get to hear about some of the things he sees for better or worse. He sent a pic of the board of patients waiting with one having the symptoms (balls really itchy). Names were cropped out for any HIPAA concerned folks here.

While urgent care has taken the place of my doctor basically outside of checkups, I wouldn't have thought to go there for a broken bone either

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Blackjack's Thread of Illness and Ailments

Postby meow » Sun Feb 10, 2019 7:17 pm

Outside of crack skull, possible broken neck or back or a broken femur, I’d probably head to an urgent care first.

One of my teams at work, this is basically their sole purpose in life. They do population health initiatives to try and direct people to the appropriate level of care for their need. We had a real issue with non emergency level patients flooding our ERs and it was a major financial burden.

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Blackjack's Thread of Illness and Ailments

Postby Willie Kool » Sun Feb 10, 2019 7:20 pm

I tried going to urgent care with my kidney stone. They told me they couldn't help me and to go to the ER. :(

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Blackjack's Thread of Illness and Ailments

Postby NTP66 » Sun Feb 10, 2019 7:21 pm

Urgent care has essentially replaced my primary doctor, too. $15 more expensive, but I don’t have to worry about getting an appointment in a timely fashion.

The location near us is actually really nice, too. They’ve got some expensive gear in there, clearly not wanting to skimp in certain areas.

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Blackjack's Thread of Illness and Ailments

Postby NTP66 » Sun Feb 10, 2019 7:24 pm

I tried going to urgent care with my kidney stone. They told me they couldn't help me and to go to the ER. :(
Was it because of the lack of a ct scan? Most urgent care centers don’t have the proper equipment to deal with kidney stones.

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Blackjack's Thread of Illness and Ailments

Postby Willie Kool » Sun Feb 10, 2019 7:30 pm

I tried going to urgent care with my kidney stone. They told me they couldn't help me and to go to the ER. :(
Was it because of the lack of a ct scan? Most urgent care centers don’t have the proper equipment to deal with kidney stones.
Not sure, could be. She said something like "if we do find you have one, we can't really do anything here to help it."

As it was, since my kidney was so swollen, I had to wait for the attending ER DO to get a urologist to look at my CT before allowing me to leave.

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Blackjack's Thread of Illness and Ailments

Postby shafnutz05 » Sun Feb 10, 2019 7:40 pm

I absolutely love our urgent care out here. You can book your time in advance too. So much quicker to get x-rays, lab results, etc.

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Postby meow » Sun Feb 10, 2019 7:45 pm

A CT scan in an urgent care is pretty rare. X ray and ultrasounds are getting to be a standard

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Blackjack's Thread of Illness and Ailments

Postby MR25 » Mon Feb 11, 2019 8:23 am

Urgent care was your best option - assuming they have an x ray machine. The ER is really reserved now for “help me now or I’ll die” scenarios.

The part that sucks, at least here, is that UPMC Urgent Care facilities are only open til 9. Difficult to go to one when you sprain your thumb during your 8 PM start hockey game.

In fact, I'm pretty sure every time I've needed to go to an Urgent Care facility since I got on my own health insurance, they've been closed.

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Blackjack's Thread of Illness and Ailments

Postby meow » Mon Feb 11, 2019 8:52 am

Urgent care was your best option - assuming they have an x ray machine. The ER is really reserved now for “help me now or I’ll die” scenarios.

The part that sucks, at least here, is that UPMC Urgent Care facilities are only open til 9. Difficult to go to one when you sprain your thumb during your 8 PM start hockey game.

In fact, I'm pretty sure every time I've needed to go to an Urgent Care facility since I got on my own health insurance, they've been closed.
That’s unfortunate. About 1/4 of our urgent cares are 24 hours.

A sprained thumb isn’t an er visit, IMO. Even if I have no other options.

