Post-Gallbladder Surgery: Same Pain as Before Surgery

I am a 38-year old female.I began having the pain I will describe at the beginning of March.The pain has remained the same, in the same places and is very constant.It is under my right rib cage(right upper quadrant)very deep,radiates around my right side into my right shoulder blade and in between my shoulder blades.The pain up under my last right rib bone feels like someone has a clothes pin on it (a pinching sensation) and is squeezing the blood out of it,which then feels the same in my right shoulder and blades and is a constant ache.

I have seen my Internist 3x since it began.Have since had several blood tests run (CBC, Chem-24, Liver enzymes,etc.);Abdominal and vaginal sonogram;Abdominal CT without contrast because they could not get the IV in;Abdominal MRI with contrast;HIDA scan with CCK;Upper endoscopy;Abdominal X-ray.The only thing that came up was that I had a cyst on my right kidney that is very small.I have seen my Gastro and then the General surgeon on request of my Internist and Gastro,they decided to do an Exploratory Lap with the possibility of removing my Gallbladder.
he Dr.'s have thought it still might be my Gallbladder even though the tests did not show it.I had the surgery 12 days ago. After surgery,the Dr. said she found my duct at an acute angle and that could have been the problem.

I returned this past Tuesday and my pathology reported the gallbladder to be "blue-gray to green and wrinkled;mucosal surface is pink-tan,bile stained;cystic duct is pin point and measures .1 cm with average mural thickness is .2 cm;a lymph node is not grossy identified and no stones are seen. Pathological Diagnoses:Gallbladder,Cholecystectomy: Chronic Cholecystitis.

Here I sit 12 days after surgery with the exact same pain I have had for 4 months to the point of crying most of the time because the pain never stops; its waxes and wanes as far as the intensity but never goes away. I am getting severly depressed with the continuous pain especially after having surgery and the pain still remains. I actually thought it might have stopped 4-5 days after surgery but it has come back in full force. I have a 3 1/2 year old and cannot hardly take care of him because of the continuous pain.  I take Darvocet but it does not take the pain away. My Surgeon does not have a good bed side manner. She did not explain anything of what she did and does not give me the opportunity to explain my problems.

So my questions are: 1)Am I expecting too much too early - Should the pain I had before the surgery (if it was due to my gallbladder be gone)? I have had a C-section and sinus surgery and this does not feel like post-surgical pain because it is the same pain I had before and because it is still radiating.
2)I am very scared of cancer, could they have missed something??
Could I still have a problem with my pancreas,Sphincter of Oddi, common bile duct or a tumor somewhere that could be causing nerve pain?

Please help.I am very desperate and depresse

[Kevin Pho, MD]

Tough to say so soon after the surgery.  However, with the normal tests that you had prior to the operation, it is possible that the gallbladder was not responsible for the pain.  A further test to consider would be an MRCP - which can evaluate the biliary ducts.

As for cancer - this would be unlikely given the tests you have received.  If there is a mass in the pancreas - the MRCP can be helpful, or you can consider an MRI.

These options can be discussed with your personal physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
Medical Weblog:
kevinmd_b

[surgeon]

12 Days after surgery is too soon to draw any conclusions, in that irritated nerves from the gallbladder area can sometimes give a sensation like that coming from the gallbladder. However, given the fact that all your tests were normal, it's not likely that the gallbladder was your problem. The finding of chronic cholecystitis on the pathology report doesn't mean much: it's a close call sometimes, and when it was as normal as the gross description (color, thickness, etc) it's probably not significant. It's possible that as more time passes from surgery you'll see improvement. If not, then finding the cause may be frustrating. The good news is that between all the tests you've had, including exporatory surgery, it's HIGHLY unlikely that something serious -- such as cancer -- was missed.

[Mizbacdraft]

I had my gallbladder removed 9 years ago and I am having severe pain as if it were still there. I have not found out what is causing it aftr having a CT sc. I am being refered to a surgeon tomorrow. I did fnd out today that my potassium level is extremely high and I hope they can find the cause of the excruciating pain it is causing me. AMy ideas?


