I'm going to die and puke- in that order

December 11, 2014 9:45 PM

I'm a 20 year old female. Since Tuesday morning, when I drank a glass of milk at lunch on an empty stomach, I've been feeling awful. Nausea and stomach pain got worse Tuesday night. I called my school's on call doctor and they told me to try and wait it out till the morning.

I went to health services in the morning and the nurse practicioner recommended that I go to the ER if I felt like I needed to. She said there was the possibility I might have appendecitis. I went to the ER and they did blood work, urine test, some exams and an ultrasound. Evertying was normal. They gave me some IV saline and stomach meds, which didn't help. They sent me home with some zolfran and pepsid (anti nausea and stomach meds).

Now it's Thursday and I still feel really awful. I'm super nauseous and tired. I can keep food down but everything I eat makes me feel gross, even water. I keep gagging and burping like I'm going to throw up but I can't. I wish I could. I'm achy all over, especially the radius around my belly button. Basically my whole abdomen aches..Tonight I've had a bad headache I've been to sleep off to no avail.

I'm really upset that I got sent home from the ER since I wasn't feeling better, but I understand that they don't really want to keep you there if they don't need too. I just don't know what to do. I've spoken to my school's doctor who called to see how I was doing, and she said to wait it out for a week if I can and follow a BRAT diet (which I am).All of my family has said the same thing and to be patient. The hospital said to come back if I'm in more pain, vomiting and or have a fever.

I'm so frustrated that I'm sick and feel so miserable. I don't want to go back to the ER or doctor's office because I don't want to seem stupid or panic-y, especially when they can't do anything for me. I feel like it's wrong for me to be suffering like this, but on the other hand I'm not dying. I just don't know what to do. Any thoughts?

posted by starlybri to Health & Fitness (27 answers total)

Response by poster: (Also I've been sweaty on and off).
posted by starlybri at 9:47 PM on December 11, 2014

I am not a doctor, etc, but I have chronic stomach problems which means any stomach illness/flu really sets me off.

1) Drink LOTS of water and mix in some gatorade/sports drink of choice for electrolytes. Sip it slowly and gently. You're probably dehydrated which is causing the headaches.

2) Try some ginger ale - I'm talking the real stuff like Reed's brand or anything with Ginger in the ingredients list. Lemon ginger tea or mint tea will also suffice but doesn't have the bubbly aspect to help the burps come up.

3) SOUP. Again it helps with liquids and is easy to digest.

4) If you don't start feeling better or get worse by sometime tomorrow, give the doctor a call. Often you can reach a nurse or PA on the phone and ask them if you should come in or if there's anything else to do. They may even have a same day appointment.

Really, this sucks but it's only been since Tuesday so personally I wouldn't be alarmed. Don't feel stupid for going to the doctor though. I've gone in for what I thought was "stupid" stuff and have had doctors say "I'm glad you came in."

Edit: Have you taken your temperature? Body aches, headaches, and sweaty can mean fever. If so you can revisit the doctor or call them and ask what to do. Even a fever can be normal for a stomach borne illness.
posted by Crystalinne at 9:57 PM on December 11, 2014 [1 favorite]

I can't know what's up with your body and I'm not a medical professional, but when I have had stomach acid issues, Pepsid hasn't done anything at all. Sipping some baking soda in water helped, as did Prilosec. I would probably not start messing with Prilosec if I was having random pains and didn't know what was going on (and it takes several days to do anything anyway), but I probably would try baking soda in water. Baking soda is not a great strategy for dealing with stomach acid problems in the long term, but it can bring some relief for stomach acid problems in the short term.
posted by needs more cowbell at 10:01 PM on December 11, 2014

Did you try the Zofran and Pepcid? (Prilosec is also a reflux medication, but it takes days to work, so I wouldn't recommend using it instead) Maalox is another over the counter medication for stomach upset and reflux-type symptoms that is fast acting (doesn't taste great but it tastes better than baking soda straight, I think!). For headache and body aches, have you tried Tylenol or ibuprofen? Unfortunately, if it's suspected that you have a viral type gastroenteritis (and I'm assuming that's what the docs who saw you have been thinking based on their recommendations), then there really is no miracle cure - you can only treat the symptoms. Symptoms like body aches and headache tend to go along with these illnesses. They are miserable but generally not life threatening.

