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Finished bowel movement and having pain in upper chest. hurts while taking deep breath. Taking Tylenol. Could I ask a doctor?

Apr 2013
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General Surgeon
Practicing since : 2008
Answered : 9351 Questions
Yesterday when I finished my bowel movement, I had a terrible pain in my upper chest, and into my back. It still hurts today --- especially if I try taking a deep breath. If I lie down, it's better and Tylenol relieves it some, but it still hurts to breathe. I think I strained a muscle, but I didn't strain that hard during the bowel movement. I called the doctor, but he didn't want to see me. Told me to continue the Tylenol and thought it was a muscle strain. I'm scared it's something else --- like my heart. But I had a heart workup last December and it was fine. Now it's Labor Day weekend, and I'm really worried. I'm 67, widowed, and live alone, and otherwise in good health. Thank you.
The pain when I try taking a deep breath is in my very left upper chest and into my upper back and underarm. Also, when I reach my arm up, or try to turn to look over that shoulder --- like backing up my car --- it hurts. Please let me know what you think. I'm an very anxious person, and I don't quite know what to think of this
Posted Sat, 21 Sep 2013 in Medicines and Side Effects
Answered by Dr. Ivan R. Rommstein 45 minutes later
Brief Answer:
hi and welcome to XXXXXXX

Detailed Answer:
It sounds like pinched intercostal nerve or pulled intercostal muscle and this is nothing serious if I am right. It should pass spontaneously within 4-5 days but good chiropractor may be helpful. Also, medicines such as benzodiazepines and nonsteroid painkillers may be helpful too so ask you doctor about it. Other possible causes are lung inflammation or pneumothorax but o don't think this is likely to be. You should rest, have massage of you neck and back and try to deep normaly. If pain persists you should do thoracal spine ct or mri. Wish you good health.regards
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Follow-up: Finished bowel movement and having pain in upper chest. hurts while taking deep breath. Taking Tylenol. Could I ask a doctor? 6 minutes later
Thank you so much for your response. I've been worried that something is wrong with my heart. It came on so very suddenly and unexpected. I sat to use the bathroom and was fine. When I got up, I had horrible pain. I'll try to breath normally. I'm anxious about it now and find myself taking a lot of deep breaths --- or trying to. I've been resting because it hurts to do much of anything else. I've been watching football. :-) Thank you, Doctor. I feel a little more relieved. I was about ready to head to the ER, but I don't think I probably have to do that. Thank you again. I do take Valium, but have been tapering off of it lately and I don't want to increase it again. I'm down to 1/2 mg every other day ----- what would happen if I increased it for a short time during this pain? Would I have to begin a new taper again?
Answered by Dr. Ivan R. Rommstein 1 hour later
Brief Answer:

Detailed Answer:

It doesn't sound like heart disease definitely,especially if your pain I aggravated by these movements you ve mentioned. Heart ischemy would have constant sharp pain in the middle of chest and left arm associated with dizziness.if you have this,you should visit er.otherwise,I think you should just wait and see at home will this progress or subside in next several days.
nerve can be pinched or muscle pulled not just by some obvious injury,but also it can occur even after minor movements such as defecation, sitting or getting up after toilet,excessive cough,sneezing etc.
so this what you experience isn't something uncommon. I don't advise to increase valium dosage,nothing can happen if you do it but better take ibuprofen or Tylenol for pain. Valium isn't actually painkiller,it will relax muscles,nerves and anxiety,but it higher dose probably won't effect on pain. Try to rest now,sleep with elevated upper body by putting some pillows under your back and head. Warm baths may be helpful too. when pain subside try to do some streching exercises. If you notice tingling in arms and loss if sensation or arm muscle weakness it may indicate something more serious but I don't think you have to be concerned at all
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Follow-up: Finished bowel movement and having pain in upper chest. hurts while taking deep breath. Taking Tylenol. Could I ask a doctor? 38 minutes later
Thank you so very much. You have been so reassuring. I'm glad to know that what I have isn't something uncommon. I'll look forward to having it subside by the first of the week or so. I'll just continue my Tylenol. It dulls the pain at least a little bit. And rest seems to help, too. I notice no pain at all when I'm lying perfectly still. But as soon as I start moving, it comes back again. Thank you. A nice warm bath will be in order for tonight. I appreciate your answer and your time.
Answered by Dr. Ivan R. Rommstein 14 minutes later
Brief Answer:

