The Pain Saga: The Lap and Beyond.

This is part two of my pain diary.  Everything is behind a cut as it's massively long; feel free to skip it if so you desire.

This particular section is also written as a list instead of a diary, mostly as things happened much faster.


~July 2013: Got engaged!  I don't remember much about my pain during this time: I just remember that I finally got in with my new gynecologist, Dr. L., about a week after Hubster and I got engaged.  She decided that I needed a diagnostic laparoscopy to rule endometriosis in or out once and for all and she wasted no time scheduling it.  I was slated for surgery less than two weeks later.

...yes...I wanted a reason to put in my ring...

~August 2013: On the 6th, I went under the knife for the first time in my life.  Her findings were simple: inflamed right ovary, broad ligament inflammation on right side, no visible problems (re: no endo).  She did, however, mention that my gallbladder was larger than she expected for someone my size.  This set off warning bells for me and my family at first as my dad's gallbladder burst when I was a toddler; my gallbladder also had never even been mentioned as an option before this point as my most severe symptoms always were in my pelvic cavity.  I recovered from surgery with no problems, and the change in medication all but erased the pelvic pain sans the occasional ovarian cyst.  To be safe, I did start paying closer attention to my digestion and other issues.

~Fall 2013: Went to PCP for annual physical.  Mentioned the findings, particularly my gallbladder.  I asked that they order an ultrasound to be safe, but he brushed me off.  "If you have gallbladder disease, you'd be in the ER, not here," was his simple reply.  I left it go, figuring he knew best.

~Winter 2013: WEDDING SEASON!  My pain symptoms came and went during this time (and my cycles became very irregular on norethindrone around the same time), but I was too busy with everything to really push the issue.  I just chocked it all off to stress and went on.

December 28, 2013 was our wedding day, and it went off without a hitch.  I woke up mostly pain-free, and managed to keep breakfast down despite nerves screwing my stomach up.  I don't recall having to take any pain killers that day--always the sign of a good day.  For once, I felt great!  The good health and pain-free streak continued through our honeymoon and for a few weeks past that.  Things were great for a change!  I really, truly thought we had made it through the fire to the other side and that, despite a few ovarian cysts along the way, I'd be a-okay.

I may be a weird bride, but I love this hug after our kiss more than the kiss picture itself...it's just...more us. 

~January 2014: I started having random bouts of nausea and was more sensitive to dairy than ever.  I brought that up with Dr. L at my 6-month follow-up about the medication change.  She mentioned my pill can make menstrual cycles super irregular, and that the random bouts of nausea and digestive upsets could be either a food allergy (but unlikely) or my pill causing problems (more likely but still not all that common).  Went off on my merry way, assured that things would even themselves out soon.

~February 2014: I ended up floored with another ovarian cyst.  By the time I got into the doctor's office for the ultrasound (a week later), it had burst.  Regardless, I still had bouts of nausea and full abdominal cramping that lasted long after the cyst healed.  I also noticed that I had a weird sense of pressure under my ribs on the right side.  I never exactly had pain there, but it was uncomfortable.  At the end of the day, I occasionally had tenderness there.  It'd even feel like something was getting pinched under my ribs.  As I was now at least 15-20 pounds heaver than I was a year before, I just assumed it was all par for the course with the weight gain.

~May 2014: Went into my PCP's office for a bad urinary tract infection.  I mentioned again my continuing pain issues and the nausea, and the physician's assistant insisted my nausea was my BCP and the UTI.  Warning bells started going off in my head here that something wasn't quite right and that they weren't truly listening, but I was so fed up with doctors overall that I just threw my hands in the air and went on with my life.  I also left the following Monday for NYACCE, so I had very little time to ponder the logic of my doctor's answers.  Nausea peaked around this time, but I assumed at first that it was the antibiotic messing up my sensitive stomach.  Eventually, the waves of nausea started calming back down.

