The ER & an Answer
All week last week I had intensifying pain in my right lower abdomen along with some seriously awful flare ups of IBS.
On Thursday I reached a breaking point with the pain. I don’t have a doctor here because every single office I have called (and believe me I have called a ton) tell me they aren’t taking new patients, or the soonest new patient appointments they have are in late winter or spring 2016.
Really? Months away!?!
I finally broke down and went to the urgent care place a mile from our house. The urgent care centers in our old town are kind of sketchy–it’s hit or miss what sort of care you’ll get from there. Definitely not my top choice for healthcare.
When I got there I was the only white person in the crowded waiting room. Everyone else was African. Not African American, but from Africa in Muslim head coverings and speaking loudly in another language. Even the secretary at the desk. I felt just a tiny bit out of place, which didn’t help my anxiety about the horrible pain I was having.
I’m pretty certain one little girl had whooping cough. It’s going around here, even in the fully vaccinated population. She was making a loud whooping sound every time she started another coughing fit. She was running around the room touching everything and coughing on everyone. I have never wished for a facemask so much in my entire life. For me, not her.
If I’m coughing my brains up in a week we’ll know why…
Anyway, after about an hour of miserable pain-filled waiting I was called back. Luckily I got to see an actual doctor (vs. a nurse practitioner) and she was very kind and attentive.
She did a physical exam of my abdomen and pressed in certain spots which intensified my pain level. She said she thought I had appendicitis and sent me to the local ER.
Tyler was at home watching the kids, so at least I didn’t have to wrestle with them, but I didn’t feel like going to the ER. I wanted to go home and lay in my bed and curl up in a ball in pain. Plus the cost of the ER? Noooooo!
But Tyler insisted I go, so I did.
The ER here was very different than the ones I’ve been to in Kentucky. The hospital was huge. HUGE. The ER was completely packed.
The first thing they had me do was pee in a cup. I was happy to find that the bathroom was super clean! At UK’s ER in Kentucky it was always dirty–the floors were dirty, the rooms were dirty, the bathrooms were dirty. This hospital was squeaky clean. My anxiety and OCD appreciated that.
After that I had to wait in the waiting room, which sucked. I analyzed all of the people trying to find the least contagious person to sit next to. Someone that looked like they had an injury instead of coughing, sneezing, fever, or even worse–a vomit basin in their lap. Shudder.
It almost felt like the high school cafeteria. A room full of people in small groups, and me alone. Who should I sit with?? There were no empty spots, so I had to choose someone. (Social anxiety alert!)
I chose another African Muslim girl who looked my age and was chatting away happily on her cell phone, not in English. On my other side was a guy with crutches and a bandage on his foot, and across from me was an older man with a sore on his arm sitting with what I presume was his wife.
After about an hour in my corner I was called back to be triaged. They determined my abdominal pain was a higher priority. Woohoo…
I got my blood drawn, and then I had to go wait about five more minutes in the waiting room–which necessitated the whole routine of choosing another seat because by then my original one had been taken.
After they called me back to a room the long, long, long waiting began. But it was a little easier to wait laying on a bed alone rather than in the crowded waiting room, even though I was awkwardly dressed in a hospital gown. After awhile a doctor came to do an exam. Unlike other ER doctors I’ve met in the past this one was actually very nice. He was slightly flamboyant, younger than me (!!), and from India, but he spoke English that was perfectly easy to understand. I really liked him, actually.
He poked around on my abdomen and asked me a bunch of questions with excellent bedside manner. It seemed like he actually cared if I lived or died, and he wasn’t the least bit annoyed that I was sitting here taking up his time.
Finally he determined that I should have a CT scan with IV contrast.
I’d never had one of those before. I’ve only had x-rays.
This is when the worst part of the waiting happened. I had to wait four hours for them to come get me and take me to the CT scan.
I lay there and worried that they would find no actual source of this horrible pain. Story of my life, right? Just like with the giardia where they told me it was only IBS and to go home and suffer because there wasn’t any cure and nothing was reallywrong with me…for more than ten years! (And ten years later I definitely have damaged intestines from having giardia all of those years, so it was a self fulling diagnosis I guess.)
I laid there in my bed for so long that I became convinced the hospital had forgotten about me. When the tech popped through the curtain and announced he was here to wheel me to the CT scan I immediately responded with, “Oh I thought this moment would never come!”
He busted out laughing.
The CT scan was so weird.
I had to lay on a bed attached to the machine. Then they hooked up my IV port to the computerized thing that releases the contrast. The cord was curly, like a phone cord from 1992, except clear.
The lady in charge of the scan kindly warned me that the contrast would feel hot as it goes through my entire body. Then she went to take shelter behind her protective glass wall in the booth, out of my sight.
A woman’s robotic voice coming from the machine instructed me to hold my breath, then breathe normally several times as the table I was laying on began to jerk back and forth without warning.
