Calling the P-F docs please

[Jared]

73951

I found this on my kids arm. I’m thinking it looks like the bullseye rash of Lyme disease. Neither me or my wife have pulled any ticks off of her. We are planning to take her to the pediatrician tomorrow to get it checked out. Am I being a nervous nelly or does it really look like the telltale sign of Lyme?

Thanks in advance. Again, we are getting her checked tomorrow.

[farscott]

Not a doc but have dealt with ticks and Lyme disease. That looks like a textbook example of what we were told was a concern needing a doctor to see/treat. There are other things caused by tick bites that need a professional to address. The one here is STARI.

Getting her to the doc is a good idea. If an urgent care is open, it may be worth the trip.

[Jim Watson]

My kid, we would be opening the MD's office.

[45dotACP]

You're making the right call by getting to the doctors office. I am a RN, not a doctor but I'd be doing the same as you.

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[revchuck38]

Jared - Something like that doesn't require a pediatrician to treat. I'd take her to an urgent care place and follow up with the pediatrician if necessary. I'm not a doc.

[Jared]

Jared - Something like that doesn't require a pediatrician to treat. I'd take her to an urgent care place and follow up with the pediatrician if necessary. I'm not a doc.

Urgent care (place is actually called Convenient Care here) is also on the table. Either way, we are gonna get her looked at tomorrow.

I don’t normally get too nervous over such things, but this one caught my eye and I had to force myself to stay calm so I didn’t freak the kid out. Wife took a couple of pics for documentation.

I don’t know much about Lyme. I have heard of the bullseye rash though.

[psalms144.1]

Urgent. Care. Now.

Our neighbor's son had a tick bite that developed a rash like that and nearly died. Go to urgent care and get treatment started.

[entropy]

No doc here.

I’d take her in, but I’ve also had bites like that before too that ended up being nothing.

[1911Nut]

The facilities you are referencing are usually convenient (as you mentioned) and are often called "urgent" care facilities for a reason. Get your child to one nearby this evening . . . . don't wait until tomorrow.

I'm not a doctor. I'm a parent of a Nurse Practitioner. She agrees with me.

Please let us know how this turns out.

[Totem Polar]

I am the furthest thing from a doc on this forum, but I also vote for getting into urgent care tonight. No sense putting it off.

[Sanch]

I’m a nobody with no credentials I’m willing to share on the internet so take this as the single dissenting opinion so far. I would not be going to urgent care if the concern is Lyme disease, they won’t treat that there.

Shortness of breath, call 911
If it starts spreading into a web like pattern in the veins in the area, with localized warmth and rapid heart rate, call 911
Localized neurological deficit, touching skin with the pin of a needle can’t be felt, call 911

Lyme disease? Requires multiple courses of antibiotics over 6 months and the Unlucky NP or PA working at the urgent care on a federal holiday isn’t the person to deal with a 6 month long antibiotics course. If you can find an urgent care with an MD or a DO that is board certified in internal medicine, then that would be worth going to. But urgent cares are a dice shoot when it comes to anything remotely complex.

But I’m a nobody and it’s generally better to err on the side of caution and go in, depending on what the urgent care provider wants to do. They can always make things worse. Medical errors are usually around the second or third leading cause of death in the US each year.

[Sensei]

Certainly could be Lyme. Definitely worth a course of doxycycline if it were my kid.

It would be a mistake to send serology to determine if treatment is necessary. Run very fast if your “provider” recommends this…

[Paul D]

I'm with Sensei. I don't deal with this stuff on a daily basis but even I am suspicious of Lyme disease. If it was my kid, I would do the doxycycline 100 mg twice a day for 10 days course and monitor for clinical signs and be done with it. If you are afraid of committing to an antibiotic course, I think the guidelines recommend at a least a prophylactic dose of doxycycline (100-200 mg once) and monitoring. Good luck and hope your kid gets better.

[Hambo]

Not a doc, but I've had spider bites that looked similar.

[UNK]

73951

I found this on my kids arm. I’m thinking it looks like the bullseye rash of Lyme disease. Neither me or my wife have pulled any ticks off of her. We are planning to take her to the pediatrician tomorrow to get it checked out. Am I being a nervous nelly or does it really look like the telltale sign of Lyme?

