Monday, February 11, 2013

A 'Knot' Which Causes Nausea

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 How tall are you (feet and inches)?: 6'0
 What is your weight in pounds?: 230
 How old are you?: 40
 How long has this been going on?: A week or two
 Check all symptoms you are currently experiencing:
 Chest Pain
 Nausea

My husband has been complaining of a "knot" in his chest, a hair to the right of his xiphoid process. It hurts to push on it and when there's pressure applied it makes him VERY nauseous! He's a very tough man. He's not one to complain of pain at all which worries me enough to come here to you. We've been to the Dr. and she gave him clairatin and omeprazole. Its NOT indigestion! He was in the military so its a VA hospital. His Dr. ordered an ultrasound but haven't gotten a call back yet. Its been two three days. I used to be a paramedic and my first "field impression" is gallbladder. He's miserable! Unlike him! He's also exhausted everyday. Fatigued. Headaches daily.

 What have you done so far to remedy this condition? Please include tests and relevant studies here.
 : Waiting on ultrasound appoint.


 Only meds he's on is Clairatin and Omeprazole.
 Please list any chronic medical problems and also list any prior surgery: No medical problems. Has only had two surgeries. One for wisdom teeth six years ago. Before that three screws in his patella after falling and shattering it. Over all excellent health. Low BP, good heart rate, typical high cholesterol.

 Check all conditions present in your immediate family... :
 Cancer
 Cardiac Disease
 Diabetes
 Please list any medication allergies that you have : : Nka
 Please list any medications you are currently taking (and dosage if known) :: Clairatin 10mg
 Omeprazole 40mg

Periodic tylenol and aleve for headaches and knee pain.
 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?: Yes
 Please describe your alcohol consumption :: Occasionally

I guess I just need to know if I need to FORCE him to the ER because he doesn't want to go. I'm also planning to pressure the VA to get him in sooner.

Gallbladder? Muscular?
____________________________________________________________

So hard to say without an exam. Would be nearly impossible to feel the gallbladder even if it was enlarged or inflamed. I have a very good friend who is a docot for the VA and I understand the delays. It's now up to one year for a hip replacement.

That being said I think the more important thing to realize is that just with what you have told me I do not thing delay is an appropriate thing in your husband's case. He needs that ultrasound but he needs a chest Xray and an EKG and yesterday. He needs a provider to examine him and these days the only place to get answers to complex medical questions in a timely fashion is in the ER.

Also, it's unclear to me from your question above if you are referring to yourself or your husband in many of the questions.

If his pain worsens, if he develops shortness of breath, fever, or vomiting you must get him to the ER. I can't put together this problem very well though I do agree that the Gall Bladder is suspect.

If you sish to clarify your responses or ask further questions in the comment section please feel free to do so.
 

4 comments:

Sheryl Hatz said...

All the info is about him. His vitals are good and no sob. I didn't think his gallbladder itself was protruding but if it was inflamed could possibly force something else out of place. The only time it seems to bother him is when its pressed on. I think I'll work on getting him in to the E.R.

Sheryl Hatz said...

Thank you.

space doc said...

The gall bladder, liver, duodenum, stomach, and pancreas could all be causing discomfort in the area. The ultrasound is an excellent first step for for liver, gall bladder and pancretic stones, cysts, tumors, etc.

If these don't provide the answer then a C-T of the abdomen will often pick up problems with a little more clarity.

Certainly muscle strains can cause thse symptoms, but there is usually some sort of trauma, exercise, heavy lifting, etc.

A gastric or doudenal ulcer might require a G.I. barium xray or an endoscopy to look for ulcers.

Blood tests for infection along with liver, gall bladder and pancreatic enzymes would also be helpful to throw more light on the condition.

If he's not in acute pain except when the area is pushed on, it would probably be good to really insist on getting the results of the gall bladder/abdominal ultrasound first.

Alcohol, cigarettes and drugs can certainly adversely affect liver, stomach, and pancreas.

I hope you can let us know how things turn out.

Best of luck! Space Doc.



space doc said...

Just another thought--I'm not sure what you mean by 'typical' high cholesterol, but elevated cholesterol can definitely be associated with gall stones.

Please let us know how things turn out.

Space Doc