To go to A&E?

[Extraordinarytimes]

I have pneumonia. In September it was severe, my lung collapsed and I was hospitalised for a week. IV/oxygen but no chest drain or ICU needed. Discharged without monitoring equipment as they advised this was just for borderline patients, and they were happy that I wouldn’t need it. (CRP was 280 when I went in, 70 when I left). I was terribly ill when I left (wheeled out) but nothing at all like when I went in.

Over the intervening months I… haven’t recovered. Seems to be I pick up a cold from the children and it goes straight to the pneumonia. I am on my 5th course of antibiotics since coming out of hospital (so 6 courses including the IV). I have recovered from infections, but seems the pneumonia just sits and waits for the next cold to flare up again 🙄 After the fourth course (last week) doc said I had to go to hospital for IV antibs. I refused as I really wasn’t that sick, and managed to get the fifth course reluctantly prescribed (coamoxiclav) which I am coming to the end of. He said he would note my refusal, and if I was any worse, or didn’t improve, to go directly to A&E as they were at the end of what they can do for me. I have checked my notes, and this is indeed reflected there.

I have a day left of this last course, and am getting increasingly worse. I don’t want to go to hospital, but also can’t think of any alternatives.

So here’s the AIBU. I’m ill, but I’m not THAT ill. There is no emergency. I don’t have a fever (temp is mildly raised) I have a lot of pain in the pneumonia site and in my chest and back but although it’s sufficient to cause insomnia, it’s not severe. I am breathless but can make a cup of T, I’m tired and weak, but can go up the stairs OK. I put away some laundry earlier for example. When I cough it’s absolutely huge, but I’m not coughing a lot; it’s brought on by exertion I think so really easily avoided 😂

AIBU to go in?
I don’t want to sit in A&E all day and then be turned away (and make the Q longer for someone else who has had an accident or needs emergency care). We have a sick child at home so there are also those logistics to consider; DH doesn’t want me to drive myself as he feels I would be unsafe; he’s probably right.

Flip side is, I stay at home without any more drugs and… hope a miracle occurs? Or wait until I am ‘really’ sick. There doesn’t seem to be a happy medium of getting IV antibs in the community; really this would be the ideal. If I was admitted it would be a waste of a bed.

WWYD?

Anyone been in a similar situation?

Glad you are going OP.

I hope you get treated quickly, and well after that.

When you're used to caring for others, it can be hard to stop and care for yourself. In this case though, that sounds like what you need.

I put off seeing a GP about gall bladder attacks. I was pretty sure that's what they were. Eventually, after a night in agony, vomiting constantly, I got an emergency GP appointment (I didn't think I was sick enough for an ambulance). The GP called an ambulance. The paramedics told me I was clearly in a lot of pain (I guess they know what that looks like). I was still walking around feeling sheepish, and apologising to people who jumped out the way so the paramedics could get me to the right ward sooner. I had emergency surgery the next day. On the plus side, i did bypass A&E! :D

So don't beat yourself up for putting off getting treatment, it's a common thing to do. Just do get yourself sorted.

Have you had your sputum cultured? I was in a similar situation a few years ago and went from one type of antibiotic to the next for years. It was only when a new Doctor took the time to have a culture grown so they could ensure I got the right type of antibiotic that things improved. They also gave me 8 weeks of the ‘right’ ones to ensure that the infection was gone and couldn’t resurface. Worth asking if it’s not already been done.

@Tiree1965 yes; when I first went in they did a CT, sputum and blood cultures as I don’t have any risk factors so on paper, shouldn’t have been so sick. Didn’t show anything ‘extra’. My Gp has repeated sputum a couple of months ago and they didn’t show anything. I’ve had x rays every 6 weeks, which show that the pneumonia is decreasing, (due one around now).

If the doctor told you that you needed to go to hospital, I don't understand why you didn't? I would go to A&E, it's not going to magically get better on it's own. Hope you are feeling better soon.

I don't think you should underestimate pneumonia it can be very serious and as you have already had several bouts of it and it is not clearing up with antibiotics at home you clearly need iv antibiotics.. what the worse that can happen you say ! Well if not treated quickly and effectively quite simply you could become dangerously unwell or even die !!! Speaking from experience of someone who's lost a family member to pneumonia. Get yourself to A&E tonight !!

