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Treatment for chronic pain in abdomen - Online Doctor Chats

Date : 13-Jan-2012
User rating for this question
Excellent Posted in: Abdominal Pain
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2380 Questions
User :   good day
Doctor :   hi
User :   hello
Doctor :  
good dat to you to
User :   if you could be so kind of explaining some things with my results that im really confused
Doctor :  
i will help you
User :   I will first give you information on my medical history
Doctor :   ok
/
User :   i have been through 6 operations already
Doctor :  
ok
User :   appendectomy, 3X C/S, subtotal hysterectomy and left oophorectomy
Doctor :  
ok
User :   i had hysterectomy last 2005 and 3-5 months after i already have been complaining of pelvic and abdominal pain
Doctor :  
ok
User :   then on january of 2007 my left ovary twisted and ruptured
Doctor :  
ok
User :   my pain in my abdomen became more severe only in a specific area
User :   the right lower quadrant
Doctor :  
ok
User :   1st i was thinking that it might be my remaining right ovary
Doctor :  
ok
User :   then when i already went for a 2nd opinion i just learned that the cervix which should have been remove last 2005 was still there with nabothian cysts
User :   until the pain became more chronic
User :   now 3 weeks ago i had dysmennoreah pain in the pelvic
User :   and i was wondering how come i would have that kind of pain since i have been hysterectomized already
User :   4 days ago i just came out from the hospital because i have chronic pain in the lower abdomen and in a new location under my rib cage
User :   that the pain was radiating up to my back and it became swollen
User :   at 1st the doctor said that it is because of gall bladder stones
User :   then in the hospital when the ultrasound has been done, yes i have gall bladder stones but is not causing the pain and my high fever
User :   again they they said that it might be the kidney
User :   but in the ultrasound report even there is a little problem with the kidney, its still not the one that is causing the pain,
User :   my doctor now has ordered for a blood test because my cbc had shown that i have chronic anemia
User :   here is the different counts: seg:43, lymph:40, mono:06, Eo's: 09, band/stab02
Doctor :  
ok
User :   Normocytic normochromic RBC. Occassional normocytic hypochromic cells. Occassional acanthocytes and schizocytes.
WBC adequate with almost equal predominance of segmenters and lymphocytes. Most of the segmenters with toxic granules. Atypical lymphocytes seen. No evidence of prematurity.
Platelets adequate occassional large forms and clumps seen.
Doctor :  
ok
User :   1st pls explain this blood result and what could it be
Doctor :   the blood report which you have provided seems to be normal

User :   before i forget last march 2009 they have seen a small nodule in my cervix in a transvaginal ultrasound
Doctor :  
ok
User :   even with the atypical lymphocytes?
Doctor :  
what if atypical lymphocyte is there?
Doctor :  
blood reports are not interpreted in isolation
User :   sorry i did not understand
Doctor :   what is your hemoglobin level?
User :   80L
User :   WBC 8.3 RBC 2.72 Hgb 80L Hct .244L
User :   doctor are you still there?
Doctor :   yes
Doctor :   the hemoglobin level is low
Doctor :  
you had anemia
Doctor :  
and you have had an infection from which you have recovered recentely
Doctor :  
this is what i can make out
Doctor :  
what did your doc say?
User :   honestly none
User :   they cant determine where the infection came from
User :   because they said even i have problems with the gall bladder and the right kidney it will not cause that much infection
Doctor :   what is the diagnosis they have made now?