The hospital is not a benign place to hang out (there are bad superbugs and lots of other sick people hanging out there, and they're constantly bugging you for vital signs and making noise so it's hard for you to rest), so I think you should be thankful you got sent home instead of admitted. I'm a doctor myself (although not your doctor, of course!) and so I'm biased, but I do think it's important to remember that the emergency department's job is to determine whether you have any life or limb threatening medical problem, whether you have an issue that requires you to be admitted to the hospital or to undergo surgery emergently. Once their evaluation is complete and they've gotten you to the point that you can be safely discharged, they will discharge you so that they can free up a bed for other patients with potentially emergent problems. 'Safe for discharge' doesn't mean that you feel 100% better, it can just mean that the pain is tolerable and that you're able to keep down fluids and medications, even if your stomach is still upset.

Also, keep in mind that the ER always advises you to return if you have any worsening or new and concerning symptoms, like inability to keep down fluids or medications despite the Zofran, high fevers and chills, lightheadedness, or worsening pain. If you feel your symptoms are worsening, then you should return for a re-evaluation because the testing is not perfect and serious diagnoses can occasionally be missed - by retesting them several days later, things may have changed and they may find something different. If your symptoms are just not getting better as fast as you want them to, then your best option is primary care, where they might be able to offer you better medication options for symptom relief or might recheck your labs as an outpatient, or something like that. It's definitely not 'nothing', but I think what you probably mean by "they can't do anything for me" is that they specifically can't get you feeling much better/cured immediately, which, if you have a viral illness, is likely to be true. Sorry, and hope you feel better soon.
posted by treehorn+bunny at 10:26 PM on December 11, 2014 [12 favorites]

Can you tell us more about what kind of pain you're feeling? Sharp? Achy? The nausea may be a symptom of your illness, or may be a side effect of the pain. (Pain makes us nauseated. As does anxiety over unresolved pain issues, so do try to distract yourself.) You say the pain is around your navel -- is it generally equidistant and not more painful on one side vs. the other? Are you experiencing any pain on the right side of your abdomen (perhaps if you press in and then release, it hurts on release)? Are you experiencing a backache or ovarian pain? Is it possible you are constipated and/or impacted? (Though one imagines the ultrasound would have shown this.)

Some of what you're describing (the burping) may be ameliorated if, when you are sleeping/resting, you stay on your left side.

I'll +1 the ginger, but you also may relieve the nausea by pressing firmly on/below your inner wrist, about three fingers' width from the joint. (Acu-pressure. I have wrist bands with marbles sewn in -- great for migraine-related nausea.)

You mention that you have been sweaty, but did not mention whether you are taking your temperature. Be sure that you take it frequently -- every three hours, perhaps -- but not immediately/soon after drinking cool fluids, as that will skew the results. Note: sometimes, viral things cause your temp to decrease; don't be freaked if you are 97.2 or something.

{Hugs.}
posted by The Wrong Kind of Cheese at 10:32 PM on December 11, 2014 [1 favorite]

Diphenhydramine is the active ingredient in Benadryl, Dramamine, and Unisom. It's an antihistamine that has significant sedative and anti-emetic side effects. Because of those side effects, it's wonderful for getting through bouts of norovirus (stomach flu) or bad hangovers where you just want to curl up somewhere dark and quiet and die to the world. It makes you drowsy, so you sleep, and it lessens the nausea, also so you can sleep.

I'm sorry you feel terrible! It'll go away soon.
posted by sportbucket at 10:45 PM on December 11, 2014 [6 favorites]

Response by poster: Update:I'm taking my medicine and will try the baking soda and the food/drink suggestions. I had a slight fever 99.2 when I went to the clinic but it dissappeared when I went the ER. I'll check my temperature every few hours.

The pain alternates between achy and sharp in random places. My back is sore, but it might be because I'm really tired (usually happens if I don't sleep well.) It's mostly painful below my belly button and it hurts when
I press in, not release.

