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Forum Name: Spinal problems and back pain

Question: Flank Pain


 sallywingles - Tue May 19, 2009 12:00 pm

*Supra Ventricular fibulation -Ablation
*Esophagus narrowing (3 places) - stretched
Heart racing on daily basis is typical

Appendectomy 1985
Upper Gastro Esophagus Stretching
Ablation

Cancer - Grandmother (stomach mass)
Cancer - Mother (vaginal)
Heart Attacks - (Grandfather - Father)
High BP - (Mother & Father)
wolves whites parkinson's (Sister)
Kidney Disease (Sister)
Diabetes (Grandmother)

Aleve (lip swelling)
Levaquin (Shakes)

Smokes (1 pack a day)
No Alcohol
Did abuse Opiates over 15 yrs ago
Methadone Maintenance (8mg)
two children
Constipation (always)
Advil 400mg (morning and night, but sometimes afternoon)



Pain started just about two years ago. The pain has changed slightly over time. I went to walk in medical on the weekend as the pain was intense. Due to my past history of narcotic abuse I was simply treated as "there for pain medication" and told I pulled a muscle. Left with medication I never filled.

Over time it just got worse. I went to my PCP. He suggested I see a Gastro Dr. for and issue I have with swallowing. Food or drink tends to get stuck (not in the throat) and goes down hard (painful). The upper gastro shown three narrow areas which they stretched. It is recommended I return to have the stretching done again.

Also it was suggested I see and ENT about my "clearing of the throat" often. Nothing was found.

My PCP had an abdominal Ultra Sound ordered, and blood work. The Ultra sound showed nothing interesting.

However, while the Ultra sound was being done she would go near my ribs it was very uncomfortable, and I mentioned "I wish you could just turn me over on my side and go up higher and take a look (all under the rib cage). But I already knew she was not allowed.

Under my ribs are where my true discomfort was. Feels like someone put 10 lbs of sand in 5 lb sacks and put them under my ribs.

Ultra sound was fine, bloodwork came back with a small amount of blood (nothing to worry about), and a chest Xray came back with "spots on lungs" ... a few weeks later another X-rays showed nothing.

It was then recommended if I have more pain to go to the Emergency Room.

Months later the pain has grown more intense and a bit different. I feel at times almost like something swelling or a strange feeling. Upon that I feel what I call a "lump in my back (cannot feel or see) and this lump seems to "contract". The pain is not radiating, but it is always under and round my entire rib cage. The center of my spine in that area feels like its being pushed on.

The pain again just kept getting worse. Now my hands and arms tingle. My face and lips tingle. My Blood Pressure has been going up and stable at 140's to 160's. I attribute this to pain.

Pain was so intense (it has been at least six months since my last Doctor visit) I decided to go to the Emergency Room. I was seen by a young female Doctor. She approached me and her exact words were "You know you should not be taking Narcotics for this, right". I was actually shocked that she would even assume what I do or not do without even meeting me yet? I knew from that very moment she read my history of opiate abuse and immediately targeted me. I quickly informed her I did not appreciate her assumptions and that I could care less about her pills and I'm here because I want answers, and I from that moment I flat out refused any pain medication she might give me. I also told her I am honest and I tell Doctors what I'm taking because I fear if they did not know I could be seriously hurt by mixing medications and more. I also know that if I am not honest my medical insurance company can deny my medical bill claims. So, due to my past I am willing and I will carry the label with me, but I will NOT tolerate that type of instant judgment.

She began to take her knuckles and knock on my spine going up and down and she said "Well it is NOT broken" (I believe she was annoyed with me from my comment). I said Yes, of course it's not broken but there is something wrong and I just want some answers. She began to press on my upper sides of my back saying oh yeah, yeah I feel that yes. I said I have no tenderness there, and the pain never went up that far nor radiates up towards that area. I was trying to be specific on the pain, but yes I understand its hard as pain can radiate. In the end I could tell she was being sarcastic with me. My husband also was extremely annoyed and being as patient as he is... he was ready to say something to the Doctor in my defense. I began to cry to explain to her that I am just so very tired of the discomfort, and I just want some answers.

That exact treatment is what kept me at home in pain for so long. I would rather not be treated like that so I hesitate to seek medical help!

I mentioned that I would be so happy to get a CT Scan or a MRI or something far better than the few things that have been done. She made it very clear she finds no reason for any such tests and will only offer a Xray, and a urine test. She said she would give a muscle relaxant. Later a nurse arrived with 10mg of Valium. The medication did help somewhat, but only for a short time. I cannot take Valium everyday and I wont.

The Dr. returned and said she found a very small amount of blood in my urine, but nothing to worry about. She also said that my Xray shows there are no broken bones, and that she will send me home with some medication, and to follow up with my PCP. She never told me, but she did write it down that she diagnosed me with Myofascial strain. Told me that she suffers from chronic back pain, but she lives with it and so should I because we are strong women (with a smile on her face).

