Friday, July 1, 2011

What would you do?

Ok, I need to vent about my frustration with myself and my pain…and there may be too much information in this post....but you are my online friends and I'm open to your suggestions.

I am still having ab/kidney/pelvic/whatever pain and the pain is exacerbated because I went to the gym 3x last week (MWF—just cardio, no toning)…then it went away by Sun, but Mon I had the most painful ovulation I’ve had since I was a teenager, and then I did yoga in meditation class Mon night which seemed to make the ab/whatever pain worse.

So it’s been in a steady state pretty much of constant, but not excruciating, pain in that area this past week. I have not gone to the gym.

So…I googled last night and scared myself again, that I think I have a hernia.

Here’s the history:

1/10: Was doing ab work at the gym (specifically “the bicycle” ab exercise, which I’ve done a million times before) and felt something pull in my abdomen, like a muscle pull, on the right side.

1/31: went to my favorite dance based cardio class and felt something pull even more. It was painful and uncomfortable and I couldn’t ignore it. It hurt to wear real pants with zippers, to laugh, to drive over potholes, to lie on my side, it woke me up in my sleep, etc,  for approx. a month after 1/31.

The PCP thought on 2/1 that my pain is a small hernia because he feels a small bulge on the right side that is not on the left side. He refers me to a surgeon. I go home and remember, I have a pelvic kidney on the right side…maybe that’s it?

Surgeon’s first available appt was a week later. The surgeon on 2/9 did not feel a hernia. She said she could feel my pelvic kidney, which is in the same area as my pain, and she correlates it to my MRI image from May 2009 (incidental finding on my lumbar spine MRI). She said it could be a rectus abdominus muscle strain, or the ligaments/whatever that hold the kidney in place could be stressed or strained. She said I could have a CT scan but said she didn’t feel strongly about it, it’s radiation exposure, and asked if I wanted the test. I SHOULD HAVE SAID YES as I *think* that would show if I have a hernia or not. She said I could book an appt to come back in 4-6 weeks or just see what happens and then book an appt if necessary. I should have booked the appt.

4/15:  had menstrual cramps so bad that I vomit, twice.  It felt like contractions—and I’ve never been pregnant/in labor.

4/22:  see my gyno for a yeast infection, and he asked if I had pelvic pain then, and I told him my story up til that point, but that was that.  He didn't seem bothered by the vomiting either.



Went back to surgeon 5/3—11 weeks later. Pain is getting better, some days 0, not gone away though. I was getting back to the gym too at first just treadmill walking and then going back to a cardio class or two, no toning classes. In general, I have to be careful to tighten my abs when doing any kind of twisting motion. She said she didn’t know the cause of my pain. Said that she still doesn’t feel a hernia. She brought up the CT scan again, but said she thought it was probably the pelvic kidney and referred me to a urologist. I should have said YES I WANT THE CT SCAN. She said if the urologist said it’s not the kidney, to come back. She also said because I’m thin I “give a good exam”, I don’t have a lot of fat so she would be able to feel it if I had a hernia, and she thought my ab muscles are quite strong based on some things she had me do.

Saw the urologist with first available appt on 6/10, 5 weeks after surgeon (he came highly recommended by a friend of mine, and pain was light and intermittent, so I felt I could wait). The urologist said it’s almost impossible to feel a pelvic kidney. He said “just because you’re skinny it doesn’t mean you can feel the kidney.” He said it could be a hernia but since surgeon said it’s not a hernia, it’s a muscle strain. He said a CT scan could be ordered, but it’s radiation exposure, and all it will show is that I have a pelvic kidney. Ordered ultrasound to see if there was a UPJ obstruction but thought it would be unlikely. Said the only way to damage a pelvic kidney is blunt trauma like being punched in the stomach or being in a car accident. At this point I should have asked, What is everyone feeling then in that area if it’s not the kidney?? The PCP, the surgeon and my chiro all feel something there.  The urologist did the exam with me standing; everyone else can feel "the thing" when I'm lying down.  I didn't think to ask him to feel it lying down, because I had sort of assumed he was going to say yes, it's the kidney, and give me some kind of treatment plan...

On 6/14 I had the ultrasound of both kidneys and bladder. Got the report in the mail 6/16. My pelvic kidney is smaller than my left kidney and slightly malrotated, standard stuff for pelvic kidneys. Urologist wrote on the report “OK. No significant abnormalities.” By this point I was feeling like, ok, it’s starting to go away, resolving itself, it’s almost over.

So 6/27 was the painful ovulation, and that night the meditation class had yoga in it that exacerbated the area. The yoga was basic PT core stretching and strengthening for the most part, I mean, no major poses or anything.

I called the surgeon’s nurse on Tuesday 6/28. The surgeon had asked me to leave the nurse a VM telling her what happened with the urologist. Well, the surgeon’s nurse calls me back and says “the surgeon does surgery, nothing muscular. You have to go back to your PCP or maybe an orthopedist, I don’t know, but not the surgeon.” I told her that the surgeon said to come back if the urologist said it wasn’t my kidney, and she said the surgeon is away now, would the 18th at 1pm be ok? Great!