Also thanks for the general suggestions and advice. I think they'll be really helpful.
posted by starlybri at 10:47 PM on December 11, 2014

You might try Gas-X. This is my completely uneducated opinion but it could be a giant gas bubble formed by a bad germ or something in the process of digesting the milk that needs help getting out.
posted by bleep at 10:48 PM on December 11, 2014 [5 favorites]

And when I say uneducated I mean I'm not a doctor or a pharmacist. But I did used to get really painful gas bubbles especially around stressful times like college finals.
posted by bleep at 10:52 PM on December 11, 2014

Usually the ER does a CT for a suspicion of appendicitis because ultrasounds don't always show what's going on in the appendix. I think you should get more medical attention ASAP.
posted by third rail at 11:05 PM on December 11, 2014 [4 favorites]

Probiotics and digestive enzymes... May help, and won't hurt you. The latter pulled me through a nasty bout of gastro not too long ago.

Hope you feel better soon.
posted by jrobin276 at 11:31 PM on December 11, 2014

Seconding gas. Drinking cold milk on an empty stomach might do it. Old wives tale of course but your symptoms sound similar. What bleep said.
posted by infini at 11:43 PM on December 11, 2014

Gas doesn't give you a fever. An attack of diverticulitis will cause you to have fever because material gets stuck in the diverticula, bacteria go to town on it and pus forms. It will also have you in pain for days, nauseated with no appetite, food doesn't taste good in my experience just as you describe this gross feeling after eating, and you absolutely will have a pain in your lower abdomen, especially centring in your lower LEFT quadrant (opposite from your appendix). Probiotics will do nothing for you. It might pass on its own but a course of antibiotics is always recommended for a diverticulitis attack just in case.
posted by ethnomethodologist at 12:02 AM on December 12, 2014 [4 favorites]

Drinking milk on an empty stomach can trigger nausea. Along with the fever and cramping, which changes in duration and intensity, it sounds like you have a mild stomach bug. These are nasty little viruses that can make you feel awful for weeks. We had one going around here that gave a person 3 days of hell, a week of feeling so so, and then a one day repeat of the following week. Get some rest and try not to worry. If the pain is so bad that you cannot sleep or walk, then go back to the e.r. In the meantime, avoid dairy and eat really bland, boring foods, in small amounts throughout the day. Don't let your tummy get all the way empty.
posted by myselfasme at 12:14 AM on December 12, 2014

I got a GI bug while I was in college and I'm certainly no physician, etc, but it felt a lot like you're describing and it took about a week to clear up. No particular food made it feel better because it was basically just needing to run its course. My lower belly in particular felt really tender. I just stuck with bland food and plenty of fluids until it got better.
posted by Sequence at 12:22 AM on December 12, 2014 [2 favorites]

2nding diverticulitis. Is the pain worse after eating? Avoid food for a few days - plenty of fluids, paracetamol and rest. Keep an eye on your temperature too. Take acetaminophen for the pain and fever You may need antibiotics if it doesn't resolve itself after a few days.
posted by missmagenta at 3:20 AM on December 12, 2014 [1 favorite]

Is there any chance you might be pregnant? If so, make sure they check you for ectopic pregnancy which can cause all sorts of odd pain and aches according to a friend who had one.
posted by mareli at 4:56 AM on December 12, 2014 [2 favorites]

Are you urinating well? Do you have any pain with urinating, or are you feeling frequent urges where only a little comes out? It's a long shot given all of your other symptoms, but aching localized to the belly button can sometimes be referred genitourinary pain. If you're having the belly button pain and any symptoms with urination, it may be worth visiting primary care again to have a repeat urine test.
posted by telegraph at 6:00 AM on December 12, 2014 [1 favorite]

I agree with third rail that despite the negative tests, appendicitis is still a possibility. So I vote that you go back to the ER.
posted by merejane at 6:29 AM on December 12, 2014

Usually the ER does a CT for a suspicion of appendicitis because ultrasounds don't always show what's going on in the appendix. I think you should get more medical attention ASAP.

This is absolutely misinformation, and it's important that you and anyone else reading this question knows it. A CT scan is NOT required to diagnose appendicitis and in fact, physicians are very much encouraged to use ultrasounds of the appendix whenever possible (i.e. whenever the patient is thin enough that ultrasound might be successful) because CT scans are not benign, and it only takes a few abdominal CT scans to raise your cancer risk for the rest of your life.

IANYD but I strongly believe in the need to reduce unnecessary CT scans. They're expensive and they're harmful!