Thanks in advance. Again, we are getting her checked tomorrow.

Little late to the party but I think as soon as you notice something like that the first thing to do is mark the outer edge with a ball point pen or fine tip marker to see if its spreading and how fast. No experience with lyme but Ive seen spider bites that looked like that.

[RoyGBiv]

I've had spider bites that looked a lot like that, but, definitely get it checked. Ticks can be very tiny.

+1 for marking the edges with a pen or sharpie.

https://www.cdc.gov/lyme/signs_symptoms/rashes.html

[Jared]

Ok, wife took her to convenient care today. They aren’t sure if it’s a tick or a spider bite, said not serious enough to warrant antibiotics at this time.

It did look better this morning in the picture my wife sent me before they went to the doc. Doc gave a cortisone cream scrip which wife/mom applied when they got home. It looks a hell of a lot better now. Kid is totally fine and normal acting.

Doc did say if we see other symptoms to follow up.

Spider bite makes more sense than tick bite given location and other factors. Wife saw a pic on the net of a Parsons Spider bite that looks nearly identical to what’s on my girls arm. But the important thing is that for now, kid seems good to go.

Thanks to everyone that replied for the advice.

[BillSWPA]

I am not a doctor, but my son has had tickborne illnesses twice. Once was lime, once was something else. If whoever you visit does not want to provide a prescription for doxycycline, I would visit another doctor.


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[Clusterfrack]

My understanding is that spider bites are rare, and significantly overdiagnosed. Just statistically, I’d guess it’s likely a tick bite. If that was on me or any of my family, I’d go for a course of antibiotics.

https://www.webmd.com/skin-problems-and-treatments/news/20110713/is-it-a-spider-bite-probably-not

[OlongJohnson]

Even if it's a spider bite and not an infection (now), monitor that stuff. I got bitten by a spider and it seemed to be OK, but damaged tissue under the surface and created a whole infected cavity that required attention weeks later. I still have a pocket that fills with gunk and needs to be cleaned out 15 years later.

[RoyGBiv]

My understanding is that spider bites are rare, and significantly overdiagnosed. Just statistically, I’d guess it’s likely a tick bite. If that was on me or any of my family, I’d go for a course of antibiotics.

https://www.webmd.com/skin-problems-and-treatments/news/20110713/is-it-a-spider-bite-probably-not

Likely depends on where. I was a frequent spider bite (and biting tree ant) victim. Spiders made me blow up much like the OP's photo. Round, swollen, warm to the touch. Cortisone cream was the solution most of the time. Frequently the center of the bite would get black (necrotic?) and weep for several days. Debriding and Neosporin with lidocaine worked well there.

Also, the timing is an indicator. If you think you got a bite today and it looks like that, it's not likely Lyme. Lyme rash takes at least a few days to show up.
https://www.mayoclinic.org/diseases-conditions/lyme-disease/symptoms-causes/syc-20374651

Spreading over days is also a Lyme indicator. Quickly resolving same-day with cortisone causes me to think spider or insect more than Lyme as well.

FWIW. Not a Doc but frequently bitten.

[Clusterfrack]

I was a frequent spider bite ... victim. Spiders made me blow up much like the OP's photo. Round, swollen, warm to the touch.

Did you see the spider bite you?

[UNK]

Even if it's a spider bite and not an infection (now), monitor that stuff. I got bitten by a spider and it seemed to be OK, but damaged tissue under the surface and created a whole infected cavity that required attention weeks later. I still have a pocket that fills with gunk and needs to be cleaned out 15 years later.

Thats typical for necrosis. Theres only a few spiders in the US that can cause that. Brown recluse are here where I live. The plant where I used to work had black widows in one area. My son was bitten by a spider in Peru and thankfully antibiotics took care of it.

https://www.termite.com/spider-identification.html

[Cookie Monster]

Not a doctor but I would take my kid with a rash like that - I would have the same thought of Lyme Disease.

[UNK]

Ok, wife took her to convenient care today. They aren’t sure if it’s a tick or a spider bite, said not serious enough to warrant antibiotics at this time.

It did look better this morning in the picture my wife sent me before they went to the doc. Doc gave a cortisone cream scrip which wife/mom applied when they got home. It looks a hell of a lot better now. Kid is totally fine and normal acting.