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Blackjack's Thread of Illness and Ailments

Postby shoeshine boy » Mon Feb 11, 2019 8:55 am

I tried going to urgent care with my kidney stone. They told me they couldn't help me and to go to the ER. :(
Was it because of the lack of a ct scan? Most urgent care centers don’t have the proper equipment to deal with kidney stones.
Not sure, could be. She said something like "if we do find you have one, we can't really do anything here to help it."

As it was, since my kidney was so swollen, I had to wait for the attending ER DO to get a urologist to look at my CT before allowing me to leave.
I would imagine that they also don't have the REALLY good drugs there for the pain. I went through a period of 2 years where I had FIVE kidney stones (lesson learned: don't drink Coke Zero if you're on Metformin) and every time I went to the ER they gave me different drugs. by far the best was Dilaudid. about 30 seconds after they put that in my IV I was feeling ZERO pain. :fist:

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Blackjack's Thread of Illness and Ailments

Postby LITT » Mon Feb 11, 2019 11:44 am

Urgent care was your best option - assuming they have an x ray machine. The ER is really reserved now for “help me now or I’ll die” scenarios.

The part that sucks, at least here, is that UPMC Urgent Care facilities are only open til 9. Difficult to go to one when you sprain your thumb during your 8 PM start hockey game.

In fact, I'm pretty sure every time I've needed to go to an Urgent Care facility since I got on my own health insurance, they've been closed.
That’s unfortunate. About 1/4 of our urgent cares are 24 hours.

A sprained thumb isn’t an er visit, IMO. Even if I have no other options.
PA has stupid laws that make 24 hour urgent cares difficult/impossible/not financially viable to execute. especially when people are going to go at 10pm for a sprained thumb. youll survive until the morning.

most states allow for stand alone EDs to operate 24/7 which is a progressive model; PA requires a facility inpatient beds to have an emergency department

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Blackjack's Thread of Illness and Ailments

Postby shmenguin » Thu Feb 14, 2019 7:31 pm

Outside of crack skull, possible broken neck or back or a broken femur, I’d probably head to an urgent care first.

One of my teams at work, this is basically their sole purpose in life. They do population health initiatives to try and direct people to the appropriate level of care for their need. We had a real issue with non emergency level patients flooding our ERs and it was a major financial burden.
Query. A few years ago I had a “time is of the essence” situation. I was having an issue where some markers in my blood were fluctuating, and it was very important that I get blood work done as soon as I felt a flare up happening to make sure the elevated markers were documented (if they existed). I also had general malaise, but nothing too terrible. If the blood came back funky I wasn’t in immediate danger, but the data collection was important.

It was late. Urgent care didn’t do blood work. So I went to the ER. They treated me accordingly, in that I had to wait 7 hours. But what say you? Foul play on my part?

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Blackjack's Thread of Illness and Ailments

Postby Shyster » Thu Feb 14, 2019 7:52 pm

Nope. You needed the service, and ER was the best option available.

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Postby meow » Thu Feb 14, 2019 8:07 pm

Outside of crack skull, possible broken neck or back or a broken femur, I’d probably head to an urgent care first.

One of my teams at work, this is basically their sole purpose in life. They do population health initiatives to try and direct people to the appropriate level of care for their need. We had a real issue with non emergency level patients flooding our ERs and it was a major financial burden.
Query. A few years ago I had a “time is of the essence” situation. I was having an issue where some markers in my blood were fluctuating, and it was very important that I get blood work done as soon as I felt a flare up happening to make sure the elevated markers were documented (if they existed). I also had general malaise, but nothing too terrible. If the blood came back funky I wasn’t in immediate danger, but the data collection was important.

It was late. Urgent care didn’t do blood work. So I went to the ER. They treated me accordingly, in that I had to wait 7 hours. But what say you? Foul play on my part?
Documenting trends in blood panels is not an emergency. I would have liked your pcp set you on a blood work schedule - probably two times a week - to track your results. That way you can assign an ouchie level in retrospect. Monday I felt awesome. Thursday I felt like death. Monday I felt like death. Thursday I felt awesome. You can do a dozen office/lab blood panels for the price of your er visit.