On another note, diverticulitis in a 20 year old would be quite unusual. It takes time for diverticulosis to form in your body. Approximately 1-2% of people under 30 have diverticulosis (the condition that predisposes to diverticulitis), whereas by the age of 80, over 50% of people have it. Only 10-20% of people with diverticulosis will ever have diverticulitis. Just FYI.
posted by treehorn+bunny at 7:57 AM on December 12, 2014 [6 favorites]

Vis a vis the above: I would just like to say that this happened to me: I had severe stomach pain. I did not want a CT scan because I'd already had several and was wary of radiation. **This was at a highly ranked hospital in 2012.** The ER, and my own doctor, first agreed to give me a sonogram instead for my severe stomach pain because I was so reluctant to get another CT scan. The sonogram did not show anything, and my pain continued. The ER doctors at this hospital, as well as my private physician, told me that a CT scan was now necessary to really rule out appendicitis since the sonogram did not show anything, and specifically they said that sonograms often could not really visualize the appendix. They convinced me to agree to the CT scan.
SO, I would like to say that, though I respect T & B, and unnecessary CT scans are to be avoided, there are certainly other ER opinions than hers about the ultimate diagnostic reliability of sonograms in the suspicion of appendicitis, and if someone needs a CT scan to rule out a burst appendix, I hope they get one -- or AT LEAST get more medical attention as I advised.
posted by third rail at 9:06 AM on December 12, 2014

I've had many of the same symptoms due to ovarian/uterine problems. (Gas, nausea, indigestion, fever, pain; eventually, these symptoms led to constipation, vomiting bile, rebound tenderness, kidney pain, and a host of other seemingly stomach-related issues.) I have also been repeatedly sent home by doctors and the ER with these symptoms (and returned to the hospital weeks, or even days, later for treatment as major as surgery). I think the problem is often that ER doctors see benign cysts and fibroids so often that they are inclined to dismiss them; these masses are very common and usually do not cause major issues. I've had ER doctors do pelvic exams and see "nothing", or review ultrasounds and fail to mention cysts or fibroids -- but upon followup, gynecologists found serious issues that had been there for a while and were the cause of my symptoms.

Check back with the doctors you've seen and ask if they saw fibroids or cysts on the ultrasound; if so, follow up with a gynaecologist, as she will better be able to distinguish between benign and problematic masses. As I said, these issues are incredibly common and likely not the source of your pain, but I think it's worth a follow up at least.
posted by lesli212 at 9:08 AM on December 12, 2014

A couple other ideas to try asking doctors about: lactose intolerance, IBS?
posted by capricorn at 9:36 AM on December 12, 2014

Your description sounds a lot like gallstones. It's usually diagnosed with ultrasound and bloodwork, though, which you've had, but still.
posted by Violet Hour at 10:44 AM on December 12, 2014

The place you went to said to go back if you have more pain, vomiting, or have a fever. If you're having more pain, vomiting, or have a fever, you should go back.

I'm appalled to read most of the comments here. Most of you are not doing anything to help this person apart from shotgunning diagnoses which may result in either dangerous acceptance of persistent symptoms or ridiculous and negligent justification for overtesting and worry.

Please: before jumping into the fray with what you think is going on, consider whether or not and how your words may help or hurt someone. Justifying guesses with anecdotal experiences is foolish noise.
posted by herrdoktor at 2:10 PM on December 12, 2014 [3 favorites]

Speaking as someone who had gallstones before her cholecystectomy to remove her gall bladder, the pain was always quite severe. Like laying on the floor of my bathroom, sweating profusely and occasionally throwing up I was so much in pain pain. It was also very very episodic. I'd have all this pain then it would suddenly disappear. It did not linger as your symptoms seems to be.

If you really are having these problems still you should seriously think about going to the emergency room again, or at least an urgent care center. If anything it will give you peace of mind, even if you feel like you people will think you are "panicky." You don't wanna mess around with this stuff.
posted by tittergrrl at 2:48 PM on December 12, 2014

Response by poster: Update:
I spoke to the school doctor on the phone (the same one who saw me first and she said that it might be stress or a stomach bug. I told her that I had pain when I eat, so she said no food, only liquids like water and gatorade. She also said to give it 24-48 hours for me to feel better.
I'll follow that, and as I said earlier, if I have any severe symptoms I'll go to the ER.

Thanks so much for everyone's concerns and opinions. I've read all the answers and feel more reassured that even though I feel awful, I probably don't have anything serious going on. :)
posted by starlybri at 3:10 PM on December 12, 2014 [1 favorite]