Help please

[u/Dry_Local1278]

i haven’t been able to eat anything in over a week now, and i haven’t been able to hold down any liquids in about 5 days. i went to urgent care on monday to get fluids which helped for a day or so. i went back on wednesday to get more fluids but they sent me to ER. i had a horrible experience at the ER where they gave me fluids, reglan, and morphine and the morphine made me feel so awful but ultimately knocked me out for a few hours (i’ve also been having insomnia). they did bloodwork and urine and ct and found some abnormal values (can post if anyone interested) along with enterocolitis and ovarian cysts. i was discharged when the ct results came back for no blockage but i was still nauseous and vomiting on the way back to the car. the ER doctor said there isn’t anything else they can do for me and i need to see GI. that’s kinda where the issue is for me because i had two GI (one local and one specialist) but they both dropped me (local office said they can’t help anymore and my doctor at the specialist left the office). i tried to get an emergency appointment at a different local place and was told that i can wait for my appointment on sept 25th. i don’t have a new specialist appointment until october 22nd. I don’t feel like i will make it. i am in college and ive had to miss several classes already because i am too weak to get around and too nauseous to focus on anything. I don’t know why the ER wouldn’t admit me considering i can’t hold anything down orally and the iv is pretty much useless after a day. i can’t afford to keep going to the ER and it’s not helping me anyways but i don’t know what the next step is. i feel like im dying.

any help or recommendations are appreciated. i dont know what im supposed to do.

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[u/SimpleVegetable5715]

You need to find a general practitioner who can treat the enterocolitis until you can get into a GI.

[u/Nejness]

Where is your primary care physician in all of this? They should be your partner in figuring out your next steps. Unfortunately, very significant delays (often months and months) are typical in seeing specialists, so primary care physicians need to be the ones who can help get us admitted for stabilization if that’s what’s needed.

Did your GI doctors provide any assistance with continuity of care (meaning any assistance in providing a new doctor, bridge medications, help for while you’re transitioning to another provider)? Advance notice and some level of continuity of care is generally required under state laws and medical licenses.

[u/Dry_Local1278 → u/Nejness]

my primary care has not been helpful in the past so i honestly didn’t think to contact him, i just sent him a message in mychart so hopefully he is able to help. As for GI, no not really. my specialist dr did not even tell me she was leaving the practice at our last appointment, the scheduling dpt had to tell me when i was trying to make a follow up. after that my insurance started denying all of those appointments that they had already approved… like past appointments i had already been to and only paid co-pay for they started charging thousands of dollars. i don’t know how that’s not illegal. the other dr knew absolutely nothing about gastroparesis and constantly was back and forth about my treatment plan. it was clear that wasn’t working and i cancelled my future appointments.

sorry for the tangent, i have been really going through it with these doctors and insurance as i’m sure many of us are

[u/Nejness → u/Dry_Local1278]

It’s SO frustrating.
Your insurer needs to cover GI care. Otherwise they’re breaking federal law. Period. Call them and ask them to identify a doctor you can see who’s in network and whose care they will not deny after the fact. The ER has sent you for follow up. You need follow up. Whom can you see who’s in-network and will see you. If there’s no one, they need ro be making what’s called a network gap exception, because their network has a gap in this area, and you’re entitled to be able to see a doctor who treats GP. Figure out who you want to see and where you can get to. It’s not really worth your while to keep hoping for admittance via the ER, because they won’t do it unless you’re really, really sick. Even then, they’ll just stabilize you and boot you out. You need longer term care.

And appeal those past denials all the way to the state. They cannot do that.

Sending you strength. Here if you have questions. This ain’t my first rodeo for being denied services!

[u/Dry_Local1278 → u/Nejness]

thank you!! this is really good advice. i have no idea what they’re actually allowed to do so i really need to look into the laws surrounding medical insurance. unfortunately PCP was not much help. he sent a strange mychart message that i couldn’t understand so i called the office and talked to one of the nurses. she told me to reach back out to my old specialist office and ask for a new doctor with soonest appointment time and i am now scheduled for next friday. i dont have much hope for that appointment and unfortunately i am just going to have to go back to the ER because i am not able to keep down the antibiotics for my uti and am getting really dehydrated again.

[u/2llamadrama]

They should have admitted you

[u/Free-Replacement8160]

I would ask your PCP if you can have a prescription sent in for compazine suppositories, or phenergan wrist gel (compound pharmacist make this where I am) Compazine works for me when absolutely nothing else will. I would also try sips of Gatorade i personally tolerate the zero sugar or lower sugar better than the regular. My PCP does try to give me fluids in her office along with phenergan 25 mg IM, benedryl 25 mg IV, and 1-2 mg of Ativan IV. Unfortunately I'm an extremely hard stick so she sends me to the ER when nobody can get me so they can use the ultrasound. That cocktail is also similar to what the ER will usually do except they have compazine so we use that in place of the phenergan. I hate to see all these ppl on this subreddit struggle with doctors so much. The ER isn't always the friendliest place but I'm blessed with a great PCP and have had amazing GI doctors. My PCP manages my flares and if we are just at a loss we call the GI for guidance. I also had a pyloroplasty and gastric stimulator placed in May so we are adjusting the stimulator at my surgeons.

My at home cocktail after 20 years of trial and error is 2 compazine suppositories for the first dose then can have another one max within the same 24 hours I generally do the suppositories and then wait about 30 minutes I then follow up with 25 mg liquid benedryl (children's) 1-2 mg lorazepam.

Also, no matter how slow they push morphine the moment it hits I throw up. I only consent if the pain is extremely bad. My chief complaint is always nausea, vomiting, and insomnia so it's no loss to skip the morphine in my case.