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Sever Upper Abdominal pain and tenderness
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Sever Upper Abdominal pain and tenderness

Ok, so for the last 5 days I have been having sever upper adminal pain.  It is just below the rib cage and slightly to the right.  As the day goes on it worsens and spreads.  By the evenings I have to keep myself from tears because it hurts so badly.  I have had an ultrasounds on my right lung, gall bladder, pancreas, and liver, all which came up normal and blood work along with that that was normal as well.  I am scheduled to have a hida scan of my gallbladder tomorrow to look for anything else but other than that my doctor (who is pretty worthless by the way) says he doesn't know what it could be.  He says he thinks I just pulled a muscle.  If that were the case, how is it that I'm sitting perfectly still and then all of a sudden get these stabbing pains?  I didn't do anything out of the ordinary that would cause a pulled muscle but I am really gettting frustrated.  He told me that if my test tomorrow comes back normal then to wait it out for 4-6 weeks and then let him know how I feel.  This is severly impacting my daily life...I can no longer work out...it hurts me all day long and when it gets really bad I feel as though I need to throw up but never do.  My whole body is starting to hurt now...almost a full body ache type thing, especially in my back.  At times I actually feel sick not just that my stomach is in pain.  It's not a nausous feeling or anything though, it's like someone is just repeatedly punching me in the stocmach over and over again.

I am a healthy 24 year old female who is 5'5 and weights 130lbs.  Not out of shape at all so I just can't figure this thing out.  Any thoughts or advice would be greatly appreicated.  
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Avatar_m_tn
hi, have you had your kidneys checked? another possibility is a diaphram rubbing disorder (inflammed diaphram).
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469934_tn?1333138882
I can totally relate.  It seems like we're all waiting for the next test to give us an answer.  Unfortunately, many of us still don't have any answers.  Wait for the HIDA tomorrow.  Pay attention to how long it takes.  If they force an attack, so much the better.  I know you don't want to have one but at least they'll be able to watch one in progress and might be able to help based on that.  Hang in there!  You might be one of the many who need a minor surgery to correct the problem and get back to your life.  don't know much about this stuff but check out, "The First Principles of Gastroenterology":  http://www.cag-acg.org/uploads/firstprinciples/english.html.  You can either save EACH CHAPTER so you can search it or view it online at no cost without registration or BS.  It is easy to read and understand and you can search for terms specific to your situation.  Chapter 12 deals with the Biliary System and the various problems and their symptoms.  You're welcome to read my journal (www.medhelp.org/user_journals/list/469934?sort_by=title) if you want, because our situations seem quite similar.  Keeping a journal is a great idea and there is one on your home page.  It is a great way to review your situation objectively and identify patterns in your symptoms and pain level.  Hindsight is 20/20 and keeping a log might help you look at things more objectively.  Try to stay positive and reach out to your Doctor, family, friends and community for support.  Take care of yourself.  Good luck and Godspeed  Let me know how you make out if you get a chance?
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Avatar_f_tn
I had exactly the same thing happen to me. I had an idiot of a local GI doc who after running all the tests he could think of (which weren't too many in his 'arsenal") decided to run a HIDA scan to basically test the functionality of my gb.  Well, lo and behold!  He finds after this test that my gb has "a low ejection fraction rate."  Essentially, it's not functioning correctly and he wants me off his back as he'd said before sending me for the HIDA scan "If nothing turns up here, you';ll have to see a doctor in Boston because I honestly don't know what is is."  Funny thing is, however, I had it narrowed it down to some form of pancreatitis after "researching" the good old internet for a day or two.

So, after gb surgery, where they find no stones, no sludge and "a healthy looking gall bladder" (quoted from the surgeon.)  I feel better for almost 2 weeks and then boom(!) it's back in full force - exact same symptom as before.  However, knowing what I know now, I am infuriated that rather than call it what is IS which is either one of several forms of pancreatitis with or without sphincter of oddi dysfunction, the medical community decided to give it a new name Post Cholecystectomy Syndrome.  Which simply means, if you're not familiar w/medical terminology, post = after,  cholecystectomy = gall bladder removal surgery, syndrome = a conveniently, ambiguous term imho, Webster's would be "1 : a group of signs and symptoms that occur together and characterize a particular abnormality or condition
2 : a set of concurrent things (as emotions or actions) that usually form an identifiable pattern

In any case, find a pancreatologist NOT just a gastroenterologist unless you have one that stays up-to-date with modern medicine!  If you've gone to the ER and been told that you do NOT have pancreatitis because your pancreatic enzymes do not rise (pancreatic enzymes amylase and lipase are often looked at to see if they rise above normal as they are SOMETIMES (but not always if they DON'T rise that is) a sign that a person is having an acute pancreatic attack.  

