Ultrasound to Emergency

This is Part 2 of the Gallbladder Saga

We left off having gone to Urgent Care, being told that my liver enzymes were elevated and that I might be looking at a serious liver disease.

The Urgent Care physician had booked an early morning ultrasound to take a look at the gallbladder and the liver. So I took some extra medication to try helping me sleep, and waited.
The ultrasound itself was fine. A little painful, really nauseating, but fine. The technician gave nothing away, really, other than being confused as to what exactly she was looking for. I try not to read too much into these if I can help it, especially since I would be getting results later that day, which is fast.

At Urgent Care the night prior, the physician suggested that I call to book an appointment with my GI specialist (who would also look after me for a liver disease if I had one). So, after a couple hours of waiting until the results had likely reached my GI's office, I called there first - before going to Urgent Care for the full results from the physician who saw me the night before. 

I called my GI.
Away on holidays. (I seem to have a lot of flares and episodes when people are out of town. My illnesses like to be inconvenient for everyone haha). My GI is kind of a superstar. He heads a ton of different research projects and speaks at conferences all over the world because of his expertise in Inflammatory Bowel Disease. I am especially fortunate to have him as my specialist.

The problem with not having him to look at the results is that sometimes the nurse or fill-in has no clue about my history.  When I spoke to the nurse, she said that nothing showed up on the ultrasound and that she was not at all concerned about my liver enzymes. She would not book an appointment.
I did mention my symptoms were worsening, but she continued to say that my ALT enzymes were not concerning.

Okay.
Here I am on one side being told that I may have a serious liver disease OR gallbladder issue (plus the threat of Primary Sclerosing Cholangitis making a comeback), AND evil Google reminding me of that 6-months-to-live doozy it so valiantly offered up onto my screen, and then on the other side,  this nurse saying it is absolutely nothing and not even booking an appointment....

I decide to still go back to Urgent Care for results from the physician from last night (since they were expecting me anyways). Apparently there was some 'Sludge' in my gallbladder, but no visible gallstones that he could see. He still felt that liver disease was the likely culprit, suggested I take a bit more pain medication, see my GI (I didn't bother to mention that they wouldn't book an appointment), but watch for any further symptoms of gallstones (not really understanding what that meant at the time).

Hmm.

So I planned to make some calls, book an appointment, and rest at home.

But the symptoms became worse. A lot worse. Every time I tried eating it would feel so much worse. This constant pain deep in my abdomen, nausea along with it, radiating pain to my back (kind of wrapping around my right side), and SO much nausea. Then, when I tried sleeping on my stomach I thought I was going to crush something valuable.
By the time midnight came around I was sobbing uncontrollably and doubled over in pain.

Well sh*t. Now what?
I have already been to Urgent Care TWICE, I have had an ultrasound, my own specialist's nurse said she was not at all concerned and would not book an appointment, but I keep getting worse. And worse. Randomly dry-heaving with no real substance, nausea, pain, and so much sobbing.
Plus, there is the complication of my illnesses and medications suppressing fevers. I don't really get fevers. I can feel like I am feverish, but the numbers rarely (if ever) show it. HAE is partly to blame, but some medication I take can do the same thing. It is a good thing overall, but when there is a question of infection and there is no fever, it takes longer to figure it out. I didn't have a fever with any of my severe UTI's or kidney infections, I didn't get fevers with pancreatitis, mono, colds, bronchitis, or any other infection.
So, as usual, I didn't have a fever either.
So what do I do? Is it nothing? Is it a chronic liver disease? Is it an acute gallbladder problem? Is it an HAE attack? Is it just a blip that will settle on its own?
How do I know how serious it is and whether or not going to the ER is warranted?
All I knew is that I could not handle the pain at home anymore. I was barely able to function because of crying from the pain and nausea. But was it really worth going to the hospital?

So I do the only thing that comes to mind from my more severe health days:

Why not call the GI on-call to ask if it is serious enough to go into the ER??

This is something I have been told in the past to do if I am scared but unsure of the severity.
THIS WAS A HUGE MISTAKE. I will explain why later. The conversation was short, not helpful to me, and definitely harmful when it came to having a rapport with this GI.

With no real advice on the direction we should take, and no improvement, we decide to take me to the ER anyways. A different ER from the GI on-call I had just royally pissed off.

The second I got in line for the triage nurse, now feeling horrendous, dizzy, faint, and kneeling down from pain, I vomited ugly brown sludge into the puke bin I brought from home.
They definitely got me in shortly thereafter.
Following immediate bloodwork, a doctor came to speak to me looking a little misty. My ALT enzymes had doubled since the night before.

It was looking more and more like liver disease. They decided to have me stay at the hospital and be monitored until they could figure out what the exact problem was and where to go from there.

As it turns out, the ER is exactly where we should have gone. At least I know we made the right decision.
That's a relief.