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Laparascopy for Severe Abdominal Pain? Any Surgeon Recommendations nea...
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Laparascopy for Severe Abdominal Pain? Any Surgeon Recommendations near Troy, MICHIGAN?

Hello, I am a 41 year old female and I am looking and searching for answers and came across this forum that I am hoping someone can help or provide advice.  Below is my story - my challenge is finding a general surgeon to do a laparascopy and I was hoping someone knew a good one near my area (Troy, Michigan) to recommend?

I have had several surgeries over the past few years - c-section (1997), gallbladder removal and hysterectomy (2008)and then last year (Dec 2010) a resection rectopexy for rectal prolapse.  

Over the last few months, I have been developing pain in my right lower abdomen.  Over the last two months, it has become extremely severe and debilitating.  It also goes around to my lower back.  I have urine retention problems (I am seeing an urologist and until my urodynamics test, have to self cather myself 4-6X/day).  But, this does NOT relieve the pain - unusually, it seems to bring it on more.

I believe that my pain is due to scar tissue build up and adhesions.  

When I first had the pain, I went to my OB and he did a pelvic exam and ultrasound and said all was good with my ovaries.  Then, I went to my internist who thought it might be appendicitis so took a trip to the ER to find it was not appendicitis.  The cat scan showed some minor cysts on my kidneys, but then also a "mixed density bilobed structure in the right lower quadrant) - my internist said that basically means an unidentifiable mass or blur of "something".  After talking further, he referred me to a general surgeon.  I saw the surgen today to discuss laparoscopic surgery, but he seems very hesitant.  

I am in such pain and distress that I have not been able to work (I am now out on disability as of this week).  I cannot eat (causes too much pain and I have lost over 15 pounds over the past month) and I was in the ER last week because the pain was so bad.  I am also very nauseous.

How can I convince the surgeon to do the laparoscopic - I am certain it is scar tissue (when I had my hysterectomy, my gynecologist saw a lot of scar tissue that he says he removed some from my c-section with my first child).

I have had issues (digestive) for the last 5 years where doctors told me I had IBS, eat more fiber, etc., and that I would be okay to find out that I had a gallbladder disfunction and then the prolapse.  I have had every test known to man (cat scan, mri, ultrasound, xray, bloodwork, urinalysis, proctogram, cystoscopy, small bowel series) and cannot go on like this.  

The surgeon seemed hesitant because he said that if I had scar tissue or adhesions, that my intestines would be blocked, but from what I have read, that is not necessarily the case.  Adhesions can cause intenstinal blockage, but not in all cases, correct?  My other symptoms seem to point me back to scar tissue buildup and adhesions from my rectopexy (it was done robotically, but the surgical incisions are quite large and my pain is where the incisions are).

Your advice or suggestions are appreciated very much!

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You should avoid surgery because that is the cause of the adhesions and can cause more adhesions. You may want to ask your doctor to refer you to a massage therapist that practices the Wurn technique.  (http://www.clearpassage.com/about/wurn-technique.php)

Treating Abdominal Adhesions with the Wurn Technique
The Wurn Technique treats abdominal adhesions with a hands-on physical therapy.

Belinda Wurn, PT treats a patient with her manual physical therapy which has been shown to reduce adhesions, decrease pain, and improve function, in peer-reviewed medical journals.

We know abdominal adhesions well. We faced this situation 20 years ago when the physical therapist director of Clear Passage Physical Therapy®, Belinda Wurn, developed severe adhesions after pelvic surgery and radiation therapy to her abdomen. Unable to work due to the pain, and having seen the devastating and debilitating effects of abdominal adhesions in her own patients, she was determined to find a non-surgical way to address abdominal adhesions.

With her husband, massage therapist Larry Wurn, Belinda took a much deeper look at the etiology and biomechanics of adhesion formation. They found that the chemical bonds that attached each of the tiny collagen fibers to its neighbor appeared to dissipate or dissolve when placed under sustained pressure over time. With this knowledge, they developed the Wurn Technique to unravel the bonds between the crosslinks that comprise adhesions.

The “hands-on” work practiced at Clear Passage Physical TherapySM clinics is designed to reduce or eliminate adhesions, crosslink by crosslink. It has been shown in peer-reviewed medical journals to reduce adhesions, decrease pain, and improve soft tissue mobility, without the risks of surgery or drugs.

