I have recently been diagnosed with adenomyosis and endemetriosis, but I'd like to know if those 2 are what's really causing my pains for sure, or if they're the only ones? I'm 47, married but never been pregnant. Which specialist should I go to other than a neurologist to get an order for MRI to find out conclusively what is or are ailing me? Who among the specialists I've seen thus far should I go to ask if they could request that an MRI:be done?
Background:
Genreally I have pains on the right side of my body from neck to toe. Becasue I have such other symptoms from diagnosed conditions (fibromyalgia, costochondritis, either gastritis or ulcers, recovering from my 1st surgery for ruptured appendix in Feb 2008, MPS on neck & shoulder which is an old ailment diagnosed about 8 yrs ago now recurring, mild scoliosis, lumbar spondylosis), it's difficult for me to stop being curious as to the culprit/s for my pains until I get an MRI. My biggest fear is I might have some form of cancer somewhere. I'm always in pain especially beginning Sept-Oct 2007, and since after my surgery for ruptured appy in Feb 2008 to date..
Consistent with my latest efforts in the quest to discover what might be ailing me, I went to see a urologist recently who ordered abdomen CT scan. CT scan impression: Right adnexal cyst with minimal pelvic ascites (and unremarkable CT scan of kidneys, ureters and urinary bladder). Among other findings (with history of right flank pain), a hypodense focus measuring 4.0 x 2.1 x 3.0 cm is seen in the right adnexa. Also minimal free fluid in the posterior cul-de-sac. Everything else appeared normal or unremarkable. I presented the findings to my OB-Gyn, who in turn ordered transvaginal ultrasound. (Routine pap smear was ordered week earlier and results showed nothing unusual.) Ultrsound impression are the ff: Diffuse adenomyosis, intact endometrium, cystic follicle (right overy), normal left overy. Others: (-) fluid in the cul-de-sac. OB-gyn's opinion: Adenomyosis and pelvic endemetriosis. Sugggested treatment: GnRH Antagonist injection for 6 months or in the alternative, progesterone, also for 6 months.
I'm tempted to go for the GnRH treatment because of the persistent pain, but upon research on the net, I found the GnRH treatment or even the progesterone treatment confusing as to its efficacy and appropiateness considering I don't have heavy bleeding but only knife like pain in the pelvic area and a specific spot below my appy surgery scar. I'm also concerned about the side effects especially irritability, osteoporosis-related stuff, other side effects of menopause which may result to other forms of pain because I'm already in that state of pain and don't need to take additional steps to reach a pain rating of 10.
Please advice best steps and measures. Currently I have a Physical Therapy program to address fibromyalgia pains (I have 18/18 of typical tender points according to the physical med & rehab doctor). I'm on a 1400 calorie reducing plan prescribed by my endocrinologist which is also friendly to the diet suggested for adenomyosis sufferers (based on my research on the net). I'm exerting best efforts to exercise at least 2x a wk or more with not much success because I'm often depressed or have low energy bec of the pains). My lumbar and pelvic pains are still killing me most and my on and off right elbow & forearm pains as well. But those aforementioned areas are relatively more painful only relatively. Because actually there are pains focused on my entire right side, plus pain on left side of breast bone, upper left side of my buttocks.and left hip.
I've alreasy gone the road of treatment using meds, specifically for my fibromyalgia pains such as xanor + lyrica (I'm allergic to this, developed recurrent mouth sores), tofranil + tramadol (gave me pounding on chest, nape and scalp plus, tremors of head though not observable by a third person, inability to sleep for 5 days except for 10 minute naps), cymbalta + tramadol + clonazepam (all made me sleep 18-20 hrs aday but successfully relieved me of pain for 2 1/2 months until my body just rejected the meds preceded by nausea just before actually vomitting them all one day). I used to take omeprazole for my hyperacidity until the day I decided to stop taking all meds the day I vomitted. I continue to use claritin for my allergies as needed, rivotril to help me sleep at night when pain is too much, orlistat to help in my reducung plan. I'm open to herbal meds though and plan to take primrose oil, vitamins E, B complex & C & others appropriate for my condition. But I'd really like cancer ruled out. How do I get that request preferably from my HMO accredited doctor?