Question: Respectfully request provider referral for nerve ablation neurotomy for confirmed diagnosis of abdominal cutaneous nerve entrapment syndrome. The diagnosis is clear. I have been trying many times on this site to find a physician to provide treatment.

Respectfully request provider referral for nerve ablation neurotomy for confirmed diagnosis of abdominal cutaneous nerve entrapment syndrome. The diagnosis is clear. I have been trying many times on this site to find a physician to provide treatment.

Dear Dr. Anders Mark Christensen,
After repeated failure in diagnosis and dismissal from 12 physicians in my local medical community, I diagnosed myself based on extensive research culminating in Dr. W K Snyder's trigger point injections and positive Carnett's sign in Oct. 2018. (I will be glad to provide a list of references if you are offended that a mere patient would dare diagnose herself.) Dr XXXXXXX Tauben, Chief of the Division of Pain Medicine, University of XXXXXXX Medical Center, XXXXXXX WA has accepted my diagnosis of Abdominal Cutaneous Nerve Entrapment Syndrome, but his Center for Pain Relief has stated surgery (neurotomy/nerve ablation) is a treatment the Center does not support. My experience with his staff was therefore completely unproductive. I hope you can help, as 3 other physicians on this site have not. The pain is upper right quadrant, unremitting, more centralized but consistent with all the surgical scarring in the area. Onset was localized to a small area in Aug. 2018 but has since extended laterally and now also mimics bilateral costochondritis (prednisone trial ). TAP block also confirmatory. The pain is severe and continually wakes me from sound sleep; over 2.5 years central sensitization has set in, likely aided by a failed splanchnic block which damaged right sciatic nerve. The fact that a simple and straightforward procedure has so long been denied me for relief does not help. Please let me know if this is not clear. Thank you.

Dear Dr. Anders Mark Christensen,
After repeated failure in diagnosis and dismissal from 12 physicians in my local medical community, I diagnosed myself based on extensive research culminating in Dr. W K Snyder's trigger point injections and positive Carnett's sign in Oct. 2018. (I will be glad to provide a list of references if you are offended that a mere patient would dare diagnose herself.) Dr XXXXXXX Tauben, Chief of the Division of Pain Medicine, University of XXXXXXX Medical Center, XXXXXXX WA has accepted my diagnosis of Abdominal Cutaneous Nerve Entrapment Syndrome, but his Center for Pain Relief has stated surgery (neurotomy/nerve ablation) is a treatment the Center does not support. My experience with his staff was therefore completely unproductive. I hope you can help, as 3 other physicians on this site have not. The pain is upper right quadrant, unremitting, more centralized but consistent with all the surgical scarring in the area. Onset was localized to a small area in Aug. 2018 but has since extended laterally and now also mimics bilateral costochondritis (prednisone trial ). TAP block also confirmatory. The pain is severe and continually wakes me from sound sleep; over 2.5 years central sensitization has set in, likely aided by a failed splanchnic block which damaged right sciatic nerve. The fact that a simple and straightforward procedure has so long been denied me for relief does not help. Please let me know if this is not clear. Thank you.

Dr. Cristensen: A representative but by no means exhaustive list:

Protracted diagnosis of ACNES: a costly exercise. S.J. Dancer, S.G. Macpherson, A.C. de Beaux. Journal of Surgical Case Reports, 2018;9, 1-3

Chronic abdominal wall pain--A diagnostic challenge for the surgeon. Rolv-Ole Lindsetmo, M.D., M.P.H., XXXXXXX Stulberg, M.P.H. The XXXXXXX Journal of Surgery, (2009) 198, 129-134

A Double-Blind, Randomized, Controlled Trial on Surgery for Chronic Abdominal Pain Due to Anterior Cutaneous Nerve Entrapment Syndrome. XXXXXXX B. Boelens, MD, Tijmen van Assen, MD, Saskia Houterman, XXXXXXX R. Scheltinga, MD, Rudi M. Roumen, MD. Annals of Surgery Vol 257, Number 5, May 2013 845-849

Abdominal Wall Pain: A Common Clinical Problem. XXXXXXX Sweetser, MD. Mayo Clinic Proc, February 2019:94(2):347-355. https://doi.org/10.1016/jmayocp.2018.04.03

Difficult differentiation of a somatic symptom disorder from anterior cutaneous nerve entrapment syndrome (ACNES): A case report. Narifumi Yokoyama, Ryousuke Shiraki, Takashi Watanabe, Makiko Shiinoki, Michihiro Nin, Taro Shimizu, Norio Yasui-Furukori and Kazutaka Shimoda. PMC Psychiatry (2019)19:394

Abdominal Cutaneous Nerve Entrapment Syndrome. XXXXXXX XXXXXXX FCAI, Saravanakumar Kanakarajan MD FCPS FRCA FFPMRCA. Continuing Education in Anaesthesia: Critical Care & Pain, Volume 15 Number 2 2015, 60-63.