User :   none unfortunately that is why im already desparate and frustrated
Doctor :  
what symptoms you have?
User :   i have pain almost 4 years now
Doctor :  
ok
Doctor :  
only pain?
User :   chronic right lower abdominal pain
User :   and pain also in the middle of the pelvic area
Doctor :   ok
User :   always dizzy, my right back still inflamed
Doctor :  
right back inflamed?
User :   the inside of the middle pelvic area is the one that i am relly complaining with pain
User :   swollen i mean
User :   i also already had my urea and creatinine checked and the result came out to be normal
Doctor :   ok
Doctor :  
every report seems to be normal
Doctor :  
and all the investigations are with in normal range
Doctor :  
the hemoglobin is little low
User :   what do you think of the soarce of my pain?
Doctor :   it is your fear in you that you have some big disease
User :   yes it may be but the pain is really bad almost everyday even i dont do anything i really feel super fatigue
Doctor :   how bad is the pain?
User :   there is this pain like cramps that is like always there but the sharp stubbing pain is what makes me really in so much pain
User :   like now dysmennoreah pain im feeling
Doctor :  
may i know your height and weight?
User :   im 5'4" and with my weight 80kls
Doctor :   may i know your age
User :   26
Doctor :  
may i know about your occupation?
User :   after my hysterectomy i cannot anymore go back to school because i became epileptic because of severe blood loss
User :   i had cardiac arrest also and clinically dead for i think 2 minutes
Doctor :   why was hysterectomy done?

User :   technically it was a misdiagnosis
Doctor :  
meaning?
User :   they said that i had placenta previa accreta
Doctor :  
ok
User :   but i was taking the injectable depoproveda
Doctor :  
ok
User :   and before going to the hospital their 1st diagnosis is eptopic pregnancy
Doctor :  
ok
User :   but i argued that it is impossible because of the med injected to me
Doctor :  
but i argued that it is impossible because of the med injected to me -- i did not understand this
User :   they had daclared after operation that they did a total hysterectomy but after i already was starting to complain of pain and got a 2nd opinion in the ciity they only done subtotal
User :   i argued with my ob gyne that day of the operation that i cannot be pregnant because of depoproveda
Doctor :   ok

Doctor :  
what did the histopathology of hystrectomy say?
User :   i really do not know what it is already, yes i might have lost my trust to the doctors here but one thing i am really sure of the pain that i have started from mild to severe
User :   well the histopathology is also not very much helpful because we got it from a mental institution from a very far place from ours
User :   they did not even seen any fetus
Doctor :   mental institute and histopathology?

User :   yes that was also my 1st reaction
Doctor :  
please provide me the the details as it is in the report
User :   its a little complicated from here
User :   ok
User :   the pathology report
User :   the specimen submitted consists of a uterus with detached uterine segment.
User :   the uterine segment corpus meas. 7.0x8.0x5.5cm.
User :   and appears brownish and ovoid.
User :   cut sections reveal a 3.0cm thick myometrium and pinkish red endometrial layer
User :   3 detached fragments are also submitted
Doctor :  
ok
User :   the 1st appears grayish, irregular and doughy, meas. 4.0x2.5cm
Doctor :  
ok
User :   2nd appears grayish meas 5.0x3.0x2.0cm
Doctor :  
ok
User :   3rd measures 4.5x3.0x2.5cm. RSEB7
Doctor :  
ok
User :   microscpic description
User :   sections of the uterus reveal gravid uterine changes exemplified by decidualization of the endometrium and hypertrophy of the myometrium
Doctor :  
ok..
User :   sections of the lower segment as well as the 3 detached tissue fragments reveal presence of chronic-villi
Doctor :  
ok..
User :   some with myxoid degeneration, on and within the upper layer of the myometrium without an apparent plate
User :   diagnosis: User :   Uterus, TAH
User :   post gravid uterine changes
User :   c/w placenta accreta
Doctor :   ok

Doctor :   the histopathology has told you have undergone TAH and you were suffering from placenta accreta
User :   yes that is what they're saying
Doctor :   for placenta accreta hysterectomy is done most of the time
User :   yes but it was my second month of just having the injection for not getting pregnant
User :   my mistake before was i did not ask for a 2nd opion
User :   they did not even had let me take pregnancy test
Doctor :   injection has nothing to do with the placenta accreta
User :   im confused
Doctor :   Why do you think you did a mistake?
User :   i did not go for a 2nd opinion
Doctor :   2nd opinion for what?
User :   as i have understood depo provera is an injectable good for 3 months that will not make you pregnant
Doctor :  
ok
Doctor :  
the chances of failure of depoprovera is also there
User :   i did not know that the side effect of that contraceptive was make your menstration irregular and sometimes heavy and sometimes not
Doctor :  
ok
User :   yes possible but their 1st diagnosis was eptopic pregnancy
Doctor :   ok

