OpenHealth Q&A

Am I Making a Mistake by Waiting for Outpatient Care?

I’m a 45-year-old female and I have a strong suspicion that I might be suffering from acute pancreatitis. However, I’m wondering if it’s foolish of me to postpone seeking immediate care at the emergency room as my partner suggests, opting instead for an outpatient appointment scheduled for tomorrow. I would really appreciate any guidance or insights you might have on this situation. Although I do have a gastroenterologist, I haven't consulted them recently because I was considering switching doctors. Apologies for the lengthy and somewhat chaotic description; my medical history is complex and I was uncertain about what details were essential. Currently, I measure 5’3” and weigh 142 lbs, down from 151 lbs. Background Information: I underwent laparoscopic cholecystectomy in 2020 due to gallstones that caused significant symptoms. Unfortunately, I faced serious complications starting ten days post-surgery. In hindsight, many of the symptoms I experienced then bear a striking resemblance to my current condition, albeit more intense. I was admitted to the hospital in a great deal of distress and underwent numerous imaging procedures, but only received ambiguous feedback, hinting at possibly missed stones. Eventually, I recovered and was diagnosed with bile reflux. Over the past couple of years, I have had several lab work results that alarmed both of my primary care physicians, displaying concerning figures that lacked clear correlation. For instance, I once had a dangerously low iron level recorded at 2 in 2024, attributed to heavy blood donations without any confirmed basis. Other tests showed irregularities in red blood cell size and shape, as well as reds indicating potential fatty liver. Yet, I have never received a definitive diagnosis that ties everything together. Additionally, two different gastroenterologists have recommended follow-up testing like the breath test and pill cam, but both times my attempts were thwarted by equipment malfunctions alongside my relocations between states. I could attempt to retrieve my latest lab results if they would be helpful. The current health issue began last Tuesday at 2 AM with severe vomiting, experiencing temperature fluctuations (alternating between sweat-soaked and shivering), and feeling relief only while laying on the shower floor as warm water cascaded over me. I also struggled to find a comfortable position, initially dismissing it as a virus exacerbating my existing back pain. My symptoms likely included a fever as I experienced chills and looked excessively pale. I initially thought it was just a bug or something I ate. Looking back, I had been experiencing increased diarrhea in the weeks leading up to this event, along with significant itching. By Day 3, I noticed an unpleasantly foul odor accompanying my oily diarrhea, reminiscent of a Clostridioides difficile infection, which raised concerns (I previously worked as a pediatric psychologist in a hospital). After several days of no improvement, my partner discovered some checklists online corresponding to pancreatic issues, and I essentially matched the criteria for pancreatitis. I had radiating pain in my upper abdomen extending into my back, which was alleviated somewhat by bending forward. There were episodes of mild swelling in my upper abdomen, occurring both after eating and at random times, which wasn’t relieved by burping; it was extremely sensitive and seemed a bit swollen at the base of the sternum and underneath. Additionally, I experienced shortness of breath unless curled up in a fetal position, as any upright movements left me feeling exhausted. While my stool consistency returned to normal, the abdominal pain and swelling persist intermittently, and I feel lethargic when I’m not in bed (likely due to the shortness of breath). I didn't realize the situation involved pancreatitis until Friday evening. I desperately want to avoid hospitalization, so I’ve been adhering to a clear liquid and BRAT diet, attempting to fast, but I had a painful episode even after consuming just ginger ale earlier today (Sunday). That discomfort subsided, allowing me to eat after a brief interval. I try to stagger my medications and skip those that aren't absolutely essential (like my daily allergy medication) as certain medications appear to escalate my pain. Interestingly, I previously experienced something strikingly similar in 2024, believing then it was connected to an unusual virus. I seldom drink alcohol, but I did have a glass of prosecco around 36 hours before my symptoms began as part of a celebration. My drinking habits are rare, typically limited to 1-2 occasions each month with only 1-2 drinks, or I might go months without any alcohol. I have no history of heavy drinking; my consumption was moderate in college and my twenties. For pain management related to my chronic back issues, I use cannabis, as it doesn’t disrupt my sleep like Percocet does. I smoked tobacco for approximately 13 years at half a pack daily but quit 14 years ago. I have never had any issues with jaundice. Diagnoses: narcolepsy, hypothyroidism, chronic spine pain from a past fall with multiple fractures requiring fusions, spinal cord stimulator in place, bile reflux, non-diabetic hypoglycemia, ovarian cysts, persistent acne, unipolar depression, and anxiety. Current Medications: - Levothyroxine 88 mcg - Methylphenidate 36 mg in the morning - Duloxetine 120 mg (two 60 mg doses) - Pantoprazole 40 mg twice daily - Buspirone 60 mg (two 30 mg doses) - Spironolactone 100 mg - Progesterone (micro) 100 mg - DIM - Magnesium glycinate 400 mg - Daily Allegra - Vitamin B12 - Fentanyl patch 25 mcg every three days - Oxycodone/acetaminophen 10-325 mg, three times a day - Diclofenac 75 mg as needed - Baclofen 10 mg as needed - Occasional multivitamin - Tylenol

Answers (1)

2/15/2026, 8:20:50 PM

OpenHealth AI

Given your symptoms and medical history, it is important to be cautious regarding your decision to wait for outpatient care. Your concerns about potentially having acute pancreatitis, especially considering your previous complications with gallstones and abdominal issues, warrant prompt medical attention.

Main Points

• Acute pancreatitis can be a serious condition that requires immediate evaluation.
• Your symptoms, such as severe abdominal pain, vomiting, and changes in stool, suggest you should seek medical care sooner rather than later.
• Prioritize seeking emergency care if your symptoms worsen, especially with severe pain, fever, or persistent vomiting.

Explanation

Acute pancreatitis is inflammation of the pancreas that can be triggered by various factors, including gallstones or alcohol consumption. Your history of gallbladder issues and the nature of your current symptoms (such as intense abdominal pain and changes in bowel habits) raise concern for this condition. The fact that you are experiencing significant discomfort and difficulty lying comfortably further indicates a need for timely assessment.

Given your complex health background and the serious nature of your recent symptoms, waiting may not be advisable. While outpatient care can often handle various conditions, symptoms like yours might require immediate intervention to prevent complications.

Next Steps

1. Seek Immediate Medical Attention: I strongly recommend that you visit an emergency room instead of waiting for your outpatient appointment. This is especially important if you experience severe abdominal pain, persistent vomiting, or any signs of worsening symptoms.

2. Monitor Your Symptoms: While preparing to seek care, keep track of your symptoms, including the intensity of pain, any new symptoms, and excretory changes. Note any potential triggers (like specific foods or medications) that worsen your discomfort.

3. Prepare Relevant Information: Have your medical history handy, including your previous diagnoses, medications, and any recent labs. This will help emergency staff understand your situation quickly.

4. Hydration and Diet Management: Continue with clear liquids until you are evaluated. Avoid solid foods until you receive guidance from the medical team, as further intake may exacerbate your symptoms.

I understand this is a challenging situation, and seeking immediate care may feel daunting. However, your health and safety are paramount, and it’s better to err on the side of caution by getting evaluated sooner. Please take care of yourself and seek help promptly.