Doc did say if we see other symptoms to follow up.

Spider bite makes more sense than tick bite given location and other factors. Wife saw a pic on the net of a Parsons Spider bite that looks nearly identical to what’s on my girls arm. But the important thing is that for now, kid seems good to go.

Thanks to everyone that replied for the advice.

Glad to hear shes doing well. Thanks for the update.

[OlongJohnson]

Thats typical for necrosis. Theres only a few spiders in the US that can cause that. Brown recluse are here where I live. The plant where I used to work had black widows in one area. My son was bitten by a spider in Peru and thankfully antibiotics took care of it.

https://www.termite.com/spider-identification.html

The guess was it was a brown recluse. First week on a new job in an office that had been vacant. Put a shell jacket on a shelf when I got there in the morning. Put it on when I went home. A mile or two down the road, I felt something on my back. Never did figure out what happened to the critter, as I didn't take off my shirt and look at things until I got home, and there was no gushed spider in any of the clothes that I could find.

[UNK]

The guess was it was a brown recluse. First week on a new job in an office that had been vacant. Put a shell jacket on a shelf when I got there in the morning. Put it on when I went home. A mile or two down the road, I felt something on my back. Never did figure out what happened to the critter, as I didn't take off my shirt and look at things until I got home, and there was no gushed spider in any of the clothes that I could find.

In high school I had a buddy who was out in the woods shooting. He had that fro perm thing that was in style. He felt something crawling in his hair and tried to grab it or squash it. Anyway he got bitten and it put him on his ass immediately. I dont believe he ever found out what it was.

[camel]

Ok, wife took her to convenient care today. They aren’t sure if it’s a tick or a spider bite, said not serious enough to warrant antibiotics at this time.

It did look better this morning in the picture my wife sent me before they went to the doc. Doc gave a cortisone cream scrip which wife/mom applied when they got home. It looks a hell of a lot better now. Kid is totally fine and normal acting.

Doc did say if we see other symptoms to follow up.

Spider bite makes more sense than tick bite given location and other factors. Wife saw a pic on the net of a Parsons Spider bite that looks nearly identical to what’s on my girls arm. But the important thing is that for now, kid seems good to go.

Thanks to everyone that replied for the advice.
Best wishes to a speedy recovery. Sometime stuff happens

[GJM]

I spent a bunch of years around Lyme ticks in CT and hate them. That is an odd place for a tick bite. They like the groin, under arms, scalp and warmer places. I got bit by a bunch of ticks in CT, but also by a brown recluse spider that left what looks like a bullet wound in the back of my neck.

[Sensei]

My understanding is that spider bites are rare, and significantly overdiagnosed. Just statistically, I’d guess it’s likely a tick bite. If that was on me or any of my family, I’d go for a course of antibiotics.

https://www.webmd.com/skin-problems-and-treatments/news/20110713/is-it-a-spider-bite-probably-not

This pretty much spot on. Most of what people call a “spider bite” is just a cutaneous abscess (often MRSA) from a folliculitis or some other break in the skin. The rest are just insect bites from thing like bees, fire ants, and wait for it….wait for it….waaait for it -ticks. Spiders are the extreme minority. Keep in mind that only 50% of people who get Lyme recall seeing the tick; it feeds and peaces out before being noticed.

The target rash of Lyme, called erythema migrans, can take on many different appearances and distinguishing it from other causes of target rashes is tough. Much of the decision to treat is based on local prevalence of Lyme.

If the OP lives in a Lyme endemic area, then a course of doxy is very reasonable and generally recommended. Wait and see is generally not the way to go because you are waiting for serious symptoms for a disease that has an exceedingly safe treatment. This is especially true for the sister spirochete disease, Rocky Mnt Spotted Fever, since that can kill you while you wait.

Someone else mentioned single dose prophylaxis which is not appropriate for someone with a rash that look like erythema migrans. Prophylaxis is for exposures without symptoms.

[Totem Polar]

Once again, I don’t have much to contribute but this: I can personally attest that a quick spritz of carburetor cleaner will kill a black widow spider dead so fast you’d think it was the hammer of Thor. Which was fine by me.

