Emergency Care vs. Urgent Care: Seeking Help After a Medical Abortion
I am a 34-year-old woman weighing 190 lbs, with a medical background that includes two cesarean sections and a diagnosis of long COVID alongside endometriosis. On July 25th, during a visit to a carespot, I discovered that I was expecting. I was also informed I had bacterial vaginosis (BV). Although I was prescribed vaginal medication, I hesitated to use it extensively due to concerns about my ongoing abortion process. Prior to starting the abortion, I consulted with my obstetrician, who performed my last two cesarean sections (the latest on December 26, 2024). He assured me that the risk of uterine rupture was minimal and gave me the green light to proceed. On July 1st, I followed the protocol from a reputable organization and began taking the abortion pills. Initially, I experienced a typical week of bleeding and cramping. This was followed by a quiet week of minimal bleeding with no cramps. However, just a few days ago, I abruptly began to experience intense bright red bleeding accompanied by severe, sharp pain localized in my right pelvic area and hip. I have faced discomfort in this region intermittently since my cesarean sections, but the current episode is more excruciating than previously encountered. The pain is so intense that it brings me to tears, even after taking 1000 mg of Tylenol. I only manage to find slight relief for a few hours before the pain returns with a vengeance. Additionally, I took 0.25 mg of Klonopin to alleviate the tension and anxiety I am feeling. The discomfort has started to radiate from my right abdomen to my hip, thigh, and down into my leg. While I don’t have a fever, I’m experiencing cold-like symptoms, including nasal congestion, postnasal drip, and green mucus production, although I’m uncertain if these are related to my current situation. Is this kind of bleeding and pain typical after such a procedure? Should I visit urgent care, or is a trip to the emergency room warranted? I worry about burdening the emergency department but also have doubts about whether urgent care could conduct the necessary tests adequately. Moreover, my regular OB is two hours away, as I’ve relocated and haven’t established care with a new provider yet. Thank you for any advice; I’m feeling quite anxious about my condition.
Answers (1)
8/15/2025, 5:02:20 PM
OpenHealth AI
It sounds like you’re experiencing a concerning situation following your medical abortion, particularly with the severe pain and bright red bleeding. Here’s a structured breakdown of your situation and recommendations on how to proceed:
Main Points
- Severe Pain and Bleeding: Intense pain and new symptoms after a medical abortion may require immediate medical evaluation.
- Urgency of Care: Given the nature of your symptoms, it’s crucial to seek help promptly.
- Consideration of Care Options: Understanding the difference between urgent care and emergency care will help you choose the appropriate facility.
Explanation
After a medical abortion, especially within the context of your history of cesarean sections and endometriosis, it’s important to recognize that while some bleeding and cramping can be normal, sudden changes such as intense bright red bleeding and severe localized pain are not typical and could indicate complications.
Your symptoms of sharp pain radiating from your right abdomen to your leg, combined with heavy bleeding, may suggest conditions like retained products of conception or other issues that could necessitate medical attention. The fact that over-the-counter pain relief hasn’t provided sufficient relief further heightens the need for evaluation.
Next Steps
-
Seek Emergency Care: Given your severe symptoms (intense pain and significant bleeding), you should go to the emergency room rather than urgent care. They can conduct the necessary examinations, including an ultrasound if needed, to assess your condition thoroughly.
-
Document Symptoms: Before you go, note down:
- The onset and progression of your bleeding and pain.
- Any other symptoms (like the cold-like symptoms and their duration).
- The medications you have taken and their effects.
-
Prioritize Comfort: While waiting for care, try to stay in a comfortable position and consider using a heating pad on the painful area if it helps ease discomfort (avoid any excessive movement).
-
Stay Hydrated: Ensure you are drinking some fluids, unless monitoring your intake is difficult due to the pain or bleeding.
-
Manage Anxiety: Given the anxiety you’re experiencing, continue to practice calming techniques such as deep breathing until you receive care. Reach out to a friend or family member for support during this time if possible.
It’s understandable to worry about possibly burdening emergency services, but your health and safety are paramount. Don’t hesitate to seek the help you need.
