Bowel Obstruction! Oh the PAIN!!! To the ER! Superior Mesenteric Artery Syndrome. Life with a Vent

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  • Опубліковано 24 лис 2024

КОМЕНТАРІ • 143

  • @shoshannafachima1306
    @shoshannafachima1306 3 роки тому +12

    Praying that you never have to go through that ever again.
    Sending warm loving healing prayers and energy with a big hug🙏💖🤗

    • @LifewithaVent
      @LifewithaVent  3 роки тому +2

      Thanks you. I hope you had a great Independence Day!

    • @shoshannafachima1306
      @shoshannafachima1306 3 роки тому +2

      @@LifewithaVent we had a beautiful independence Day.we watched the fabulous Bible quiz,and other fabulous events and enjoyed a festive meal with discussions about Jewish and Israeli history

    • @LifewithaVent
      @LifewithaVent  3 роки тому

      @@shoshannafachima1306 How wonderful! It sounds like it was a lot of fun!

    • @shoshannafachima1306
      @shoshannafachima1306 3 роки тому

      @@LifewithaVent it was wonderful
      I hope you are doing better
      We are praying 🙏🙏🙏 for you daily and sending hugs and smiles

    • @LifewithaVent
      @LifewithaVent  3 роки тому +1

      @@shoshannafachima1306 Thank you so much for all the prayers.

  • @donnaghanim6091
    @donnaghanim6091 2 роки тому +3

    Brave woman and a great sense of humor...I am going through major gi issues and I feel your pain. Been tense many doctors inthink it's an obstruction

    • @LifewithaVent
      @LifewithaVent  2 роки тому

      I am so sorry to hear you are going through GI issues. I hope it is soon sorted out, and you are soon on the path to better health.

  • @soheltamboli6626
    @soheltamboli6626 2 роки тому +3

    May God keep you healthy and stealthy!

  • @michellecrawford9847
    @michellecrawford9847 Рік тому +1

    Sweetie I have an obstruction right now and I'm very happy that you were sharing this

    • @LifewithaVent
      @LifewithaVent  Рік тому

      I am so sorry to hear this. I hope you are soon on the path to better health.

  • @parrotpirate9648
    @parrotpirate9648 2 роки тому +7

    Damn I’m so so so so so beyond sorry. I have GI issues myself. Vomiting shaking vagas reactions ext.... I sympathize with you. People ignore don’t believe you or do not give a shit. No pun intended. I’m sorry. We need to support one another in these dark times. Please feel free to reach out if your ever in bad shape. My name is Autumn I’m 34 live in Michigan. Sending my love healing kindnesses!

    • @LifewithaVent
      @LifewithaVent  2 роки тому

      Thank you for your kindness and support. It means a lot to me. I am so sorry you also have GI issues. I hope you have a good year of health in 2022.

    • @vivianstevens4249
      @vivianstevens4249 2 роки тому

      I can’t keep no food down the drs are fucking stupid

  • @Bigday1111
    @Bigday1111 3 роки тому +4

    What a roller coaster! Hope you have some smooth sailing now!

  • @janejohnstone5795
    @janejohnstone5795 Рік тому +1

    Poor lady...you seem..soo sensible...very sad...pain is the worse thing..

  • @jprichardson9630
    @jprichardson9630 2 роки тому +2

    🙏🏾🙏🏾 Prayers for you! I’m so sorry this happened to you. I’ve been dealing with SMA since 2002. I was misdiagnosed as having IBS since 1994. Sending hugs and love to you. Stay strong!

    • @LifewithaVent
      @LifewithaVent  2 роки тому +1

      I am sorry you have been dealing with SMA for so many years. Thank you for the well wishes. All my best to you.

  • @pamhicks2022
    @pamhicks2022 3 роки тому +2

    I m glad that you are not in such pain no more you look.alot better thank God and the doctors for making you better stay strong

  • @luving689
    @luving689 Рік тому +1

    Omg I had that too it’s so hard to see you in that pain I had hernia mesh bowel obstruction throwing up for a week till my surgeon fixed it! It’s no joke!!! It’s unbelievable the NG tube is horrific god bless you for getting through it!

    • @LifewithaVent
      @LifewithaVent  Рік тому

      I am so sorry to hear this. I cannot imagine how challenging that must have been. Thank you for your kind words.

