Ask the Doc: Q & A with Edward Kasarskis, MD, PhD
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Dr. Kasarskis |
Edward Kasarskis, MD, PhD is Director of the University of Kentucky ALS Multidisciplinary Clinic at Cardinal Hill Rehabilitation Hospital in Lexington, Kentucky, professor in the Department of Neurology at the University of Kentucky, and Chief of Neurology at the VA Medical Center in Lexington KY.
Amber Walters. Please understand that we won’t be able to address all questions and we won’t be able to respond to individuals personally.
Q: What would an emergency department physician need to know about me if I have to go to there?
Dr. Kasarskis: Sometimes the diagnosis of ALS is so overwhelming in and of itself that people forget that they’re still susceptible to everyday health problems and the occasional emergency, ranging from “pink eye” and bladder infections to cuts, sprains, broken bones and back problems. And depending on the severity of the problem (which always seems to occur on weekends or after your physician’s office hours), an emergency room visit is a distinct possibility.
Emergency room physicians and staff will first need to know that you are a person with ALS, because that diagnosis can affect not just how your symptoms are approached, but what medications and treatments will be prescribed. If you should need anesthesia, it is critical that the staff understands you have ALS. If you have any significant allergies, those should be prominently noted, too. I urge everyone with ALS to wear a MedicAlert bracelet or locket to make sure that this essential information is quickly communicated.
The staff needs to know what other conditions or diagnoses you have, such as diabetes, heart disease, chronic obstructive pulmonary disease (COPD), high blood pressure, thyroid conditions, and others. They’ll also need to know your medications, and the exact dosages. Please prepare a list of both your diagnoses and your current medications – and stow it in your wallet – so it will be easily accessible in an emergency. Ideally you’ll also have a list of your physicians with their address and phone numbers.
If you have communication challenges, it is important that the ER staff be aware of that. If possible, try to have a spouse, friend, or neighbor come with you to the Emergency Department to assist you with communication. The ALS Association has wallet cards available to describe your communication challenges to someone quickly and easily; the cards are also handy if the police pull you over so they don't misinterpret any communication problems you may have.
Emergency room physicians may, in serious circumstances, need to understand your wishes about medical intervention. It’s important to discuss this with a family member BEFORE such an emergency arises, and designate someone to serve as a surrogate for medical decision making. This means this individual would have the authority to express your wishes to the physician in case you’re unable to express yourself or are unconscious.
Sometimes it’s hard to decide whether a health problem necessitates a trip to the emergency room. There are particular problems that should get immediate attention, and they include breathing problems, allergic reactions, a fever, symptoms of a blood clot in a leg or an arm (deep vein thrombosis), or a sudden acceleration of the symptoms you experience with ALS.
If you live alone or are sometimes alone in your home, (or have a spouse who can’t drive) it’s smart to have a pre-identified friend or neighbor to call in case you need to be taken to the emergency department.
Your question shows you’re already thinking ahead and planning for the unexpected. With ALS, the Boy Scout motto always applies: Be Prepared!
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