[LittleLebowski]

Ok, wife took her to convenient care today. They aren’t sure if it’s a tick or a spider bite, said not serious enough to warrant antibiotics at this time.

It did look better this morning in the picture my wife sent me before they went to the doc. Doc gave a cortisone cream scrip which wife/mom applied when they got home. It looks a hell of a lot better now. Kid is totally fine and normal acting.

Doc did say if we see other symptoms to follow up.

Spider bite makes more sense than tick bite given location and other factors. Wife saw a pic on the net of a Parsons Spider bite that looks nearly identical to what’s on my girls arm. But the important thing is that for now, kid seems good to go.

Thanks to everyone that replied for the advice.

Whew. Keep us updated.

[Doc_Glock]

This pretty much spot on. Most of what people call a “spider bite” is just a cutaneous abscess (often MRSA) from a folliculitis or some other break in the skin. The rest are just insect bites from thing like bees, fire ants, and wait for it….wait for it….waaait for it -ticks. Spiders are the extreme minority. Keep in mind that only 50% of people who get Lyme recall seeing the tick; it feeds and peaces out before being noticed.

The target rash of Lyme, called erythema migrans, can take on many different appearances and distinguishing it from other causes of target rashes is tough. Much of the decision to treat is based on local prevalence of Lyme.

If the OP lives in a Lyme endemic area, then a course of doxy is very reasonable and generally recommended. Wait and see is generally not the way to go because you are waiting for serious symptoms for a disease that has an exceedingly safe treatment. This is especially true for the sister spirochete disease, Rocky Mnt Spotted Fever, since that can kill you while you wait.

Someone else mentioned single dose prophylaxis which is not appropriate for someone with a rash that look like erythema migrans. Prophylaxis is for exposures without symptoms.

Excellent advise and I want to add the "convenient care" or Urgent care type places have some of the worst docs on the planet IMO. Show your photos to a real pediatrician in the area or a dermatologist. It could be just local irritation from a bug bite (very unlikely a spider). Both those docs are rash experts.

Edited to add: There are two reasons for antibiotics:

1. for a local infection due to bacteria capitalizing on the bite and getting into the tissue. Apparently this is not needed in your case.

2. to prevent spirochete disease (Lyme Disease) from a potential tick bite. If Lyme is prevalent in your area, then it is super reasonable to treat this before symptoms appear. We don't have Lyme in Arizona for the most part so I would probably blow it off. If you are in CT though...different story.

[Maple Syrup Actual]

Excellent advise and I want to add the "convenient care" or Urgent care type places have some of the worst docs on the planet IMO. Show your photos to a real pediatrician in the area or a dermatologist. It could be just local irritation from a bug bite (very unlikely a spider). Both those docs are rash experts.


A lot of Canadians like to gush about our "free" medical treatment but these are the posts that make me envious.

To see a pediatrician or dermatologist here I would need a referral.

The referral process could take six weeks for a common specialty. A friend who had almost certainly inherited a progressive, fatal neurological disease (it killed his mother) wanted to see a neurologist after finding his coordination starting to degrade at work. The referral took three years. He was wheeled in to get the by-then-meaningless diagnosis, and doesn't have much time left now.



Anyway, I'm really happy to hear your kid is getting treated and it doesn't seem like a big problem. Kid-focused medical stuff just redlines my heart these days.

[Jared]

Whew. Keep us updated.

Day 3 update:

The spot is almost impossible to see now and she is not showing any symptoms.

I’ll add for the other poster that Lyme is not terribly prevalent in my area. I’ve only known one person that contracted it, though I have heard of a few others. Not a lot, maybe 5 over the last 20 years.

Also, if she does get antibiotics, my reading indicates she is too young for doxycycline, so it seems amoxicillin is the best option for her.

Again though, the cortisone cream basically knocked the mark on her arm out. It was already beginning to look better when she got out of bed yesterday morning before the trip to see the doc. By the time I got home from work, after the first application of the cream, it looked dramatically better. Today there is hardly any perceptible redness left.

Knowing that Lyme can progress, we will save the photos and at the first sign of any other symptoms she will be at her pediatricians office, but for now I believe she is ok. Whether it was a spider bite or a tick bite or something else, I just cannot say for sure. Just happy that she seems ok.