Related Questions
Understanding Abductor Hallucis Muscle Herniation
Greetings everyone, after enduring two months of significant discomfort in my foot, I've finally received the results from my medical tests. It turns out I’m dealing with a herniation of the abductor hallucis muscle in my right foot. I won’t consult with my physician until Thursday of next week, and I'm curious about the typical procedures that follow such a diagnosis. The herniation measures 9mm; is that considered substantial? If surgical intervention is necessary, is there a possibility of remaining awake during the procedure? The thought of general anesthesia frightens me. What should I expect in terms of treatment for my foot? I’ve heard that this condition is relatively uncommon, which adds to my anxiety. I'm prone to overthinking things, and now I worry about the possibility of losing my foot or complications arising, like restricted blood flow while I await treatment. For some context, I’m a 30-year-old woman, standing at 5'9. Any insights would be greatly appreciated!
Concerns About Mid-Cycle Bleeding
Hello everyone, I hope this isn't too personal, but I could really use some guidance. For the past three months, I've been experiencing unexpected bleeding around the middle of my menstrual cycle, which has left me feeling uncertain. Normally, my periods are consistent, and I have never had issues with mid-cycle bleeding prior to this. Typically, my cycle spans from 28 to 33 days, with a duration of about four to six days. Here's a breakdown of what I've noticed: - **June**: I experienced light spotting from cycle days 13 to 15. - **July**: This spotting repeated itself from days 13 to 15 and also occurred on days 21 and 22. - **August**: As of today, I'm on cycle day 11 and have begun to observe some light spotting again. While these episodes are generally accompanied by mild cramps, they’re not severe enough to be considered painful. I'm wondering if anyone has insights on what could be causing this? I intend to reach out to my doctor on Monday to arrange a visit. Any thoughts or hypotheses on this would be greatly appreciated!
Concerns About an Absent Period Without Pregnancy
I haven't seen my menstrual cycle since June 23rd, making it 24 days overdue now. I missed my entire period in July, and I'm anxious that I won't see it return this month either. At 17 years old and weighing 105 pounds, I've always had regular cycles without any past delays. I'm seeking answers desperately, as I can't visit a healthcare provider because my mother would jump to the conclusion that I'm expecting and react strongly. I have an upcoming appointment for birth control soon and hope to get some guidance there.
Unfortunate Hyaluronic Acid Injection Experience
Hello, I’m a 32-year-old woman, and in 2018, I received a diagnosis of Grade II osteoarthritis in both of my knees. This was somewhat expected, given my history of painful growth spurts in childhood. At that time, I was employed as a dog walker, enduring persistent and debilitating knee pain. A friend suggested I consult a sports medicine specialist, which I was eager to do since I have a history of being an athlete, particularly as a former competitive swimmer. My aim was to manage the osteoarthritis in the least invasive manner possible. The doctor recommended hyaluronic acid injections for both knees, and regrettably, my insurance approved this course of action. During the injection in my left knee, I experienced excruciating pain and cried out in agony. I felt faint, but the physician accused me of moving too much. I assure you, it was an involuntary reaction. Even as I was reeling from shock and near unconsciousness, he proceeded to inject my right knee. The pain was so intense that I nearly blacked out. I expressed that I was feeling unwell, but he brushed aside my concerns, claiming, "some people are just more sensitive." He then insisted I was free to leave. I tried to explain that standing would likely cause me to pass out, yet he informed me he had another patient awaiting attention and urged me to exit. My mother and the receptionist had to support me to a chair in the waiting area. I sat there for 20 minutes before I felt steady enough to make my way to the car. By then, my knees were excruciatingly painful and felt as if they were under immense pressure. Approximately an hour and a half after the procedure, the pain escalated dramatically. My knees swelled to the point where I felt like passing out and was on the verge of vomiting. The spasms in my knees and thighs resembled severe cramps, and they swollen to a size comparable to basketballs. This incident occurred on a Friday, and the physician didn’t respond to any of my messages. Residing in a two-story house, I found it utterly impossible to walk, let alone descend the stairs. Sadly, the lack of initial care was compounded by further