31 year old female. 5'6", 115lbs. Non-smoker, 2-3 alcoholic drinks a week. No previous pregnancies. Has been with her husband for 11 years and was married in 2008. Active in dance 3 hours a week, including dancing ballet en pointe. Had a copper IUD inserted in September 2012. Not on any medication. Mentally and physically happy and healthy. Works as a Medical Laboratory Technologist. Experienced sudden onset of pelvic pressure, bladder discomfort and urgency that has not gone away since the beginning of August. The symptoms began on day 2 of a long road trip/vacation. Pressure and bloating discomfort increases to a blinding discomfort as the bladder fills. I am able to sleep through the night without getting up and can will-away the thoughts of needing to void if I am calm and non-mobile. Ambulating creates enormous pressure with each footfall. I have been unable to work.
So far I have been twice treated for a UTI despite a clear urinalysis results on 4 different occasions throughout the month. After UTI was ruled out, I was given 7 days of Vesicare, because a Doctor thought all of the sitting in the car during the trip created muscle spasms. The Vesicare did not ease my symptoms and made me feel "high" and extremely constipated. I had an ultrasound done and a 5cm x 4.2cm x 4.0 pedunculated uterine fibroid was found left of midline. The gynecologist told me it couldn't be the cause of my issues because, "women are designed to carry babies, and they are much bigger than your fibroid".
I experienced a random episode of vomiting one morning during these 3 weeks, which is very unusual for me.
After attempting to work a shift at my lab I broke down in tears because walking was so painful/distressing. I was sent to the Hospital's staff nurse who sent me to my Family Practice walk-in clinic. The Doctor there told me to go back to Emergency because I had a fever of 37.8 and he was concerned about the possibility of PID. I had not had a pelvic exam or swabs taken at this point.
CBC, urinalysis, lipase, glucose, electrolytes and kidney function all appear normal. He said my risk of PID is low despite having an IUD because I am in a longterm monogamous relationship. The cervix did not display any purulent discharge. That Doctor I saw thinks maybe the fibroid is twisted and dying and causing my symptoms. He had me go for another ultrasound just 2 weeks after my first one. He said he could do nothing for me and prescribed me morphine, even after telling him I am not in PAIN like a broken bone or a sore back -- it's crushing pressure around my bladder that gets worse as the bladder fills makes ambulation difficult. I experience relief after my bladder is emptied, but the discomfort builds up quickly as my bladder refills.
I have never missed a day of work in 4 years and since this began I have missed 4 shifts. I was told that they will not take the fibroid out, since it's "not that big". I have a Gyno consult in 3 weeks.
My thoughts:
- could I need pelvic hypertonia with sudden onset? I have had NO incontinence, just mind-numbing pressure and discomfort around my bladder. During a pelvic exam the speculum was inserted without any problems, so my pelvic floor doesn't seem to be too tight.
- could this be sudden onset interstitial cystitis? Do I need to see a urologist? I have no problems starting the stream when I go to void. The foods I eat make no difference in the severity of symptoms. I have lost 5lbs form going 3 days only eating crackers and water, terrified that anything I put in me may make me more disabled. I gave that up after I realized it was pointless. I still do not have much of an appetite and am not drinking as much water as I should because the after-effects are unpleasant.
- could it be chronic appendicitis? During the pelvic exam, when the Doctor palpated to the right of my cervix with his fingers, I howled in pain and started crying. Externally, I only have pain when palpated directly above the pubic bone.
- should the fibroid be removed? Is it really "not that big"?
- I am very depressed and anxious and feel as though my quality of life is very low. I went from being a very happy, active and strong woman to a broken shell of a human who has been passed around to at least 6 different Doctors and nobody has any answers for me. I am scared for my future if I am unable to work. I have lost all faith in the Healthcare system I am a part of and spend the first half of my day crying and the second half being mad and looking for answers.