# When to go to ER?



## f1307

Today was a really bad day. I have felt bad all day. Heart palpitations and confusion and just pure exhaustion. Diagnosed with graves over week ago. I have a goiter as well my first appt to see endo is April 6. This may sound like a stupid question but when do u know when u should go to the emergency room? I don't want to go if they r just gonna say it's a side affect of graves and send me home with a huge bill.


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## AngeInBoston

I'd like to leave this to someone with more experience than me, but it definitely sounds like you should be seeing your Dr. sooner than another month away! Are you on any meds yet? Heart palpitations are scary and can trigger an anxiety attack. My daughter's Dr. told us to go to the ER if she had a fever that hit 101, but I don't know about the other symptoms.


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## f1307

A month is the soonest I could get in to dr. No meds have been prescribed yet. Just have to tough the month out. Just not sure how bad I should let it get before going to ER.


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## lavender

Sorry to hear you're feeling so lousy. I have been in your shoes and the decision of when to get emergency care can be murky at times. I had chest pain, was having a hard time breathing and was very dehydrated when I called the squad (the paramedics didn't take me seriously, but hospital did and kept me for two days). I probably should have gone a lot sooner, but I honestly had no idea how sick I was.

I had to wait a really long time to see my endo as well and ended up being hospitalized because I had no treatment. Found out from the doc at the hospital that family docs are perfectly qualified to prescribe meds to treat hyperthyroidism. Mine just didn't, which I think was negligent. If your family doc won't treat you now, find someone who will. Risking your life while waiting to see an endo is unacceptable.

I think if your heart rate goes above 100, especially if it goes above 120, it's time to go. My current doc told me if I was having heart palpitations and started to feel dizzy or fatigued that I should go to the ER and either have someone else drive or call the squad.

Assuming you are in the US, If you have a hard time paying the ER bill, you can call the hospital billing department and ask to file an HCAP application when you get your bill. You will have to send in some financial records. They will look at your income and put you on a sliding fee scale after your insurance pays. I have done this many times, and even spoke with the financial department while I was in the hospital to start the process. And as long as you pay at least $5 per month, they can't send your bill to collections no matter how long it takes you to pay.

From the NIH website: http://www.nlm.nih.gov/medlineplus/ency/article/000356.htm
"Thyroid crisis (storm), also called thyrotoxicosis, is a sudden worsening of hyperthyroidism symptoms that may occur with infection or stress. Fever, decreased mental alertness, and abdominal pain may occur. Immediate hospitalization is needed.
When to Contact a Medical Professional

Call your health care provider if you have symptoms that could be caused by too much thyroid hormone production. Go to an emergency room or call the local emergency number (such as 911), if you have:

* Change in consciousness
* Dizziness
* Rapid, irregular heartbeat"

Another NIH website:http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001437/

"Thyroid storm is a life-threatening condition that develops in cases of untreated thyrotoxicosis (hyperthyroidism).

Thyroid storm results from untreated hyperthyroidism. It is usually brought on by a stress such as trauma or infection.

Symptoms are severe and may include:
Agitation
Change in alertness (consciousness)
Confusion
Diarrhea
Fever
Pounding heart (tachycardia)
Restlessness
Shaking
Sweating

Signs and tests
The top number in a blood pressure reading may be high
Increased heart rate
Blood tests are done to evaluate thyroid function.

Congestive heart failure and pulmonary edema can develop rapidly and lead to death.

This is an emergency condition. Call 911 or another emergency number if you have hyperthyroidism and experience symptoms of thyroid storm."


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## desrtbloom

I'm sorry you are having such a rough time. How about an Urgent Care versus the Emergency Room. At least you can get evaluated and if the doc at the Urgent Care thinks you should be treated at the ER then you could go. Also, I agree that a lot of family docs can treat you until you can get into the endo.


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## f1307

Thank you so much! I have a call into my Dr. this morning. I am so glad I found this site. Does anyone know of any books on graves that are helpful? I have tried to explain this disease to my family but I don't think they really understand how bad it is.


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## Andros

Farris1307 said:


> Today was a really bad day. I have felt bad all day. Heart palpitations and confusion and just pure exhaustion. Diagnosed with graves over week ago. I have a goiter as well my first appt to see endo is April 6. This may sound like a stupid question but when do u know when u should go to the emergency room? I don't want to go if they r just gonna say it's a side affect of graves and send me home with a huge bill.


Thyroid Storm (hyper) is an emergency!

Thyroid Storm Symptoms
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001437

Symptoms are severe and may include:

•Agitation

•Change in alertness (consciousness)

•Confusion

•Diarrhea

•Fever

•Pounding heart (tachycardia)

•Restlessness

•Shaking

•Sweating

There is more so please use the link and read the information. Take your temperature.

Have you not been put on beta blocker and antithyroid medication?

No question is stupid. Ever!


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## desrtbloom

Hi Farris:

I find a lot of great information on the Graves' Foundation site and they provide all types of information on publications regarding Graves' Disease.

www.ngdf.org

What did the doctor say?


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## happysunshine

I was in the same boat as you when first diagnosed, I ended up in er with a tachicardia ( severe fast heart rate) the nurses were surprised that I was not on any meds yet. Sorry to say but drs treat thyroid patients like ****, we are never told anything always kept under the rug and it's like here take a blood test and I see you in 6 weeks. Stuff that, you need to get on some medication, even if you see another GP. Also I know it's hard but try to relax, stress makes it worse


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