  • @belindamartinez8441
    @belindamartinez8441 Рік тому

    Oh my goodness😔
    So sorry you're going through this pain.
    I pray that you get better

  • @garybernhard3267
    @garybernhard3267 2 роки тому +1

    Same thing happened to me following abdominal surgery, I know exactly what you experienced and I know what excruciating pain you had to endure. Sorry this happened to you, hope you are feeling better.

    • @LifewithaVent
      @LifewithaVent  2 роки тому

      I am so sorry you also had to endure such terrible pain. All my best to you.

  • @JackMartens-xc4cv
    @JackMartens-xc4cv Рік тому +1

    I had small bowel obstruction and emergency laparotomy exploratory surgery on 2/25/23 at 2am. Four days in the hospital.
    An overall horrible and extremely painful experience similar to yours. I am slowly recovering. The scar on my abdomen is totally grotesque. Glad to see you are recovering.

    • @LifewithaVent
      @LifewithaVent  Рік тому +2

      Thank you for sharing some of your story with me. I am sorry you have been through so much. I hope you have a complete recovery.

    • @MrGeorgewf
      @MrGeorgewf Рік тому

      Did you have bowel movements or were you constipated before?

    • @JackMartens-xc4cv
      @JackMartens-xc4cv Рік тому

      @@MrGeorgewf I was actually fine before the pain started with normal bowel movements. No constipation. The pain seemed to come on suddenly and unexpectedly. I didn't have a bowel movement for six days after the emergency surgery. That was probably due not eating for three days. During those first recovery days the doctors kept asking me if I was passing gas, which I was. Thanks for asking.

    • @MrGeorgewf
      @MrGeorgewf Рік тому

      @@JackMartens-xc4cv
      I don’t know how you could have bowel movements and a blockage at the same time. They say you can’t even pass gas with bowel blockage.

    • @Muslimah_R
      @Muslimah_R 4 місяці тому

      Yes I have also heard so​@@MrGeorgewf

  • @rema439
    @rema439 Рік тому

    Thank you for being motivational. I learn alot from you both attitude toward life and infromation!

  • @Tony-gv6ty
    @Tony-gv6ty 3 роки тому +4

    Your amazing going through this and smiling❤

  • @dianehansma1725
    @dianehansma1725 Рік тому +1

    Everyone is so different…amazes me! My pain was so bad with a twisted small bowel, I was in shock and can’t remember anything and doped up and eight hour wait!

    • @LifewithaVent
      @LifewithaVent  Рік тому +1

      Wow. I am so sorry you went through so much. I hope you are on the road to better health.

    • @dianehansma1725
      @dianehansma1725 Рік тому

      @@LifewithaVent thank you for caring! I hope you are on the mend too Hon! I almost died because of the long eight hour wait…three hours of it was waiting for an ambulance to take me to Calgary, AB. Only when I collapsed and I was crashing, that they knew how serious it is! I lost 126cm of small intestine that died and I’m so lucky to be alive! Canada’s healthcare is bad and wait times and shortage of Ambulance’s! Hope your healthcare system is better where you live! Take care and stay healthy! Warm greetings from Canada💕

    • @LifewithaVent
      @LifewithaVent  Рік тому +1

      @@dianehansma1725 Oh my! I am so sorry to hear this! What an ordeal! I am so sorry you went through so much. I am happy you were able to pull through everything. All my best to you.

    • @dianehansma1725
      @dianehansma1725 Рік тому

      @@LifewithaVent all the best to you too Hon!💕

  • @Germistephens
    @Germistephens 2 роки тому +5

    Omg this pain is the worst

  • @yougotaluvme
    @yougotaluvme 2 роки тому

    Your spirit and joking under such pain. You go through so much. I'm not going through nowhere. What you are and I'm breaking down.

    • @LifewithaVent
      @LifewithaVent  2 роки тому +1

      Thank you for your kind words. All my best to you!

    • @yougotaluvme
      @yougotaluvme 2 роки тому

      @@LifewithaVent Thank you, keep fighting. You have my prayers 🙏🏿

    • @LifewithaVent
      @LifewithaVent  2 роки тому +1

      @@yougotaluvme Thank you.