Here is where I am at today. I am tired, in more pain, and not getting anywhere. The pain is worse, and I tend to spend most of my days home in pain, and rarely venture out anymore (I work at home). Depression is starting to take over. I have not taken any of the "medication" she prescribed (it does help to a point) but I cannot work and juggle my daily life with Valium.

My heart acts up so much more often these days, and I do not know if it is from stress or whatever else. I feel pressure up the sides of my neck, and a dull headache often. My heart beats so hard and fast at times it feels like I have a cold ice pack in my throat! It is a scary feeling. I did not have medical insurance to continue with following up with my Cardio, but yet my husband made to much to get any type of help. I fell out of the loop, and have outstanding bills with them. This is what keeps me from seeing them again.

I've been on a Methadone maintenance program for some years now. I've been an outstanding patient on this program, and was considered to "mentor" other patients due to my record. I've not accepted as I have no interest at this time in my life. This program has saved my life, given me back my family, and I am now a productive mother, wife, and citizen. My family is proud and are now so sad to see me in such pain. I've been safe, and productive for over 14 yrs now.

I fear that something serious could be going on or something so simple and easy to treat, but yet it will never happen because I am denied the tests that I feel could help me and my Doctors find the right treatments for me. I am fully aware what the Insurance Companies will allow and what they will not. I also know a Doctor can "recommend". I feel I may have said to much to these Doctors as to my symptoms which makes them feel I'm a nutter. However, I was always told write down everything, and tell the Doctors.

This is my plea - my last hope that someone could please give me some ideas on what I can do to help myself. I'm not stupid and I know this is not an official "Doctors Visit", but maybe some advice to put me in a more positive direction? I sit here now in pain, with the heating pad on my back, and holding my breath 98% of the day due to my pain. I was unaware that I was doing this until friends have told me they see me doing this and I actually "Squeak" like a mouse at times. I think it all ties together and it is far from funny. I was always so proud of not being sick and beating the flu when everyone else around me had it!

I am only 39 yrs old, and I worked hard to get where I am today. I just want some answers so that I can live a happy - life. Can someone toss me a bone here?
 sallywingles - Wed Jun 10, 2009 10:07 am

I would like to add an update.

On the pain scale of 0 - 10, my morning pain is pretty average at a 4.

During and after eating my pain level would rise to 6 and 8.

I decided to try something on the next day. I held off on breakfast and lunch, and planned to eat my dinner at 3pm. I had baked chicken cutlets, pasta, and green beans. While I was eating I could feel that contracting lumpy feeling in my back. The pain scale started to get higher and the flank fullness feeling would drastically increase (this is most uncomfortable)

After eating the pain would rise to an 8, and just stay that way until I would fall asleep. I find sitting up and getting into a comfy position allows me to relax enough to deal with the pain so that I can get sleepy for the evening.
 Tom Plamondon PA-C - Fri Jun 12, 2009 8:39 pm

User avatar Hello,
It sounds like the location of the pain is in the mid back and off to one side?

The pain worsens with a deep breath.

Any other symptoms? Cough, chills, fever.

In other words, there are lots of questions that should be asked before coming to a diagnosis. I think the best physician to work with is your primary physician.

You may consider a chest and thoracic spine CT scan.

Also, consider something straightforward as pleurisy which can cause pain which increases with deep breathing.

Again, your family physician can coordinate your care plan.

All the best to you.
 sallywingles - Fri Jun 19, 2009 1:23 pm

The pain is more of a pressure. The best I can explain this is to be a fullness, almost like someone put a football between my stomach and my spine. I can feel it contract at times. Sometimes the pain/pressure is so intense I can't bare it. I found when I eat the pain starts to get worse.

No, no real cough, no chills, no fever. The pain/pressure I complain about on breathing is because my flanks feel so full (stuffed) so I think I tend to hold my breath without me even realizing I'm doing it (due to the fullness feeling)

I truly believe its my stomach. Whatever it is right now feels like it is pressing on my spine. Once in a while I will wake up to this feeling of air in my stomach as if I was about to vomit, but without the nausea. What helps is getting something to drink. However, I did post an update to this post, which most likely has not been updated yet. The post was to explain what happens when I do, and do not eat. The pain/pressure begins to get worse while and after eating.

I'm tired of Doctors saying its a Myofacial Sprain in my back. If it didn't make me look like a nutter I would do tumbles, jumping jacks, and more in front of them to just prove I have full range of motion, and no pain in my muscles with this type of activity.

What I wish would happen is they listen to "ME" and I say it is my stomach or gallbladder. However, the ultrasound showed my gallbladder was of normal size. I still feel something could have been missed. Whatever it is ... it has been getting worse over the past two years.

Thank you in advance for taking the time to answer. I do check often to see if there is an update. I'm so eager to at least hear something on this. THANKS!
 Tom Plamondon PA-C - Sun Jul 12, 2009 8:52 pm

User avatar I would consider doing a HIDA scan of the gallbladder which will determine how well the organ is functioning.

Also, CT scan with and without constrast of the abdomen may be in order.

Take care.

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