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Pauline
Pauline, Doctor (MD)
Category: Health
Satisfied Customers: 8631
Experience:  Medical Doctor & Registered Pharmacist. Worked as Community pharmacist for 17 years.
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Should I go back to the ER

Customer Question

Should I go back to the ER?
Submitted: 8 years ago.
Category: Health
Expert:  Pauline replied 8 years ago.
Hello, can you tell us more about your problem and the history around it?
Expert:  Pauline replied 8 years ago.

Did you have any investigations, scans or tests when you were at the hospital?

What treatment or medication have you been given?

Customer: replied 8 years ago.
I was given Vicodin. They said I have to wait for my pap results. I had a pelvic exam and a pap smear done.
Expert:  Pauline replied 8 years ago.

Thanks for the extra information.

Did they mention any possible causes of your problem?

Did they do abdominal ultrasound?

Are you sexually active?

Have you been using any contraceptive tablets/implants/injection or coil?

Where is the pain now?

Any fever?

Any changes to bowel motions or urine?

Customer: replied 8 years ago.

Did they mention any possible causes of your problem?

No. I had a surgical abortion on December 13th, so I'm guessing the chronic bleeding is from that.

 

Did they do abdominal ultrasound?

No

 

Are you sexually active?

January 24th was the first time I had sex since the abortion.

 

Have you been using any contraceptive tablets/implants/injection or coil?

I'm on the Depo shot.

 

Where is the pain now?

Lower abdomin.

 

Any fever?

98.1

 

Any changes to bowel motions or urine?

I've been urinating a lot more.

Expert:  Pauline replied 8 years ago.

Thanks for the extra information. I assume that from examination they have ruled out a post-surgery infection and the normal temperature also supports this.

 

Depo provera can, in the early months of use ,cause heavy and unusual patterns of bleeding. It can also cause abdominal pain but as the pain is increasing in severity then I would have been inclined to run a pelvic ultrasound to look for possible causes, including any post-abortion complications. This allows full examination of ovaries (rules out cyst and torsion) as well as the uterus.

 

This increase in bleeding and pain does require being checked over again however I feel that you would be better served at a gyn clinic who can give you an adequate assessment although I understand that cost may be a factor.

 

The other thing that needs checking is your hemoglobin. Bleeding for this duration does suggest that you are at risk of anemia which can lead to dizziness. I would also check a urine sample to rule out an incidental urinary tract infection.

 

So you do need to be followed up, you need to determine which facilities local to you can give the best treatment. A course of hormones may reduce the bleeding once other problems have been ruled out.

 

 

Customer: replied 8 years ago.
So, I don't need to go?
Expert:  Pauline replied 8 years ago.

You do need to be followed up, my concern is that the ER may not be the best place for a full assessment.

 

Increasing pain is one reason to go to ER. And we should also remember that there are other possible causes for abdominal pain including appendicitis, obstruction, pancreatitis etc.

 

I would like you to be seen by a Gyn, but only you can decide whether you have the money for that consultation if there are no non-profit clinics or teaching hospitals close to you.

Customer: replied 8 years ago.
Alright, I will have to go to Planned Parenthood on Monday.
Customer: replied 8 years ago.
Vomitting is not a symptom of anything?
Expert:  Pauline replied 8 years ago.

Vomiting can occur due to pain, intestinal infection and side effect of some medication.

 

How bad has the vomiting been?

Customer: replied 8 years ago.
Once or twice a day.
Expert:  Pauline replied 8 years ago.

If you have been vomiting for a long time then this can contribute to dehydration and electrolyte imbalance. A blood test will help understand if this is a problem. If the vomiting has been continual since your procedure in December then I would suggest that you get blood hormone levels checked as this may be a factor.

 

 

Customer: replied 8 years ago.
I got my blood taken at the ER and they did tests. If there was a problem, they would have found it it, correct?
Expert:  Pauline replied 8 years ago.

Depending on the tests performed then yes. although it depends how quickly the results came back. I assume that they did not discharge you until blood test results were available.

 

 

Customer: replied 8 years ago.
Yes, they even gave me a sheet of how my blood tests went. Apparently, my red blood cell count is low. But, I suppose, it is to be expected if I've been bleeding for over a month.
Expert:  Pauline replied 8 years ago.

Yes, your low blood count is to be expected however you will need to have follow up treatment such as iron supplement (depending on the exact level)

 

If this has been helpful, please remember to click the accept button.

 

Regards

Pauline and other Health Specialists are ready to help you
Customer: replied 8 years ago.
I now have a 99.5 temperature and I'm extremely dizzy and nauseous.
Expert:  Pauline replied 8 years ago.
As temperature is rising together with dizziness then you should go back to ER for an acute assessment. Infection needs to be ruled out as well as other causes of acute abdominal pain.