A&E Tonight, GP Tomorrow or Woman Up?

[MoonOnTheRain]

Just curious to see what most people would do. Don't want to waste anyone's time.

I'm anaemic, taking daily iron supplement, but the reason for the anaemia is ongoing. Last blood test about 6 weeks ago.

I'm under a consultant, but no recourse to message them. Expecting biopsy results in about ten days, when hopefully treatment plan will be come up with. Consultant will be in touch then.

Last week, have felt more tired and weak. Am pretty much on bed rest due to issue, plus anaemia. Tonight while going to loo, almost fainted. Made it back to bed, but couple of hours later, heart still pounding and feel dizzy. Feel quite unwell. However didn't eat much today, just didn't want it, so that could be part of it. Have now forced small snack in.

Not sure what I should do. Go to A&E tonight? Emergency GP appointment tomorrow if I can get one? Or am I just being a total drama queen and should just woman up until results are in, in ten days?

Both A&E and GP, phone 111.. Iron meds when that low is a bit naff tbh. It takes a while for reserves to build and if the cause of it is ongoing, you're never going to get on top of it.
Ask for to be considered for an iron infusion too. An hour of your time and totally topped up. Takes a couple weeks to start feeling better. Can get them done privately too but honestly, the GP/consultant should've helped here imo. Good luck OP, it's a horrible feeling.

I had heavy vaginal bleeding a few years back. Kind of ignored it (lots going on), it got worse and I ended up going to A&E because I thought like I was dying. I collapsed in the waiting room and came round in resus. I was severely anaemia and in haemorrhagic shock.
Prior to presenting at A&E, I’d done the 111 online triage OOH and it told me to contact my GP, which would have been the next day. 111 can be great, but going to A&E in this instance probable saved my life

How anaemic on bloods 6 weeks ago?
any further episodes of bleeding since then?

a&e could admit and arrange a blood transfusion if Hb very low but you sound like you need long term plan so this would just be a band aid.

iron supplements and fluids as pp said sounds like a sensible plan.

You don’t need a blood pressure monitor - if you can feel a radial pulse then your blood pressure is not low enough to worry. You do not need A & E. Many hospitals in UK are in internal critical
incidents due to huge numbers of patients. You’ll be waiting until tomorrow morning so you should just ring GP in morning and get an appointment, even if it’s for repeat bloods (I am a registered HCP)

I wouldn’t say A&E because it’s neither accident nor emergency, I’d get in touch with GP tomorrow but in the mean time get a couple of good meals int and lots of water/juice because anybody would be feeling dizzy after a day of essentially no eating and is the first thing a medical professional will tell you.

It could be an emergency. Without medical advice and a full medical history noone on here can say it isn't an emergency. The reason for the anemia could be internal bleeding that has increased suddenly today. Could be a hemorrhage of some type. Noone here can advise it isn't an emergency. She should ring 111 to get medical advice.

I’d say eat something, drink something, take your iron and go to bed, then assess whether you think you need to be seen by GP in the morning.

More like to be the not eating much, try having something like toast and see how you feel in an hour. DH has got atrial fibriliation and is permanent AF (has been since last Sunday). Heartrate anything between 50 and 128 bpm, and truthfully A & E didn't want to know. They did an ECG and blood test but told him it was a 12 hr wait to see a Dr and he'd be better off seeing his GP in the morning where they'd have those results.

I don't think people advising you to attend have been in A & E recently. The system is fucked, big time.

How much have you drank today?

OP, have you had your thyroid checked? My mum experienced similar symptoms and it turned out it was her thyroid - she ended up having a surgery.
I think that anything with high blood pressure it’s important you are seen pretty quickly.
hope you feel better soon

Thanks everyone for your advice. I have had a small dinner, and had tomato juice which has salt in it, plus some extra fluid. I no longer feel like I will faint while laying down, but still pretty wobbly and dizzy on loo trips.