  • @patmcgregor
    @patmcgregor 2 роки тому +4

    I just got out of the hospital with the same thing. Ended up being there for 4 days. Worst fucking pain of my life. I wanted to literally die. They gave me a ton of laxatives which made it 100x worse and then bloated me up even more. I vomited so much that my stomach is soooo sore. Anyways, it was enough pain to make a grown man cry so I’m glad you’re doing good.

    • @LifewithaVent
      @LifewithaVent  2 роки тому

      Thank you for sharing some of your story with me. I am so sorry for everything you went through. I hope you are now on the path to better health.

    • @Copilot1204
      @Copilot1204 Рік тому +1

      Was the pain so bad that you automatically knew something was wrong ? I’m trying to figure out if I have this.

    • @Copilot1204
      @Copilot1204 Рік тому

      You went to the ER right away ?

    • @patmcgregor
      @patmcgregor Рік тому

      @@Copilot1204 it took a a few hours before I realized something wasn’t right

    • @patmcgregor
      @patmcgregor Рік тому

      @@Copilot1204 I would take some gas-x and see if that helps first

  • @Andyisbeep
    @Andyisbeep 2 роки тому +1

    Wow you are really strong everytime I get an ng tube I cry and I cannot even talk it’s terrible idk how you did it

    • @LifewithaVent
      @LifewithaVent  2 роки тому

      Thank you for your kind words. I am sorry you have such a rough time with NG tubes. All my best to you.

  • @jaredkaye3669
    @jaredkaye3669 5 місяців тому

    I had a pressimon and developed a bezoar. I vomited for 8 hours until a pea came out. I kept on squirting and vomiting bile. I am very fit and I was passing out on the bathroom floor from dry heaving so much. I had to sit on a shower chair and constantly drink warm shower water. I needed help.
    My sister's dog died from an intedtinal blockage after 11 days😢

    • @LifewithaVent
      @LifewithaVent  5 місяців тому

      Thank you for sharing. I am sorry you went through so much. I cannot imagine everything you endured. I am sorry your sister's dog died from a blockage after 11 days. How very sad.

  • @roshantweerasinghe9866
    @roshantweerasinghe9866 Рік тому

    God bless you. Hope you are well.

  • @maxitosh8465
    @maxitosh8465 5 місяців тому

    God Bless You So Much 💫💜💫 do you have a unifying diagnosis? complex vascular disease?

    • @LifewithaVent
      @LifewithaVent  5 місяців тому +1

      I have Mitochondrial Disease which seems to be the underlying issue.

  • @sunnya8
    @sunnya8 9 місяців тому

    I have SMA syndrome too. I had surgery for it in 2021. Before that, I was TPN dependent.

    • @LifewithaVent
      @LifewithaVent  9 місяців тому

      Thank you for sharing. I am so glad the surgery helped.

  • @enemanozzle
    @enemanozzle Рік тому

    You will have to distinguish between a constipation and an intestinal blockage. In the first case you will have to swallow early in the morning on an empty stomach 1 tablespoon (= 15 ml) castor oil In the second case you will have to take early in the morning on an empty stomach 1 tablespoon (= 15 ml) castor oil and one hour later a second tablespoon castor oil, eventually another hour later a third tablespoon. In this manner there will be produced a sufficient amount of gall by the liver in order to split the castor oil completely in ricinoleic acid and glycerine, for exclusively the ricinoleic acid will activate the passive histamines in the intestine in order to achieve the peristalsis in the bowels.

    • @LifewithaVent
      @LifewithaVent  Рік тому

      Thank you so much for this information. I do have a question. When I have had bowel obstructions, even taking just a sip of water caused me to have violent vomiting attacks. My vomiting was so severe, they had to place a tube into my stomach to pump out the stomach acid because even the stomach acid in my stomach made me vomit. How does a person take 1 tablespoon of castor oil during a bowel obstruction and not vomit it back up?

    • @enemanozzle
      @enemanozzle Рік тому

      @@LifewithaVent I am sorry, but being no doctor I am not able to answer your question.

    • @LifewithaVent
      @LifewithaVent  Рік тому

      @@enemanozzle Ok, thanks.

    • @Muslimah_R
      @Muslimah_R 4 місяці тому

      You got it all of sudden or you faced some symptoms of obstruction before hand​@@LifewithaVent

    • @LifewithaVent
      @LifewithaVent  4 місяці тому

      @@Muslimah_R Hello. The symptoms came on quite suddenly.

