A trip to the Emergency Room

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swalker

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We wound up making a trip to the emergency room earlier this week.

I was woken up by significant pain in my ankle. I have a rheumatological condition (mixed connective tissue disease) that causes periodic joint pain, so a bit of an issue with a joint is not something I get terribly excited about.

But, this seemed different. The pain was quite a bit worse than I have experienced before, my ankle was warm to the touch, and I was running a fever.

After much discussion with my wife, we decided to call my primary care physician. She was out of the office and there no one else in the practice available to see me. That practice also runs an urgent care clinic and they encouraged us to go there. So, off we went.

That pactice was purchased by our local hospital and within the last week it was relocated to be physically in the hospital. It turns out that the urgent care clinic is now in the same suite in the hospital as my primary care physician's office.

I arrived and checked in without issue. Since I know they take folks based on order of severity rather than order of arrival, I was very glad to see that they took back someone who needed stitches removed. So, my issue was obviously less severe than getting stitches removed.

I was even more relieved when they took back a family of 6 for covid vaccine booster shots. My issue must have been judged to be really trival! Things were looking good.

Eventually, it was my turn. They examined me and then left the room to consult with their colleagues. They came back and encouraged us to go to the emergency room. They said the likely diagnostic options were either a septic joint or gout. They escorted us to the emergency room and made sure I got checked in OK.

We spent about 5 hours in the emergency room. Along the way, they were strongly leaning toward a diagnosis of an infected (septic) joint. They briefed my on what I could expect when the tests confirmed that. If it was septic, I was looking at being admitted to the hospital, etc. etc. None of that sounded good at all.

After many tests, a bit of poking and prodding, and examining some fluid they extracted from my ankle, they concluded that I had gout.

They sent me home with some drugs and asked that I contact my primary care physician the next day.

I am improving and seem to be doing pretty well. I sure hope this is a one-off attack of gout and not something that will happen again!

Here are some interesting tidbits from the ER visit:

1. I did not bring my bipap, as I usually don't need it when I am sitting up in my wheelchair. But, I did start to feel pretty short of breath. Saying you are short of breath in the emergency room sure gets you lots of extra attention. I had to communicate that my breathing normally sucks and that, while I was short of breath, I was not in tremendous distress.

2. They initially requested that I transfer out of the wheelchair onto a bed in the ER. My wheelchair is very comfortable and the bed looked very uncomfortable (no support for my arms or my thoracic area). They were fine when I explained my needs and let me stay in the wheelchair.

3. While I have been using a wheelchair for over 7 years, I can still stand a walk a few paces on my own. The affected ankle is in my "strong" leg. It is amazing how much that affected my mobility. I should have anticipated this and had things in place before hand, but I did not. We are working on that now. Meanwhile, getting from my hospital bed (at home) to the bathroom has been a bit more adventurous than normal.

Steve
 

Nikki J

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I am sorry that you went through all that Steve and hope that you are soon much better. Your point about what to do if something happens to your stronger side is important. I have worried about it but I admit have not made any plans or preparations.

good for you for speaking up about staying in your chair.

and indeed breathing issues command attention pretty quickly in the ED.

wishing you swift recovery. Keep us posted when you can
 

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Hope this is resolved quickly Steve!
 

KimT

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That's a relief, Steve. Gout can be managed. I know it was painful but not life threatening.

Good reminders about preparations.

I ended up typing a "handout" for emergencies and try to keep it updated as things progress.

The reason I was approved for my PWC so early was that I sprained my "good" ankle and was hopping around for several months. This put my back out and I was living in my lift chair and bed when the PT and OT came over for the evaluation.

I hope you're feeling better soon. Did they tell you to drink a lot of pure cherry juice or eat cherries?
 

swalker

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Kim, they did not mention cherries or cherry juice, but we read about it on the internet (from reliable sources). Cherries are one of my favorite treats and we were well supplied with them even before the trip to the emergency room. I have eaten a lot of cherries in the last few days.

The challenge going forward is that I cannot take most of the drugs that would normally be prescribed for gout. Due to other health issues, I cannot take NSAIDs, or other drugs typically prescribed for a gout episode or to reduce the likelihood of a future gout attack.

It appears that I am limited to tylenol, steroids, and narcotic pain killers. I have chosen not to take the narcotic pain killers and have settled on the relief provided by tylenol and steroids.

Steve
 

Samkl

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Why cherries, Kim?
 

KimT

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Cherries reduce uric acid and uric acid causes gout.
 

wishmobbing

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Steve, hope you find relief and this stays a one-off, good it wasn't something septic!

I didn't know that about cherries, Kim. They're gaining extra points on top of being incredible delicious.
 

KimT

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Supposedly the real dark ones are best. Tart cherry juice, too.

Steve, I hope today finds you in less pain.
 

Narrowminded

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Steve,

So thankful it was only gout. I don't get here often anymore, but did manage to catch this post. You are in my prayers.

Hugs
 

swalker

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Thank you everyone for all the support and suggestions!

Tomorrow it will have been a week since we made the visit to the emergency room.

I have carefully followed doctors orders and have seen much relief from the discomfort over the last few days.

I am very much weaker now than I was a week ago! My body is just not able to handle this kind of insult as well as it was a decade ago!

Steve
 
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