OpenHealth Q&A

Concerns After ER Visit Without Clear Results

Age: 34, Female-to-Male Transition, Height: 5'4", Weight: 160 lbs, Ethnicity: Caucasian, Country of Residence: United States. Diagnoses include Bipolar II disorder, anxiety disorder, PTSD, gender dysphoria, sleep apnea, and potential rheumatoid arthritis (RA). A month ago, lab tests indicated increased rheumatoid factor levels. I have experienced persistent body pain, joint inflammation, mild fevers, fatigue, diminished muscle strength, and night sweats for over 15 years. I am currently awaiting an appointment with a rheumatologist. My medical history includes positive results for Jo-1 antibodies and elevated C-reactive protein (CRP). Recently, I experienced a two-month flare-up of symptoms. Current medications consist of 2 mg of Abilify, 200 mg of Lamictal taken twice daily, 30 mg of Buspar taken twice daily, 125 mg of Effexor, and testosterone injections. For about a week, I have been intermittently suffering from chest discomfort, palpitations, and an elevated heart rate, which I initially attributed to anxiety. On March 13th, the chest pain intensified, my heart rate remained above 120 beats per minute even at rest, and I felt faint. My wife insisted that I visit the ER, thinking it necessary. Upon arriving, I noticed the emergency department was extremely busy, likely due to staff shortages. During triage, I recounted my medical history, and the attending nurse inquired if I thought the symptoms were related to anxiety or a panic attack. I clarified that this sensation was entirely dissimilar to any panic attacks I had previously experienced, which had only occurred three times in my life after particularly traumatic events. The nurse responded somewhat dismissively, suggesting it might be anxiety nonetheless. They conducted an EKG, blood tests, and a chest X-ray. After several hours of waiting without any updates, I was informed that I would be discharged with instructions to see my doctor. I left without receiving any results or clear information, feeling mentally exhausted and overwhelmed. The following afternoon, I received an email notification indicating that my lab results were available online. The tests reflected low levels of carbon dioxide, while the chest X-ray indicated mild pulmonary vascular congestion. I can't help but wonder if these findings warranted further investigation while I was in the emergency room. I felt thoroughly overlooked. My next appointment with my primary care physician isn't scheduled until April 25th, and I am contemplating whether I should seek a second opinion at another emergency department, especially since my symptoms persist. Is it advisable to return for further assessment?

Answers (1)

3/17/2025, 1:30:55 PM

OpenHealth AI

It's understandable to feel frustrated and concerned after your recent ER visit, especially given your complex medical history and ongoing symptoms. Here’s a breakdown of your situation and suggested next steps.

Key Points:

1. Persistent Symptoms: You've experienced significant symptoms like chest discomfort, elevated heart rate, and ongoing joint inflammation.
2. Lab Findings: Recent tests indicated low carbon dioxide levels and mild pulmonary congestion, which may need further evaluation.
3. ER Experience: It’s common for patients in busy ERs to feel overlooked, but your concerns about your chest discomfort are valid.

Explanation:

Your symptoms, especially the chest discomfort and elevated heart rate, combined with your chronic conditions, merit attention. While anxiety can play a role, these symptoms could also indicate underlying issues needing further assessment, particularly given your recent lab findings. Low carbon dioxide levels and pulmonary congestion can suggest respiratory or cardiac concerns that should not be ignored.

Next Steps:

1. Monitor Your Symptoms: Keep track of your symptoms, including heart rate, chest pain intensity, and any new developments. This information can be helpful if you seek further medical attention.

2. Hydration and Rest: Ensure you stay hydrated and get adequate rest to help manage fatigue and support your overall wellbeing.

3. Consider Returning to the ER: If your chest discomfort worsens, you experience severe shortness of breath, or if your heart rate remains elevated, it's important to seek immediate medical attention. Given your symptoms and lab findings, another visit could provide the clarity you need.

4. Prepare for Next Physician Visit: Compile your symptoms, the timeline of their occurrence, your ER experience, and lab results to discuss with your primary care physician when you meet them on April 25. This can help them understand the urgency and the need for further investigation.

5. Explore Alternative Emergency Care: If you're contemplating a second opinion, research local urgent care or emergency departments that may have shorter wait times. Bring along your records to ensure they have complete information.

Empathy & Reassurance:

It’s completely normal to feel overwhelmed in this situation. You know your body best, and your concerns are valid. Trust your instincts about your health, and don’t hesitate to pursue answers until you feel satisfied with the guidance you receive. You're advocating for yourself, which is crucial in managing your health. If you need more help, I'm here to guide you.