Friday, September 28, 2012

Bothersome Pelvic Pain

I AGREE TO USE MD STAT FOR EDUCATIONAL PURPOSES ONLY, THAT NO DOCTOR PATIENT RELATIONSHIP IS FORMED BY MY PARTICIPATION IN THIS EXCHANGE, AND I UNDERSTAND THAT MY QUESTION AND ANSWER(S) WILL BE POSTED ON THE WEBSITE AND WILL BE VIEWABLE BY VISITORS TO THE SITE.: Yes, I agree.

I am a 69 year old very healthy woman - never had surgery.  I am post-menopausal for 15 - 18 years.  I take no hormones.  Have never had any post-menopausal bleeding.  I have been  celibate for the past 5 yr. About 2 weeks ago I noticed an uncomfortable, crampy feeling in my very low abdomen - like the menstrual cramps of years ago - and also low back discomfort.  No discharge or bleeding.  Bowels fine.  No stomach discomfort or nausea.  Eating normally.  I do not feel bloated.  My last Pap test was 2 yr. ago. What do you think?


Gender: Female
How tall are you (feet and inches)?: 5 ft 5 in.
What is your weight in pounds?: 169
How old are you?: 69
How long has this been going on?: A week or two

Check all symptoms you are currently experiencing:
Abdominal Pain

What have you done so far to remedy this condition? Please include tests and relevant studies here.

I have appt. with my GP tomorrow - plan to ask for referral to gynocologist.  I had my yearly physical 6 mo, ago and all labs were good.

Please list any chronic medical problems and also list any prior surgery  Hypertension (controlled)
Occasional atrial fib - none for 3 months (on med)
Check all conditions present in your immediate family... :
Asthma / Lung Problems
Cancer
Cardiac Disease
History of Back Pain
Hypertension
Stroke

Please list any medications you are currently taking (and dosage if known) Norvasc 5 mg qd
Amiodarone 100 mg qd
Prilosec 10 mg qd
Asa 61 mg qd

When was your last menstrual cycle?: I no longer have a menstrual cycle

Are you currently using or do you have a history of tobacco use?: No

Are you currently using or do you have a history of illegal drug use?: No

Please describe your alcohol consumption :: Weekly

I would like to know how I should proceed, after I see my GP tomorrow.  Should I request a CT, ultrasound, or MRI?

_____________________________________



Great question. The list of possible problems is great but abdominal pain such as you are experiencing and at your age needs to be taken seriously indeed. To get to you most important question at the bottom here, it's going to be your GP's call. But before you get to the CT v MRI v US it's time for another pelvic exam and pap smear. This may give your GP a good clue as to the best imaging test to order. As a rule the CT of the abdomen and pelvis is easy to get, quick, and very sensitive for most problems that occur in the abdomen up to and including various cancers. Deep breath, I am not suggesting this is the answer, I am merely pointing out that the CT is the best exam to get quickly to see everything between the diaphragms to the pelvic floor. An MRI is typically better for detail of soft tissue, but we are getting ahead of ourselves. An ultrasound is best to look at the ovaries and uterus but otherwise probably won't have much utility in your case. Expect your GP to do a pelvic exam and to check your stool for blood. Expect some labs to be drawn along with a urine sample. And then ask your doctor, who knows you well, what the top three things he is concerned about are. I will tell you that when you look at it this way, in terms of BAD diagnoses, that cancer does appear on the list. Cancer of the bowel, uterus, ovary, or bladder. But against these possibilities is the fact that these symptoms have been apparent for two weeks and happened rather acutely and seem to be accompanied by no other symptoms other than pain. Not a worrisome story for cancer, more likely pointing to a more benign cause. Constipation? Bladder infection? Hernia? I hope this has been helpful. Please feel free to comment or ask more questions below. Please check back in and let us know the result. God Bless.

Tuesday, September 25, 2012

Chest Pain? Palpitations? GI problem?

I AGREE TO USE MD STAT FOR EDUCATIONAL PURPOSES ONLY, THAT NO DOCTOR PATIENT RELATIONSHIP IS FORMED BY MY PARTICIPATION IN THIS EXCHANGE, AND I UNDERSTAND THAT MY QUESTION AND ANSWER(S) WILL BE POSTED ON THE WEBSITE AND WILL BE VIEWABLE BY VISITORS TO THE SITE.: Yes, I agree.