Thanks

[LindeLee]

I too experienced the same symptoms post -op as pre-op.  I had 100% remission of all symptoms for 4 days and then they all came back.  Preliminary diagnostic (blood & urine) tests were within normal ranges.  Don't accept normal findings when you don't feel normal.  (my surgeon at 10 day post-op exam got me started with a simple explanation of the anatomy and physiology in the gastric system)

This article "PostCholesystectomy Syndrome" is located www.emedicine.com/med/topic2740.htm  It is a broad umbrella under which a host of possible disorders are listed with links for you to follow.  That is where I started to investigate. I am 25 days post -op.  Since narrowing down the scope of possibles w/support from new docs I've had good results treating symptoms while a proper diagnosis is being pursued.  I still don't feel well, but I do feel better than I did.  Patient education is critical.  You have the time (doctors frequently don't - and can't always "spoon feed" us all the information we need -- plus motivation (pain relief provides strong incentives) and you above all others know yourself best.  Pass any suspicions on to your doctor for professional assesments.  If your doctor won't work with you -- get a new one.  I won't work with a doctor that refuses to involve me in my own health care.

Following some research on the web I found strong indications - symptoms matched - and when applied to my medical history both past and present - it matched too.  Following my lead - my Docs have narrowed down the most probable cause is located with the endocrine system (you'd be amazed at how intermingled all the body's systems are with the endocrine system) -- my matches - specifically for me - adrenal insufficienty and/or Addison's Disease secondary to a lesion left over from a previous pituitary tumor or a reocurrence of that tumor.  

Links and research applied to your personal medical history - past and present might lead you in a different direction.  Think very hard about what changes have happened in your life before you got ill.  My thinking revealed that I became ill 2 weeks after very succesful back surgery.  Epidural steroid injections, oral and IV steroids abruptly stopped because the surgery stopped the pain and the inflamation (inflammation) that the steroids had been controlling.

The unknown is generally frightening and poorly tolerated.  I hope you are feeling better soon.

[Mizbacdraft]

I had my gallbladder removed about 9 years ago and have been going through hell!!!! I have been told it is stress. I went to my gastro Dr. yesterday and he is doing an endoscopic test Thursday as he feels I have a blockage. I have been throwing up my food 10 to 12 hours after eating it and it looks as if I just ate it. If he finds nothing with this test he is sending me to Charleston, South Carolina for the ERCP. I am in severe pain most of the time and can't function with normal everyday activities. Any input to my letter would be greatly apppreciated. I am at my wits end with what could be causing all my pain. It is located under my upper ribs and radiates to my back and now is starting to bother me in my shoulder. PLEASE someone answer and let me know anything that you all could possibly think I could have.


Thanks Kim

[SYLLIE]

Hello, everyone..

I just want to say that I also had my gall bladder removed.
I had an attack one month before my baby was born and several
after she was born. It was removed shortly after that. It was
about 8 months ago. The surgery went great and I was cleaning my house the next day! That was the end of the good news. I have
been going through HELL ever since. I'm taking  pain almost
as bad as the attacks themselves! To make it worse, I have what they call "dumping syndrome" really bad.

I still call the pain "attacks" when explaining it to people.
I just want to let everyone know to try what works for me.
I force myself to cough really hard. It works! I feel a "pop"
in the spot where my gall bladder was and then the pain subsides
from there on.  It doesn't stop me from having future attacks,
but now my husband says "cough it out honey, you can do it"
He's so great about it.

I just have a question that NOBODY has mentioned.
I only have one baby and I'm 33 and I would like to have another.
Has anyone gone through an entire pregnancy without a gall bladder while being able to deal with the dumping and cramping and after surgery attacks? Can I do it? I'm scared. Thanks.

[JulesNJ]

I was slightly depressed reading these postings.  I had a gallbladder attack May 17, 2005, and then had my gallbladder removed May 25, 2005.  Afterward I had pancreatitis, gastritis, and then H. pylori.  I went back to work for a couple weeks, but now I am now on short-term disability because of chronic pain in my high abdomen, under my ribs, especially the right side, that radiates to my back.  It is there all the time!  Pain killers dull the pain, but it never completely goes away.  It is much worse when I am sitting up than when I am lying down or standing up.  Unfortunately, I have a desk job!  I have had an EGD, flexible sigmoidoscopy, CT with contrast, cortrosyn stimulation test, tons of blood work, and most recently an MRI and MRCP.  All were negative, except I have not received the results from the MRI/MRCP yet, but the physicians are sure it will be negative.  I have also been passed around from doctor to doctor, and I am so frustrated!  I was hoping I would find a posting from someone saying that this went away after a little while.  Anyone?  I need to get back to work and back to my regular life!  I am a single mom, a full-time employee, and a half-time student.  I need to feel better than this to be able to function!!  Should I resign myself to the fact that I am never going to feel much better than this?  I hope someone out there posts a big old "NO" to this question!  Any advice would help.  Thanks!