  • @venternicky9599
    @venternicky9599 Рік тому

    God Bless you ❤

  • @clarkhedrick720
    @clarkhedrick720 3 місяці тому

    Here is how it is going for me in two weeks I had seen primary care doctor twice and 1 urgent care visit and been discharged twice from the hospital saying I had viral tonsillitis which was likely since I was in weak shape but I knew something was more wrong. I was admitted the third time after losing 7 pounds in a week even though I had only been eating 300 calories less. I have lost 21 pounds in a year from my all time heaviest weight of 130 and I’m not that short at 5ft 10in. I was admitted in the hospital the nurse was really heavy she ran me into a room and I had first an ultrasound nothing appeared then a ct scan without contrast and ct scan with contrast which showed SMA syndrome and a Nurse practitioner knew what it was but never expected to see it and she showed her colleagues and they were in shock and they brought 5 specialists of the same speciality and they were all in 100 percent agreement that this is SMA. I also, had mri scan with and without contrast and it showed up on those tests too. The worst part for me is that I can’t vomit easily so I constantly have nausea and it just sits and the cramping is agonizing and I can tolerate a lot of pain and I have tried the strongest anti nausea medicine and even that makes me nauseous. The problem too is my kidneys really work extremely well so I have to urinate a lot which would leads to dehydration normally but this makes this condition much harder because I’m drinking 5 liters of liquid a day and close to dying of dehydration according to lab tests and I was only given two bags of saline over a 3 day hospital stay. I been fortunate I can still tolerate eating normal food but with limitations and I cannot eat lunch so I’m forced to eat two large meals to keep up with my calorie goals which is 3,000 so I eat a 1,500 calorie breakfast and a 1,500 calorie dinner and in the meantime I have not only deal with the usual symptoms but hypoglycemia as well.

    • @LifewithaVent
      @LifewithaVent  3 місяці тому

      Thank you for sharing some of your story with me. I am sorry you have been through so much. I cannot imagine everything you have endured. I am glad you are able to still eat normally but with limitations. All my best to you.

    • @clarkhedrick720
      @clarkhedrick720 3 місяці тому

      @@LifewithaVent It has radically changed over the last three days and I’m down to two small meals and will require tube feeding.

    • @LifewithaVent
      @LifewithaVent  3 місяці тому

      @@clarkhedrick720 Thank you for the update. I am so sorry it has radically changed. I hope everything goes well with getting a feeding tube.

    • @clarkhedrick720
      @clarkhedrick720 Місяць тому

      I have a j tube and have gone through seven formulas due to intolerance.

    • @LifewithaVent
      @LifewithaVent  Місяць тому

      @@clarkhedrick720 Thank you for the update. I am sorry to hear about the formula intolerances. I hope you have found something which works for you.

  • @ginabizzarosghosts7831
    @ginabizzarosghosts7831 Рік тому

    It's been 5 weeks for me and I'm terrified.

  • @venternicky9599
    @venternicky9599 Рік тому

    When did all this begin? I try to look at your previous video’s, but can find the beginning?😢

    • @LifewithaVent
      @LifewithaVent  Рік тому

      I have another channel where I chronicle more of my health issues. Here is a link to a playlist which has some of my medical struggles: ua-cam.com/play/PLTvbHDoOBqfWMKI3C2sVtrjOE5kkdKkT7.html

  • @MsLiz2005
    @MsLiz2005 3 роки тому +1

    Get well soon🙏🙏🙏🙏💖💖🙏🙏🙏

  • @vch1436
    @vch1436 6 місяців тому

    Any tips for getting an NG tube in? I had an SBO a few months ago and really struggled with getting it put in

    • @LifewithaVent
      @LifewithaVent  6 місяців тому

      The best way to get a NG tube in is by drinking water while it is inserted. However, if you have a SBO, drinking water during the insertion process is not an option. If you need an NG with a SBO, swallowing as much as you can help with the NG tube insertion process.

  • @donna3465
    @donna3465 Рік тому

    Can I ask what hospital you were admitted to?

  • @RockymountainRobert
    @RockymountainRobert 2 роки тому

    I've had an ng tube, and bowel obstructions, I couldn't even talk with the tube up my nose and down my throat, it was painful and discomforting.

