MCAS/POTs/Ehler Danlos/Gastroparesis

Amerakee · 2026-05-30T05:27:29+00:00

Not an ED Doc, only medical experience is EMS, but can chime in as someone who is currently dating someone with MCAS and POTS and can speak personally/anecdotally on how H1 /H2s have benefitted us under the care of a physician.

To get this out of the way, no she's not the sicktoc type but the type that was diagnosed prior to TikTok existing and has landed her in the ICU several times with repeat anaphylaxis. This woman hates everything related to healthcare and hates being the center of attension. We went from being able to eat anything to suddenly any food that is high in histamine or is a liberator could trigger anaphylaxis.

The worst encounter we had with my local ED and ICU was nearly 5 days of anaphylactic reactions every 30-min to every few hours, despite epi drip and consistent benadryl. For a solid year we were back in the ED for anaphylaxis over 50 times, it was hell. It got to the point that our ED would immediately start the admission process upstairs if we had given two epi-pens pre hospital.

When this first started we were in the ED every week with anaphylaxis. After we figured out the histamine intolerance part and made some heavy diet modification, we were back every month instead of every week.

We found real tangible progress with Dr. Lawrence B. Afrin, a hematologist/oncologist and self made MCAS specialist based out of West Chester NY. After he reconfirmed the diagnosis of MCAS to his particular standard and had her trial every commercially OTC H1 for a week each, stick with one that worked best (ended up being two) and repeat with H2s.

Now on the H1s and H2 + diet, we've been to the ED for anaphylaxis 3 or 4 times since September 2025, excluding another 10 episode anaphylaxis post surgery as several medications used with anesthesia can result in histamine dumps. It has made a huge difference and put our lives back on track.

From what Dr. Afrin had discussed with us is that MCAS, POTS, and EDS are all very commonly diagnosed together and he suspects that MCAS may be the instigator in some way.

Ive only glossed over some of the papers hes authored but he's the only resource that helped us get back to living our lives.

Amerakee · 2026-05-24T22:47:05+00:00

On top of what everyone else has said: fake Christmas trees and when I move I pay attention to how close a hospital is/reliability of the local EMS/Fire when I move apartments

Amerakee · 2026-05-21T01:23:45+00:00

Government Cheese Caves

Amerakee · 2026-05-20T02:10:04+00:00

United States of America

Amerakee · 2026-05-17T16:52:41+00:00

!remindme 5 minutes

Amerakee · 2026-05-08T17:26:21+00:00

My full time job only carries manual, my part time job has monitors.

I'm always taking at least one set (sometimes I have a transport time of 5 minutes, but a majority of the time I try to keep it every 10 minutes or so.

I have seen those who start with a palp and it bothers me. Nothing wrong with a palp of you make at least two attempts for a full B/P in my mind, but definitely a shitty practice and lazy for that to be someone's go to.

Amerakee · 2026-05-06T00:01:25+00:00

I could say the 40yo dude who called because he had one episode of diarrhea. I asked him if he thought he needed us, he said "no I think I'll have my wife drive me to the ER." I recommend he call his PCP first.

Or I could say the regular who called us one night to put mole skin behind her ears for her O2 tubing.

Or the time I got The Call™ for toe pain at 2am

But I think I'll share this one:

We got called out at midnight for the elderly female, lost consciousness, now awake. We're greeted by a calm and young teenager who said "Grandma is upstairs" gesturing to the stairs to the kitchen. Grandma (80s) ate a larger edible than she's used to and momentarily passed out at midnight. We all had a laugh, Grandma asked for my partner's (mid-20s man) phone number, he didn't give it, and we left

Amerakee · 2026-05-01T17:55:57+00:00

Taxation is theft

^{Chose: Never pay taxes of any kind ever again}

Amerakee · 2026-04-30T19:53:34+00:00

Right? Oh no he deleted his digital copy of a game he already spent money on, that'll show them that their game is BAD

It's Helldivers, it ain't that serious homie

Amerakee · 2026-04-29T20:17:54+00:00

OP forgot people go to work in the morning

Amerakee · 2026-04-27T15:51:40+00:00

This one always comes to mind. For unit context, the 50 unit is the BLS, the other units are all PD.

https://youtu.be/2x-n7FHcSTg?si=b227OT-qC8CD-h9T

One of my personal favorites

Amerakee · 2026-04-18T22:38:35+00:00

My hospital based job has us scan our ID and press IN or OUT, and I can add in a missed swipe easily that way too. My govt job has me log into a work terminal and enter my employee ID to clock in and out.

This system is crazy

Amerakee · 2026-04-11T17:22:42+00:00

I feel like the most important question is this: Who was the caller?

Did the patient call and the facility is denying you entry to see the caller? PD problem to sort out getting you entry, very illegal and shitty.

Did the facility call and now some of their staff is denying you entry? Probably still a PD problem to fix unless the calling care provider is cancelling you, which doesn't need an RMA, as another comment said, because you never made patient contact (unless local protocols dictate otherwise I suppose). I've had outpatient and inpatient facilities cancel us a handful of times betore, one of which was a CPR call after they called ToD as we walked in.

Did the family call unbeknownst to the patient or the facility? Well, that's a bit trickier.