Ask your medical question here. : MD STAT is an educational service. We do not prescribe medication. We do not enter into a doctor-patient relationship with you. We explain, educate, clarify, and suggest possible solutions to your medical questions. Thank you for your interest.
For the past year I have been having episodes of severe chest pressure that lasts 5-20 minutes it goes straight through between my shoulder blades. It leaves me feeling worn out for hours. It only occurs at rest, sometimes waking me from sleep. I have gone to the ER and had EKG, chest Xray, and stress test which all came back normal. I had 2 EKG's done in the ambulance during the pain and they both came back abnormal says possible inferior infarct of undetermined age. the ER staff acted like they were never made aware of this, even though I heard the EMT tell them twice. The pain is relieved with nitro, but I usually just ride it out med free. I have about 6-10 episodes a month now.  Should i see a cardiologist first or a gastroenterologist? My NP is clueless and not sure where to send me.
I have also recently starting getting these flip flop feelings in my chest. They are happening more often they take my breath away for a few seconds then they are gone.

Gender: Female
How tall are you (feet and inches)?: 5'9"
What is your weight in pounds?: 219
How old are you?: 34
How long has this been going on?: More than a year
Check all symptoms you are currently experiencing:
Chest Pain
What have you done so far to remedy this condition? Please include tests and relevant studies here.
Chest Xray, abdominal ultrasound, chest CT to rule out aneurysm, stress test, EKG, cardiac enzymes
Please list any chronic medical problems and also list any prior surgery (lacerations don't count!): tubal ligation, gall bladder removal, tendon repair in foot

Check all conditions present in your immediate family... :
Cancer
Cardiac Disease
Diabetes
Hypertension
Stroke

Please list any medication allergies that you have : : none
Please list any medications you are currently taking (and dosage if known) :: lisinopril 5 mg
When was your last menstrual cycle?: 1 week ago
Are you currently using or do you have a history of tobacco use?: Yes
Are you currently using or do you have a history of illegal drug use?: No
Please describe your alcohol consumption :: Rarely


Which type of doctor should I see first?
Can i go to a cardio and request an event monitor or a cath?
May we send you a satisfaction survey after your question is answered? It takes a minut to fill out.: Yes

_________________________________________________________________

GREAT QUESTION. I THINK YOU SHOULD SEE BOTH A CARDIOLOGIST AND A GASTROENTEROLOGIST. INSIDE THE CHEST WE DO NOT FEEL PAIN LIKE WE DO ON OUR SKIN. IN OTHER WORDS, PAIN FROM THE STOMACH OR ESOPHAGUS CAN BE EXPERIENCED AS CHEST PAIN, AND, PAIN FROM THE HEART CAN BE FELT IN THE ARMS, JAW, OR THE STOMACH. ALSO, NITROGLYCERIN RELIEVES PAIN FROM THE HEART AND ALSO, OFTEN, PAIN FROM THE GI TRACT. IF YOU WERE MY PATIENT I WOULD HAVE YOU ON A HOLTER OR EVENT MONITOR TO CAPTURE THESE PALPITATION EPISODES ON A COMPUTER DEVICE SO A DOCTOR CAN REVIEW IT AND SEE IF YOUR HEART RHYTHM IS CHANGING WHEN YOU HAVE THESE EPISODES. YOU ALSO NEED AN ECHOCARDIOGRAM (ULTRASOUND OF THE HEART) AND YOU NEED AN UPPER ENDOSCOPY BY A GI DOC. THE REASON YOU NEED THE ECHO IS TO SEE IF YOUR HEART AND IT'S VALVES ARE ALL NORMAL. IF YOU HAVE HAD AN OLD INFERIOR INFACT THIS WILL SHOW IT, THOUGH THE EKG IS NOT THE WAY WE DIGANOSE AN OLD INFARCT (HEART ATTACK). THE FACT YOU HAVE PASSED A STRESS TEST POINTS AWAY FROM YOUR HEART AS A CASUE BUT DOES NOT RULE IT OUT. ALSO, THE TYPE OF SYMPTOMS YOU DESCRIBE ALSO SUGGEST YOU MAY HAVE ESOPHAGEAL SPASM AND THIS IS WHY YOU NEED THE GI DOCTOR TO LOOK AT YOU AS WELL. I THINK WITH THESE SYMPTOMS I WOULD START WITH THE CARDIOLOGIST, AND, IT WOULD BE GOOD TO HAVE THE HOLTER OR EVENT MONITOR DATA BEFORE YOU GO AND SEE HIM. SECONDLY, I WOULD SEE THE GASTROENTEROLOGIST. I HOPE THIS HELPS!

