still unexplained after 2 years of social medicine



in this diagram, my internal abdominal oblique and tendionouse inscriptions both seem to hurt?

I have had abdominal pain on and off for 2 years.  After various tests by socialized medicine, I have not been given a definitive idea of what the problem might be.

Permanent lower abdominal cramps

Two years ago the pain started like monthly female period cramps (these are great fun, just ask your girlfriend, wife or mother!) which lasted over a month.  I started taking lots of ibuprofen.  Cramps seem to worsen. 

Ultrasound

Went for ultrasound to check female parts and appointment with intestinal specialist.  All OK on the ultrasound. Cramps really bad one morning around 3am so went to emergency clinic.  African doctor said no more ibuprofen, I was making issues worse.  Switched to panadol (tylenol) which is paracetamol.  Had to take 4-5 days a week sometimes 8-9 pills a day.  My local doctor recommends I see a dietician and agrees with intestinal specialist I should get a colonoscopy. Local blood tests confirm very low iron and low iron absorption.  I'm given couple months worth of doses of codeine for bad pain. I take it periodically when needed.

Dietician

About 8-9 months ago, I started seeing a dietician.  I give up coffee, caffeine, soda / fizzy drink and incorporate more fiber and iron into my diet.  This seems to help a bit.  Yet, periodic cramping pain continues.

Colonoscopy

It took about 1 year to get a colonscopy. I was put on the waiting list Oct-2010 and had the procedure end of Sep-2011.  Minor divurticulitus found, nothing major and no cancer or anything.  Surgeon gives me prescription for couple months of fiber drink.

New, severe pain

Sunday morning 27-Nov-11 I awoke about 3:00am with a new, sharper abdominal pain near the appendix area and shooting upwards.  Felt like a knife inside me.  I took some codeine and panadol.  I went to work Monday but wasn't too happy. Tuesday I stay home and try to self medicate some more.  Pain is intensifying.

30-Nov-11 in hospital

Wed 30-Nov-11 I go to my doctor first thing.  He worries about my appendix.  He sends me to hospital.  My husband leaves work to drive me there.  I'm given some intra-venous pain meds (morphine?) and try to explain my symptoms to a couple of different doctors. 

X-ray

Later in afternoon at hospital, they Xray my abdomen but apparently not much found.  I send husband home.  It hurts to stand up or walk, but mostly ok if I just lay still. I stay overnight.  No dinner or breakfast but am given more pain medications.  Next morning head of surgical and team of doctors assess me.  He recommends CT scan of my abdomen.  They don't think appendix - my symptoms are different.

CT scan

Next day I get a CT scan at 1pm.  I'm allowed to eat so have some dinner.  Yum: hospital food. One of the surgeons who had assessed me yesterday (twice), came by with CT results around 6pm.  He says he doesn't see any divirticulitis, anything wrong with intestines or any other organs.  CT is a "snapshot" but it is inconclusive.  He says I can go home if I'm feeling OK. He thinks it might just be an issue with an internal abdominal muscle.  He advises it will either get better on its own by just relaxing for a week - but if pain worsens, I have to go back to hospital.  I get a prescription about 8pm for about a week's worth "tramadol". 

On Tramadol

"Tramadol - is a synthetic opioid analgesic indicated for moderate-moderately severe pain. Tramadol, like all opioids, does produce "morphine-like" effects including analgesia, euphoria, anxiolysis (reduced anxiety), dizziness, somnolence, nausea/vomiting, constipation, and sweating. However, tramadol causes significantly less respiratory depression than morphine. In contrast to morphine, tramadol has not been shown to cause histamine release. At therapeutic doses, tramadol has no clinically significant effect on heart rate."

Lingering pain

So after I got home from hospital, I stayed home that  Friday and basically was in bed for 4 days. I took Tramadol here and there and have been taking a dose of Tramadol nightly. I have one more dose left.  Tues night, I did not take any and Wed I woke up with lingering pain - so took another day off work and laid in bed all day.  So what is the end to this story?  I still don't know.  Today is Thu 15-Dec-11.

No diagnosis yet

Two years later... and I still have periodic abdominal pain.  It is slightly better with changes to diet - and with a week's worth of rest and tramadol.  However, if I don't eat for a day or two?  I still have some pain.  I've been ultra-sounded, x-ray-ed and CT-ed.  I feel slightly better?  Sorta...  I can walk around and I'm at work today - will see how long I can sit without pain.  I just took some more panadol. 

Hopefully my liver won't shrivel up from too much panadol. 

My opinion of socialized medicine?  Well, it seems OK so far but I still have some pain and no definitive diagnosis yet.  This is frustrating.  I wonder if Chicago doctors would have figured this out by now...   I'll never know I guess... *sigh*, so if I keel over and die, it was nice blogging with you.  Wish me luck...



internal organs - mine are supposedly all OK