[1911Nut]

Jared: Thanks for the update. Vey glad to hear your daughter is, as most kids seem to be, pretty resilient. Best wishes to her and your family, and thanks for updating us.

[TheNewbie]

Excellent advise and I want to add the "convenient care" or Urgent care type places have some of the worst docs on the planet IMO.


Not a doc, but my wife practiced medicine for over a decade. For the most part, she and I would agree with your statement.


My experience with them has been pretty bad and I would now only go if I had no other choice. Obviously there are good docs in the listed roles, but I have only met one.


It's a shame, because it is an important and needed service.

[Duelist]

Not a doc, but my wife practiced medicine for over a decade. For the most part, she and I would agree with your statement.


My experience with them has been pretty bad and I would now only go if I had no other choice. Obviously there are good docs in the listed roles, but I have only met one.


It's a shame, because it is an important and needed service.

Two contrasting stitches visits: an ER in rural Texas. I split my left little finger open longitudinally between a downed sapling and another tree as I pulled the sapling loose. I sat in the waiting room for about three hours. The ER doc said, “There’s no point in stitching that up,” slapped a butterfly on it and sent me on my way. It “healed” as the ugliest, most puckered, messed up scar I have on my body. It crosses a joint, and limited my ability to span and fret notes on guitar for about three years until I worked it enough to stretch the scar tissue out. 5at stretching process helped it to shrink in size as well, thankfully.

Knife cut on a finger on a holiday weekend. Went to the local urgent care. I was in and out in about 35 minutes, with one of the tidiest sets of stitches I ever recal receiving.

I’m not doubting there are poor providers at some urgent cares, but I hesitate to judge a place or a doctor based on what type of facility it is. After all, I hear a lot of negative crap about the high school where I work, yet we have some of the most dedicated educators I’ve ever worked with. I assume the same is probably true of most hospitals and urgent cares: nobody is there to neglect or harm the patients, but they could still suck at their job.

[TheNewbie]

double post

[TheNewbie]

Two contrasting stitches visits: an ER in rural Texas. I split my left little finger open longitudinally between a downed sapling and another tree as I pulled the sapling loose. I sat in the waiting room for about three hours. The ER doc said, “There’s no point in stitching that up,” slapped a butterfly on it and sent me on my way. It “healed” as the ugliest, most puckered, messed up scar I have on my body. It crosses a joint, and limited my ability to span and fret notes on guitar for about three years until I worked it enough to stretch the scar tissue out. 5at stretching process helped it to shrink in size as well, thankfully.

Knife cut on a finger on a holiday weekend. Went to the local urgent care. I was in and out in about 35 minutes, with one of the tidiest sets of stitches I ever recal receiving.

I’m not doubting there are poor providers at some urgent cares, but I hesitate to judge a place or a doctor based on what type of facility it is. After all, I hear a lot of negative crap about the high school where I work, yet we have some of the most dedicated educators I’ve ever worked with. I assume the same is probably true of most hospitals and urgent cares: nobody is there to neglect or harm the patients, but they could still suck at their job.



I agree. Just my personal experience with multiple visits. The ER has been a little more hit or miss.

[Balisong]

Once again, I don’t have much to contribute but this: I can personally attest that a quick spritz of carburetor cleaner will kill a black widow spider dead so fast you’d think it was the hammer of Thor. Which was fine by me.

A blow gun dart isn't fast, but it's interesting to see it try flee as it's pinned to the ground.

[Sensei]

Two contrasting stitches visits: an ER in rural Texas. I split my left little finger open longitudinally between a downed sapling and another tree as I pulled the sapling loose. I sat in the waiting room for about three hours. The ER doc said, “There’s no point in stitching that up,” slapped a butterfly on it and sent me on my way. It “healed” as the ugliest, most puckered, messed up scar I have on my body. It crosses a joint, and limited my ability to span and fret notes on guitar for about three years until I worked it enough to stretch the scar tissue out. 5at stretching process helped it to shrink in size as well, thankfully.


…and so ended you career as a hand model for L’Oréal. ;)

It is a sad commentary on our medical system that people need to go to an urgent care for a rash that might be Lyme or an emergency department for a cut finger.

In a high-functioning system, people would go to urgent care for a cut finger and schedule a next-day appointment with their family ”provider” for the for the Lyme. Welcome to America.