User :   and they said that only raspa which they also said is a minor operation is the only thing that they would do
Doctor :  
ok
User :   but what really matters for me now is what im feeling, the pain is really affecting me physically, emotionally and my family
Doctor :   yes

Doctor :  
it is because you are upset
User :   all i really wanted ang hoping is to let my suffering go away
User :   i did not understood
Doctor :   i think you are unable to accept and tolerate the loss of uterus
Doctor :   right

User :   at first yes but as time passed because i already have 2 boys it did not anymore matter
User :   3 boys i mean
Doctor :  
but that stress is still not left your mind
User :   technically no, i only remember it everytime i have to explain to a doctor about my history
Doctor :   presently are you taking any medications?
User :   yes anti convulsants for my siezures (tonic clonic) i have 2 clots in the right side of the brain
Doctor :  
ok
User :   but my neuro already is lowering my dose because i am siezure free for 8 months already
Doctor :  
good..
User :   until this week that i got 1 episode because of very high fever in the hospital
Doctor :  
ok
User :   my left side of the body cannot anymore feel hot and cold
User :   my left knee when being tap doesnt anymore jerks
Doctor :  
ok
User :   what do you think might be causing my pain?
Doctor :  
stress
User :   if its stress thats causing my pain what do you suggest i should do?
Doctor :   all your investigations are normal
Doctor :  
you are having a medical history
Doctor :  
of 6 operations
Doctor :  
and also had an episode of cardiac arrest
User :   yes
Doctor :  
this is very much stresfull to any body
Doctor :   you are really a strong person
Doctor :  
you ahve withstand all of this very stressful events
User :   thank you but i need to be for my kids
Doctor :   i repeat
Doctor :  
you are strong
User :   but to be able to help my kids and to do my obligations i need first to fix whats wrong with me physically
Doctor :  
you will defenitely take care of your kids
Doctor :  
there is no physical wrong in you
Doctor :  
as all the diagnosis is normal
User :   now im relly super confused...
Doctor :  
it is very complex
Doctor :  
i shall tell you in simple words
Doctor :  
shall i..
User :   i have swollen back, i have been having nose bleeds for 3 days now and i forgot to include the i am bleeding
User :   of course
Doctor :   pain is percived when there is injury to body

Doctor :  
and also to mind
Doctor :  
do you agree
User :   yes
Doctor :  
we treat the body injury with medicines
Doctor :   and for pain of the mind there is no medicines, it will take time to heal
Doctor :  
in your case there is repeatedly body injury in the form of disease
Doctor :  
and you also have the responsibility of kids
User :   if what i am understanding what you are saying, is that all my physical pain is psychological?
Doctor :  
not psychological it is a reaction to stress in life
User :   i not lost
User :   im now lost is what i meant
Doctor :   relax
Doctor :   that is why i said it is very complex
Doctor :   but i will help you
User :   thank you
User :   what would you suggest?
Doctor :   relaxation therapy
Doctor :   have you heard of yoga?
User :   and pls be patient with me im still trying to digest it in my brain what you are saying
Doctor :  
i am there to help you
User :   yes i have but in the province that i am theres no yoga here
User :   so what youre saying is i need to get rid of stress to make my pain go away?
Doctor :  
very much
User :   i have a stupid question... how can i get rid of stress while i am feeling pain?
Doctor :   this is good question

Doctor :   you feel pain because you have stress
Doctor :  
and if you only treat pain for time being it will disappear
Doctor :  
but it keep coming again and again
Doctor :  
as the stress is still there
Doctor :  
so only in your case chronic pain with no diagnosis and all investigations are normal and not responding to any medicines
User :   in a way yes
Doctor :   are you there?

