Dr. Stephen Brooke Cox, MD

Call 911 and get her to the hospital immediately. This is a serious overdose. She could vomit and inhale (aspirate) it, stop breathing, have brain damage.

Thank you very much,
Stephen B. Cox, MD, BCEM, FACEP

Take her directly to the ER. Don't take chances.

No. They are completely different chemicals. Thank you very much.

What happened to all of you was a near-death experience. Taking unknown pills from a stranger or acquaintance can easily end in your death or that of a friend. From you description, the most likely case is that you ingested/snorted pain pills, probably oxycontin, mixed with fentanyl - an extremely powerful narcotic (100 times stronger than morphine) that can cause you to stop breathing and die, and that often causes nausea and/or vomiting. If anyone in your group gets out of it enough to be unresponsive even to a painful stimuli, you should immediately call 911 and get them to the ER. It is possible that sometimes this will turn out to have been unnecessary. It is guaranteed to save a life some of the time. Mixing heroin or oxycontin with fentanyl is becoming increasingly common, and I have personally seen people come in dead on arrival from using one or the other, and others I couldn't bring back no matter how much Narcan I gave them.
Be careful!

Thank you very much,

Stephen B. Cox, MD BCEM FACEP

Short answer: If you are still having any of those symptoms, then go to the ER immediately as you may be having a stroke. IF the symptoms have resolved, you need to see your regular doctor (or get one if you don't have one) within 3-4 days. You need lab work, an EKG, and possibly a CT scan of the brain. These are very serious symptoms and need to be evaluated by a doctor. Just in case the keto diet is a factor, I would stop it immediately until you can discuss your options with a physician.

Stephen B. Cox, MD, BCEM

Hallucinations are always serious. They indicate a serious malfunction in your brain's ability to process sensory input and tell the difference between reality and illusion. It is often due to mental illness such as schizophrenia or bipolar disorder. There are good treatments for these that a doctor can prescribe. Doing some street drugs such as methamphetamine or heroin or cocaine can also cause hallucinations. In any case, it is extremely important that you see a doctor right away. I would recommend going to an emergency room. I am an emergency doctor and can promise you that an emergency doctor will be able to help you to figure out the cause and refer you to the right specialist. One last thing. Hallucinations often get worse over time. I strongly urge you to seek immediate emergency medical care. Good Luck!

Stephen B. Cox MD BCEM txerdoc1@yahoo.com

Yes definitely. The reasons are 1. Pain is in your chest, a dangerous area 2. You describe pain as bad or severe, which means it is more likely to be serious 3. You seem to say that the pain is still there. All three are reasons to go to the ER.  When you have all 3 you definitely need to go to the ER. It might be nothing serious but it isn't worth taking a chance. Good luck!

Stephen B. Cox MD BCEM txerdoc1@yahoo.com

If you think you have a simple bladder infection then you should see your family doctor or (if its more urgent) go to an urgent care center. If you develop pain in your back /flank or fever over 102 or vomiting then go to the ER as the infection may have spread to your kidneys, which is more serious. If you are pregnant see a doctor within 24 hours of having burning with urination- can be urgent care, your OBGYN, or family doctor.

If he gets anaphylaxis the only safe answer is to call 911 for an ambulance to take him to the ER. Anaphylaxis can kill- by swelling the throat closed.
You should have his doctor prescribe 2 pediatric epi (epinephrine) pens. These are for you to inject in his thigh as soon as the anaphylactic reaction begins and buy him enough time to go to the ER.

If he is having trouble breathing or is unable to swallow his saliva then take him to an ER right away. If not, an urgent care center or his primary care doctor are the best choices. An ER will cost you a lot ($1000 and up) more without any benefit.

Yes it happens all the time. If you have any concern this is definitely worth an ER visit, especially if you're over 40 and/or have diabetes/hypertension/high cholesterol which increase your risk.

Yes, lymph nodes serve as the body's immune system filtering process.They can swell in response to any infection (viral or bacterial) or foreign material(tattoo). If your lymph nodes swell near a tattoo make sure to look carefully for redness of the skin around the tattoo (if redness spreads out from actual tattoo may be an infection). Other signs of an infection (tattoo or other) are increased warmth over the area and increased tenderness. I recommend that you see a doctor promptly to make sure it isn't getting infected. That can be a serious problem.

Stephen B. Cox, MD, BCEM

The best thing for you to do is take a basic life support course. These are inexpensive, only take 1 or 2 days, and teach you how to deal with all kinds of emergencies including drowning. They are offered by the Red Cross and YMCAs as well as others. If you google Basic life support course in your area you should find plenty.

Yes that can happen. It would take a pretty forceful punch to do it though.
If a person is having a seizure, make sure there is nothing near them that they can roll onto and hurt themselves, and turn them face up. DO NOT EVER put anything in their mouth (especially your fingers) to "keep them from swallowing their tongue (that's impossible to do). Most seizures go away on their own within 5 minutes. Have someone call 911 or you do it and stay with them until the ambulance arrives. IF the seizure stops but they don't appear to be breathing, you can give them mouth to mouth. Check for a pulse at their neck (carotid artery) and if no pulse start CPR.