[Joe in PNG]

…and so ended you career as a hand model for L’Oréal. ;)

It is a sad commentary on our medical system that people need to go to an urgent care for a rash that might be Lyme or an emergency department for a cut finger.

In a high-functioning system, people would to urgent care for a cut finger and schedule a next-day appointment with their family ”provider” for the for the Lyme. Welcome to America.

Could be worse- see Maple's comments about Canada.

[Coyotesfan97]

Two contrasting stitches visits: an ER in rural Texas. I split my left little finger open longitudinally between a downed sapling and another tree as I pulled the sapling loose. I sat in the waiting room for about three hours. The ER doc said, “There’s no point in stitching that up,” slapped a butterfly on it and sent me on my way. It “healed” as the ugliest, most puckered, messed up scar I have on my body. It crosses a joint, and limited my ability to span and fret notes on guitar for about three years until I worked it enough to stretch the scar tissue out. 5at stretching process helped it to shrink in size as well, thankfully.

Knife cut on a finger on a holiday weekend. Went to the local urgent care. I was in and out in about 35 minutes, with one of the tidiest sets of stitches I ever recal receiving.

I’m not doubting there are poor providers at some urgent cares, but I hesitate to judge a place or a doctor based on what type of facility it is. After all, I hear a lot of negative crap about the high school where I work, yet we have some of the most dedicated educators I’ve ever worked with. I assume the same is probably true of most hospitals and urgent cares: nobody is there to neglect or harm the patients, but they could still suck at their job.

I think I’ve been to the ER at least ten times for dog bites most of which were just punctures with no real laceration. Generally I went to ERs on the west side of my city. One is a trauma center and that’s where we usually take suspects. If there’s no tearing they’ll leave the puncture open to drain to prevent infection after they flush it out. If they do stitch they don’t close the wound tight so it’ll drain.

One time I went to an ER the east side for single puncture on my hand. The doctor that treated me told me it had to be sutured closed to heal. It got flushed out good and then she sewed it up. It was early morning so I didn’t argue. I’ll admit it was probably the most I was worried about infection.

[Hemiram]

I'm done with "Urgent Care" places after I had 3 trips where I was either misdiagnosed, or given the wrong antibiotic.

First one:

A friend and I were about 22 years old, and he and his future wife were living with his parents. His mom would "bargain hunt" clothes for him and she found what had to be the ugliest shirt at some place for $5.00. It was just hideous, and he said to me, "Hey, lets start wrestling around and grab my collar and yank it off!". OK, so I did it. The shirt might have been ugly, but it was very well made. I really had to pull on the collar and actually lifted him into the air before it ripped off. It was permanent press, which usually means it has nylon threads in the fabric, and one of those threads went in between my nail and the side of my finger. I thought I got it all out, but I didn't. The next day, my right ring finger is about 2X the size of my thumb and it's hot and hurts like crazy. Off to Urgent Care, and the doctor seems to think I'm crazy, "There is nothing in the nail crevice!", he said. The next day, it woke me up and I went to my GP who said, "There's obviously something in there!", and after numbing it, pulled out about a half inch long hunk of white nylon thread. I had to soak my finger in salt water and take antibiotic pills for a few days to resolve it.

Second one:

