Stuffing Yourself This Thanksgiving Could Lead to an Avoidable Trip to the Emergency Room

As a health insurance agent, I naturally meet a lot of people who work in the health care field and I hear some pretty crazy stories about patients. This is especially true of the stories I hear from friends and acquaintances who work in the emergency room about their patients — from the 15-year-old boy with an earache who reported that his mother blew cigarette smoke in his ear to “loosen up the wax,” to the man who drove himself to the ER after falling on a length of 1-inch pipe, which was imbedded through his right shoulder when he arrived.

One thing I consistently hear about is how busy the emergency room can be on Thanksgiving, often with patients who could have easily avoided the trip. And for people who have high ER co-pays, or who don’t have health insurance at all, those visits can be expensive propositions.

A lot of people — particularly later in the day, after Thanksgiving dinners have been eaten — come into the ER complaining of chest pain. Many believe they are having heart attacks. And for some, this could be the case. But for many, it’s more often pain due to one of three causes: stress, muscular strain, or overeating.

Stress is a given during the holidays. Relatives are either coming in, or you are going out of town to see loved ones. Dinner has to be on at a certain time and the smallest mistake in the kitchen can seem like a monumental crisis. Family members bicker and argue. Rarely does the day live up to the ideal we build up in our minds. And for some, this stress can lead to anxiety, panic attacks and hyperventilation syndrome, which can very often mimic heart attacks.

When a person panics or hyperventilates, very often he or she may feel chest pain, shortness of breath, light-headed dizziness and numbness in the arms and legs. Though these symptoms are often present in a heart attack, it is important to note that a heart attack typically presents as left-sided chest pain, with numbness and tingling radiating into the neck and down the left arm.

Although some people do experience pain in other places during atypical heart attacks, if you were feeling anxious or stressed just before onset, keep in mind that you could just be having a panic episode with hyperventilation. Try holding your breath for 20 seconds or so, or breathing into a paper bag. This allows the high blood oxygen level that comes with rapid breathing to even out, and should resolve the symptoms if it is indeed hyperventilation is to blame.

Musculoskeletal strain on the chest wall, ribs, back, abdomen or shoulders can often masquerade as a heart attack. Bending and twisting in the kitchen, lifting heavy frozen turkeys or full pots and pans, or bringing Christmas decorations up from storage can stretch and strain muscles, tendons and ligaments. Remember, with a heart attack, you would typically also feel short of breath and light-headed. If you are just feeling pain and that pain isn’t radiating to your arm, back, neck or jaw, you may only have strained something.

Overeating is one of the most common causes of false alarm pains on Thanksgiving. Fatty foods like gravy, turkey, buttery stuffing or mashed potatoes, pumpkin pie, or glasses of egg nog and milk can all cause gallbladder pains.

The gallbladder is the organ in the body that secretes bile — which aids in fat digestion — and when a person eats an overload of fatty foods, the gallbladder has to work hard to keep up. Often, this causes the gallbladder to become inflamed and irritated. The gallbladder is situated high in the abdomen, just to the right of a person’s stomach, next to the liver. Many people who are experiencing gallbladder pains for the first time mistake them, since they tend to be sharp and throbbing and often radiate into the chest, for heart attack pains.

So, if your chest pain or upper abdominal pain began immediately after you ate a food with a lot of fat content, it is possible your gallbladder may be to blame. You typically will not feel short of breath or dizzy with it, and pressing on the right side of your upper abdomen would make the pain worse. There’s nothing to be done in the ER for a bad gallbladder — they’ll end up referring you to a gastroenterologist or surgeon (if there’s a blockage) instead.

Now of course I am not advising anyone to blow off chest pain and not go to the emergency room if they feel like they are in trouble. But the problems above are common and are things to be aware of in advance, and knowing them could help you to make a rational decision about whether or not you should seek immediate care.

If you are having chest pain and you think you need immediate care, take some chewable aspirin and call the life squadimmediately — especially if you are elderly, have any history of heart disease, any previous heart attacks or strokes, or a strong family history of heart disease.

But if you are a reasonably healthy young adult and you just feel a little bit of a twinge after picking up your little niece or nephew, or you had a sharp pain right after polishing off that third piece of Grandma’s pecan pie, think about it a second before you dial the squad. If the pain resolves quickly, save the high ER co-pay and call your primary care doctor’s office in the morning. It’s a better use of your health insurance and cheaper for you.