Last night 6/30 I saw my acupuncturist, she said it sounds like I have a hernia since it is exacerbated by physical movement (i.e. going to the gym, or twisting motions like if I’m not careful turning over in bed). She used to be an occupational therapist, so she is a nice blend of eastern and western medicine. She does this energy medicine work too now, like reiki. So she did that on my abdomen and said it doesn’t feel inflamed, it’s not pulsing or giving off heat. She said she feels something there, though, and maybe it’s not a hernia, maybe it’s just the kidney. She said I could have uterine fibroids, an ovarian cyst, or endometriosis. She thinks I should see my gyno. My annual gyno visit is July 25. She doesn’t think my PCP can do anything about this problem.
My chiropractor, who I have been seeing lately for my shoulder pain, thinks the ab pain is from my pelvic kidney, and that the urologist is full of himself. My chiro can feel the pelvic kidney and also correlate it to my MRI image like the surgeon. He says I need to do strengthening work on my core. (But I was doing strengthening work when I injured myself!)

So I don’t know what to do??? Ask my PCP if he can order the CT scan so I can find out NOW if I have a hernia? Try to move up my gyno visit? Wait it out til the 18th and 25th???

In the meantime, my back pain, which has generally been decreasing since kicking off my new eating plan in Jan, is pretty much light to nil the past 2 weeks, my shoulder is still annoyed from PR weekend Chicago and I’m going to start doing my own PT on it in earnest. My knees have been great since Sept 2010.  My 6 month dental and annual eye exams were fine!

Sigh…while I am getting better at going to doctors there is room for me to improve....

15 comments:

  1. If the CT can also tell if you have uterine fibroids or an ovarian cyst, then get the CT now.

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  2. Have you kept track of your caffeine as it is related to abdominal pain? Or other food changes you have made? Just a thought.

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  3. Oh, Kyle. I guess I'd get the CT scan now. Sorry you're in so much pain! Wish the answer was easy and obvious.

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  4. Hi, Kyle,

    there's a great article in the NYtimes (may 16, 2011) by Jane Brody that discusses women and hernias (and how the are hard to diagnose in women). Please check it out.

    i'm sorry that you are going through so much pain.

    Rose in SV

    http://www.nytimes.com/2011/05/17/health/17brody.html

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  5. I'm adding that you should keep working on finding a solution for getting rid of your ongoing pain. I would send a copy of this blog post and NY times article to your doctor before your next visit, so that your doctor can research this ahead of time. From reading the article, it sounds like the hernias don't 'present' themselves in a the expected way when they are present in women (and they hide during MRIs, etc). I do wish you the best. I enjoyed meeting you in Chicago!

    Rose in SV

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  6. Remember YOU know your body better than anyone else, no matter how qualified they may be. If you felt something pull during exercise and again later then it should be followed up and if it was me I would definitely have another CT scan. At least then you will know for sure what caused the pain. Pain should never be ignored. All the best for what you decide, I really enjoy your blog. I hope you're feeling better again soon.

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  7. Sounds a lot like the symptoms I had with ovarian cysts and endometriosis. Definately get the scan. My pain would worsen on activity and as the day went along.Good luck and I hope you get this resolved soon.

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  8. I agree with Waikikimum. Sounds like the pain I had when I had an ovarian cyst. My gyno was able to feel mine. For me the treatment was easy. High dose birth control pills for 3 months to shrink it. Haven't had a problem since then and that was over 20 years ago!

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  9. Hi Kyle,

    That sounds awful. I'm sorry you are in so much pain. I don't know what to recommend except that for me it was worth putting in the time to find a PCP I felt I could trust and was "on my side."

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  10. Get the CT Scan or go to your OBGYN to see if you have fibroids. I hope you feel better soon.

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  11. I also vote for the CT scan. You need to find out for sure what it is.

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  12. So sorry you've had to go through all of that. I hope they are able to get tot he root of the problem asap.

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  13. Get the CT scan. We're exposed to radiation every day, all day. Just go. Don't make me come over there!

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  14. Hey Kyle! Sorry to hear you are in pain still. I am guessing from your post that it is right or left lower abdominal pain you are having? It really sounds a lot like ovarian cysts, which I too have had. They can be very painful, and mimic other illnesses.

    Have you seen your gynecologist and mentioned the pain to him/her lately? They can do an ultrasound (transvaginal if they need to) to see if there are any cysts or masses that are causing you discomfort.

    I think I would pursue the route with your gynecologist first in order to rule out any reproductive issues (especially if you have not had an exam in a while). Then, if all is clear, I would pursue the CT scan.

    I will be praying that you make the right decision concerning all of this. Go with the decision you have the most peace about, and I hope you get answers soon!!

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