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Forum Name: Gynecology

Question: Large anterial rectocele, houseboundafter severe whiplash?


 honey1601 - Tue Jan 13, 2009 3:25 pm

I have a large anterial rectocele,diagnosed 3 year ao, I have had numerous admissions, have a few tests, then no follow up, as they keep forgetting about me??? later, still no appoitments, as was told I needed to be reffered back to my consultant, I called & called but 3 years on still no joy? is it possible a severe whiplash injury,could have cntributed or caused my large anterial rectocele? it bulges out of my vagina...I was told 3yrs ago I needed this repaired, but nothing since??..I self catheterise and have had bad IBS, also had salmonella 10yrs ago, I was seriously ill & in Hopital for 3 wks..Iv always had bowel problems,was abused & raped age 11,the pain is awful.one dr said I have narcotic bowel, he only had limited medical notes, as 3 of my gynae files are archived, yet I have never had an internal exam, for 13yrs,I had a defacating proctogram in 06' that showed the rectocele??? please help, its gettng worse & I am desperate, I had a colpo burch suspension 13yrs ago?? My consultant who last saw me in jan 05', said, my pelvic was weak & could collapse, however, I had intermittent exasccerbation of IBS..having time of work.. I was fine until the car ran into the back of mine & I hit the car in front ,working as a support worker for the mental & physically disabled,70 hrs a week, swimming half mile a day.. im on huge doses of medication... I think the insurance providers, are tryingto blame my prior problems..even tho the driver who ran into me, admitted full lability..All I want is my life back & to be off this medication...All the dr's I don't know,or who don't know my full medical history, treat me like a junkie... but I cant stand for more than a few minutes without severe pain... I have to digitally evacuate, I swallowed beads, for xrays, they took a week to move from just under my right rib to my left rib, when I had a colonoscoy, they could not get the scope further than, the middle of my transverse colon... please please can anyone help me??? im only 39 & this is the eleventh time, my follow ups have not appeared, I have heard nothing from my own surgeon since jan 05'.. I was also told a week prior to the last appointment, by the registrar, he was 104% sure i needed no surgery? surely something must be done?? I eat real healthy, trying to open my bowels is horrendous.. my life is passing me by with no light at the end of the tunnel....ty.
 rosebec - Thu May 28, 2009 12:46 am

A rectocele occurs when the the rectum prolapses or drops into the back wall of the vagina, surgery is needed to fix this.You need to consult with gynaecology to get this fixed. It is uncomfortable and painful, but it can be corrected.


Housebound after severe whiplash

Whiplash is a nonmedical term to describe neck pain following an injury to the soft tissue of the neck(ligaments, tendons and muscle) I presume that this is since the accident that you described. You will need rehabilitation.
It is going to take time and in time you can be weaned from the medications. Make an appointment to see your PCP so he can refer you for rehab.
 Parks P, RN - Thu May 28, 2009 1:14 pm

User avatar Honey1601,

Surgical repair of rectocele does not always alleviate symptoms related to difficulty in defecation, and some patients have impaired fecal continence after surgical treatment. To avoid complications of surgical repair, we investigated the efficacy of botulinum toxin in treating patients with symptomatic rectocele.patients with anterior rectocele were included in the study. The patients were studied by using anorectal manometry and defecography, and then treated with a total of 30 units of type A botulinum toxin, injected into 3 sites, 2 on either side of the puborectalis muscle and the third anteriorly in the external anal sphincter, under ultrasonographic guidance. Results. After 2 months, symptomatic improvement was noted in 9 patients.Botulinum toxin injections should be considered as a simple therapeutic approach in patients with anterior rectocele. The treatment is safe and less expensive than surgical repair. A more precise method of toxin injections under transrectal ultrasonography accounts for the high success rate. Repeated injections may be necessary to maintain the clinical improvement. As a consultant myself I would start with finding a good gastroenterologists that would do a thourough GI workup and discuss the use of botox as an option in your
case. It is not clear to me if you have filed or are planning in filing a claim for the MVA whiplash. If you decide to file a claim, a legal nurse consultant like myself would retrieve ALL of your medical records and screen
the medicl record as to make a decision if the whiplash worsened your rectocele. My initial responce is to say any force from a MVA can aggravate underlying conditions, yes you had whiplash but your whole body
moved foreward and backward with substantial force. I am not giving you legal advice as my job is to stay objective, bit I feel patients/clients need to be aware of their options especially with personal injury.
A musculoskeletal examination for compensation and pension purposes differs from a traditional medical examination in that it requires specific detailed assessment of functioning of all areas to be examined. Include damage to muscles and joints and any atrophy, skin changes or absence of normal callosity. Since anatomical disabilities of the musculoskeletal system affect the ability of the body to perform normal working movements such as excursion, strength, speed, coordination and endurance, the Court now requires every musculoskeletal examination to include the degrees of functional loss due to pain, weakened movement, excess fatigability, or incoordination. (from 38 CFR 4.40, part of the basis of the Court’s DeLuca v. Brown precedent opinion).
As I am sure you know the constipation is caused from the opiates ie. Oxycontin .Milk of Mag would be good before bed if not allergic and tolerated. I would also consider methadone as a choice of pain
management as they have pain clinics to safely monitor your dosage, methadone is a very long acting opiate 24-48 hours but must be managed by your doctor/clinic.I hope this answers some questions for you and good luck. If you are indeed the plaintiff in this case you need to have the attorney or legal nurse consultant obtain
your medical records and find out why the lack of follow up care, believe me everything in the records will be scrutinized. As stated earlier it would be a good idea to have a independent medical exam an RN will go with you so need to feel intimidated. Since you are the plaintiff none of these costs are billed to you. Most
insurance companies like to settle out of court. Consider retaining your consultant again or another more aggresive one since it has been 4 years.

Respectfully,

Paul Parks RN LNC

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