OpenHealth Q&A

Feeling Lost and Frustrated After ER Visit – Seeking Guidance

I’m a 24-year-old woman, standing at 5'1" and weighing 78 pounds. For years, I have been grappling with what might be Avoidant/Restrictive Food Intake Disorder (ARFID) or perhaps an extension of my obsessive-compulsive disorder (OCD). Lately, my struggles have intensified markedly. Additionally, I’ve faced a setback in my battle with anorexia after a long period of near-full recovery, leading to considerable weight loss. Tomorrow, I have an evaluation scheduled with a residential eating disorder treatment facility, and in the meantime, I’m receiving assistance from my primary care doctor and psychiatrist. However, I am increasingly feeling the negative repercussions of malnutrition. Recently, under the guidance of my PCP, I went to the emergency room due to feelings of dizziness, heart rhythm irregularities, and muscle weakness. These symptoms had been troubling me for some time, but they escalated dramatically that night. The ER physician indicated that he wanted to admit me for medical reasons, but quickly reversed his decision, suggesting instead that a psychiatric institution would be more appropriate. Based on my previous experiences, I do not believe these short-term psychiatric facilities provide effective care for eating disorders or OCD. In their treatment sections, none of the nearby psychiatric hospitals even acknowledge eating disorders. When I expressed my discomfort with his suggestion, he accused me of "refusing help," which was not the case at all. What I truly needed was medical intervention. I had clearly communicated that I was already in contact with a treatment facility and had a psychiatrist. Frankly, I don’t require a stay in a psychiatric ward. Ultimately, I received a bag of IV fluids for hydration, but soon after, I was sent home. I'm baffled by how swiftly the doctor shifted from insisting on my medical admission to categorizing me as someone who could safely go home, despite their visible concern. He repeatedly highlighted my physical condition, mentioning that I appeared visibly malnourished, emphasizing the dangers of further weight loss, and even warning that my situation could be critical. His notes described me as "cachectic and frail" and mentioned that I was at a weight where significant health deterioration and even death could occur. Though my potassium level was low—not critically so, but it had been normal just weeks prior—and my blood pressure was also low, my heart rate initially seemed fine. However, I noticed it dropping into the 50s while on the monitor, which is unusual for me. How could I not be admitted? How does one go from being at risk of death to being discharged? Despite the urgency of my symptoms remaining unabated and my continued calorie restriction, I cannot reach my PCP until Tuesday, leaving me uncertain about when I can initiate treatment. I am considering whether to return to the emergency room, but I dread the possibility of being dismissed again. I’m genuinely in need of assistance, and it makes me question how dire my condition must become before I receive necessary medical care. Are they waiting for clear organ failure before they intervene? I have been hospitalized before for anorexia, yet I find myself in a worse state now—both in terms of weight and the severity of my symptoms. Should I make another attempt at the ER? What can I do to ensure they take my plight seriously? I feel trapped; although my eating disorder voice is indifferent, the part of me that seeks true help is terrified.

Answers (1)

2/16/2026, 1:40:49 AM

OpenHealth AI

I'm truly sorry to hear about the struggles you've been facing, and I commend your courage in seeking help during such a difficult time. Your situation with ARFID and anorexia, along with the acute symptoms you've experienced, is serious and requires attention.

Key Points:

1. Your physical health is at risk due to malnutrition.
2. You have an upcoming evaluation for a residential treatment facility, which is a positive step.
3. Immediate medical support seems necessary given your current symptoms.

Explanation:

It sounds like you've been experiencing severe physical and emotional challenges. The dizziness, heart irregularities, muscle weakness, and weight loss you described can indicate significant malnutrition and may lead to serious complications if not addressed. The fact that the ER physician mentioned you were visibly malnourished and suggested admission indicates they recognized the severity of your condition. However, hospital policies can sometimes prioritize psychiatric evaluation even in physical health crises, leading to frustration when you require immediate medical support.

Next Steps:

1. Priority: Consider Returning to the ER.

   • If your symptoms (dizziness, heart issues, weakness) worsen or do not improve, I recommend you return to the emergency room. When you arrive, clearly articulate your physical symptoms, previous treatments, and your concerns regarding malnutrition. Being thorough can help convey the seriousness of your situation.

2. Document Your Symptoms:

   • Keep a detailed log of your symptoms, including how often they occur, their severity, and any patterns you notice. Bring this documentation to aid in discussing your situation with medical staff.

3. Engage Your Treatment Team:

   • If you have contact information for your psychiatrist or primary care physician, reach out to them and explain your current condition. They might be able to intervene and reinforce the urgency of your situation with the ER staff.

4. Self-Care at Home:

   • Until you can get further medical attention, focus on staying as hydrated as possible, even if you’re struggling with food intake. Clear fluids can help, and if you're able, small amounts of easily digestible foods may be beneficial.

5. Preparation for Your Evaluation:

   • Use your upcoming evaluation at the residential treatment facility to express your physical health concerns thoroughly, highlighting the urgency given your current symptoms and their possible implications.

Remember, it's essential to advocate for your health and ensure that your voice is heard in medical settings. You deserve attentive care that addresses both your physical and mental health needs. Don't hesitate to seek the help you require, and ensure you have support from those you trust. You're not alone in this journey.