I had tons of ear infections as a kid, so I know when I am getting one. It was Sat night, and so I went to the same Urgent Care, but there was another doctor there. He looks into my right ear, and says, "Oh boy, you've got a good one going there!" and writes me a script for an antibiotic. By Monday morning, I was miserable, and my left ear was starting to hurt, so I called my GP and they told me to come in and they would work me in. I took the bottle of antibiotics with me, as I was going to be due for my next pill about 90 minutes after I got to the GP's office. He comes in and asks me what he gave me, and when I showed him, he rolled his eyes and said, "That's not an antibiotic for ear infections!", and then looks in my right ear and says, "Wow, it's a mess!", and then looked on the left and said, "It's almost as bad as the right one!!, when was the last time you had an ear infection?". I said, "1974", it was 1994. He put me on what normally would be the right antibiotic but my ears were too far along, and it did take the pain away for a couple of days, the infection and pain came roaring back to the point I was nearly totally deaf and had "stuff" running out of both ears. I ended up taking a hugely expensive antibiotic along with steroids and it resolved in a week or so, but one thing hung over. I started having problems with my Eustation tube in my right ear, and it slowly got worse over time, and in 2020, it would clog up and make my right ear somewhat useless, unless I held my nose and "popped" it. Doing so restored my hearing, but as time went by, the restoration lasted less and less time, eventually being 30 seconds or less.
At that point, I made a huge mistake and went to the local ENT physicians and they told me I had a very odd hearing loss, and my options were a hearing aid, a tube in my eardrum, or doing nothing. I decided to try the tube, and it did nothing but make my right ear useless. I had one Sunday morning about a month ago where my ear was "full" and I held my nose and popped it, only hoping it would take the pressure off and drop the Cicada like tinnitus I get sometimes. Instead, it BANGED loudy enough to make me jump, and for almost an hour, I could hear pretty well, but it went back to nothing. I'm convinced the balloon dilation of my eustation tube would resolve my problem, but insurance won't cover the $4000 cost. I am still getting bills for my cataract surgery, so I don't want to even think about popping for that until that is totally paid off, and one of my docs thinks it's not going to do anything, the other one agrees with me.

Strike 3.

I kicked a couch in 1996, and the next day I could barely walk, my whole foot and heel was purple. I suffered through it at work all night, and in the morning, went to an entirely different Urgent Care. I sit for a while and then go into a room and the nurse helps me take my shoe and sock off. "Wow!, That's horrible!", and then she left. About 10 minutes later, the doctor comes in, it's a neighbor of mine! I never knew she was a doctor. She and her husband were getting ready to build their dream home, and both of them, he was an orthopedic guy, were working all the time to save up money so they wouldn't have a mortgage, she normally worked as an ER doc in a local hospital. She looks at my foot, and says, "I think you have the gout!". "I kicked a steel framed sofa bed!". "I still think you have the gout!", and gives me a script for Colcrys. About 2010 I did develop gout, and this was NOT GOUT. I called my GP and he had me come in and I told him that "XXXXX XXXXXXX thinks it's gout!". He and the nurse started laughing, and said, "I'm pretty sure it's not, did she check your uric acid?". Nope, she didn't. They drew blood and came back and said, "Did you take any of that Colcrys?". I had taken one. He said, "No more, your Uric acid is a little low!". He ended up giving me some Percocets and an anti inflammatory and a couple of days later I was walking my dog again, and guess who I ran into? She asked me, "So the Colcrys worked?". I said, "Nope, but some percocets and an antiinflammatory did!". She still insisted I probably had gout.

That was it, I was done with urgent cares. I go to my GP's office or the one ER where they seem to know what's up.

[Nephrology]

…and so ended you career as a hand model for L’Oréal. ;)

It is a sad commentary on our medical system that people need to go to an urgent care for a rash that might be Lyme or an emergency department for a cut finger.

In a high-functioning system, people would go to urgent care for a cut finger and schedule a next-day appointment with their family ”provider” for the for the Lyme. Welcome to America.

Not to mention the quality of care you are likely to be getting from your "provider" at said urgent care...



I’m not doubting there are poor providers at some urgent cares, but I hesitate to judge a place or a doctor based on what type of facility it is. After all, I hear a lot of negative crap about the high school where I work, yet we have some of the most dedicated educators I’ve ever worked with. I assume the same is probably true of most hospitals and urgent cares: nobody is there to neglect or harm the patients, but they could still suck at their job.

Sure fair counterpoint - for simple, non life threatening problems that do not require significant intervention, urgent cares are fine. However the biggest piece of the issue with urgent care is that emergency medicine (incl. urgent care...) is a specialty that has to be (strives to be) 100% sensitive for disabling/life threatening disease (i.e. it finds every single one, every single time).

Here (https://whnt.com/news/the-misdiagnosis-ended-up-costing-her-her-life-a-texas-familys-warning-for-all-parents/) is an illustrative example of the consequences when this fails to occur. Anyone with half a brain who laid eyeballs on that girl would have sent her by ambulance running code to a real hospital. Unfortunately, even half a brain was too much to ask from this particular "provider."

I'm sure computers can land airplanes quite most of the time too... I still like having human pilots