Re: Is this really a gall bladder problem?

Posted By HFHSM.D.-rf on September 11, 1998 at 07:46:56:

In Reply to: Is this really a gall bladder problem? posted by Amei on September 08, 1998 at 22:32:24:






I am a 34 year old female, no children. I don't smoke, drink or use anything stronger than ibuprofen and watch my fat intake as well as limit beef in my diet.   I woke up one night with intense pain just below the breastbone and more pain (I thought it was a muscle spasm at the time) in my back just below the right shoulder blade next to the spine.  I also had a fair amount of nausea and felt like I should vomit.  Nothing I could do would alleviate the pain in the slightest, there was no position that was better than any other, sitting, lying on my back, side or stomach, standing, walking, even upside down (feet & hips elevated), I tried them all.  My husband called his mother (an RN) and she said it might be extreme indigestion.  She suggested I vomit then take an antacid and pain killers so I took Pepto-Bismol and 1000 mg of ibuprofen.  I also put an icepack on my back.  I never did have enough nausea to vomit.  
The next day I started seeing the doctors.  One asked me if I had had a very loose bowel movement afterward (I had but that happens anytime I have extreme pain like a migraine or bad cramps).  I also attribute the nausea to the severity of the pain.  
I had been experiencing much milder symptoms for several months.  A mild pain under the breastbone in the morning with an empty stomach that went away after I ate something and a pain (spasm?) just below the right shoulder blade which was usually worse in the evening (I thought it was due to the long commute each day and tried lumbar supports which didn't help).  They sometimes appear together but frequently happen alone.  
Right after the attack I started taking Vicodin but in very small doses and usually at night.  I also bought one of those buckwheat heat packs and would use it on my back after dinner and it seemed to help.  
I have had a cholocystogram and ultrasound that confirm the presence of gall stones but the symptoms don't match with the classical symptoms and my blood work shows no problems with amylase or white blood count, everything is normal.  
I have had at least 4 doctors tell me to have the gall bladder removed 'because it's just so easy these days.'  Maybe I have a bad attitude about it but I don't think that is sufficient medical reason to have surgery.  
What I'm dealing with now is bearable but I'm afraid of having another attack.  Usually in the morning I wake up feeling fine and the pain under the breastbone starts (really mild) while I'm in the shower.  By the time I get to work the pain is worse (still bearable) and the back pain has kicked in as well.  I will usually have a cup of orange tea and some rice cakes or a bagel when I get to work and about 1/2 to 1 hour later the pain is gone.  
One of the doctors (when I declined to immediately schedule the surgery) gave me a prescription for Tagamet but I thought that if this really was my gall bladder an antiacid couldn't be much help so I didn't take it.  One day the pain was worse than usual and I had an OTC antacid in my desk so I decided to see if it would do anything.  Amazingly, my pain went away.  I now have a stock of OTC stuff like Pepcid, Tagamet and Zantac that I take when the pain starts getting too bad (at first almost every day but now maybe once every week or so).  The weird part is that when I got the prescription for Tagamet filled (the higher dose) it didn't seem to work at all, I'm not sure why.  
Other strange stuff that may shed some light on this:  
a) I don't usually have much gas or belching but occaisionally (when I do belch) I will instead bring up a mouthful of foamy stuff.
b) I have been having sinus problems but the mucous isn't green or yellow.
c) I am technically obese (about 40-45 lbs overweight) and haven't been able to lose any weight even on a very lo-cal diet.
d) I have been having strange cramps, usually in the large muscles but sometimes in my feet, where the pain starts off very small but grows in intensity over several minutes until it is quite painful.  These can last up to 1/2 hour.  
e)  I sometimes can't seem to get enough air.  I take extremely deep breaths until my ribs hurt but I still feel like I just ran up a flight of stairs even when sitting.  I also have no endurance, one flight of stairs leaves me breathing heavy for a few minutes.  
f)  I am very tired and lack energy most of the time and frequently don't sleep well.
g)  The stools are usually normal but I sometimes (about every 2 weeks) have an unexpected bout of severe abdominal cramping followed by diarrhea that lasts maybe an hour.  I have not been able to connect this to any particular food or activity.  
I'm sure most of that is unrelated to the actual problem but you never know, I wouldn't have connected loose stools with back pain until someone asked about it.  
I mentioned all of this to a friend a few days ago who suggested I research a hiatal hernia due to the location of the pain.  I have done some research but I'm not sure my symptoms match that either.  Any ideas?  
I'm tired of being tired and in pain and would welcome any suggestions you may have on this.  
Thank you.

Dear Amei,
It is difficult to determine conclusively that a specific problem is the cause for your pain.  Much valuable information is obtained from the physicial examination findings.  Based on your history, I am suspicious for gallbladder disease.  It is necessary however, to exclude esopphageal and gastroduodenal diseases.  This can be done with endoscopy.  It is necessary for a physician to examine you while you are having an acute attack of pain.  This doctor is the one who will have the most information to make the correct diagnosis.
This information is provided for educational purposes only.  Always consult your personal physician for specific medical questions.
HFHSM.D.-rf
*keywords: gall bladder, abdominal pain
0.2