justifying hospital

Am I the only one who feels they need to come up with a really good reason to go into hospital? I so often will spend a long period of time thinking 'i probably need to go in - but i cant let them see me as well as this or they'll think im a wuss' kind of thing. I know that i leave it longer than i should - there are a lot more majors beds than resus beds, i usually go to resus, when surely the best time to go in is when you need to go to majors...and yet i cannot get my head round that! I feel the need to apologise, minimise symptoms, shrug off pain/nausea etc and justify why i came in, even if theyre not in any way implying i shouldnt have come - in fact usually they're complaining i left it too late. I also know in myself that they're a lot more sympathetic and kind if you are more unwell and as I am pretty phobic and stressed by docs and the whoe A&E environment - the idea of them telling me off for being there is overwhelming - thus the appeal of being undeniably ill.

I have a similar thing with 999. I know that i shouldnt drive in when i do decide to go - it would be incredibly irresponsible - i wouldnt like to think of being on the roads with people in the state im in when i go. I'm also a poor student (*sob* *sniff*) and dont usually have much cash on me to get to A&E in a taxi, so if im on my own im pretty stuck as to how to get there. again - i know that if any of my mates were that ill, id not question that they needed and ambulance and blue lights and sirens - yet because im ill so often i feel like i should be able to cope better with it. does that make sense??

being at uni - the main way i justify the whole thing is by the number of drunk or hungover students get an ambulance to A&E and stay there for a good few hours...but that doesnt really help much. does anyone else think like this - or have any thoughts as to how to convince my brain im doing the right thing???

11 Replies

  • Therapy ;)

    Whilst I said that tongue in cheek, it might help you shift your thinking. I don't get options as I live with a husband who also happens to be a doctor. If I didn't, certainly in the past I would have left it too late. Almost being ventilated in ITU changed my attitude. I don't like hospitals or ambulances - who does, but one particular incidence brought home to me the real risk of death (not just from the asthma but because of that combined with my severe restrictive lung disease) and I'm sensible now.

    I don't think you're alone in that, not at all - but it's not helping you manage your health responsibly. And to that end, my tongue in cheek suggestion was also a serious one :) x

  • hehehe! i spend a ot of time hiding from my GP sis!! hehehe! and medical friends! In fact, even my non-medical friends nag me, so i scurry off to my room! i think afterwards i forget how bad it was. I tend to remember just the fact that i was pretty well when i left the hospital, and not the state i was when i got there. i find esp if theyve given me morphine/cyclizine (which makes me a bit high) in A&E i tend to think i wasnt that ill - which is ridiculous because obvs they dont give morphine out like sweeties, but it does have an amazing way with making me forget what it was like!

    I am getting some councelling at uni - obvs they're not really trained with medially stuff but might have some ideas! Frankly i feel sorry for my councellor - im booming howing at the moon me!! hehehe!

    its so strange - if it was someone else id not let them wait even nearly as long as i do - but when its me i feel like im making a fuss! glad its not just me! silly brains!!

  • Soph my asthma's not as bad but can really relate to this as you probs know! So much! I feel like I absolutely can't go before I'm hacking and hacking and can't talk properly - reason being that I feel if I go any earlier I just won't get treated because I'm 'too well' and like you I hate the thought of them saying 'so why are you here...?' As a non-wheezer I find that's particularly the case as I feel I have to wait till my chest is doing something definite (ie going a bit quiet and not shifting air) before I can get help or I'll just get the 'well it sounds fine, no wheeze'. I still do get that at times from drs who don't know how to do it properly and are only interested in wheezing. Grrr. And when there I am atypical and numbers can look ok though I have also done the mag/resus thing even with that so assuming they are going on something else.

    For me, it also doesn't help (and you know all about this Soph so won't go on too much) that every time I see my cons he gives me the third degree about why I went, asks me if I 'thought I was going to die' (apparently the ONLY valid reason to go even though a) I don't think about that as my attacks are not at that level and that's not how I respond and b) I thought you were meant to catch them before they got too bad?). He has a go about my PF being ok ie not below 50% (despite the fact that it's not that reliable for me and when I go I can't really talk properly and am following guidelines) and apparently about my ABGs being ok (because I am psychic and can predict that,,,) - I have pointed out I have had NOT such great ABGs with a PF of 66% of best so if I did what he wanted and waited for it to drop to below 50% they might have been rather worse.

    He also seems to think A&E will just dismiss me as being mad, and that if they do treat me for asthma (which actually they almost always have so far and done it fairly well despite me being terrified they won't) they are being overcautious, admitting me is always unnecessary and overcautious and 'just scared junior doctors' and if he'd been there he could have come and told me I didn't need to be there. So basically I am meant to know that only his advice should be followed and I should ignore others...

    Apologies for anyone who's heard that moan before, but that definitely does affect my decision-making re hospital and makes me want to leave it as late as possible - which I feel like I might be able to get away with now but probably isn't ideal and I don't think having someone put it in an asthmatic's head to ignore guidelines and other medical advice is the best idea. I was already inclined to leave it anyway now I have experienced hospital as I do not like it and am not one to jump at the first sign of trouble, plus now I do have what might politely be called hang-ups about being told I am anxious/overdoing it/don't have asthma/don't need to be there. ugh.

  • Philomela - you could be describing my thoughts! I sit around for hours thinking should I phone/go or not. I do think I better now at explaining my symptoms and emphasising that I don't wheeze but over the past few weeks a few doctors have started to indicate that I could be worries/panicking and that there is no real indication that I am in any danger. I also refused to see one nurse over Christmas because last time I saw her she said I was just going round to different people to get what I want - I'm not quite sure what that is but didn't appreciate it from a senior nurse!