Abdominal Wall Pain: Clinical Evaluation, Differential Diagnosis, and Treatment. XXXXXXX Shian, MD and XXXXXXX T. Larson, MD. XXXXXXX Family Physician, ww.aafp.org/afp, Volume 98, Number 7 October 1, 2018.

Please let me know if this information is inadequate. I will send more references if you wish.
Juliane Marx

Dr. Cristensen: A representative but by no means exhaustive list:

Protracted diagnosis of ACNES: a costly exercise. S.J. Dancer, S.G. Macpherson, A.C. de Beaux. Journal of Surgical Case Reports, 2018;9, 1-3

Chronic abdominal wall pain--A diagnostic challenge for the surgeon. Rolv-Ole Lindsetmo, M.D., M.P.H., XXXXXXX Stulberg, M.P.H. The XXXXXXX Journal of Surgery, (2009) 198, 129-134

A Double-Blind, Randomized, Controlled Trial on Surgery for Chronic Abdominal Pain Due to Anterior Cutaneous Nerve Entrapment Syndrome. XXXXXXX B. Boelens, MD, Tijmen van Assen, MD, Saskia Houterman, XXXXXXX R. Scheltinga, MD, Rudi M. Roumen, MD. Annals of Surgery Vol 257, Number 5, May 2013 845-849

Abdominal Wall Pain: A Common Clinical Problem. XXXXXXX Sweetser, MD. Mayo Clinic Proc, February 2019:94(2):347-355. https://doi.org/10.1016/jmayocp.2018.04.03

Difficult differentiation of a somatic symptom disorder from anterior cutaneous nerve entrapment syndrome (ACNES): A case report. Narifumi Yokoyama, Ryousuke Shiraki, Takashi Watanabe, Makiko Shiinoki, Michihiro Nin, Taro Shimizu, Norio Yasui-Furukori and Kazutaka Shimoda. PMC Psychiatry (2019)19:394

Abdominal Cutaneous Nerve Entrapment Syndrome. XXXXXXX XXXXXXX FCAI, Saravanakumar Kanakarajan MD FCPS FRCA FFPMRCA. Continuing Education in Anaesthesia: Critical Care & Pain, Volume 15 Number 2 2015, 60-63.

Abdominal Wall Pain: Clinical Evaluation, Differential Diagnosis, and Treatment. XXXXXXX Shian, MD and XXXXXXX T. Larson, MD. XXXXXXX Family Physician, ww.aafp.org/afp, Volume 98, Number 7 October 1, 2018.

Please let me know if this information is inadequate. I will send more references if you wish.
Juliane Marx

Thank you most sincerely. But I have had no success contacting anyone on my own behalf, save for you. How do you recommend I communicate with Dr. Boelens? Would you be willing to introduce me to Dr. B?

Regarding the insurance question, I will certainly have to pay. Please understand I want to make sure this physician can help me before I go.
Gratefully,
Juliane Marx

Thank you most sincerely. But I have had no success contacting anyone on my own behalf, save for you. How do you recommend I communicate with Dr. Boelens? Would you be willing to introduce me to Dr. B?

Regarding the insurance question, I will certainly have to pay. Please understand I want to make sure this physician can help me before I go.
Gratefully,
Juliane Marx

Dear Dr. Anders Mark Christensen,
Without wishing to offend, I would like to know if there is some way I can make you some kind of payment for all you have done on my behalf. You took the time to ask questions, read my responses, study the case reports and findings, and offer your support AND contact information for a physician who may be likely to help. Most of all you have offered me hope. Please tell me how I can express my gratitude for your professionalism and kindness. No other physicians have done that at all. "Thank you" is not enough!
Juliane
(P.S. No matter what, I will try to let you know if I become successful.

Dear Dr. Anders Mark Christensen,
Without wishing to offend, I would like to know if there is some way I can make you some kind of payment for all you have done on my behalf. You took the time to ask questions, read my responses, study the case reports and findings, and offer your support AND contact information for a physician who may be likely to help. Most of all you have offered me hope. Please tell me how I can express my gratitude for your professionalism and kindness. No other physicians have done that at all. "Thank you" is not enough!
Juliane
(P.S. No matter what, I will try to let you know if I become successful.