To answer a couple of questions: the reason for anaemia is heavy gynaecological bleeding (100 days now), which is under investigation. I also do have a thyroid issue, but pretty sure that's not the problem this time. I have been taking full sets of iron, B bits, multi bits, etc. Not overdosed, but definitely topped up.

Unless I get worse overnight, I will ring GP for appointment for tomorrow, and take it from there.

We are fortunate to have an A&E locally which posts it's wait time, and it's currently a couple of hours, but going in not ideal for me due to the bleeding.

How do you measure your blood loss from the gynae bleeding OP? I ask because I got to the point with my own excessive bleeding where it was heavy enough they were worried I would need admitting if they couldn't get the rate down as it was potentially dangerous to my health.

Is there any chance the bleeding could have ramped up further, because if that has combined with the dizziness, that would concern me.

Do you know what's putting you off eating at the moment - and has that just been today?

Long term bleeding and how you feel now needs to be taken seriously, don't be fobbed off.

No, but they can bring you back to Same Day Emergency Care (SDEC) for exactly that

I'm here to remind people that before they ring 111 they can always try their own GP. In my local area all the surgeries divert to a central clinic who operate on evenings and weekends and while there's a long wait you can get appointments at like 11pm, 3am etc.

If you phone 111 they'll give advice over the phone, or direct you'll to A&E, but if you need to be seen Face to Face they'll send your details to the out of hours clinic to be seen by one of the local GPs, it's not actually a 111 GP who sees you. Phoning 111 just adds another step to the process.

Have I read this right, you’ve been bleeding for 100 days??

Helpful advice in your area but in many OOO is diverted to 111 and they then contact the GP on call. It’s not the same in all places, just to say. Certainly where I live we are told to call 111 for OOO GP services.

And you know it’s not an emergency how?

Round here 111 books you out of hours gp appointments. I think it varies so check for local info.

Low iron isn’t an A&E thing - https://www.nhs.uk/conditions/iron-deficiency-anaemia/

i think you are doing the right thing to drink plenty of water, have something to eat and ask for a GP appointment tomorrow

I’d say 111 it. Your description of your situation reminds me of my symptoms when still bleeding after an operation which long story short I ended up back in emergency surgery and blood transfusion. The blood loss might be what’s making you feel like not eating also. I literally couldn’t sleep for the sound of my heart pounding. Hope you feel better soon.

Yes, that's right. Heavily so. It is under investigation. Waiting for biopsy results.

I didn't get much sleep, but didn't get worse overnight. Waiting for a callback from GP surgery now.

Those of you telling op her heart rate is too high when she stands up - have you ANY idea what your heart rate is when you stand up? If it doesn’t go up over 100 then you feel terrible and can pass out! That’s the way the body works! Your maximum heart rate is 220 minus your age. So if your HR is sitting at over that when you’re lying down then yes that is a problem but a slightly higher than usual HR when OP hasn’t eaten and the body will be struggling 🤷‍♀️ first thing first eat something and also up your drinks as that helps.

op are you also taking b12 and vitamin c with your iron? Unless you do your iron levels won’t go up as it needs both of these to absorb the iron properly and use it. I had severe anemia all my life due to the very heavy periods I had and until I had a hysterectomy it didn’t get any better due to severe endometriosis and adenymyosis that went along with the periods and iron infusions and blood transfusions just kept me going till the hysterectomy sorted everything

I think that's pretty normal. You've not eaten much and have been lying down all day. Get up and obviously get a dizzy and feel faint. That happens to most people in that situation doesn't it? For me I would also lose sound for a bit and go all woozy but then get over it and stumble back to bed.

I'd recommend getting up slowly in future. Sit up for 10 mins and then sit with legs over the side of the bed for another 5. If you've been flat all day you're blood won't be flowing.

It was essentially a nearly faint, how long do you think you'll sit in a&e for that? I've fainted, smashed my head open and needed stitches and sat for hours and hours.