Pelvic Pain

Nurses General Nursing

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First off I want to say I am not looking for medical advice more advice on how to deal with doctors. I have been having pelvic pain off and on for the last 4 months after being pretty much pain free for 4 years since a hysterectomy. I am on oxycontin which hasn't done anything this last week so I was told to go home and take some morphine to try and break the cycle (don't worry I am a secretary not a nurse and I have given up driving). My frustration is that my new gyn sees no need to exam me (trust me I don't really want an exam but I would like to know what is causing the pain. Does it make sense that my new gyn who I have seen twice in the last 3 weeks, my internist who I saw today, and the ED a week ago don't see any need for a pelvic? The reasoning I get is that I don't have any female organs and they don't want to cause more pain which I am grateful for. They did do a urinalysis which was negative. I had a CT and MRI in May that were negative. I have seen a gastroneterologist and urologist who say it is not their department but my new gyn wants me to be seen again. I can't schedule an appt (not be seen but schedule an appt) for two weeks at the hospital's gastro clinic Another embarassing symptom besides the pain is that I am occassionally having fecal incontinence. Very embarassing. My doctors say it isn't normal for a 33 year old (never thought it was) but nobody has done a rectal on me. How do you ask for that? The fecal incontinence is not due to the hysterectomy since the problem didn't start until 3-4 years afterwards.

I don't want to be back on narcotics and I need a doctor who will take charge of overseeing the various doctors I do see which is what I told my PCP when I started seeing him. I feel like I am being bounced between specialities because everyone says it is not their department which is what I went through 10 years ago before finally being diagnosed with chronic pelvic pain and finally having a hysterectomy.

I really enjoy Allnurses especially reading the humor section.

Okay I just needed to vent. I am trying not to let my family know since they say I need to be more forceful with the doctors and they get upset with me for missing work.

Specializes in ER.

A pelvic exam is certainly in order for this complaint. I would push until someone does a pelvic or you find a different physician.

5 differrent healthcare providers-2 gyns, 1 ER PA, and my doc today and his colleague (I was scheduled to see her since I was told he didn't have time for me but she went and got him) haven't felt I needed a pelvic. I guess I am just tired of the buck being passed and feel weird asking for a pelvic and a rectal.

is anyone giving you possible reasons for your pain?

leslie

They say the pain is possibly due to an ovarian remanent which showed up on CT/MRI. Also, most are just passing it off as chronic pelvic pain which is just a diagnosis when they don't know what else it could be. I thihk someone thought possibly IC or IBS but I have been checked for all of those in the past. Several years ago I had a colonoscopy in fact I have had two which came back negative, cystoscopies/urodynamics, barium swallow, upper GI all of this when they were first trying to diagnose the problem when they said it wasn't GYN but then I had a hysterectomy and was pain free for several years. I never wanted to see another doctor for the rest of my life.

I sat arguing with the doctor about the fact that I have never had sex because she was like everyones definition is different. I think I finally convinced her. They tested me a few months back for STDs because they didn't believe me, oh well just don't make me pay for a pregnancy test. If you still think I could be pregnant after having had a comlplete hysterctomy then you get to pay for that test. Sorry probably TMI.

They say the pain is possibly due to an ovarian remanent which showed up on CT/MRI. Also, most are just passing it off as chronic pelvic pain which is just a diagnosis when they don't know what else it could be. I thihk someone thought possibly IC or IBS but I have been checked for all of those in the past.

very recently, i saw a tv clip of an actress saying that it took them 2 yrs and 8 doctors, to finally diagnose this actress w/uterine cancer...

2 yrs, 8 doctors.

that's insane.

so i guess in your case, persistence is key.

do online research and seek those who can help you.

one of these doctors will get it, i'm sure.

or, you will have found a doctor w/whom you trust, regardless of what s/he says.

how long have you had this fecal incontinence?

and no one is concerned or curious about that??

if you could see me, i am sitting here just shaking my head.

really, this is beyond my comprehension.

just keep on moving forward.

something will break.

leslie

10 months of fecal staining and not one rectal. It is more embarassing than anything else but I also know it is not normal and I am concerned. Yesterday I decided to wear beige pants because I hadn't been having issues in a while. You guessed it, I found I had gone through my pants. I went around the rest of the day with a sweater wrapped around my waist wondering how many people had seen the stain but not said anything. I have seen many doctors at a top hospital, nobody thinks I need one and when I had my annual pelvic that doctor didn't do one. At least I know if can't be uterine or ovarian cancer. I just feel very lost and frustrated. My life was on hold for ten years when I had all this pain and finally it got better and I have felt like I have really been living.

Adhesions secondary to the surgery could also cause you severe pain and bowel dysfunction aeb the fecal staining.

Good luck in getting this resolved.

Wishing you all the best!

Specializes in med/surg, telemetry, IV therapy, mgmt.

