Just got back from my second visit to the ER and am not very happy with them. I've gotten hives all over (which is similar to my normal reaction to penicillin or poison ivy) twice in the last 5 months. First visit was after cutting down a tree, in which I suspected must have had poison on it. They took my self diagnosis, gave me steroids and sent me on my way with a script. It cleared after 3 weeks, but I started getting small blotchy and random allergic reactions ever since. Until yesterday morning when it was full blown facial swelling hives again. This visit the ER was negligent. Nurse brings me back, gets me in a very uncomfortable IV, and proceeds to draw 5 tubes of blood. She leaves the blood on the counter, the doctor sees me, says he can't tell me what is causing it, I need to see a specialist. Nurse comes back, gives me an IV with Pepcid and steroids. Blood is still on the counter. I asked, did you get any results from the blood work? She said looked in the computer, told me it looked like the doctor didn't order any tests, strange look face. It had been 3 hours at this point, 2 random nurses had popped in, noticed the blood sitting there, and did a quick, huh. I got a script for steroids, over the counter Claritin that the pharmacist advised me to get, and 5 tubes of blood that no way in hell I was leaving in that table. Anyway, I know I need to see a specialist, but is drawing my blood without the doctor even ordering it, standard operating procedure???
I am sorry to hear about your miserable illness and the sub-optimum caring that characterized your ER visits. First, your question: “Anyway, I know I need to see a specialist, but is drawing my blood without the doctor even ordering it, standard operating procedure???” For some acute health conditions some medical institutions will have protocols that specify certain blood tests, that in that circumstance, will invariably be ordered. Nevertheless, the blood draw you experienced was probably not based on a protocol and, in any event, leaving your blood on the counter was bad form.
Hives is a complex body reaction to an enormous number of allergens, irritants physical exposures such as to sunlight and many more, and in approximately 50% of the cases, a specific cause is not found. Seeing an Allergy specialist would offer you the best chance of diagnosis and effective treatment. Getting the recommendation of a specialist, from your Primary Care Physician, is no guarantee of quality care but it will increase your odds of that happening.
When you see that physician, you might ask him/her about a report on urticaria that just appeared in the March 7, 2013 New England Journal of Medicine that describes the effect of treatment with a drug called Omalizumab
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