[SYLLIE]

Well, nobody has written back on my question about being
pregnant without a gall bladder, but I do have a comment for
julesnj.

Yes, it does get better!  Mine still hurts sometimes, but if this you gives you any hope at all, I'll tell ya that right after my gall bladder was removed, it was MUCH worse.

The pain will subside. TRUST ME.

Good luck.

[JulesNJ]

Thank you so very much SYLLIE!  I really appreciate you replying to my posting.  It makes me feel more hopeful and like there is an end point in sight.  I have tried the coughing thing, but so far it hasn't helped.  Maybe I am not doing it right.  I will keep trying.

As far as your question, I wish I knew so I could provide some answers for you.  I would think the pregnancy might be enough of a distraction that things would go okay for you.  I mean, I am 29 and fully intend on having another baby at some point, gallbladder or not.  Good luck!  Thanks again for replying to me!

Julie

[astros18]

I had 2 children without my gallbladder. I was not as aware of my body as I am now, so I really don't remember having too many problems. If you are still having pain, then you may still have stones in your liver. Most doctors say this is impossible, but I know it is not. There is something you can do to find out if it's stones or not. Take 1 tablespoon of epsom salts in 3/4 cup of cold water( yuck, I know). It should relieve pain with in 30 min. Make sure you drink plenty of water or Gatorade to replenish electrolytes. The salts may give you temporary diarreah (diarrhea). They work by opening up the ducts in your liver and the stones can move, relieving your pain. It is a temporary fix. Consider doing Dr. Hulda Clark's liver/gallbladder flush for longer relief. Unfortunately, once you suffer from stones, you will probably always suffer from stones. Magnesium defiency can also cause stones. A liquid magnesium supplement is better than pills.

[santacruzshell]

I had my gallbladder removed when I was 17. Iam am now 32. Ever since the removal, I still have the same pains. It starts From the middle of the rib cage to the right side, right shoulder, back. I sweat during my attack like crazy. Peoples say I am pale as can be, clammy, Much like a labor pain, It hits hard for a bit. I even try the breathing to help the pain. I have found myself ever since my gallbladder was removed in the ER so many times. They have no explanation for it. I have kept food diaries. Nothing really agrivates it except eggs and bacon and that is not all the time. I could have nothing in my stomach and get an attack. I have tryed vomiting, enemas, hot showers, different positions. These attacks wipe me out and I will sleep like a baby after one for hours. When I awake I feel as someone punched me in the area and it is even tender to the touch.
I have had ultrasounds, cat scans., mri's, blood tests, and finally a colonoscopy last month. He could only go 1/3 of the way in cause I had so much scar tissue in my intestines. He says I will have to come back in and be put asleep for another one, soon. What is that all about? I had the lapriscopic surgey. Scarring in the intestines?
As for the pain, I have been put on everything from little anti spasms that I place under my tongue to Valuim, anti nauseas to antibiotics. Belladonna to antiacids. Nothing works...
I hate the fact of not know what causes it, how to prevent it, how to stop it, just how to live with it.

[astros18]

I can honestly say the ONLY thing that has given me any relief is doing the liver flush. Many people debunk it as nonsense but I know it worked for me. You can find the recipe and information at curezone.com. Just make sure you do not get dehydrated. I don't think you should have scar tissue in your colon as a result of gallbladder surgery. Do your bowels move regularly and without problems? If you don't have a gallbladder, you should be taking digestive food enzymes, especially a hi lipase, to help digest fats. I hope you feel better.

[davryanna]

I have had severe dumping syndrome for more than 12 years when I had extensive abdominal surgery including the removal of my gallbladder.  Since then I have had 2 children and am now expecting my third.  I found that during the 2nd and 3rd trimesters my dumping syndrome was actually lessened but I had more problems with my blood sugar.  I don't know if you've tried it but I've found that by controling my carbohydrate intake I'm better able to control my dumping syndrome.  Also I've found that if I wait 30 mins - 1 hr after eating to drink anything I have less problems.  Hope this helps!

