How has she maintained jobs or other things requiring regular attendance up to now?

In 2010 I started getting ridiculous pain around the area below my right ribs that radiated into my back where it aggravated an old injury, got me vomiting though I'd almost never vomited before, no relief from OTCs or trying moving into different positions. It took a couple episodes before I went to the ER, didn't have insurance at the time (did qualify for Medicaid, which covered this care retroactively). Dx'd gall bladder issue, removed 2 weeks later. I haven't had as intense pain since then, but do get attacks without identifiable cause. The first time I went back to the ER, concerned there was something really wrong. They said I had a UTI, second time I went to my GP who said it was the flu. Found these conclusions perplexing, the pain and its' location seemed nothing like those causes, stopped going to anyone when an attack came after that. I've since heard pain signals can get mixed up, registering as pain in one area when it's a different area sending the signals. Also, the doctor I see now speculates a nerve could have been left exposed in the surgery, so I would get the pain when that nerve gets aggravated. When it happens I take Trazodone and lay down until it passes, taking Zofran when the pain gets me nauseous. These do work for me, but if I can't lie down it doesn't work well.
My pain is/was from the gall bladder and apparently post-surgery issues. I expect she's been checked for gallstones at some point, and you haven't mentioned a surgery so I'm guessing its' cause isn't like mine. With the exception of the possibilities of experiencing pain in the wrong location.
I couldn't establish any trigger for my pain; eating fatty food is often connected to gall bladder problems because it taxes the system, calling for more bile than otherwise to digest the fat - but I've found no connection with that for me. Nor with a drink or dehydration, but lately if I fail to eat the feeling of hunger starts feeling similar to the pain, but not as bad, and I eat something before I could know how bad it could get.

There's a lot of options of where to go for such pain around here - 4 ERs in what I'd consider "in the area", and maybe a dozen urgent care centers within the same area, judging by the number of them I can count in the areas I frequent or otherwise know of. If you have any urgent care centers near you I'd recommend going there instead of the ER, if possible. Such pain needs treatment asap, but seems to have no life-threatening cause, which would make urgent care centers a better - and likely cheaper - choice. Returning to the ER often for non-life threatening causes can get less-professional treatment, especially if there's a more appropriate place available.