Wanna hear my story about pelvic pain? I also had a total hysterectomy many years ago. I also had colon cancer in 2007 for which I had surgery and chemotherapy and have been followed regularly by an oncologist. I started having pelvic pain in March. It was in my left groin. I've been palpated, CT scanned, had a colonoscopy, EGD and a number of different x-rays. Nothing was found. Tumor markers (blood tests of enzymes secreted by certain tumors) started showing up in my blood work. My pain persisted but nothing else was found. The elevated tumors markers, I was told, are not worrisome without any other evidence of malignancy. I kept asking "what could this be?" Finally, last week a mass was found in my pelvis right around where all this pain was that I had been having. It was actually seen on the CT scan that was done in April by the surgeon that I was sent to for a consult who conscientiously decided to check the films himself. I was sick over this. As I am writing this post the pain in my groin has been bothering me for the last hour and the pain pill I took for it hasn't worked. I fear it is a metastasis from the cancer from 2007, but we won't know until this surgeon goes in and takes this mass out and it is biopsied. I can't lie on my back anymore because the pain starts up right away. Now that we know where this mass is, I can palpate and feel it myself although it hurts like the dickens when I mash on it. It's the size of a golf ball and it sits to the left of the symphysis pubis. For months I only wanted to know what the heck this pain was. Now, I just want to know what the heck this lump is. Surgery is August 19th and I'll know more then. It's the problem of being a nurse. We always want to know what is going on and we are never satisfied until we get the answers.

I spent most of the last 5 months journaling the pain for the doctors so they had documentation of it. It was hard to describe for them because it came and went without any reason, it seemed. It also changed its location a bit from time to time.

I wish you luck with your own journey.

W

Daytonite, I am so sory to hear about your problems. I guess in a way I am sort of worried I might have cancer but I am sure if I verbalized that I would be seen as a hypochondriac. I hear you about the pain coming and going, that is what I think confuses them especially since it is mostly on the right hand side but sometimes on the left as well. It almost sounds like I can't keep my story straight but it is just that is how the pain is. I understand just wanting to know what the pain is, it is very frustrating to not know. It is so easy to dismiss pain as being all in the person's head. I keep thinking I am just going to have to learn to live the pain again but it has been a great 3 or 4 years without being on narcotics and I swore I would never be on them long term again. Thankfully I live now in the city where I can get around on public transporation but when I feel as bad as I do I don't want to go out.

I am sorry you have to wait almost 3 more weeks, it is terrible that you possibly have cancer again and you are being made to wait. I am confused about your CT scan done in April. The surgeon saw it then or did you just see the surgeon and he waw reviewing your CT scan? I had an MRI/CT scan done and saw a new gyn who said my pelvis hadn't been imaged. I ended up arguing with him that it had been only because I had seen the images. I even asked a radiologist to double check and she said indeed I had had my pelvis imaged when they did my stomach.

Hang in there and let me know how you are doing. I think we have communicated a long time ago. I haven't posted in a long time.

Specializes in med/surg, telemetry, IV therapy, mgmt.

what has been most frustrating is how to describe the pain. to me, of course it has been very real. my docs, bless them, have addressed it with a straight face. because of my history of cancer and the elevating tumor markers i am sure my complaint was taken seriously. i, myself, was frustrated with how to describe and localize this pain. every doc was palpating my abdomen and no one was finding the exact spot. i didn't even know the exact spot. the pain seemed to be moving around. it didn't help that i have lost over 200 pounds over the years and have a roll of skin down there. "is the pain in your skin or does it seem to be deeper?" is the question i got asked all the time. it seems to be in that roll of skin, but i press on the skin and its not there. it is deep inside. i specifically looked in my nursing books for how to describe pain (i mostly post on, and answer questions on the student forums) and developed a nice list for assessing pain and decided i had better start following it myself in order to help my doctors. it wasn't until just recently that i was finally able to localize exactly where this pain was and could point it out to the surgeon who did a deep palpation and found the mass.

don't worry about me. i'm glad they finally found something. it was bothering me that the tumor markers were elevating, all these x-rays were being done, i was having pain and they were finding nothing. i'm satisfied that we're going to get some action going and do something. whatever this mass is, it's better out than in and the faster the better. i'll deal with any fallout later.

if you need to see the pain assessment list i have posted it on a number of threads. it might help to just write down the time and location as well as circumstances going on when the pain came on to give to your docs. it gives them objective documentation for their records. you can make a check off list based on that assessment information. you never know how important it might prove to be later:

Specializes in Med/Surg.

You mentioned being checked for IC.......so, you've had a cysto/hydro? That's the only true way to diagnose.

I had one 2 years ago that found mine, and it was done in response to my pelvic pain becoming a daily concern rather than a monthly concern. Also, at least in the case of endometriosis (which I also have...bah!), a hyster will NOT necessarily cure the pain, and endo doesn't show up on radiographic tests.

Just a couple thoughts. I know how frustrating it is.

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