BEST

DOC1

Tuesday, September 18, 2012

Pain Two Years after Motorcycle Accident

I AGREE TO USE MD STAT FOR EDUCATIONAL PURPOSES ONLY, THAT NO DOCTOR PATIENT RELATIONSHIP IS FORMED BY MY PARTICIPATION IN THIS EXCHANGE, AND I UNDERSTAND THAT MY QUESTION AND ANSWER(S) WILL BE POSTED ON THE WEBSITE AND WILL BE VIEWABLE BY VISITORS TO THE SITE.: Yes, I agree.
Ask your medical question here. : I had a motorcycle accident 2 years ago (Aug 2010) Had broken neck. I now have two titanium rods in neck and 10 screws. Still having pain in neck and back. More severe the past 3 weeks. Hurts to take a deep breath and cough. I have been seeing a massage therapist for over a year. There is no sensation on dermis of skin area between the shoilder blades. Pain is more severe when turning body to left than right.

Gender: Male
How tall are you (feet and inches)?: 5-08
What is your weight in pounds?: 180
How old are you?: 62
How long has this been going on?: A few days
Check all symptoms you are currently experiencing:
Difficulty Breathing
Vomiting
Musculoskeletal Pain

What have you done so far to remedy this condition? Please include tests and relevant studies here.

Heat therapy and Stim. Aleve at night.

Check all conditions present in your immediate family... :
Cancer
History of Back Pain
Please list any medication allergies that you have : : CIPRO
Please list any medications you are currently taking (and dosage if known) :: Sertraline (100mg)
Flomax
When was your last menstrual cycle?: I'm a man, baby!
Are you currently using or do you have a history of tobacco use?: No
Are you currently using or do you have a history of illegal drug use?: No
Please describe your alcohol consumption :: Rarely
HOW QUICKLY DO YOU NEED THIS TO BE ANSWERED?: As soon as possible
Why is the pain still there after two years.

Low Potassium after Gastric Bypass

I AGREE TO USE MD STAT FOR EDUCATIONAL PURPOSES ONLY, THAT NO DOCTOR PATIENT RELATIONSHIP IS FORMED BY MY PARTICIPATION IN THIS EXCHANGE, AND I UNDERSTAND THAT MY QUESTION AND ANSWER(S) WILL BE POSTED ON THE WEBSITE AND WILL BE VIEWABLE BY VISITORS TO THE SITE.: Yes, I agree.
I would like to know how fast my potassium level can drop below a 3.0? I had blood work done 2 Weeks ago and my NP sent me to see my Dr that did my gastric bypass and he told me to go back to my NP and have her deal with it. I'm so frustrated with the round about... I don't feel well and do not have an appetite. Body hurts and some times my chest. But I also get shortness of breath or feel like I'm dizzy when I bend over and come back up. I'm not sure if I should wait to make another app with my NP or go to the ER. I have read up on this issue and am now afraid. Please help... Thank u. Btw this was just found because I asked for blood work to be done since I did not feel well and it's beena long time since I had my blood work done I had gastric bypass 1 year and 9 months ago. But have been feeling bad for 3 to 4 months so asked for the blood work.