    • @LifewithaVent
      @LifewithaVent  2 роки тому

      I am so sorry to hear this. I cannot imagine everything you have been through. All my best to you.

  • @donlow7036
    @donlow7036 10 місяців тому

    Oh dear, you poor thing.

  • @janejohnstone5795
    @janejohnstone5795 Рік тому +1

    There is nothing...worse than pain...bread lack of fibre....creates all these constipated issues..

  • @syafiqprol5501
    @syafiqprol5501 3 роки тому +1

    Hello are you healthy now?

    • @LifewithaVent
      @LifewithaVent  3 роки тому +4

      Hello. The bowel obstruction is gone. My intestines are better.

  • @jasonmccollum6786
    @jasonmccollum6786 Рік тому

    I'm going through this right now.

  • @janejohnstone5795
    @janejohnstone5795 Рік тому +1

    You look...like you lost lots of weight...you seems such a nice good humoured young lady..

    • @LifewithaVent
      @LifewithaVent  Рік тому

      Thank you. I did lose a lot of weight. I was very sick from chronic pancreatitis. Here is a video which explains what I was going through at the time: ua-cam.com/video/hH10YT9yHxI/v-deo.html

  • @cloudsuba3897
    @cloudsuba3897 2 роки тому

    How are you now mam? My daughter diagnosed has a SmAS..

    • @LifewithaVent
      @LifewithaVent  2 роки тому

      Hello. I am doing fine. I am sorry your daughter has SmAS. I hope she is able to find relief from her symptoms.

  • @moustafaalaa1997
    @moustafaalaa1997 2 роки тому

    Hello, I want to ask you, does this syndrome cause chronic constipation and gas retention?

    • @LifewithaVent
      @LifewithaVent  2 роки тому

      Most of the symptoms associated with SMAS are directly related to the obstruction, most commonly being feelings of nausea, vomiting (especially after eating), stomach pain and tenderness, and feeling full shortly after beginning a meal. Symptoms are often more intense following meals.

  • @thisperson6655
    @thisperson6655 3 роки тому +1

    How to you throw up with trache?

    • @LifewithaVent
      @LifewithaVent  3 роки тому +1

      Throwing up is the same. The stomach forces the stomach contents up the esophagus and out the mouth.

  • @ziggymorris8760
    @ziggymorris8760 Рік тому

    It put me in the hospital a few months ago, third fucking time in 15 years.

    • @LifewithaVent
      @LifewithaVent  Рік тому

      I am so sorry to hear this. I hope you are on the path to better health.

  • @luminitagheorghe6163
    @luminitagheorghe6163 10 місяців тому

    Hi i have too this diseas how is manifested bowel obstruction ? I have costipation and no bowel movement

    • @LifewithaVent
      @LifewithaVent  10 місяців тому

      I am sorry you have this. It manifests as vomiting and severe pain.

    • @luminitagheorghe6163
      @luminitagheorghe6163 10 місяців тому

      @@LifewithaVent i see on internet you can take of pancreas and live a good life....put islet cell from liver! Whay don t you do this ?

    • @LifewithaVent
      @LifewithaVent  10 місяців тому +1

      It is a very risky procedure. Many people have complications. My friend, who had the surgery, passed away yesterday from complications.

    • @luminitagheorghe6163
      @luminitagheorghe6163 10 місяців тому

      @@LifewithaVent o my God! So sorry! But i see a girl on internet after procedure is doing weel a woman same ...is ok even pancreas!

    • @LifewithaVent
      @LifewithaVent  10 місяців тому +1

      @@luminitagheorghe6163 That is great to hear. I am glad she is doing well.

  • @colywogable
    @colywogable 2 роки тому +2

    You shouldn't have waited to go

  • @symanowrin1941
    @symanowrin1941 2 роки тому

    Hi , I had a colonoscopy and they gave me a sedative but it didn’t work out . During colonoscopy I was moving and telling them to stop but they didn’t stop .now I am afraid maybe I have bowel perforation. I have diarrhea And abdomen pain . Doctor is not helping me . Please guide me

    • @LifewithaVent
      @LifewithaVent  2 роки тому

      Hello. I am so sorry to hear this. It is common to have diarrhea and abdominal pain for 3 to 5 days after having a colonoscopy. If your pain is lasting longer than this, please seek medical attention at a walk-in clinic, urgent care or primary care provider.
      If you have symptoms such as fever, chills, nausea, vomiting, abdominal pain and diarrhea, please go to the nearest emergency department as this may indicate a serious health issue.

