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Forum Name: Cardiology Symptoms

Question: Chronic pain syndrome


 MRROBP - Mon Sep 20, 2004 2:51 pm

I'm a 27 yr old white-male; 6ft 3 in, 230 lbs. I was diagnosed with high BP in mid-March 2004. I was given 10mg of Lisinopril at the time, and I weighed about 290 lbs. I still take 5mg of Lisinopril, but am hoping to be off it soon with continued weight loss.

In mid-June 2004, I was diagnosed with GERD. The diagnosis was based solely on the symptoms I reported, digital exam, and blood work. No imaging or follow up testing was performed. I was prescribed 150mg of Zantac 2xs daily for a month. The symptoms didn't improve at all. At the follow-up, I was given 20mg of Prilosec 1x daily. Again, no improvement in the symptoms.

Since that time, I started getting this really severe pain on my left side, kind of parallel to the bottom portion of the rib cage. It radiates into my back and left chest. However, I get pain in the left side of my chest without the side pain as well.

The chest pain is usually just below the left breast region, and shoots up to a little above my nipple. It also heads towards the center from time to time. I've also been getting pain in my left shoulder and arm as well. The pain is seemingly not brought on by anything that I can think of.

I also experience severe abdominal pain, mostly around my belly button, to the left of it, and lower to the left of it. I am also nauseated most of the time, have vomitted here and there, and get cold and the chills real easily.

I told my dr about all of this when I saw him last in early August, and he basically couldn't come up with an explanation and said I could have a chronic pain syndrome or that my nerves were more sensitive to the pain than normal. I basically decided to just live with the symptoms and decided that I would only seek medical attention for them if it got to the point where I couldn't take it anymore.

In late August 2004, I went to another dr because the pains were getting bad again. I told him everything and he did blood work, a digital exam, abdominal x-rays, and an abdominal ct where I had to drink two glasses of iodine laced juice. Everything came back normal, and this dr said, and I quote "some people get headaches, some people get stomach aches. You seem to be in the last group. I see you had a ct done last summer and it was normal too." I responded by telling him that it was normal, and I also had my appendix removed 3 hours after the ct was taken. He was inserting his foot into his mouth at that point. He did give me 40mg 1xdaily of Protonix though, as he thought they might help more than the Zantac or Prilosec. However, the Protonix has done nothing.

It is now late September, and I still am experiencing all of the symptoms I listed above. My BP is usually in the 110s/70s, pulse in 60s. So in a sense I'm not worried that this is heart related. But at the same time I am, because of the location of the pains and stuff. I really don't know what to do or who to see. I'm hesitant to go back to my dr, as he was basically clueless when I saw him last. I also don't want to go back to the dr I saw last, as I was less than thrilled with his professionalism or lack there of. I've been tempted to go to the ER when the side pain really kicks in, but have decided not to. I live in a small city, and have a health plan that limits who my primary care provider can be. I also need referrals for any tests and specialists that are not ordered by my phcp or in an emergency setting. I'll stop babbling now. Any advice, insight, or suggestions would be greatly appreciated.
 MRROBP - Tue Sep 21, 2004 7:32 pm

I saw my dr today. I wasn't planning on it, but I was awaken at about 4 a.m. with a strange feeling in the area that I can best describe as where the chest and abdomen meet. I felt really nauseated...like I needed to vomit or belch like never before. I couldn't though. I also had a hard time getting comfortbale, and subsequently back to bed. I tosed and turned, and eventually was able to get a few more hours of sleep.

When I woke up, I still had that weird feeling so I called my dr's office. They got me in and I told him, again, what's going on, as well as the onset of this new discomfort and its location. He took me of the Protonix, as he doesn't think I have GERD...he's not the only one :wink: . He also said that the CT results pretty much rule out gallbladder or other issues.

He drew blood, took a urine sample, ordered a chest x-ray where they also x-rayed my left side. I won't know the results of the lab work for a while, but the x-ray tech said the images looked good. But she also said that she is not the radiologist so her word is not official.

I talked to my dr about this all possibly being heart related, and he didn't think it was a serious possibility. This is despite the pains in my left shoulder, upper arm, upper-mid back, side, and chest. Again, all on the left side. As well as the discomfort in the area where the abdomen and chest meet. I told him I was concerned it could be, but he didn't want to order anything like an echo or stress test. I do believe he included the cardiac markers as part of my blood work though. I hope.

Despite all of this, I still feel clueless and frustrated. Any advice and insight is most welcome.
 Dr. Yasser Mokhtar - Tue Oct 26, 2004 10:57 am

User avatar Dear Guest,

Naturally, we cannot exclude anything as serious as heart disease over the internet but your symptoms are not of heart origin according to what i think.

You have some risk factors that you had for a short while but the pain characteristics are not typical of coronary disease, so the chance of this being heart related is small.

Regarding your abdominal pain, it is not easy for me to tell what is causing it but if you have not been seen by a gastrointestinal specialist may be it is time to do so. An endoscopy might be indicated to try and get to the bottom of your problem.

Thank you very much for using our website http://doctorslounge.com and i hope that this information helped.

Yasser Mokhtar, M.D.

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