  • Hi Soph, no you definitely aren't the only person who thinks that they need to have a really good reason to go into hospital. I can remember my first admission I was sent by the walk in centre to A&E and was genuinely shocked to be taken so seriously - was still talking and all!! But then as the admissions became more frequent and I encountered the whole anxiety/in your head etc stuff which we have already spoken about I became more and more reluctant - its not difficult to find an excuse not to go when 1. you really really dont want to be in and 2. you are worried that you might come across someone who doesn't take you seriously.

    Like you, when I do end up in I always go through resus - cant remember the last time I didn't. Usually end up in HDU and more often than not have several ICU reviews. Its not good and quite frankly its dangerous.

    I will say though hun, leaving it that late is not a good idea - my last attack REALLY scared me and talking to my consultant have a much stricter plan of when I have to go in - if pf at any point drops to 50% or I need nebs 2 hourly or more frequently. Unless I have a really sudden type 2 attack I am not allowed to go to A&E not talking. My consultant and nursing staff and a few medicy friends have said that with the severity of the last attack things could have been a lot lot worse!

    I'm seeing a clinical psychologist to help with the issues I have with presenting at A&E and do need to go in earlier than I used to do. Its not only me that matters, but my family and friends that would be left if I carried down the path I have been on recently.

    Remind me of this next time I'm whining about ""not wanting to go to A&E"" LOL

    Take care xxx

  • Hi all i can relate to this, its me that strings it out refusing to call 999 or go to hospital, its ususally my husband that hand me the phone as a reminder and is seriously hinting and looking at the 999 buttons on it on more than one occasion!!! i am beginning to learn my lessons though and a fantastic husband that gently kindly suggests of help being cool as a cucumber, i think i do the panaking for both of us during an attack lol !!

  • AH no Kayla :( I have found writing a summary helps - I was worried it would be seen as pushy but it was because I get asked loads of questions when I can't talk properly. I have included a section on my 'weirdness' ie why and how I'm not typical and how I present (because they get hung up on the cough a lot which is an asthma symptom for me but they don't always get that) and how I appreciate it's not a severe attack but it's how I present and I really try hard not to have to go to hosp etc. It seems to have gone down pretty well with most ppl and have had comments that it's useful and well put together. It also has the advantage that I wrote it when my brain was working and I wasn't struggling to breathe which means it says what I want to say much better than I ever could when I actually need help!

    re your 'not in danger' point, I also did point out (very politely, and it seems ok) on that summary and to my cons (not rudely but a bit less politely as I was frustrated) that I don't really see why we should have to wait till we feel like we're dying to get help? I would have thought, as I said to cons, that it is reasonable to get help when you have run out of options to manage things at home. Not just because most of us are NOT medical professionals and therefore may not be able to make that judgment (I'm really not worried about having a bad attack based on the pattern so far but I could be caught out potentially) but also because even if we're not about to die, it's pretty uncomfortable and if I don't do anything it will just drag on and disrupt my sleep/work/life and everything - seems like this ought to be a legitimate reason to get help but apparently not to some drs etc! Last time I was admitted they said well it's not nec a severe attack as they go but you certainly aren't well enough to go to work and need to be careful not to let this happen again; they weren't saying my life had been in danger but acknowledged that yes, I was actually ill and it was reasonable to treat it for that reason.

    Not impressed by that nurse you saw - grr at some people'e attitudes.

  • If i go in I have some form of message that comes up under my hospital number warning them I'm a frequent flyer and have been to itu with breathing. I still get the 'why did you come?' from some staff even with this. Usually newer doctors as the nurses all know me by name! My GP seems to have 999 ready on speed dial if I see him ( even though I don't feel unwell for me) so I usually cheat and get a phone appointment, then he can't see me.

    I tend to hide how ill I am from my family as I hate going into my local. I do everything to avoid as I know I won't come out for a while if I go in via a and e.

    Sometimes we are the worst people at judging how Ill we actually are. After so many years of watching me seriously ill, collapsing, relapsing etc I've given my husband the right to say to me 'you need to go in'. I know he won't take me there unless I really need it.

    The thing that rally irks me is getting treated with iv etc, sent to a raft of different wards, then finally respiratory to be asked 'why are you here again?'

    My resp consultant told me that asthma attacks can change between being mild and severe so don't risk it!

  • I can really relate to where you're coming from but if you're really sick or uncomfortable, that's what the hospital is there for. Asthma is a common condition with 300 million sufferers: statista.com/topics/1356/as...

    But some cases are far worse than others. I'm lucky that my asthma is relatively mild but once or twice, I had very bad instances where a hospital would have been a good idea. I would not feel bad about it - if you're suffering, it makes sense to go there.

  • oh this is me all over ! Ive just gone a day and a night breathless telling my parnter im fine until in the end he just rang an ambulance! I feel like i shouldnt be going to hospital unless ive got a limb hanging off!! My other issue is work though. The amount of hospital admissions I have had in the past two years im sure my boss is getting fed up of it. I need to go to hospital at the moment to be honest, but due in work tomorrow and dont want to ring in sick, yet again!!

  • Yep this is me, i hate going always feel like a fraud. I am feeling an attack coming pf dropped and chest tight struggling to breathe when I move. just putting it off as I can still speak.

    I hate asthma

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