I see what you mean. The idea is good, the word “lying” is the wrong choice though. Self advocating or being proactive or assertive in presenting your situation would be much better.
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It is technically lying. I don’t know this person obviously but I know what it’s like to be scared and alone and not thinking straight and this sounds like a matter of life or death and it seems for whatever reason he doesn’t have someone around him to be his advocate right now. The specialist he saw seemed to discourage him from even checking in at the hospital, telling him they won’t admit him given x, y, z pedantic points about his presentation. Frankly that sounds like malpractice to me and it should have been this specialist himself to facilitate checking him in but that’s neither here nor there. Instead he seems to have ruled out the hospital and is grasping at straws here seeking advice from strangers and looking for human milk. He mentioned he felt very weakened by what it took to even get to this specialist so this might be the end of the rope. He should rally his energy and do one last push to get admitted to the hospital. It would literally save his life. If he needs to make up some scarier sounding symptoms to the check-in nurses then so be it. These things are done via soulless 38 question questionnaires at triage unless there’s a bullet in your abdomen and yes, I am explicitly advocating that he lie just to get admitted. Or at least know that that’s an option on the spot if he feels he isn’t being taken seriously. So I hope we can all push him in the same direction to make the obviously right decision here instead of splitting hairs on what to call the creative license.
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For clarity, I suggested lying or doing whatever she needs to do to save her life only after all traditional means failed.
Once the ER doc Grant said her BMI is a short term life threat, then this becomes about saving her life and not dying. I think you are correct in that no one is advocating for lying if she can get help in any other way. But, if she can’t, I personally would lie to save my life with zero regret. Others would never lie no matter what, and that is fair.
People do die all the time due to well meaning people in the hospital sending them home because they were wrong. My sister’s ex bf was told nothing was wrong with him and they didn’t admit him to the hospital and he died at home that very night.
PS @Vida Sorry, I didn’t know if vida was a woman or a man, and it seems you are a man, my mistake.
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@medaura You’re so out of touch I can’t even bring myself to finish reading your toxic message. I guess replies like this are the risk when one seeks help from an otherwise good forum.
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Ok … best of luck. I wish you the best.
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This is unfortunate, but that is one of life’s realities. The people doing the admitting triage are just putting in a shift and making decisions from a script.
The most sure way to gain admittance in my experience with family members is to complain of severe chest pain and pain in the left arm. Then, to confuse matters a little, put in some of the symptoms of the problem you are really having, or add to the list of symptoms once you are admitted and talking to an ER doc
The people in the ER are some of the best and brightest. They tend to compete with each other to show off their diagnostic skills.
My local ERs have been fantastic in making diagnoses that your PCP will probably have missed. In addition, they have immediate access to lab work, x-rays, MRIs, etc. Things your PCP wouldn’t commonly prescribe and things your insurance wouldn’t normally pay for.
In my state, the ER has to admit and treat you. As a result, many people without life-threatening conditions and without insurance are in the ER waiting room. Another reason to lie to get in.
There is no moral high ground when your life is at stake.
So, I don’t care what other people’s opinions of this are.
If you have a problem that you think is life-threatening and your PCP hasn’t properly addressed it, lie to get in.
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Generally in a case like this a patient should have a PCP they trust who is managing their healthcare and making referrals. After the internist orders their own blood panels and other tests and gets reports back from specialists which aren’t providing answers, at some point the patient’s deteriorating condition would lead them to make what’s called a tertiary referral to an academic medical center (AMC) where a patient can expect a highly specialized, comprehensive evaluation aimed at uncovering rare or complex diagnoses that have eluded standard care. Some of these AMCs like Mayo and Stanford Medicine and others collaborate in a program known as the UDN (Undiagnosed Diseases Network), which focuses on solving medical mysteries through advanced diagnostics that’s often beyond the capabilities of a patient’s local doctor and city hospital; e.g. genetic sequencing and specialty lab work that’s generally only available in a research setting. They may also do a full body MRI looking for occult cancer or benign tumors. And in the case of unexplained severe weight loss, a psych evaluation may also be ordered.
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That aint gonna happen with HMOs that most seniors belong to. If it were to happen, they would probably be too far gone to be of any use.
And for people, and there are many, especially young people, who have no health insurance, that certainly isn’t going to happen.
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MD here with some Integrative Med training- I’m a PCP not a GI specialist. Would be concerned with that weight loss to rule out any malignancy that could be triggering cachexia. Wondering if pancreatic insufficiency has been ruled out.
Some of the labs you mentioned suggest you’ve had some extensive testing done. Fatty acid oxidation disorders would be genetic, would not anticipate you developed these but some of the markers were consistent according to ClinicalKey AI which I use to reference. I will include below a summary of what was recommended:
• FAODs are caused by genetic mutations affecting enzymes like Carnitine Acylcarnitine Translocase (CACT) and Very Long-Chain Acyl-CoA Dehydrogenase (VLCAD).[1]
• Elevated acylcarnitines and urinary ammonia indicate impaired fatty acid oxidation and secondary carnitine deficiency.[1-3]
• Treatment includes a high-carbohydrate, low-fat diet, medium-chain triglyceride (MCT) or triheptanoin supplementation, and avoidance of prolonged fasting.[1]
• Levocarnitine (Carnitor) can be used to treat secondary carnitine deficiency, with dosages of 990 mg orally two or three times a day or 50 mg/kg intravenously.[4-5]
• Intravenous glucose (D10 or higher) is essential during acute metabolic crises to provide an alternative energy source and inhibit lipolysis.[2][6]
I am so sorry you are going through this, definitely ask any friends, family to advocate for you and get you the short term care you need until this can be properly worked up and treated.
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May my prayers go with you. I’d be tempted to just lay down on them, just lay down in the ER floor, don’t get up, refuse to walk, don’t even talk, just moan. They might drag you out and dump you on the sidewalk, idk. Dire situation, requires dire actions.
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I don´t know if they have ruled out severe infections? Cachexia can be caused by chronic, severe infections that trigger metabolic dysregulation. HIV/AIDS: is a classic example. Tuberculosis is another. as well as Schistosomiasis.
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Testing is very important in this situation. I’d not go in with any assumptions, just seek answers. Test cancer, viruses, parasites, etc.