https://paulnystrom.com/tags/not-an-emergency/Recent content in Not an Emergency on Paul NystromHugoen-usTue, 07 Oct 2025 00:00:00 +0000https://paulnystrom.com/posts/chronic-disease-in-the-er/Tue, 07 Oct 2025 00:00:00 +0000https://paulnystrom.com/posts/chronic-disease-in-the-er/<p>The ER is not for chronic diseases. The acute recognition of a chronic condition does not make it an emergency. It doesn&rsquo;t matter how you describe it, how distressing it is to you, or that today is a worse day. Acknowledging that everyone feels better or worse on some days than others also holds true when you think about your disease process. Your arthritis will be better or worse on some days. Your residual symptoms from your prior stroke will be better or worse on some days. Your chronic chest pain, whether it&rsquo;s from angina or any other cause, will be better or worse on some days. Your IBS, which, as I mentioned, is a controversial diagnosis, will be better or worse on some days. Virtually every condition you have has better or worse days. But at the end of the day, it&rsquo;s still a chronic medical condition and not something that requires emergency attention.</p>https://paulnystrom.com/posts/second-opinions/Tue, 07 Oct 2025 00:00:00 +0000https://paulnystrom.com/posts/second-opinions/<p>The ER is not for second opinions. Particularly after a patient has seen multiple specialists, coming to the ER because you&rsquo;re unhappy with the answers or frustrated with your ongoing condition is unlikely to yield the results you seek. I have a limited set of tests, which are designed to detect specific conditions. Strokes, for example, are easy to identify with imaging, but seizures are not. Heart attacks are easy to diagnose; other causes of chest pain are not. It&rsquo;s highly unlikely that the specialists you have previously consulted are withholding tests or deliberately avoiding certain procedures. In our litigious society, doctors tend to over-test and refer to specialists more often than they did in the past. When you come to the ER, I don&rsquo;t have any secret tools. There’s no secret sauce or hidden test. Longevity discussions may involve highly detailed tests at the cellular level, testing for specific toxins, or whole-body MRIs&hellip; these are all things that exist. However, none of them are available in the ER. For example, I can check your thyroid function, but I cannot perform an in-depth study to determine if your cells are effectively utilizing thyroid hormones. I cannot test your mitochondrial function. I cannot test for the myriad viruses that cause influenza-like illness (ILI).</p>