The donut I was inside of had a red lining that began to whir in a circle around me quickly. I felt like I was going into a time machine! It was like the Tardis, except round and red instead of rectangle and blue.
Above me there was a little sign that said, “High powered laser. Do not look directly into this.”
I couldn’t stop looking at it, of course, and then reading the sign and trying not to look at it. I wished I could have taken a picture of it with my phone. I don’t know why it seemed so funny in that moment. High powered laser, watch out dude! OMG they’re shooting a high powered laser at my body?
Then the IV contrast started flowing into my veins and I was completely distracted from the high powered laser sign.
First my arm burned. And then I felt it going up to my scalp, hot, like when you drink very hot coffee and you can feel it going down your throat into your stomach, except even hotter and eerily in my veins instead of my stomach.
I was completely freaked out while the contrast traveled all over. I felt it go down both sides of my neck and it actually hurt because it burned so much. It was hard to breathe for a second! I felt my breasts and my nipples heat up.
Then it moved through my abdomen and it felt very much like I was peeing in on the table. I wasn’t peeing though, it was just the heat spreading to the tip of my urethra and down my thighs.
I had to resist the urge to squirm and reach down to make sure nothing was actually wet.
Even my anus felt like a burning hot circle. I felt every tiny part of my body in a surreal way.
Finally I felt the contrast flow all the way down to my toenails.
Then it was over.
They wheeled me back to my room in the ER and I had to continue waiting and waiting.
About an hour later (yes, only an hour this time!) the doctor came back in with my results.
He sat down in the chair next to the bed and asked me how I was feeling. The same, I told him.
He said that my results showed no appendicitis.
I prepared myself for what was coming–There is no source of your pain. Maybe it’s just IBS or indigestion. Sorry. Follow up with your GP next week.
Then Dr. Patel opened his mouth and uttered words I did not expect. The best thing anyone has ever said to me, I’m pretty certain.
But something else did incidentally show up on your CT scan that is the likely cause of your pain.
Be still my heart. Dr. Patel, I love you.
For about two seconds, before the doctor continued with his explanation, I absolutely did not care what the source of the pain was as long as there was an identifiable source.
Do you know what it’s like to have life altering pain with no known cause? That comes and goes, sometimes severe or other times just nagging enough to make you miserable? For people (family) to not take it seriously, or to think you’re only complaining all the time?
THERE WAS A CAUSE TO MY PAIN ON THE CT SCAN. PRAISE BABY JESUS!
Then those two seconds of pause while the doctor took a breath ended and I realized I did indeed care what the cause of pain was, and I felt scared for a millisecond.
He continued on: Your scan showed findings that are consistent with Pelvic Congestion Syndrome.
As a nerdy person who loves to research various medical conditions I was surprised to know that I have a syndrome I’ve never heard of. Ever.
He went on to explain that PCS is caused by varicose veins inside of the abdomen around the girly organs. You can’t see them from the outside, they’re only internal. They can be caused in young women by genetics and multiple births. (Yay me!)
This is a chronic pain condition. He suggested consistent use of prescription pain killers. There’s also some kind of creepy vein cath surgery they can do to seal off the offending veins, which is 80% successful.
Here’s the best part: PCS causes pain in the lower abdomen that ranges from a constant dull ache to severe pains. It’s aggravated by standing a lot, or doing strenuous activity, and worse at the end of the day. The pain and inflammation are also thought to be a cause of IBS, because it’s all around your intestines and irritates them, and it causes pain with bowel movements. It also causes severe pain during the menstrual cycle and sometimes during ovulation.
I have all of those symptoms.
This explains absolutely EVERYTHING I have been suffering from.
You know what? Even if it’s never cured just knowing that there is an actual identifiable issue is a huge relief to me.
That pain isn’t coming from my intestines. It’s coming from the area around them. I don’t have cancer, or some huge tumor, or ulcers, or diverticulitis, or appendicitis, or any other kind of related issue. It’s all from those varicose veins hidden deep inside of me.
Flappy, saggy, veins that cause pain by swelling up and allowing the blood to pool or flow backwards. Gross, but surprisingly harmless. Believe me, I asked. It does not affect fertility or pregnancies, it isn’t a significant risk of dangerous clots, and it doesn’t change your life span.
Thank you Dr. Patel for putting up with my in depth questioning.
Since I don’t want to become addicted to prescription painkillers the doctor suggested I try ibuprofen. It has the added benefit of reducing swelling and inflammation. I got through the weekend traveling to Kentucky, photographing a wedding, and doing another photo session with massive amounts of ibuprofen.
I’m not sure what to do long term. I need to investigate to see if there are any herbs that help strengthen varicose veins. I’m sure there are.
I can also make an appointment to see the OB that the ER doc referred me to for further examination and maybe that surgery. I haven’t decided yet.
For the time being I’m just happy to know that my pain is real, with a name and a cause.