~Summer 2014: My nausea started happening every single day.  Few pregnancy tests ruled out morning sickness as a cause, which was strange.  I started trying to eat less at meals, drink more water, cut caffeine completely out again--the works.  Still no relief.  I mentioned it to my gyno at my annual pap smear, and she mentioned that norethindrone rarely causes nausea that long, but it could be a possibility.  She also noted that my ankles and feet were puffier than she expected, but we couldn't figure out a reason for that past the heat wave our area was suffering.  She recommended I ask my PCP to check the gallbladder again--just to be safe--and that I consider allergy testing if the gallbladder exam comes back negative.

After a bad bout of feeling crappy, my husband decided I needed a pick-me-up.  Man knows me too well!

During this time, I also started having strange bouts of pain.  My legs constantly ached, particularly in my knees and heels.  Moving around after sitting, standing still, or laying down was excruciating for a step or two.  Within a few weeks, stomach pains started happening, too.  Think of when you have (and forgive me for the image) very bad diarrhea--where your stomach cramps with such intensity that you break out in a cold sweat.  I started having that at really random times.  As that was always a symptom of my life-long lactose intolerance, I started watching my diet carefully, trying to cut down dairy to nothing and assuming I was just growing more sensitive to lactose now that I was older.  I noticed I was less bloated if I did cut dairy down, so I didn't go much into it.  (I also noticed at this time that I bloated 10 pounds at random times, then would lose it just as fast and as randomly.)  When I finally got my PCP to return my calls and mentioned all the changes and my gyno's concerns, he and his nurse brushed it off as a symptom of my period.

~August 2014: I woke up in excruciating pain one morning out of no where.  I had my usual ovarian cyst symptoms (bloating, tenderness in the right side of my pelvic cavity, spotting, nausea, and stabbing pains near my right ovary), but I had a ton of other symptoms, too.  My entire stomach felt like I had the worst diarrhea ever, but after one bathroom trip, nothing happened in that regard.  Nothing stopped the pain.  I was fluctuating between hot and cold quickly, even though it was still summer and hot out.  The nausea was extreme, and the area under my ribs on the right side was very tender.  When things got bad, the pain would start on my right side, move up through my ribs, then down my left side.  I spent the entire day either on the toilet or curled up on the couch with a heating pad on my abdomen.

Now, during this time a weird stomach bug was making its way through my office, and both my nieces had been sick with some nasty stomach virus.  I assumed I had managed to start growing a cyst just in time to get the stomach flu or food poisoning.  I called off work, parked myself on the couch, and lived off of soup, crackers, and ginger ale.  Hubster kept a close eye on me, but he was concerned that the pain was so intense for what little was coming out of me; the hot flashes and cold chills also confused us as I never spiked a fever.  I agreed to let him take me to urgent care if I spiked a fever.

After two days of this, I called my PCP.  I tried Gas-X (thinking I had free air in me from the burst cyst), laxatives ("Maybe I'm constipated?"), Tylenol, Advil, Aleve (not all at the same time, obviously)--literally, I tried anything I could think of.  Nothing was helping.  The PCP's nurse called me back, telling me it was gas pains, that I was overreacting for no reason, and that I had to take the exact gas relief medication they told me to take if I expected to feel better.  That set me off.  I had told them I tried that exact medicine, yet they were treating me like I was a five-year-old with a splinter when I was genuinely concerned something was wrong.  I hung up on the nurse and drove home from work early, too in pain to function.  I took the medication to humor them, and the pain finally began to taper off.  It was a good two weeks until I felt even semi-normal after that, but the nausea and the tenderness in my ribs remained.  The pain was less, but my digestion was finickier than ever before.

Summer 2014--decided I needed a new profile picture on Twitter.  Yay office laptop cameras!

~September 2014: My dad told my husband and me over dinner at our place that he needed a total hip replacement.  This wasn't totally a surprise--he had had horrible hip pain for years--but the reason behind it was.  Turns out his PCP--the same one I saw--ordered MRIs over three years of the wrong hip.  As a result, his pain was misdiagnosed for years, and the damage his hip had was now too extensive to even attempt repairing.  He flew through the surgery with flying colors and now is feeling fantastic.

That conversation, however, prompted me to do some research.  I found a new primary care physician near my apartment; as an added bonus, he saw my brother as a patient (who highly recommended him) and worked with that same brother at my local hospital, and he was a doctor I saw sporadically as a little kid.  I made an appointment to establish care with him in November, when I was off on vacation and up for a new annual physical with my insurance.