[sharee]

hello. well i just wanted to say that i had my gallbladder removed october 2004 . i don't have pain actually i fell releived , they end up removing mine because i had gallstones on my gallbladder wich came from me eating alot of greasy food,  but the only problem is , if i continue to eat to much greasy food the gallstones will end up on my kidney your gall bladder is what breaks the fat from food . so in order to keep my bowels moving your suppose to eat anything that has fiber in it .right now i'm having intestines problems and that 's because of the surgey that i went through with my gallbladder, so i ended up constipated for so long that my intestines became infalmmed, but i done had an ulcer, infection in my stomach from cyst on my ovaries to my gall bladder being removed, so my advice for the pain that you'll have is pray and always get a second opinion , and i will pray for you'll.

[shannonv33]

Look in the message boards hear under sphincer of oddi dysfuntion, it sounds like thats what alot of you have.

[hammi04]

I had my gallbladder out in Nov. 2005.   Mine was removed due to stones and it was enlarged and infected.  Thankfully i have not had pain since the removal.  Since they removed mine i have had constant watery stools.  The stools are so loose they are like water, explosive and the stench is awful..  i may have this all day, every day.  I also have IBS on top of this but the loose stools are driving me crazy.  I am almost afraid to go out in public because the fear of "sharting".  I have little warning just a pressure then it is almost instantaneous.  I have tried fiber (re-live product)helped for quite a while but had to quit taking it for now.  I tried other fiber such as citracil to see if i could regulate it or to give the stools some bulk.  Does anyone else have this problem and have you found solutions?  i can look skinny one day then look six months pregnate the next which i am assuming is gas.?  Do you all have these problems along with your removal

[Nancy1230]

I had gall bladder surgery after having my second child last September.  I ended up back in the ER 3 days after getting out of the hospital with "fluid on my liver."  I had the pain alot of you had mentioned.  It felt like someone was sitting on my ribs.  I could barely breath, especially when I was lying down.  I still feel pain similar to this, but not to that degree.  I looked on different websites, and I am wondering if my liver was cut.  My surgeon was very shady when I asked him about the "fluid."  He would just say it's maybe blood or something.  You would think he would know.  I have every test you can imagine and they just seen this fluid.  I got so frustrated with this surgeon that I went to another to get an opinion, and in our area, they are partners, and so he said it could be the sphinter thing.  I truly believe with the pain I am having that he hit my liver.  On Webmd it does say that this can be a complication of the lap. surgery.  If this could have happened, my liver should regenerate itself, right?  Is there any end in sight?  What can I do from here?  Any tests that woudl be conclusive?  If this did happen, will my liver be okay?  I still have the diarhea (diarrhea) and constipation problems and a lot of abdominal pain.  If anyone has any ideas, please let me know.

Thanks

[LaurLiz]

I am so relieved that I am not alone in my suffering.  I had my gallbladder removed in April 2005.  For two months I had no syptoms (symptoms) whatsoever.  Then they came back all of a sudden.  Pain in the same place, radiates into my back and shoulder, even the sternum area.  It seems to be worse when I haven't had anything to eat for a while.  Yesterday I was miserable, and barely got any sleep last night because of the pain in my abdomen and back!  It helps to press on the area - does anyone else feel relief when they do that?  The area is very tender to the touch.

[astros18]

If you have gallbladder problems or no gallbladder you must work on the liver, cleansing and strengthening and supplementing. Once the gallbladder is gone, this is a lifelong work in progress.

[Cretia]

I had surgery April 2004 and every since then i have had severe diarreah (diarrhea). I get very sick i have to go to the bathroom immediately i get short of breath and very hot and it feels as if i am going to pass out. I don't know what to do it is very disruptive because i have to miss work and i don't feel really comfortable being out for long periods of time. Is this normal? Can anyone help me with any advice?

[JackieG]

PLEASE BEWARE OF THE LIVER FLUSHES THAT ASTRO IS PEDDLING!!!  Look up Dr. Hulda Clark on Quackwatch.com for more information on this nonsense. Clarke had to flee to Mexico to escape prosecution in the USA.  She publishes nonsense books such as "The Cure For All Cancers" and "The Cure For All Diseases". She even clainms to have a cure for AIDS.  This woman is truly a dangerous fraud. In the best case, she will separate you from your money. More likely, she'll lead you down a false cure path while your condition worsens and you miss out on the opportunity for legitimate medical care.