We treat men, women and some children for abdominal adhesions. Visit our “what treatment is like” web page for more information, or click the link at the bottom of this page now, to complete a medical history questionnaire and apply for a free, in-depth consultation.
http://www.clearpassage.com/abdominal-adhesions.php

I looked up Troy and found you were near Detroit. I found 9 therapists that are trained in the Wurn technique. (http://www.amtamassage.org/findamassage/results.html?q=Wurn+technique&l=Detroit+Michigan&searchcat=famt).

I hope this helps.
Reta
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547368_tn?1332173665
Hi Koda,

Welcome to the Pain Management Forum. I am sorry about your increasing pain and the problems it has presented.

Please don't chase unfounded remedies. There are gimmicks and ppl that are prey on ppl with chronic pain. If something sounds too good to be true it often is... so investigate any and all suggestions, including mine.

That said I know how extreme the pain of adhesions can be. We have a member that can attest to the same. I don't know if you have adhesions are not but it certainly sounds feasible. There is a fairly new MRI Scan that can detect adhesions. This scan is not every where. Cine-MRI provides valid information with respect to extent, location, and strength of intra-abdominal adhesions. To my knowledge it is the only scan/test that can do so. I would request a Cine- MRI to rule in or out your suspicions.

Once you know what you are dealing with it will be more easy to proceed. Even of you have adhesions that are the cause of your pain a surgeon may be reluctant to perform a procedure that is all probability could produce more adhesions. However there are new products available that inhibit or limit the development of additional scar tissues/adhesions. I have no personal knowledge as to their effectiveness.

I am inoperable and will have to live with the pain of adhesions for the remaining time I have on this earth. As you indicated you don't have to have an obstruction to cause pain. The surgeon you consulted may not be up on the latest in this area..... or he may be of the opinion, as some physicians are that adhesions do not produce pain or restrictions. After your Cine MRI you may want to a surgeon that is associated with a large teaching facility or a nationally known clinic. They seem to be on the cutting edge of medical science. ..no pun intended.

In the mean time you deserve to be more comfortable. Request something to better control your pain. There are treatments and medications that can aid in your pain control. Life is too short to live it with constant uncontrolled chronic pain.

If it proves to be that you do not have adhesions then you'll want to investigate other possibilities. If I were in your position I would want more information on the "mixed density bilobed structure in the right lower quadrant". Why do you have to self-cath? I would want answers for that also and it's not usual for ppl to have to use a cath to void. You may want to consider a second urology consult.

Be assertive and insist on answers. You are you own best health care advocate. I think you need a lot more answers. Please keep in touch and let us know what you discover. I'll be very interested to hear your updates. We are here to offer you support so please feel free to ask additional questions, chat or just vent.

Take Care,
~Tuck
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547368_tn?1332173665
Sorry I didn't respond to your question regarding a recommendation for a surgeon in your area. We do not recommend specific physicians for obvious reasons.

However as suggested above I do encourage you to consult a physician that is associated with a large teaching facility .... a national clinic.

Gin Best of Luck,
~Tuck
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1804836_tn?1318539183
Tuck,
Thank you!  I will ask about this MRi test and see if they do this testing here in my area.

I am supposed to have a urodynamics test in Mid October to try to determine why I have urine retention (which actually gave me a pretty severe kidney infection a couple of weeks ago).  It is really hard in my particular area of Michigan because there is one large Urological Institute and they do not like to "overstep" each other.  When I did see the urologist, he told me I had a stage 2 rectocele but no cystocele that he could see, thus the urodynamic test scheduled.  After my rectopexy surgery, I had acute urine retention and had to wear a foley catheter for 5 weeks - I think that it may be related to that (potential scarring in my urether from that very uncomfortable catheter that they had to replace 3 times because of infections I was getting or something else similar to that).

I will be assertive - over the last 5 years of dealing with my health issues and going through all the "standard" medical tests to only find that my problems were diagnosed by non typical medical tests (HIDA scan, defacating proctogram, etc.), I will NOT give up until I can find out what is going on.

Thank you for your advice and I will keep you updated!
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