“Should I stay or should I go?” Chances are you’ve grappled with that question during an apparent lupus flare, trying to suss out if your symptoms could be handled at home or warranted a rush to the emergency room (ER).

“I’ve learned if you think something is wrong, just go to the emergency room,” a MyLupusTeam member stated. “I know we all hate to go, but when you have lupus and other autoimmune diseases, anything could be happening to your body, and it’s best not to take chances.”

If you’re on the fence about going to the hospital, in some cases it’s OK to call your doctor first and ask for advice. They should be able to tell you over the phone if you need to go to the ER or if you can manage your health issue at home. When a problem strikes during regular business hours, you might be able to get a last-minute appointment with your usual health care provider or visit an urgent care facility.

During off-hours or life-threatening situations, however, the emergency room may be your only option for medical attention. Here are some general guidelines on what indicates an emergency versus common symptoms of lupus.

Are You Having a Serious Emergency?

The emergency room is nonnegotiable if your health and safety are in immediate danger. People with systemic lupus erythematosus, the most common type of lupus, may tend to assume that a medical problem is autoimmune-related. However, symptoms can also be caused by another medical condition, like a heart attack or injury.

Examples of when to head straight to the emergency department include the following symptoms and situations:

• An allergic reaction that causes swelling and difficulty breathing
• Severe chest pain or tightness
• A broken bone or deep wound
• Choking
• Coughing or vomiting blood
• Drug or alcohol overdose or poisoning
• Fainting
• Inability to talk, walk, move, or see
• A severe burn
• Weakness or drooping on one side of the body

If you’re in immediate trouble, call an ambulance rather than get a ride to the ER. Paramedics may be able to assist you at home and stabilize you before traveling for further care.

Other Symptoms You Shouldn’t Ignore

Drawing a line between a medical emergency and a normal lupus flare-up can be difficult. Everyone has their own comfort level when it comes to monitoring their health at home. And unfortunately, the expense, fear, and inconvenience of a trip to the hospital can keep some people staying home longer than they should. Listening to your gut can help you make the right choice.

Don’t waste time if you experience any of the following symptoms:

• Shortness of breath
• Confusion
• Excessive bruising or bleeding
• Spiking fever
• Intense abdominal pain
• Seizures
• Unusual changes in mood

If you have a combination of multiple symptoms, like a stiff neck, headache, and fever, it’s especially important to seek medical care. MyLupusTeam members have shared their reasons for heading to the emergency room.

“I went to the ER last summer because I felt like I couldn’t catch my breath, and my blood pressure and resting pulse were extremely high. They admitted me overnight,” one member said.

“I’ve had ER visits for weakness, which were usually the flu, infection, anemia, or dehydration,” explained another.

Urgent care clinics can be a good in-between option for symptoms that need to be addressed quickly but aren’t necessarily life-threatening. People with lupus might go to urgent care for symptoms like a small rash, a viral illness, an earache, a sprain, or a minor injury. For example, you can quickly get a test for strep throat and a prescription for an antibiotic from a health care provider there rather than waiting to see your usual doctor.

The urgent care provider may encourage you to follow up with your rheumatologist afterward, because lupus and lupus medications can affect your immune system and make you more vulnerable to further complications.

When To Call Your Doctor First

If you don’t feel well with lupus, you could be having a flare-up. Your rheumatologist is the most qualified person to help. Not only do they have expertise in treating lupus and managing lupus medications, but they’re also familiar with your personal medical history and treatment plan.

Reasons to call your rheumatologist include:

• Extreme tiredness
• Hair loss
• Swollen or painful joints
• Sensitivity to light
• Poor appetite
• Rashes

You should also contact your rheumatologist if you think you’re experiencing medication side effects or lupus symptoms that indicate your treatment isn’t working. Your rheumatologist may prescribe temporary treatments like corticosteroids, antimalarial drugs, and immune-suppressing drugs to get your symptoms under control.

Lupus flare-ups and medication side effects can cause swelling in the hands and legs. However, this is a tricky symptom that could also indicate a more serious blood clot. “I had a really bad pain in my upper thigh but wasn’t sure what I may have done,” a MyLupusTeam member shared. “After nine days, this pain moved to my calf area and hurt so badly I couldn’t walk! I called the doctor, and they said to get to the ER right away. I had a blood clot in my leg. I stayed in the hospital for four days while they dissolved the clot.”

Paying for Emergency Care

If you’ve ever gone to the emergency room only to be hit with a staggering medical bill, you’re not alone. Treatment in the ER can be double or triple what you’d pay for care at your provider’s office. Depending on your insurance plan and the hospital’s policies, the ER may also collect a high copay during your visit.

However, you should never hesitate to go to the emergency room because you’re worried about the cost. Even if you don’t have health insurance, the hospital is required to help you out of imminent danger. After evaluating your health, they may send you to a different facility (like urgent care) if you’re stable enough.

Many resources are available to help cover the cost of medical bills. If you have health insurance, start by double-checking your policy and calling your carrier to make sure you were charged correctly.

Next, call the hospital’s billing department and explain your situation. You may be able to apply for financial aid to cover some or all of the bills or, if you’re willing to pay the full sum at once, get a discounted rate. If needed, the hospital should be able to set you up with a financing plan to pay off the bill gradually.

Take your time with getting home and getting well before facing the added stress of paying for your ER visit. You may have more options than you think, so it’s OK to set that concern aside for a couple of days. Try not to get anxious when the first bill arrives — your health is more important. What matters most is that you always seek out and receive the care you need while living with lupus.

Talk With Others Who Understand

MyLupusTeam is the social network for people with lupus and their loved ones. On MyLupusTeam, over 223,000 people with lupus come together to ask questions, give advice, and share their stories.

What new symptoms have you encountered, and where did you seek treatment? What’s been your experience with health care professionals in the ER versus your regular doctor? Post your thoughts in the comments below, or start a conversation by sharing on your Activities page.