I cannot understand why Astro continues to peddle this nonsense.  Perhaps she works for Hulda Clarke.

[bell2]

I am also relieved that I am not suffering alone!  I had my gall bladder out in January 1999 after the birth of my first baby.  Within weeks of having it removed I suffered more "attacks".  The pain did not radiate out this time, it stayed localized in the center but bad enough that I had to go to the emergency room.  The doctor thought they possibly left stones in.  After a sonogram, upper endoscopy and colonoscopy - they told me not only did they not leave any stones behind but there was nothing wrong with me.  They said I could be having "phantom pains" or IBS or even stress.  This was/is also accompanied by diarrhea.  The pain is worse on an empty stomach and very tender to the touch.  Occasionally, a very hot shower would help.  Well, it's been 6 1/2 years and I still get the pain!  Not as frequently as before but it's still there.  My sister just had her gall bladder out this morning, pregnancy related as well.  It's comforting to know there are others out there like me!

[Halley]

After years of problems my Doctor encouraged me to have my Gall Bladder removed which he said would solve my probems.  I did that and for a few months things seemed to go well.  However one day all the pain started coming back.  I was so devasted and sad.  I approached my Gastrologist and he said there was no way it could be Gall Bladder related as they also clear the ducts during surgery to make sure there are no obstructions. I was put on Nexium , Carafate with no relief.  One day I had excruciating pain and rushed to ER.  An Ultrasound detected something and they did an ERCP to check the bile ducts.  They found a large stone embedded in the duct that was infected and the infection had backed up in my liver and pancrease. They removed the stone, put me on Levaquin which I was on for about three months.  It took the better part of a year for me to recover but I am doing very well now.  The Doctor that removed the Gall Bladder laprascopally said he didn't check out the ducts because the Gall Bladder was so bad nothing could have been relased by it.  The Ultrasound and ERCP found my problem And My good Doctor corrected the problem.  This is just my experience, don't know if it will help anyone, but I do know sometimes Doctors can overlook things.  I didn't blame my surgeon, he fixed an abdominal hernia at the same time and did a very good job.  I am doing real well now.

[lparker]

I had gall bladder surgery about 2 1/2 weeks ago.  Everything seemed to go fine.  But in the last week I have experienced what seems to be an intense gall bladder attack 6-8 hours after eating a very moderate amount of fat (approximately 2 cookies)  I experience intense pressure and pain under my rib cage and extends to my back and lasts about 1 to 2 minutes.  Is this normal?

[baked potato]

I too had gallgladder surgery Sept. 2 due to having vomiting, pain upon eating, and bowel fluctuations.  From July to Sept. I lost 21lbs.  I am very small,5'2", and typically weigh about 120.  My entire life, I have had reflux and stomach problems, but nothing like this.  Everything I ate made my stomach hurt under my right rib, in the middle and to my back.  Then the naseau would hit, somtimes vomiting, and finally bloating and gas, with bowels going from one extreme to the other.  I had the ultrasound and then the Hida Scan, which showed only 27% function.  So the Dr.  thought that this would remedy the problem.  I felt "better" for about 3 days, now the pain is back, along with the nausea.  Only the pain under my rib is HORRIBLE!  I stay on the pain meds!  Will this get better, my surgeon says it is normal----FOR Whom?  My family seems to think that I just want to be sick-ha-I used to think it was all in peoples heads--when they could'nt eat--NOT NOW!  I loved to eat, enjoyed life--but the past few months have been hell! I don't know how people have lived years like this.  I don't think I can. Any HOPE?

[KIMGWEN]

I don't know how many of you are going to want to hear this but I know how to make the cramping and other yucky sensations go away, I discovered this quite by accident. I got my gallbladder out at age 18 and for years had stomach disorders. I had my first two children age 21,22 and the pains became worse, I felt like a poisoned dog half the time, mega when I ate sausage. I have heard girls who have to get their gallbladders out at a early age is because of bad emotional childhood trauma, I had this. I got Hodgkin's Disease(lymphoma cancer)at age 33 and through the advice of a friend after my treatment, dwelved into the world of alternative medicine, it is hard because alot of people out there are quacks. I turned vegetarian 7 years ago and after giving up meat which was hard, it's what I ate the most of my stomach stopped hurting, I stopped having the doubling over pain, run to the restroom and hope it all comes out alright. NO MORE PAIN, like that ever again. So that is my story take it or leave it.