Go to a&e now! i know someone that passed at 39 from sepsis developed from pneumonia. Please don't ignore, your kids need yoh

Several people I know have experienced this. Why do they blame us for antibiotic resistance but just chuck any old antibiotic down our throats for weeks on end without bothering to find out whether it’s the right one?!

What type if pneumonia is it? Have they ruled out inflammatory pneumonia? Antibiotics don't work on inflammatory pneumonia you need steroids.

Many years ago I was admitted to hospital with a minor partial collapsed lung (pneumothorax). They expected it to resolve on its own, so I was discharged after 1 night of observation. It did not resolve on its own. I had to beg to get further x-rays taken which didn’t happen for a month. By the time the next x-ray was taken, the entire lung had collapsed (revealed by the massive dark patch on the x-ray). This was dangerous. A pneumothorax can suddenly become a “tension pneumothorax” and cut off blood flow or air supply quite suddenly. If you haven’t had x-ray confirmation that your collapsed lung is gone, and also if you are feeling bad, you should get an x-ray.

My doctors were careless because I didn’t have classic symptoms of pain and they were unable to hear the trapped air by tapping my chest. No excuse really though. They knew I’d had a small collapse as confirmed by the initial x-ray and should have taken it more seriously. (Instead they questioned my experience of my symptoms and sent me for blood tests).

I ended up having surgery and my lungs are fine now.

Good luck. It does sound like you should seek help from the hospital.

My brother had pneumonia. Wouldn't get medical advice and died from sepsis.

Glad you've taken the advice and hope they can help you.

OP "There doesn’t seem to be a happy medium of getting IV antibs in the community; really this would be the ideal."

Yes, I had the same issue with my bouts of pneumonia. If only this was available, so much better.

Not suggesting you follow me, but the second time, I refused point blank to go to hospital. I was in my 20s and my poor father was so upset.

I was okay on pills and the third time, hospital wasn't necessary.

But if you go, crack on tonight as the Friday drinkers will be in later. Hope you recover fully.

Oh, and seconding you might need steroids, so go!

Your doctor has already told you what to do.

go to hospital. Now.

You will not make the queue longer for emergencies as patients are triaged. There's not a queue that takes patients in order of how long they have waited, they will prioritise. Infections do not get better without antibiotics, that's why live expectancy is so much higher now than pre-antibiotics.

The sputum sample should have been sent to microbiology lab to see what antibiotics would work best.

You are ill. Trust your gut and go. Get well soon x

I can understand you not wanting to go, but am glad you are. I’m so sorry you are so unwell x

Good luck.OP
hope all goes well and you feel tons better soon
ps
CRP. 280.when you first went in Good grief that was high ! You must have felt awful

@Extraordinarytimes

He said he would note my refusal, and if I was any worse, or didn’t improve, to go directly to A&E as they were at the end of what they can do for me

what part of that is unclear??

go, personally if I thought I'd be ok overnight, I'd go in the morning, with phone charger warm fleece, drinks (& snacks). Be prepared to wait. You won't take anyone else's place, if they're in more need than you, they'll get seen before you.

it sounds absolutely miserable, go and get seen to!!

@Extraordinarytimes sorry. MN not loading properly for me tonight, so missed your updates. Hope they get you sorted quickly cx

Pneumonia, especially in someone with your history, is not something with which to fuck around. Very glad you're heading in.

Pneumonia can lead to sepsis. I suggest you take your doctors advice and go to a and E like you should have done when he first told you to go.

You’re going and I really don’t want to kick you when you are down, but do you need to work on your own boundaries? It’s ok, it really is, to get the care you deserve when you need it. And I know you mentioned a sick child at home but unless and until you feel better, how can you look after them? Put your own oxygen mask on first….quite literally!

Had sepsis in April 2023 from chest infection

Only been in the last three months I've felt better and not been unwell. Every cold I've had become a chest infection.
It will take time your immune system is still low.
The last one in December I went to A and E and I caught it in time