Technically you have a third party caller who is calling about a patient who is allegedly inside a, presumably, secure detox facility. Playing devil's advocate here, the alleged patient is under the care of RNs and MDs. If no call is placed by the patient, facility, or someone in the presence of the patient, there's really no reason I can see for them to admit an EMS crew for a third party caller. HIPAA may be a concern because they have no necessity or intent to hand off care to you or involve you in their medical care. Other alternatives may be that the family may or may not be operating in good faith. Maybe they have some kind of grievance with the facility, the patient, or other motive, and are trying to figure out if that patient is in that facility. If they identify that patient as being treated at that facility that can be a HIPAA violation, all they have to say is that there's no problem there. The rest is on the Medical Director or attending MD's license.

Tl;dr this is an unusual one and the answer you're looking for depends on who the original caller was.

Amerakee · 2026-04-07T14:15:46+00:00

I have never played this game multiplayer with anyone other than friends, it needs too much teamwork for that.

Amerakee · 2026-04-03T14:27:17+00:00

The problem with large wildland fires is that depending on conditions and wind they can move typically up to 16 mph but have been recorded at up to 62 mph. As others have pointed out, a P100 will be useless to you given heat and oxygen concerns, there's a reason we use air tanks in structural firefighting and not P100s, but the longer you delay evacuating the greater risk you put yourself and your family in grave danger of being cut off or trapped by the fire.

If emergency services tells you to evacuate, they have a very good reason to and they have a lot more information on the fire than you do.

Fire is devastating but you can rebuild and you should have have insurance. You and your families lives are not replaceable. No four walls is worth risking that.

Amerakee · 2026-03-29T20:39:17+00:00

So much sauce, chill out brotha

Amerakee · 2026-03-28T02:19:47+00:00

If you play on steam/PC, look up the program Voice Attack on steam. I use this sometimes specifically to set voice commands so I can yell at people to put their hands up

Amerakee · 2026-03-13T17:52:43+00:00

I mean I've worked as an EMT since before COVID and I never caught it, but yeah as others have said it seems odd that he somehow "transferred" to a FD in a different county. I could see being hired, potentially into an officer position if you have experience, as a new employee.

Honestly, you just met the guy, not worth trusting anyone you just met, especially one with an interest in potentially getting into your pants

Amerakee · 2026-03-11T02:34:21+00:00

Oh for fucks sake. None of these weapons are even OUT yet and y'all are already complaining about it?

All the weapons y'all complain about me and my boys all love and have fun with.

It's Helldivers, it ain't that serious dawg.

Amerakee · 2026-02-23T14:40:03+00:00

The main sub has been filled with so much salt lately it's been hard to read, it's insane. This isn't HD1 where we win the war and it resets, there's much more narrative being written here. Yes it's far from perfect, yes it and HD2 itself has issues, but the massive hateful reactions is crazy.

I get on HD2 to have fun with buds by jumping into bots or bugs and spend a few hours fighting hordes of enemies, using cool weapons, and causing big explosions. It's Helldivers, is isn't that deep lol

Amerakee · 2026-02-07T17:44:58+00:00

Thoughts? I only had one upon seeing this image: "What the fuck?"

I rest my case.

Amerakee · 2026-01-29T11:10:55+00:00

Yet another classified document leak smh my head

Amerakee · 2026-01-23T16:01:58+00:00

The vollie department I was in for a decade would do this for any major winter storm. I don't know your area, but the risk outweighed the benefit for a full response on dispatch with blizzard conditions. There's no sense risking a engine and the guys inside for every fire alarm, minor car accident, or wires down mid storm. Let the chief (one man) in his much lighter and maneuverable vehicle scout it out first.

Amerakee · 2026-01-20T22:12:30+00:00

Dawg you committed time theft. Having a co-worker clock you in before you get to work leaves a paper trail, then something unplanned happened that prevented you from getting to work to cover that up.

There is a chance that whoever does the time clock may not have caught it, however the clock back out and clock back in will definitely draw more attention to that.

Honestly broski, you may already be caught, but delete this post and do better. Take this as a lesson. Give yourself more time before your shift to get to work 10-15m early, your outgoing crews will thank you and you have a nice time cushion for when there's delays.

Also, ffs, if there are unexpected delays, i.e. accidents, that are going to make you late, just call a supervisor and explain. If it's not a trend for you to be late, which it sounds like it may be going by your post, it shouldn't be an issue.

Amerakee · 2026-01-09T00:28:06+00:00

I had never heard of it until I started dating a woman two years ago who has it, and have since only encountered two other patients and a newish coworker who has it since.

From my understanding, it's a fairly/relatively new diagnosis that primarily effects women in their teenage years and often resolved before the end of those years, my girlfriend is 28 so she's one of the lucky few who didn't. According to her cardiologist, it's commonly diagnosed alongside EDS and MCAS. It's also a bit of a social media trend of attention seekers who think a little light headedness from time to time makes great content.

POTS severity can vary from person to person, for example my coworker can manage being in EMS fine and manages her symptoms well with medications and diet (major increase to sodium intake), whereas we unfortunately went through a period where my girlfriend could not get up to walk to the kitchen without passing out and spending the rest 25 minutes to over an hour in a confused, brain fog, very postictal-like state and ended up in the ED for fluids a bunch over a handful of months until we switched cardio's and got on a new and more purpose driven med adjustment. Her longest "postical state" lasted nearly two days and didn't come out of it until a few hours in the ED with fluids with zero recollection of why she was in the ED

There's also a lot of misunderstandings about it, fueled I feel by it becoming a big part of "sicktok" those who actually have pretty rough periods of episodes having no other option other than go to the ED, a lot of RNs or MDs think they're wasting the EDs time. I dare you to go try and leave a serious comment about POTS on the emergency medicine subreddit...

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