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Right lower quadrant pain due to appendicitis - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Average Posted in: Abdominal Pain
Answered by

General & Family Physician
Practicing since : 2004
Answered : 1722 Questions
User :   I am a 30 year old male. For the past several days I have had some symptoms that are worrisome. For about 7-8 days I have had on and off lower abdominal pain from midline to RLQ. I have been vomiting for 4 days anytime I eat or drink anything, I am able to keep medicine, ie Tylenol, down which has seemed to help with the low grade fever of about 99-100 I have been running. The pain has become more severe now and continues to increase in the RLQ. I have no appetite and havent eaten or drank anything over the past 36 hours. I havent urinated in over 24 hours. I also have severe watery diarrhea. The pain is becoming increasingly unbearable. My main concern is this. I have to been to the local ER multiple times in the past several months for cluster headaches. I know they have labeled me a drug seeker although I am not. My major concern is they will just blow me off again and not help with the pain or nausea or doing anything else. What do I do? Does my symptoms warrant a trip to the ER?
Doctor :   Pls. Give me few secs to go through your query.
User :   Okay. Thank you.
Doctor :   Hi The symptoms you have described clearly indiacate that it is an Emergency situation and you might be having a very bad appendicitis.
Doctor :   As all the symptoms clearly indicate that - vomiting, decreased apetite, pain in RLQ.
Doctor :   Do you have rebound tenderness ?
User :   Well, my main concern is 2 fold. I have been to the ER in the past for the same thing and everything "appeared normal" except for some secum inflammation. Also my most worry concern is the label I have received as a drug seeker makes me very nervous to go. I have been multiple times for cluster headache treatment and when I say frequent visits they are numerous. How do I not get treated like a drug seeker, but still get relief for the nausea and pain and a unbias diagnosis.
User :   What is rebound tenderness?
Doctor :   Ok,Dont worry.
Doctor :   I would advise you to seek a gen. surgeon's consultation as soon as possible, he may help you out.
User :   Do I go to the ER?
Doctor :   Rebound tendreness is pain on examination, if you touch/press the affected area , you may have no pain, but after you remove your hand and stop pressing , you will have pain ?'
Doctor :   I would say ER is the best place, but If they dont treat you well, I would advise you to seek a gen. surgeon's emergency appointment.
User :   Yes I just tried and I have rebound tenderness. It doesn't really hurt when I press, but it sends a shock wave of pain through my abdomen that hurts.
User :   Is there anything I can say to them that will help in receiving relief from the nausea and pain and not be treated like a crazy drug seeker?
Doctor :   Ok, There is no way that you should wait
Doctor :   you have to go to ER and take a sugeon's advise and get an ultrasound done immmediately.
User :   Also I have a feeling that it is my appendix and have learned to listen to my body. What is my WBC comes back normal and the CT or ultrasound sound no problems what should I do. I know deep down inside that it is my appendix and it has been making my whole body sick for quite some time.
User :   Is it possible for me to insist that they remove it?
Doctor :   Ok.
Doctor :   The CT & USD were normal ?
User :   I hope I'm not sounding to crazy to you. The CT's I have done for this type of pain in the past were always normal.
Doctor :   This seems to confirm that there is no appendicitis previously, but how about now ?
User :   Yeah I don't know. Like I said i have been hurting off and on for about 7 days, but now the pain is increasing in severity and isn't going away like normal.
User :   So it is your opinion that I go to the emergency room?
Doctor :   In that case i feel you have to visit ER.
User :   Do you have any tips as far as being treated with dignity and compassion?
Doctor :   But please let them know the problem you are in and if they feel you are a drug seeker , they can get a psychiatric evaluation done , but you can let them know that you are in a real emergeny.
Doctor :   And they will surely undersatnd the situation.
Doctor :   Dont worry.
User :   Well I appreciate your time and I think I will take your advice as long as I can get up the nerve to ask someone to take me.
Doctor :   They will treat you with dignty.
Doctor :   Thank you for consulting me
Doctor :   take care
Doctor :   bye for now
User :   Thanks.
User :   Bye
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