No Stupid Questions

You got the right idea. Heart problems are a bit of a mystery until you can get an EKG done. Urgent cares aren't usually equipped to do more that that. If it's ongoing, maybe look for a cardiologist. But if you're having any sudden shortness of breath then you might need to head to the ER.

Since you're in the US I imagine my method won't apply to you, but just in case, or for other people reading: in my country there is a phone number you can call in situations like this. They have doctors, nurses and specialists on call, initially you talk with a nurse that asks triage questions once you've explained your problem they give you advice for home treatment, if relevant, or send you to the correct urgency level care, including already sending the information on the triage questions to wherever you are going.

I once had an interesting conversation with a nurse at my GP's office. I was scheduling an appointment with my GP. The nurse asked what I wanted to see him about. I mentioned light headedness, dizziness, globus, chest pain, palpi-

She stopped me at "chest pain" and said "I'm going to write down chest pressure, because otherwise, they'll send you to the ER."

At the time, I was scheduled for all the heart tests you can think of and a few neurological tests and had been having chest pain daily for months during which I'd had plenty of heart tests already. And the nurse was familiar with my case. Had she not been, she definitely would have just sent me to the ER.

She made the right call. All the heart and brain tests came back fine. Nobody ever saw fit to give me a diagnosis beyond "your nervous system is too sensitive." (I asked if he was talking about "dysautonomia" and he agreed to that. Not a "diagnosis" per se, but better than nothing.)

If you are capable of driving yourself, it's 90% of the time not worth going to the ER. If it's actually during working hours and you have a primary care doctor call them first.

Dude, if you're having heart palpations, go to fucking urgent care. That shit can be lethal. Atrial fibrillation? Atrial flutter? They can cause blood clots which can cause stroke. Urgent care will know what to do, even if that's just calling a cardiologist elsewhere to look at your EKG or even stuffing you in an ambulance and driving you to an ER.

Don't want to take medical advice from a rando on the internet? (You shouldn't!) Then call your goddamned nurse line. They will sort you out and tell you exactly where to go.

Good luck.

This is why healthcare in the US sucks.

• A wealthy person will have a 24-hour hotline to connect with a nurse or doctor (immediately or through return call) with access to their medical history who will help them figure out what to do.
• A moderately well-off person will have a web/phone interface where they can send a message and someone will return their message in a day or two.
• Everyone else has to make a gamble: do I spent money to try to figure this out? Do I risk spending money and then it turns out to be nothing? But what if it's something and it's more expensive later on? What will my insurance pay for? How do I find someone that's reliable, but also inexpensive? All of this causes stress which makes things worse.

In your case, think of anyone who knows your medical history and who you can ask questions of. The doctor who prescribed your anxiety medications - can you call/message them and ask them? The pharmacist who dispenses the meds - can you go/call and ask a question about your medications? Some pharmacies also have nurse / clinic stations, too. If you have any kind of medical insurance, check out their web page - a lot of them have set up tele-medicine offerings recently. If your job has an HR department, this is actually one case they can be helpful; an HR person in my company helped me figure out what health resources I had access to, based on my plan. Finally, if you haven't been getting annual checkups, you should start thinking of doing so (especially as you get older), and ask them how you can contact them to ask questions like this.

Good luck fam, I hope it turns out OK for you.

Clinics are when you can call ahead to make sure they can handle your issue that can't wait for a GP appointment. Your burning genitals or deep cut will be seen at their earliest convenience. They can be used for GP services if you do not have a regular care provider.

Hospitals are for when you were referred there, have an on-going issue, or no clinics are open. You are not in urgent need of medical intervention, or are man enough to die in the waiting room with your 104° fever and almond smelling cut you got from a fence two weeks ago that has dark veins radiating from it because "it's nothing, just a cut". You can use them for typical GP services if you don't have a regular care provider and many offer clinic services.

GPs are for regular checkups or visits for something you are concerned about.

ER is for when dispatch calls ahead for you, severe pain, severe injury, unconsciousness, or OD. Expect to wait for hours if you are conscious and not leaking, because others are and you aren't the main character today.

For what it's worth urgent care will definitely tell you to go to the hospital ER if they deem it more emergency related. And of course they'll still bill you for coming in there to ask them :P

In other words urgent care is not emergency care, if that makes sense.

If you have insurance, they typically have a hotline you can ask about stuff like this.