Kimberly/Jacksonville Florida

[lexxi]

Hi Folks,
Boy this gallbladder stuff is the worst. I had mine out may 2005 and have had pain and a bout of pancreatitis since. Had an MRCP,it was 'normal' saw a specialist in Boston and I`m having an endoscopic ultrasound on friday. THe doc thinks this is what my problem is... check this out and if you cant get to the link from here,  http://www.indiana.edu/%7Eengs/hints/oddi.html
just type in   'Sphincter of Oddi or bile duct spasms' into your search engine. The pain I`ve had is the exact as before I had my gallbladder removed, actually its worse. The docs treated me like I was crazy till my pancreatic enzymes shyrocketed. Personally I think all docs should have to experience undiagnosed illness for a few months before the get their MD.
Anyway, if you have the same kind of pain and your doc is shrugging his shoulders (they take a class in that I think!) check this out... it makes sense to me!
Hope EVERYONE fares well!
Lexxi

[TAZ44]

I DID NOT HAVE TYPICAL GALL BLADDER SYMPTOMS. I HAVE HAD PAIN IN MY SHOULDERS THAT RADIATES INTO MY CHEST. THIS PAIN COMES ONCE PER MONTH EVERY MONTH AND LASTS FOR 2-6 DAYS. IT ALL STARTED AFTER INGUINAL HERNIA SURGERY. IT FEELS LIKE AN AIR BUBBLE THAT WON'T BURST. IT HAS CONTINUED FOR ALMOST A YEAR. I HAVE SEEN MANY DOCTORS AND BEEN TESTED FOR MANY THINGS BUTTHE DOCTORS ARE DUMBFOUNDED AT THE SYMPTOMS, MAINLY BECAUSE THEY COME AND GO LIKE CLOCKWORK. THE PAIN IS WORSE WHEN LYING DOWN AND IT IS PAINFUL TO BREATHE OR BEND. IT'S LIKE SOMETHING IS CUTTING OFF MY BREATHING. THEY THOUGHT IT WAS MY GALL BLADDER AND IT WAS REMOVED BUT THE SYMPTOMS HAVE CONTINUED AS BEFORE. PLEASE, ANYBODY WHO HAS HAD THIS HELP......

[Zoie68]

Please check out Sphincter of Oddi Dysfunction!!  I went 7 years with spasm type pain after my gallbladder was removed (laproscopically) without a diagnosis.  Finally ended up at the Mayo Clinic and was diagnosed with sphincter of oddi and chronic pancreatitis.  The pancreatitis is presumed to be caused by SOD (undiagnosed for so many years).  Most GI docs are not willing hang in there and find the exact cause of pain, most just say IBS, fibromyalgia or the dreaded "shrug the shoulder and say you are depressed" look.
Hope this helps!
Z

[anieD]

I also had my gallbladder out about 3 months ago, and most everything has been fine since.  Except everynow and again i get a random, minute long "phantom" pain, and now i just woke up after eating steak for dinner last night and am quite sore!  i never eat steak so i am assuming that is the cause. I wanted to comment on the whole experience with doctors, i kept asking my dr about supplement and diet change now that i do not have a gallbladder and he assured me i needed to change nothing in my lifestyle!  which i know is ridiculous, first i would like to hear about some possible supplements i should be taking.... and second i want to throw my theory out there that no doctor seems to want to hear about my experience with gallbladder attacks!  I believe my illness is related to my estrogen levels.  MOstly because my attacks were months apart for years-not often spurred by food.  they were so far apart, i just assumed i had a 24 hour bug-but then i started noticing they always occured during the last few days of my period, ALWAYS! i am in my early 20's, no kids yet, but heaing that most people who get the gallbladders out are women who have been pregnant seems to support my theory about the illness being associated with female hormones, i have many other reasons to believe this association, but my doctor does not want to hear it, and i have minimal health insurance so i haven't had a second opinion.  Anyone else experience or have support for this theory or any comment?