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Blackjack's Thread of Illness and Ailments

Postby shmenguin » Thu Feb 14, 2019 9:05 pm

Outside of crack skull, possible broken neck or back or a broken femur, I’d probably head to an urgent care first.

One of my teams at work, this is basically their sole purpose in life. They do population health initiatives to try and direct people to the appropriate level of care for their need. We had a real issue with non emergency level patients flooding our ERs and it was a major financial burden.
Query. A few years ago I had a “time is of the essence” situation. I was having an issue where some markers in my blood were fluctuating, and it was very important that I get blood work done as soon as I felt a flare up happening to make sure the elevated markers were documented (if they existed). I also had general malaise, but nothing too terrible. If the blood came back funky I wasn’t in immediate danger, but the data collection was important.

It was late. Urgent care didn’t do blood work. So I went to the ER. They treated me accordingly, in that I had to wait 7 hours. But what say you? Foul play on my part?
Documenting trends in blood panels is not an emergency. I would have liked your pcp set you on a blood work schedule - probably two times a week - to track your results. That way you can assign an ouchie level in retrospect. Monday I felt awesome. Thursday I felt like death. Monday I felt like death. Thursday I felt awesome. You can do a dozen office/lab blood panels for the price of your er visit.
Lots to unpack here. “Price” for whom? For me, that’s not true. It costs me $25 for an ER trip.

I also did not have a PCP. I barely do now. They are appropriate for routine maintenance and a starting point in my case. I deal with specialists exclusively. There are some other details that take this out of the realm of a twice weekly plan being viable. It’s not the right data collection method for my situation. But put a pin in that. Not sure it’s relevant.

I was effectively the last man called back that night. 7 hour wait. And I thought that was appropriate. So I guess my question is, in practical terms, treating this as an isolated thing, what is the difference where I go?

This is just me asking. Not a defense.

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Blackjack's Thread of Illness and Ailments

Postby RonnieFranchise » Fri Feb 15, 2019 6:22 pm

I’m butthurt.

Seriously I pulled whatever connects my leg to my butt getting in the car and have an ice pack on my butt.

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Blackjack's Thread of Illness and Ailments

Postby tifosi77 » Fri Feb 15, 2019 9:18 pm

Outside of crack skull, possible broken neck or back or a broken femur, I’d probably head to an urgent care first.
Anything potentially cardiac is straight to ER; no fcking around with that. Same with respiratory distress. Anything potentially neurological in nature - seizures, slurred speech, fainting, concussion. Any laceration requiring stitches, especially on the head or neck region. Any severe traumatic injury, really. I'm not totally square with the idea of presenting any of those symptoms and being looked at by a PA.

All imo, of course.

Back around Thanksgiving, I had a run of around six or seven Dr visits, a trip to UC and two to the ER, all clustered in like a 2-week span. I had a staph infection on the side of my head, and ended up allergic to the antibiotic (sulfamethsomethingorother), and in all the hustle and the bustle of that I forgot to take the med for my hand tremor... which is a beta blocker, and after missing like four out of five days, my heart rate skyrocketed to like 180 bpm sustained for most of the day. It was essentially withdrawal from the med, but I had no idea of that, I just thought my heart was going to explode. I still have a little segment of a vein upstream of where they ran the IV that's..... 'hardened'? I guess that's the word. It doesn't hurt, but it's weird and annoying (like me, generally).

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Blackjack's Thread of Illness and Ailments

Postby Freddy Rumsen » Fri Feb 15, 2019 9:23 pm

Jesus

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Postby meow » Sat Feb 16, 2019 8:54 am

My original comment was directed toward fractures and breaks. Not cardiac or similar episodes

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Postby meow » Sat Feb 16, 2019 8:56 am

Outside of crack skull, possible broken neck or back or a broken femur, I’d probably head to an urgent care first.