neglect from both my family and the hospital visit that came when I eventually managed to get down to the ground floor. The aftermath of this procedure was devastating: I spent nearly a month confined to bed, grappling with fever and intolerable pain. I faced a significant decline in mobility, almost losing the ability to straighten my legs. The long-term repercussions of this experience exceeded my original ailment: a Baker’s cyst, aggravation of my arthritis and osteoarthritis, removal of both menisci, chronic pain, persistent swelling, and significant limitations—crouching, sitting for extended durations, standing, or even lying down comfortably required a pillow beneath my legs. Now, I’m seeking answers: what might have transpired above my knees that causes that area to feel colder than the rest of my legs and results in diminished sensation? In 2019, I walked an average of 12 kilometers daily, and this year, I can finally say I feel close to full recovery. The pain has subsided, my legs appear significantly stronger, I can almost crouch for over a minute, and I feel confident enough to consider running again. Nevertheless, I still experience an unusual, “dead” sensation in the area just above my knees that often feels cold to the touch. To this day, I remain uncertain whether the doctor mislocated the injection site or if I had a severe allergic reaction. I suspect it could have been pseudoseptic arthritis, as I developed a high fever and my urine was dark and reddish. When I finally reached the emergency room, the attending physician, who identified himself as a “spine bro,” had no insight into my condition and discharged me without conducting blood tests or providing any pain relief. Initially, my injection specialist advised against taking anti-inflammatories. After voicing my struggles repeatedly, he prescribed Tylex (a combination of acetaminophen and codeine), which did nothing to alleviate my pain. For two weeks, I endured severe discomfort with no effective treatment until he ceased responding to my calls and refused further consultations. At this juncture, my sister, a veterinarian, urged me to begin taking anti-inflammatories. I eventually consulted a private knee specialist who was appalled by my condition and prescribed corticosteroid injections, which significantly improved my quality of life. Thank you for your understanding, and I apologize for any errors in my English, which is not my first language!
Concerning CA19-9 Levels: Unexpected Weight Loss Without Answers
• 19 years old, assigned female at birth • Weight: 137 lbs, Height: 5'6" • Current Medication: 10mg Focalin • Diagnoses: PCOS, OCD, ADHD, anxiety, and depression Since December 2024, I've experienced a dramatic weight reduction of over 100 lbs, dropping from nearly 240 lbs to my current weight of 137 lbs. I have undergone extensive medical evaluations including comprehensive blood panels, colonoscopy, endoscopy, x-rays, and CT scans of the chest, abdomen, and pelvis, in addition to physical examinations, yet no conclusive answers have surfaced. We've ruled out numerous possibilities, and it feels as though my situation might simply be attributed to a natural physiological shift. The only notable finding from my most recent blood test was a CA19-9 antigen level of 61. While my doctor mentioned this isn't alarmingly high, it is sufficient to warrant attention. Additionally, my free T4 was slightly elevated, but my physician did not seem to think it was a cause for concern. As previously stated, all imaging tests returned with normal results. I do not use any drugs, and I do not engage in vomiting, either intentionally or otherwise; in fact, I rarely experience significant nausea. What I do encounter is intense hunger that strikes every three hours, making it exceedingly painful at times, regardless of my previous intake or quantity. Eating on an hourly basis has become essential to avoid losing weight at a rapid pace of five pounds every five days, which is becoming increasingly frustrating. I have a follow-up appointment scheduled for this coming Friday to retest my CA19-9 levels, and I suspect it will remain elevated. Despite the antigen's sensitivity, it feels like we might not have captured it at its peak. I am also set to have a transvaginal ultrasound for ovarian examination soon, and a family friend who is a physician recommended I inquire about a thyroid ultrasound as well. Overall, I feel somewhat lost regarding the next steps to take, which is why I'm reaching out here. - If my test shows elevated levels again, what additional diagnostic measures can we pursue? - If it returns normal, what could have accounted for these symptoms? I’ve been told that various potential causes, even the more alarming ones, are unlikely, leaving me uncertain about what could be the root of this issue. Thank you for any guidance you can provide! :)