Former EMT here: The body has a way of sending you to the ER lol

If it's bugging you not knowing and you don't want to wait until your clinic appt, then yes, urgent care would be able to at least tell you if it's an emergency cardiac event and send you on to the ER, or if it's something like afib and it can wait to follow up with an office visit.

My general hierarchy...

Something chronic, or changing, go to a Dr.

Something rashy, uncomfortable or parasitic, go to clinic.

If you call an ambulance, go to the ER.

If you already know what is wrong and just need a doctor's note (and maybe antibiotics), go to the clinic. While their staff are significantly more skilled knowledgeable than the general public, their policies limit them to only simple diagnostics and treatments. Your medical knowledge is certainly less than that of the Nurse Practitioners and Physician Assistants that staff these clinics, but likely exceeds the scope of practice they are limited to by their employer. If you don't know what the problem is, the clinic is going to refer you to your PCP or urgent care anyway, so you should only visit the clinic to appease HR or get access to basic prescription medications.

If something is bothering you, but you can tolerate it for a couple weeks, schedule an appointment with primary care.

If you don't know what's wrong, or you need something more than a note and a prescription, and you can transport yourself, go to urgent care.

The only time you should go to the ER voluntarily is if urgent care sends you there. Any other trip to the ER should be because someone dragged you there without giving you a choice.

Depending what county you live in, etc. There are nurse hotlines that you can call. That said I've never used them.

Okay this is easy if you're an American. Whichever one's the cheapest, unless it's an obvious life or death situation or head injury. That's it.

i tend to use the pain scale to give me a hint on decisions like this. so i guess the first question to ask before the pain scale is "am i in a state of shock?"

note: i am not in any medical field nor had intensive training.

Stitches don't necessarily mean ER.

Guess it really depends on your urgent care.

For the most part, I'll go to my urgent care unless I know damn sure ER is needed (the urgent care is in my network). It's no farther away, (ER is a couple blocks away), and urgent care is less out of pocket. If they determine ER is required, they'll say so (and recommend ambulance if they feel it's necessary).

Basically the triage nurse will assess and make a determination.

I've had family go there for cardiovascular issues (and be treated and sent home). They're fully equipped to stabilize someone if they need to go elsewhere. They have a full complement of equipment, including radiology (everything but CAT).

PSA for those in the US; the Urgent Care type places that advertise “ER” in their title will be absurdly more expensive than “regular” Urgent Care places that do not advertise as such.

The reason is that the “ER” places have actual ER type equipment, but regardless if you use them or not, you will be charged as such.

Maybe this is common knowledge, but we learned the hard way when my partner went in for something very benign and we received a $1,000 bill, even though we had insurance.

These “ER” places are popping up everywhere, and there’s nothing to tell you that if you go down the road a block or so, it could make the difference between a cheaper co-pay and owing the full amount. In our case, almost $1,000.

Where I live, we have a special phone line we can call to talk with a nurse. While most people know when to call 911, when your unsure what to do, the nurse can give you tips, tell you when and if to book an appointment in a clinic, when a pharmacist could be of any help, or what to do to treat yourself if you don't need medication (like, drink this, apply hot or cold somewhere, etc).

It comes down to what's open, how dangerous the condition is, and who was outfitted to do what.

If you're having legitimate trouble breathing like you are filling your lungs and it's not enough, or you can't get enough air in your lungs for any reason, straight to the ER.

Unknown irregular heartbeat or chest pain that doesn't go away with antacid, go to the ER.

Urgent cares near me generally have x-ray equipment. They're capable of a few stitches, they can handle prescriptions for emergent illness. If you walk in there with a f'dup heart rhythm or breathing problems they're going to call you an ambulance.

Scheduling something with your primary care is for all your other long-term needs. Preventative maintenance, blood tests, they can probably do an EKG and they should be the ones managing your long-term medications.

If you have something that feels urgent and the urgent care isn't open the ER is always an option.

There are a range of tachycardia/arrythmia that you can have since birth that may not show up until you're older, or get triggered by certain meds or nutrient deficiencies (things like potassium).

I wouldn't ignore this for a minute longer. Maybe just walk into urgent care and ask if they're equipped to check it out (basically EKG). I know my urgent care is.

If they aren't equipped, then go to ER.

But please don't sit on this any longer. Some arrythmias are fairly benign, but if it's happening repeatedly, it will eventually cause tissue damage that you don't really fully recover from. Plus you don't know if yours is benign (and most docs would say arrythmia is never benign, even if it isn't killing you in the moment).