One of my teams at work, this is basically their sole purpose in life. They do population health initiatives to try and direct people to the appropriate level of care for their need. We had a real issue with non emergency level patients flooding our ERs and it was a major financial burden.
Query. A few years ago I had a “time is of the essence” situation. I was having an issue where some markers in my blood were fluctuating, and it was very important that I get blood work done as soon as I felt a flare up happening to make sure the elevated markers were documented (if they existed). I also had general malaise, but nothing too terrible. If the blood came back funky I wasn’t in immediate danger, but the data collection was important.

It was late. Urgent care didn’t do blood work. So I went to the ER. They treated me accordingly, in that I had to wait 7 hours. But what say you? Foul play on my part?
Documenting trends in blood panels is not an emergency. I would have liked your pcp set you on a blood work schedule - probably two times a week - to track your results. That way you can assign an ouchie level in retrospect. Monday I felt awesome. Thursday I felt like death. Monday I felt like death. Thursday I felt awesome. You can do a dozen office/lab blood panels for the price of your er visit.
Lots to unpack here. “Price” for whom? For me, that’s not true. It costs me $25 for an ER trip.

I also did not have a PCP. I barely do now. They are appropriate for routine maintenance and a starting point in my case. I deal with specialists exclusively. There are some other details that take this out of the realm of a twice weekly plan being viable. It’s not the right data collection method for my situation. But put a pin in that. Not sure it’s relevant.

I was effectively the last man called back that night. 7 hour wait. And I thought that was appropriate. So I guess my question is, in practical terms, treating this as an isolated thing, what is the difference where I go?

This is just me asking. Not a defense.
I think I understand now. In retrospect, knowing you waited 7 hours before being seen, would you do it again or wait until the next morning and go to a UC?

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Blackjack's Thread of Illness and Ailments

Postby shmenguin » Sat Feb 16, 2019 9:18 am

I would do the same. Camping out and watching a few movies on the tablet isn’t the worst Friday night. My markers are very hard to predict, and these types of illnesses make you feel like it’s all in your head more days than not. I got a result that night and a doctor looked at me and reinforced that something is clincally wrong. It meant the world to ole shmengy. If I waited until the next day, those levels might have gone poof.

I went to the wrong hospital, though. That was my mistake. I like to keep all my records in one place, but that meant going to gunshot central in Philly rather than a mellow suburban place.

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Postby shmenguin » Sat Feb 16, 2019 9:40 am

I also wouldn’t do this at a regular cadence. This was the early exploratory stage. I’m now in the late exploratory stage where I sit around and criticize the field of rheumatology.

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Blackjack's Thread of Illness and Ailments

Postby blackjack68 » Sat Feb 16, 2019 10:03 am

I would do the same. Camping out and watching a few movies on the tablet isn’t the worst Friday night. My markers are very hard to predict, and these types of illnesses make you feel like it’s all in your head more days than not. I got a result that night and a doctor looked at me and reinforced that something is clincally wrong. It meant the world to ole shmengy. If I waited until the next day, those levels might have gone poof.

I went to the wrong hospital, though. That was my mistake. I like to keep all my records in one place, but that meant going to gunshot central in Philly rather than a mellow suburban place.
Virtua Voorhees

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Blackjack's Thread of Illness and Ailments

Postby shmenguin » Sat Feb 16, 2019 10:06 am

I would do the same. Camping out and watching a few movies on the tablet isn’t the worst Friday night. My markers are very hard to predict, and these types of illnesses make you feel like it’s all in your head more days than not. I got a result that night and a doctor looked at me and reinforced that something is clincally wrong. It meant the world to ole shmengy. If I waited until the next day, those levels might have gone poof.

I went to the wrong hospital, though. That was my mistake. I like to keep all my records in one place, but that meant going to gunshot central in Philly rather than a mellow suburban place.
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