It is likely that the ER docs aren't completely up-to-speed w/this VERY poorly understood and relatively rare disease, and do not know that in many cases, particularly, EARLY (they are loathe to use this term for reasons I'll explain later) chronic pancreatitis w/or w/o sphincter of oddi dysfunction aka SOD - the pancreatic enzymes amylase/lipase do NOT rise EVER in many people (I was a prime example of this.)  For a good reference on this to print out and bring w/you to the ER, go to the Johns Hopkins web site and do a search for chronic pancreatitis and/or amylase and lipase.  They have a very good article on the subject that I printed out to bring to the ER although some doctors will dismiss it anyway because it is coming from you - the patient.  Sad but true.  This article may also be found in the database, links section of the web site I provided below as well.

The reason I stress seeing a pancreatologist is because it took 3 years of going to gastro aka GI doc after GI doc before I finally saw the pancreatologist in Boston, MA at Beth Israel Hospital to administer the one test no-one else had given me - the secretin stimulation test.  The results of this test are basically a numbering system whereby if your number is under 70 (some docs say under 80) you are considered to have pancreatitis.  My number was something like 62.  

Also, what state do you live in?  I may be able to refer you to some good doctors depending on what state you live in...you needn't list the city for privacy factors but state would be helpful for the above reasons.  But again, at the yahoo web site I provided below, they have a list of "good" doctors by state.  

In any case, many GI docs will not diagnose EARLY chronic pancreatitis as by most standards chronic pancreatitis aka cp won't be diagnosed until enough damage is done to the pancreas that it is visible through imaging studies like CT scans, MRIs, etc.  This damage can literally take years to occur until it is visible. Usually after many, many repeated attacks to the pancreas.  

I did have one dr say something to me that resonated as the truth and has stayed with me until this day although because of the above parameters or limitations he would not diagnose me definitively with cp.  Which is problematic if you need a definitive diagnosis in order to retire or to receive social security disability (the $ they take out of your checks when you work but you must convince them that you have a definitive diagnosis in order to receive this money to live on if you're too ill to work.  

Anyway, this doctor said "EVERY disease process whether it be cancer, pancreatitis, ANY disease - has to begin at the cellular, molecular level.  Before it can be seen even by a microscope, it exists at the tiniest, molecular level.  So, just because we cannot yet see it w/our vision, even vision enhanced a million times by our current imaging techniques, it does not mean that the disease does not exist."  That is such a simple yet true statement and yet doctors will not diagnose pancreatitis just by the pain, etc.  They, like the true scientists they are, want what they call "objective, quantifiable evidence" and enough signs and symptoms proven out with this objective evidence in order to make a definitive diagnosis.  

Hopefully, #1, this isn't what you have to begin with although your symptoms are exactly what mine were both before and after having my gb removed, and #2 If it is, I hope, unlike me, you will have other signs and symptoms that doctors can go on such as the rising amylase/lipase levels so that they DO have enough objective evidence to go on and don't have to continually play guessing games or have to go from doctor to doctor until you find one who knows what he's talking about in regard to pancreatic illness.

But, please do yourself a favor, even to rule it out - go to see a gastroenterologist who further specializes in pancreatology - a pancreatologist.  This will save you years unless you're very lucky, of having to see doctor after doctor.  As I said, this disease is very poorly understood by the medical community these days.  Probably due to the lack of funding that goes to other well deserved diseases like cancer and heart disease - but compared to those diseases, pancreatitis is in the stone ages when it comes to how well known/understood it is except for the very best specialized, specialists.

I had cp for 3 years before it was definitively diagnosed by the pancreatologist I didn't find until 11/06!  Another thing you may want to consider is going to see a pain management specialist doctor.  He/she can help with pain meds, etc., if the pain you're having is unbearable.  It is best to have it managed by one doctor who is familiar with the latest methodology and medications and/or procedures to help minimize your pain.

I'd like to give you a web site to go to which was very helpful to me (more so than any doctor in terms of the things I learned there from the databases they have and links to relevant web sites as well as a forum similar to this one where the people are wonderfully kind and supportive.  It is:  http://health.groups.yahoo.com/group/pancreatitis/

You can feel free to click on my name as well and I believe you can email me - I'd be happy to answer any questions you may have.  I just had a total pancreatectomy with islet cell transplant as well as a colectomy because the pancreatic enzymes had damaged my colon so (not to scare you!) they had to remove 70% of it.  This, after only 5 years with the disease.  But, that is too much info for today.  

Again, I'm happy to help in any way I can and I would highly recommend and urge you to explore the links, databases and the forum at the web site I provided.  I learned more there than I ever could have on my own.

Best wishes to you,
Laura

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469934_tn?1333138882
How are you doing?  Any changes in your pain?

I've been thinking of you and hope you're better.

All the best,

Sam
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