For the last week I’ve been battling really awful stomach cramps. This is not a new symptom at all. It’s a very common one. What’s new is that that none of my rescue medications are really working to resolve it. It’s kind of like when you start laughing and then you can’t stop and you can’t breath because you can’t stop and then your ribs actually start to hurt because you can’t stop.
I’ve been faced with a lot of those moments where I’m like: this is getting pretty bad. Perhaps I should go to the emergency room instead of sitting here on my bathroom floor hysterically grabbing for Zofran tablets?
But now that I have the port–many of what used to be “emergencies” can be taken care of at home. Eureka! I can now inject non-narcotic pain killers and nausea medication straight into my blood stream. This is a life-saver. However, I have also just figured out that it is not an end game to my flare.
No, in fact the ability to define when I am past the point of no return has become more blurred than ever. Between stomach cramps, migraines, and general other situations where it just goes to far–I’ve had to make some definitive rules about when I really have to take things to the next level.
Here are some (but not all, because hell, new ones get introduced everyday) rules to when I decide I need to go to the emergency room:
1. Medication Failure
Generally my first clue that I have a problem is that I’ve taken a rescue medication and it’s had no (or maybe just not enough of) an effect. I know that oral medications are not as powerful as injectables, and sometimes they just mess me up worse by having to travel through my distorted digestive system. If a combination of a migraine and a pain medication have failed–it is time to go to the ER.
2. Nutrition Issues
I’ve gone considerably long periods without solid foods before–but most often that’s when I’m hooked up to an IV 24/7 with a heart monitor and little-to-no activity. If I’m having trouble keeping anything down at home for more than three days with no improvement (because if I’m somewhat improving, I’ll probably manage it on my own) then I go to the ER. Generally it goes regular food–> Solid food bland diet–>liquid food bland diet—> Ensure–>gatorade–>check into the hospital.
3. When It Should Not Be Doing That
Is your eyeball bleeding? Is brain matter leaking out of your left nostril? Are you hallucinating? If you are, I would highly recommend you find a way to your local ER as soon as possible. My body may be pretty messed up, but I can generally tell when something is “normal awful” and when something is “abnormally awful.”
4. When I Am Exhausted From Pain/Hunger/Dehydration
Pain, hunger and dehydration are all part of the chronic illness experience. (Did you get your ponchos?) But everyone has a breaking point. If it’s been weeks, or even just a particularly rough few days where symptoms have been unmanageable and the fatigue has worn you through to the point where you can’t take care of yourself. What do I mean by that? I mean you can’t go to the kitchen to get food. You can’t get out of the bathtub once you’ve sat down. You can’t figure out what pills you’ve already taken…Time to put your well-being into the hands of someone who has already had their coffee/adderall.
5. When Your Pain is Out of Control
When I get the whole “What is your pain level on a scale from one to ten” question, I’m always like: why? I only have two levels of pain: bearable and unbearable. If the pain was bearable I would not be in this waiting room. I’d be at home with a heat pack in my nice, cozy bed. Signs of unmanageable pain are: crying, hyperventilating, visible cringing, cold sweats, continuous dry-heaving, losing vision temporarily, being unable to control your deep breathing, and bitchiness. Bitchiness goes up to like a level 12. So if you ask me what level of pain I’m in, I hope you like being talked down to by a girl in pajama pants that say “tough cookie” on them.
Anyways, there’s like a 84% chance I’m going to end up there tomorrow because I can’t get it together, so I thought I’d do this preemptively. You are welcome.