User :   what should i do first?
Doctor :   ok

Doctor :  
do you have any pain clinics in your province
User :   none that i know of
User :   but like just at home remedies
Doctor :   this is very good idea

User :   im just thinking of theres no harm of trying and understanding what you are trying to explain to me
Doctor :   this is a very new concept
Doctor :   so it is little difficult initally to accept
Doctor :   may i know about your daily activites
User :   well i love to do craft
Doctor :   ok
User :   when i feel very much hopeless of my pain i try to divert my mind so i color or draw
Doctor :  
ok
User :   i love decorating my home
Doctor :  
ok
User :   when my kids are hear i try to be friends with then
Doctor :   how old are the kids?
User :   when they're at school and not in the mood for any project i sit down with my dog
User :   10, 8, 6
User :   all boys
Doctor :  
ok
User :   and when im in super in pain i get to my computer to do a little research on my own trying to understand whats wrong and trying to search any solutions or even temporary remidies
Doctor :   ok
Doctor :  
now
Doctor :   daily regular physical exercise
User :   technically almost none
User :   i cant stand up straight anymore because wrong movement relly is pain fully
Doctor :   ok
Doctor :   about other family members?
User :   what do you mean?
Doctor :   like apart from kids who all are there in your family
User :   my husband is here, my father comes here everyday just to check on me,
User :   my biological father who is in the states call everyday we talk like for 4 hours
Doctor :   so you are alone in some part of the day
User :   his trying to fix my papers going back home so i could be checked from there
User :   no,
Doctor :   ok

User :   when i was still having siezures thats the time they never left me alone because of some occassions i think that i fall and hit my head and just arriving looking at me with a wounded forehead
Doctor :   ok
Doctor :  
now i suggest you this
Doctor :  
start from simple regular physical exercise
Doctor :  
this means
Doctor :  
simple drill exercises every dau 30 min in the morning and 30 min in the evening, almost same time every day
User :   drill exercise?
Doctor :   yes

User :   sorry but im not aware of how to do that
Doctor :   i will tell you
User :   hehehe is that like the one walking?
Doctor :   no not like walking,
Doctor :  
it is like in school they used to do pt exercises
Doctor :  
like that
User :   i really dont know this but ill asking
Doctor :   it is preferable to do in standing position, if you are not comfortable than you can do it in lying position only
Doctor :  
it is like stand straight
Doctor :   lift both hands above the head
User :   ok
Doctor :   bring it to the side in horizontal position
Doctor :  
hold it for some time
Doctor :  
than drop the hands
User :   ok
Doctor :   these are called stretching exercises
Doctor :  
you can check in web for muscle stretching exercise
User :   oh ok that i know
Doctor :   ok
User :   copy that
Doctor :   one min
User :   ok
Doctor :   WWW.WWWW.WW
Doctor :   this shows hoe to do for neck
Doctor :  
like wise for hands and legs also are there
User :   ok thank you that would be very helpful
Doctor :  
remember do only for limited period
Doctor :  
when you feel you are getting pain
Doctor :  
than lie down flat
Doctor :  
close your eyes
User :   ok
Doctor :  
take deepbreath
Doctor :  
hold the breath
User :   another stupid question
Doctor :  
and start counting
User :   is there any food that i should be avoiding?
Doctor :  
see how long you can hold the breath
Doctor :  
food
Doctor :  
no restrictions
User :   ok
Doctor :   you can take a small walk in the fresh air in the morning hours
Doctor :   this has a pleasing effect as well as the fresh air increases the oxygen capacity of the blood
User :   yes i sometime do that
Doctor :   only morning walk
Doctor :  
cos the air will be pure
Doctor :  
avoid the evening walk
User :   ok
Doctor :  
i think these are the simple steps to start
Doctor :  
than after a week you can start aerobic exercises
User :   well i try to do first the simple ones with aerobics i will try
Doctor :   Please fill the feedback form say done.

User :   doctor im really very gratefull for sharing your time to help me, thank you but unfortunately its already morning here and already very tired
Doctor :   yes you need to rest
Doctor :  
adequate rest is also important
User :   thank you again from the bottom of my heart
Doctor :  
be in touch with us so that we can togather find a solution for the pain
Doctor :  
Thanks for consulting HealthcareMagic. Bye for now. Please refer your friends to our service.
User :   i will, take care and god bless you and your family
Doctor :   thank you
Doctor :  
i also pray that the pain and suffering in you shall soon end by the blessings of god
Doctor :  
bye
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