Detailed Answer:
Don't worry Mrs. This is really some minor neuromuscular issue. we know how to recognize serious conditions trust me. Now it is more important that you are not anxious because it can worsen symptoms and have bad effect on heart. Measure you bp now more frequently these days to see are there any variations. Don't deep rapidly and shallow because it will cause hyperventilation and panic attacks.just relax and breathe from your diaphragma muscle(abdominal breathing),don't raise your shoulder. Hope you will feel better soon. Regards.
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Follow-up: Finished bowel movement and having pain in upper chest. hurts while taking deep breath. Taking Tylenol. Could I ask a doctor? 14 hours later
I'm trying not to worry. I had a good night's sleep last night, but this morning it still hurts when I turn my head to look back. And also when I take a deep breath --- like before coughing or clearing my throat. It's pretty much the same as it was yesterday with no improvement. Would a strained muscle really cause such sensations? The pain when drawing in a deep breath is in the extreme upper and outer part of my left chest and then into the shoulder blade area in the back. I don't want to go to ER over this weekend if it's not necessary. I think I need to get myself calmed down a bit. My husband died just 2 years ago. We were married for 42 years. I keep thinking I should be all over this by now, but I'm not. Thank you for your help.
Answered by Dr. Ivan R. Rommstein 4 hours later
Brief Answer:

Detailed Answer:
I am sorry about our husband. Such tragedies usually cause anxiety and amny other psychosomatic problems which can be manifested as pain in chest,headache, innability to sleep, nightmares, fatigue, muscle pain,back pain etc. Of course that you are stressed and that you cant forget your husband, and trust me many people dont recover even 10 years after such things. YOu should find enough strength to live with it, no m,atter how hard it is and I am sure you are strong lady. surround yourself with friends and everything will be easier.
Of course, we should never underestimate any symptoms and we should never consider it as psychosomatic until we ruled out everything else.
But is still think this is pulled muscle and recovery may last for sevral days till 1 week.
I have few questions more.
Do you get tired easy? can you walk for 500 meters without pain or dizziness? is there pain when you exhale fully or just when you inhale? is there pain when you hold your hands up for more than 15 seconds? is pain more intensive in the morning or in the evening? do cough? do you have swollen legs?
I ll be smarter when you answer these. thank you
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Follow-up: Finished bowel movement and having pain in upper chest. hurts while taking deep breath. Taking Tylenol. Could I ask a doctor? 2 hours later
I do get tired easily, but that's been the case since my husband died. But I'm even more tired lately because I haven't been eating well. When I'm upset and worried, my appetite goes away and I feel somewhat nauseous. The pain seems to be easing up just a little bit as the day goes on. I was able to water my flowers with no trouble. There is no pain when I exhale, but only when I inhale. I can easily hold my hands up for 15 seconds. The pain isn't more intense at any particular time of the day. I do cough--- but that's nothing new for me either. And no, I don't have swollen legs. I hope I can get over the loss of my husband. He was sick our entire married life. He had Type 1 diabetes and got it 3 months after we were married. He had a kidney transplant 13 years ago and all sorts of other medical issues. The marriage was NOT easy. I should clarify about the cough. It's not constant and mostly in the mornings. I have post nasal junk going on all the time, and that's a reason for the cough I think. And sometimes I believe it's kind of a nervous cough. I was under a lot of stress during the marriage. Other than the medical issues, the marriage was not ideal at all, but I stuck it out. But now that it's over, I still miss what I had. I also want to say that I have a basement here in my house with 14 stair steps. I can come up the steps just fine ---- no problems with that. I have one more question. This happens to me so very seldom, but I wonder about it. It happened yesterday, so it's on my mind again. I got up quickly and had a tickle in my throat and coughed. I coughed several times and then got terribly dizzy and my fingers tingled. It was just for a very short time and went away right away. This sometimes happens ---- maybe one a year --- so not very often. But I just wonder what causes that. I wonder if my blood pressure takes a dip about that time.
Answered by Dr. Ivan R. Rommstein 18 hours later
Brief Answer:

Detailed Answer:
Yes. this is called orthostatic hypotension and it happens when get up quickly. then it may trigger cough which causes lack of oxygen and you experience dizziness. you should get up slowly and drink enough fluids and B vitamin. also, nutrition is very important,you simoly must eat 5-6 x a day but smaller meals. it should be healthy balanced diet.
Considering your medical history and symptoms I still dont see some serious heart or lung condition. Some those signs are typical for your age and it is aggravated by stress, anxiety and fear. However if chest pain persists for another day you should do at least chest xray and basic blood tests. If everything is clear then you can be relaxed,but ask your doctor if he can do lung functional test where your lung capacity can be measured and evaluated. I am sure that your condition will improve in short time. do streching exercises and have warm baths or ask someone to massage your back and shoulders. also, avoid noisy and smoky places.try to spend more time outside walking on fresh air.
How is your condition today? is it better?
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Follow-up: Finished bowel movement and having pain in upper chest. hurts while taking deep breath. Taking Tylenol. Could I ask a doctor? 11 minutes later
Thank you again for your response --- and your patience with me. I appreciate it so much. And you have done a lot to relieve some anxiety. I should get outside today for a walk. It's 73 degrees and just a perfect day for walking. I wore a heart monitor for 48 hours in XXXXXXX when I was having skipped heart beats. It came back normal and the skipped beats were considered benign and due to anxiety. My blood pressure usually averages about 120/70. I catch it sometimes in the 150s, but it doesn't stay that high for long. Lots of times it's in the 100 - 110 range. I guess it's pretty much normal --- with fluctuations.
The pain is a little better today. Today it feels very much muscular, as the pain when breathing is gone, but I feel a twinge when I pick something up --- like my watering can to water my flowers. When I picked it up with my right hand, I felt a pull and a twinge of pain in my right upper back -- and also yet when I turn my head in that direction. But I do believe it's easing out, and I doubt I'll need to see the doctor.
I also had a CBC done in XXXXXXX and it was normal. I guess the white count was a tad low, but the doctor still considered it normal enough. Does that sound right to you? A little low -- and still normal???
I don't want to bother you anymore. I know you are busy. But maybe you can still address some of the issues that I stated here.
Thank you, Doctor.
Answered by Dr. Ivan R. Rommstein 23 minutes later
Brief Answer:

Detailed Answer:
skip heart beats on ergometry means nothing unless there is atrial fibrillation or weakened heart muscle.such skip beats can be found in 20-25% of general population aged >60. You have great blood pressure,this is very positive.
It is probably muscular pain because intercostal and neck muscles are contracting even during slight breathing so this obviously causes your pain. the same happens while bearing some things or during other physical activity. I am sure it will subside soon.
Little low wbc is in every case better than little high wbc. low wbc isnt indicating disease unless there is significant fall and other symptoms such as uncontrolled infections or anemia. So this shouldnt concern you,just repeat it in 2-3 months.
I think you are pretty healthy lady and I dont see why to waste your time on unnecessary tests at this point. enjoy in your life and try to ignore some minor difficulties. Of course,always be cautious about signs and symptoms of heart disease but give your best to prevent it: eat healthy, do physical activity and avoid smoking, alcohol and most of all stress.
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Follow-up: Finished bowel movement and having pain in upper chest. hurts while taking deep breath. Taking Tylenol. Could I ask a doctor? 15 minutes later
Thank you, Doctor. My doctor here always tells me that I'm healthy. I was born in an anxiety-ridden household, so it's been part of me forever. Then the marriage that I experienced didn't help things at all. Now I need to figure out how to go forward after all of that.
I asked my doctor about repeating the CBC, but he didn't see any reason to do it. So I guess I'm more worried about it than he is --- which is very normal for me. I worry way too much. I jus wish I could go forward with my life and get this grieving behind me. I think I grieve more at times for what I never had than for what I lost. I'll give you the TOP rating that's available when time comes to rate -- which will be very soon. :-)
Answered by Dr. Ivan R. Rommstein 3 hours later
Brief Answer:

Detailed Answer:
Yes, I understand your concerns. I also think you are healthy and you should be happy when we all know that some people have much bigger problems than you ,both medical and psychological. Unfortunately, people begin to appreciate life and health only when something bad happens. It is hard for me to give psychiatry advise since I am mostly doing surgery and XXXXXXX medicine,but from my point of you I think you should listen to your body and prevent bad psychosomatic effects of anxiety and grief on your physical health. I am sure you can do it.
Wish you good health and good luck.
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Follow-up: Finished bowel movement and having pain in upper chest. hurts while taking deep breath. Taking Tylenol. Could I ask a doctor? 35 minutes later
I'm going to let this open just another day --- in case I need you. :-) The next time you write, I promise to close the discussion and give you an wonderful review. Thank you SO much for all of your help and reassurance. Yes, I'm thankful, and I do see a psychologist for grief and anxiety counseling, and I know that there are many people who have a lot worse problems than me. In fact, I guess I really don't have many at all. Thank you for reminding me of that. I need to get control of my anxiety, but I'm tapering off valium, because I don't want to take the drug anymore after being on it for 20 years!! I'm almost finished with it and feel a sense of freedom about that. I could probably stop it anytime since I now take just 1/2 mg every other day. It's certainly not very much. I'll give you a good review the next time I hear from you, and the discussion will close. Thank you so very much. You have been more than kind and patient. Oh -- and my pain is just about completely gone. If I think about it, it's still there a little bit. But for the most part, it's about gone. I bet by tomorrow, I won't feel it at all anymore. I spoke too soon. After I wrote last night, I sat in a different chair than I'd been in the past few days, and the pain came back. For some reason, that chair seemed to aggravate it all again. I took Tylenol, but they didn't help much. I slept well, and this morning I woke without much pain at all again. It still feels kind of muscular to me. Do you still think it is? Do you think it's OK to give this a couple more days before I head off to the doctor? Maybe it will be gone in a couple of days. You did mention giving it perhaps a week. What do you think? Thank you. Well, I did end up going to the doctor's office today. I called, and they thought I should come in and have things checked out. The doctor ran a CBC, chest x-ray, and an EKG. Oh, and something called a D-DIMER. What on earth is that????? She said everything was normal, and that she thinks it's muscular related and should ease itself away with a few more days time. I'm giving thanks for good test results and feeling much more at ease. Thank you for all you have done. You have been so helpful and patient --- and it seems that everyone is in agreement --- I'm healthy and need to be thankful. The doctor also told me to force myself a little bit with this grieving. She suggested volunteer work --- and doing things when I really don't feel like doing them. Thank you again, Doctor. You are the greatest!
Answered by Dr. Ivan R. Rommstein 2 days later
Brief Answer:

Detailed Answer:
Well, high D-dimer may indicate something very serious called pulmonary it is good that it is within normal range. This test was probably done just beacuse doctors did have anything else to check since obviously everything is fine. You should do anything,not just volunter work. you can find some hoby,sports or join literature group;). Any activity will clear your mind and you wont think only about the disease that you might have. and you wont consider every sign as alarming and life threatening. I am sure you ll find how to enjoy in life.
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