~October 2014: I started realizing most everything I eat makes me really uncomfortable.  As I work a half hour's drive from home and can't just leave class to, y'know, go do toilety things, I took to eating a very light breakfast (FiberOne brownie at most) and equally light lunch (maybe a granola bar...if that) to prevent emergency bathroom trips.  As a wicked stomach flu whipped through our office yet again, I assume I'm just not bouncing back all that well.  Nausea is still plaguing me.  I also started getting heartburn regularly: pretty sure I took anti-acids at least once a week.

~November 2014: Dr. T, my new PCP, took one look at my medical history and results of my previous laparoscopy, then gave me a concerned look.  "Why has no one done an ultrasound of your gallbladder?" he asked.  I told him what my previous doctor told me--that a real gallbladder issue would have me in the ER.  The look on Dr. T's face was priceless--he looked like he wanted to slap my previous doctor.  He quickly told me that ANY abdominal pain should be examined by ultrasound because gallbladder issues were incredibly common in women my age.  As my family has issues with those particular organs bursting with little to no warning, it was especially concerning that no one thought of that with me.  Off I was sent for the ultrasound in question.

Please ignore the face I'm making--I was trying to get a second opinion from my husband on the sweater.

...Also, this is literally the only picture I have of me for the past 6 months.  Clearly, I hide from cameras lately...

The ultrasound went off without much of a hitch.  It was incredibly painful afterwards to move around: my bottom ribs on the right side felt very bruised, and I had more heartburn and nausea than I normally did.  The pain actually kept me up a few nights, it was that impossible to get comfortable with it.  During the scan, though, I heard a question that filled my heart with dread:  "...when was the lap showing the enlarged gallbladder?"  That question haunted me as it seemed pretty telling.

Week later, the ultrasound is totally normal, to my frustration (and, later, tears...a lot of tears...).  I, without really thinking, voiced my frustrations to the nurse who called me...pretty sure my (not nice) words were, "I'm just disappointed that, after 3 and a half years of pain or more, I still have no answers.  Then again, I should know better now than to expect those answers when so many doctors have failed and told me it's all CLEARLY in my head.  Thank you for your time."  To my surprise, the nurse called me back.  She had talked to Dr. T, and they decided I needed a HIDA scan with CCK to rule in our out the gallbladder once and for all as so many of my more recent symptoms fit the spectrum for gallbladder disease.  I took a few days to think about it, and my family and friends talked me into going for the scan.

December 6, 2014: I went in for my HIDA scan not at all optimistic.  Figured it'd be a miserable experience (...I hate needles...), much like the ultrasound was.  The scan (after a very hectic morning with a surprise blood pregnancy test I needed to have done) went off without a hitch, though a lot of techs kept coming into to look at the scan.  The nurse who administered the CCK for the second part of the scan was shocked, though, that the CCK made me as sick as it did as fast as it did.  The tech, later, was puzzled that my abdominal cramping from the CCK lasted as long as it did; I was still mildly cramping when I left 40 minutes later.  I went back to work, eating a quick meal at my office before the afternoon's meetings and the evening's Breakfast with Santa set-up.  Throughout the day, though, I was light-headed and nauseous.

December 7-8, 2014: I'm nauseous and uncomfortable most of the time; heartburn also refuses to subside no matter what I do.  I'm not miserable enough to call the doctor, but I'm uncomfortable enough to really think hard about the timing of when I eat.

December 9, 2014: I teach my last class of the day and go to check my cell phone for any text messages.  I find I missed a call from my doctor.  I quickly called them back, and the same nurse who pushed for my HIDA answered.  I nearly dropped the phone when I heard, "Well, Cherish, we got the results of the HIDA scan, and your gallbladder doesn't work...pretty much at all.  It has to come out."  After a few moments of me babbling about something or other, I asked the nurse if I was nuts for being thrilled I needed surgery.  "I'd be thrilled if I were you!  After all your years of pain, we found it!"  The nurse set up the referral, and the surgeon's office called me the next day to schedule.

...so, that's the whole story!  Hopefully this saga ends with much less pain soon!