  • @tanschi8449
    @tanschi8449 2 роки тому +4

    Why do you get so lousy health care. Getting an NG tube without any suction. Having a nurse push too much fluid through your already sensitive j tube and the just being there. Sounds like a hispital from hell. I'm so sorry you have to go there. Is ther a way you can go to another hospital for your care? I mean, to a place that doen's make your life misrable unnecesarily? I wish you the best

    • @LifewithaVent
      @LifewithaVent  2 роки тому +2

      Thank you for your concern. This hospital is very good. It is the best in the area. Sometimes the patient care is less than ideal. However, my primary care team works at the hospital. They are very knowledgeable about my medical history and provide excellent care and follow-up after discharge.

    • @Guess_Who-g7b
      @Guess_Who-g7b 2 роки тому +1

      @@LifewithaVent Gosh you are a trooper! I went through a 9&1/2 hour surgery after my 4th BO. Mine is due to cancer treatments (in remission now) I am presently going through it again 😞. I refuse to go to ER as I also went through heck with ng tube. Health care here is a mess. I’m at the point of just giving it to God. He will either heal me or take me as I cannot do this no more. God Bless you! 🙏🏼

    • @LifewithaVent
      @LifewithaVent  2 роки тому +2

      @@Guess_Who-g7b Thank you for sharing some of your story with me. I am so sorry you have been through so much. I pray you have strength and can find medical care. All my best to you.

    • @yougotaluvme
      @yougotaluvme 2 роки тому

      @@Guess_Who-g7b How you feeling now. I hope God healed you up.🙏🏿

  • @akadriopeyemi5347
    @akadriopeyemi5347 Рік тому

    The Lord will strengthen and restore you to a better health in Jesus Christ name 🙏🙏

    • @LifewithaVent
      @LifewithaVent  Рік тому

      Thank you.

    • @akadriopeyemi5347
      @akadriopeyemi5347 Рік тому

      @@LifewithaVent Heb.11.6 But without faith it is impossible to please him: for he that cometh to God must believe that he is, and that he is a rewarder of them that diligently seek him. (KJV).
      Hold on to God♥️

    • @LifewithaVent
      @LifewithaVent  Рік тому

      @@akadriopeyemi5347 Thank you. I really appreciate that.

  • @bleulotus
    @bleulotus 2 роки тому

    Triphala!! So you never have this problem again

    • @LifewithaVent
      @LifewithaVent  2 роки тому

      Thank you for the information. I have been taking triphala since 2013.

  • @fernandosaldivar238
    @fernandosaldivar238 Рік тому +1

    I had 4 bowel obstruction with 2 surgery that pain is the worst i was in the hospital 🏥 for 3 weeek got elieus after surgery was very bloated an still having gi problems till this days now am seen specialist any info u can help me out with I file for disability cause not able to work for this reason it sucks good videos

    • @LifewithaVent
      @LifewithaVent  Рік тому

      Hello. Thank you for sharing some of your story with me. I am sorry you are having so many issues. It may be helpful to keep a food journal. Document what you eat and any symptoms you may have. There may be certain foods which are causing symptoms. All my best to you.

  • @Oppinnindi
    @Oppinnindi 2 роки тому

    Pain wasn’t that bad if you “prefer to go to the ER on a weekday 🙄

    • @LifewithaVent
      @LifewithaVent  2 роки тому +2

      Your comment made me smile. I am guessing you do not have complex medical conditions and have gone to the emergency department (ED) on the weekend. If I go to the ED on the weekend, they will not treat me. They will either 1. discharge me home and tell me to call my doctor on Monday morning. 2. Keep me waiting in the ED until Monday. Then they call my doctors to let them know I am waiting for them in the ED. If I stay in the ED, they will put me in the hall, place me back out in the waiting room or put me in an un-staffed area. No medical treatment is given while I wait.
      I prefer to go to the ED on a weekday because that is when my doctors are working. If I go on a weekday, I can medical treatment.
      If you watch any of my other videos, I have made the same decision. I was sick with sepsis and organ failure over a weekend. I waited to go to the ED. I was extremely sick with pneumonia over a weekend. I again waited until Monday to go to the ED.