Gender: Female
How tall are you (feet and inches)?: 5.4
What is your weight in pounds?: 180
How old are you?: 32
How long has this been going on?: A week or two
Check all symptoms you are currently experiencing:
Difficulty Breathing
Chest Pain
Diarrhea
Nausea
Musculoskeletal Pain
Respiratory
Weight Loss

What have you done so far to remedy this condition? Please include tests and relevant studies here.
 I am on a prenatal vit (not pg) I take iorn, vit d, b12, b1 and potassium

Please list any chronic medical problems and also list any prior surgery (lacerations don't count!): Had my gullbladder out had an instrumentation fusation of my L5 to S1 and gastric bypass also had a nerve cord stimulator implanted in my back. I have  spinolisosis,degenerative disc disease, bipolar 1, ptsd, anxiety, sleep issues ADD that's all I want to list

Check all conditions present in your immediate family... :
Asthma / Lung Problems
Cancer
Cardiac Disease
History of Back Pain
Psychiatric Disorders
Stroke

Please list any medication allergies that you have : : Penicillin, morphine
Please list any medications you are currently taking (and dosage if known) :: Saphris 10mg sublingual at night, xanax 2mg twice a day as needed, lunesta 3mg every night, vyvanse 40 mg once a day and aderall 15mg once a day and all the vitamins I listed above
When was your last menstrual cycle?: 4 weeks ago
Are you currently using or do you have a history of tobacco use?: Yes
Are you currently using or do you have a history of illegal drug use?: No
Please describe your alcohol consumption :: Never

HOW QUICKLY DO YOU NEED THIS TO BE ANSWERED?: As soon as possible
How fast potassium can drop. And should I wait to make yet another app with my Doc or go to ER

Sunday, September 16, 2012

Abdominal Pain? Back Pain?

I AGREE TO USE MD STAT FOR EDUCATIONAL PURPOSES ONLY, THAT NO DOCTOR PATIENT RELATIONSHIP IS FORMED BY MY PARTICIPATION IN THIS EXCHANGE, AND I UNDERSTAND THAT MY QUESTION AND ANSWER(S) WILL BE POSTED ON THE WEBSITE AND WILL BE VIEWABLE BY VISITORS TO THE SITE.: Yes, I agree.

MD STAT is an educational service. We do not prescribe medication. We do not enter into a doctor-patient relationship with you. We explain, educate, clarify, and suggest possible solutions to your medical questions. Thank you for your interest.


Gender: Female
How tall are you (feet and inches)?: 5'6"
What is your weight in pounds?: 171
How old are you?: 65
How long has this been going on?: More than a year


Describe associated symptoms not listed above: Quite a few years ago I began to have a slight twinge in the area of my solar plexis.  Went through all kinds of tests by a gastroenterologist and finally it was chalked up to IBF.  It has gotten progressively worse but the next time I went back he came up come up with the same diagnosis because he couldn't find anything else.  But that was still quite a few years ago.  Now it's really pronounced and the twinge radiates down my legs and I can feel it in my ankles.  Some sort of nerve thing????  It happens at night in bed mostly.  Any idea what this might be?

Please include tests and relevant studies here. Endoscopy, colonoscopy, MRI (or catscan) of my abdomen.  Again all quite a few years ago.

Please list any chronic medical problems and also list any prior surgery (lacerations don't count!): Used to have chronic fatigue - but it has been under control for quite awhile.

Complete hysterectomy, hip replacement, carpel tunnel, many trigger fingers, orthoscopic knee ( 2 surgeries), stent for May Thurner syndrome in iliac vein.

Check all conditions present in your immediate family... : Stroke

Please list any medication allergies that you have : : MRI Contrast - hives

Please list any medications you are currently taking (and dosage if known) :: levothyroxine .088 mg 1/daily
imitrex 5mg as needed for migraine

When was your last menstrual cycle?: I no longer have a menstrual cycle
Are you currently using or do you have a history of tobacco use?: Yes
Are you currently using or do you have a history of illegal drug use?: No
Please describe your alcohol consumption :: Occasionally

HOW QUICKLY DO YOU NEED THIS TO BE ANSWERED?: As soon as possible
 
I'd like to know what this is since it's getting progressively more intense.  Or what type of physician I should see and what to tell them.  When I try to describe it no one seems to have any idea what it might be and tests don't find anything.  But the feeling is like the fright/flight internal shock.
May we send you a satisfaction survey after your question is answered? It takes a minut to fill out.: Yes