RadicalRNAdvocate

As someone with multiple chronic illnesses, where do I go when I am in a flare?

Today I had to go to my local Urgent Care facility and I am so relieved I went there instead of the emergency room. I have been experiencing a POTs flare for the past 10-14 days which has been barely mangaged.

I was trying to wait for my cardiologist appointment, which would have been the day after my urgent care visit. I didn’t make it because of my symptoms of lethargy, increased dizziness, brain fog, pain, elevated heart rate, and just not feeling myself.

I did not have chest pain, severe shortness of breath, a severe headache that wouldn’t go away or other symptoms that would mean I was having a significant emergency. Our local Urgent Care, since we are very remote in our location, offers alot of services. The main ones I listed below. Not all Urgent Care centers have everything listed so please make sure the one close to you has what you need.

Some key difference between Urgent Care and Emergency Room

Here is a summary of my experience at the Urgent Care today.

I arrived and signed in, did some basic paperwork and insurance information. I only waited an hour. While I was waiting there is no medical professionals that have seen me, or have received report. So you have to feel stable enough to wait for care in order to use an Urgent Care (UC) instead of an emergency room.

A nurse took me back, obtained a quick basic vitals and history. I voiced my concerns and that I really needed some IV fluids (if the provider thought it was appropriate) and also quickly explained how I tried to manage this on my own and was not able to anymore.

I waited a little longer in the exam room then the Nurse Practitioner came in to see me. Obtained so more pertinent details and agreed to give me fluids, an ekg, rapid flu and covid tests and ordered labs for me to get outside the clinic to check my thyroid.

Nurse came back with co-worker, one worked on setting up IV fluids while the other got my 12-lead ekg. I am a hard “stick” when it comes to IVs. So the one nurse tried 2x, the other RN tried once and then they got one of the NPs who is like their IV Guru to try. They also have a basic vein finder that locates veins but does not tell them depth.

They were getting the 24 gauge needle in but due to my veins being small they kept blowing. So I felt this was the first limiation I experienced vs if I went to the ER they would have possibly moved to more invasive measure to start an IV.

I was not severely dehydrated so we decided to let it go and the NP did not feel I needed to go the ER. She prescribed me zofran for nausea and to help me better hydrate by mouth.

The whole trip was about 2 hrs or so. Some would ask if it was worth it. For me hearing my EKG was normal and that they felt I could wait for my cardiologist appointment the next day alone made it worth it.

I want to clearly state here while you are reading that this blog does not count as medical adivce, nor can it direct you in this specific situation you are experiencing. I am just wanting to provide you with basic understanding of the more general differences.

I am very medically complex and I was pleased today with the care I received today. That being said if you have illness that are not normally controlled, or if you have a history of hospitalizations that also would be a reason to go the ER.

Conditions most appropriate for Urgent Cares

• Ear infection
• Small lacerations
• fractures of limbs that the bone is not exposed
• sprains or strains
• colds, flu, covid (without shortness of breath)
• moderate pain acute or chronic

Conditions/symptoms for ER

• Chest pain (signs of heart attack or stroke)
• Anaphalaxis (severe allergic reaction)
• significant trauma (broke ribs, concussion etc.)
• deep wounds
• animal bites
• pregnancy complications
• Uncontrolled bleeding

This morning, I felt lost and unsupported when I woke up. Despite not actually receiving the fluids, which was my motivator for seeking care, after my 2-3 hour UC visit was completed, I felt significantly better.

I had a plan to get through the next 26 hrs until my appointment. I had 4 people help me, and I had/have peace of mind. I knew, leaving urgent care, a little more clearly what I should go to the ER for in this specific instance.

As you can see (or read really), Urgent Cares can be a great resource in outpatient care.

I do want to say again, please remember that this small blog does not replace direct care, nor is it medical advice on what to do the next time you are experiencing an acute change in your health. This is just for basic education purposes. Every situation is different, every urgent care is different and there is no way for me to guide you through a computer in specific moments.

I wish you many spoons, low symptom days and providers that listen.