Re: Saw the surgeon today regarding adhesions

From: Ginny King (gking@myrick.com)
Tue Aug 31 19:44:53 1999


At Tue, 31 Aug 1999, Christine M. Smith wrote: >
>At Mon, 30 Aug 1999, Ginny King wrote:
>>
>>Well, I saw the surgeon today regarding adhesions. He doubted that the
>>right side, burning tearing pain that I am experiencing is caused by the
>>Crohn's, but when I am in an active state of inflammation, all pain gets
>>worse including adhesions as the tolerance level of the patient is so
>>low. He didn't seem to have much of anything to say regarding surgery
>>as an option and stated that many doctors now believe that because the
>>pain can come back so quickly after surgery that they have done nothing
>>to help the patient and that the temporary relief one feels is from the
>>residual effects of the anesthesia and pain medication given after
>>surgery. He also indicated that when a doctor takes down adhesions the
>>best they hope for is that they will reform in a different configuration
>>that might not cause the pain the patient was in before. He is going to
>>get with my PCP and GI and thinks we might should try a pain management
>>clinic. At least he semed sympathetic and indicated that no one should
>>have to continue in pain. He said that it is a shame but only recently
>>has the medical profession really started to focus on pain manegement. I
>>don't know if he is correct or not and left feeling more confused than
>>ever. I have experienced some relief in the inflammation type symtoms
>>from the medication the GI gave me for the Crohn's but the "other" pain
>>that I have is just as bad and I just don't know what to do. I know we
>>all could use just one day that we wake up pain free. I don't know what
>>that feels like anymore as it's been so long. I know you all
>>understand. Best wishes. Ginny
>
>Hi Ginny:
>I am curious about a few things you have said in your post. Maybe your
>explanations can help me figure a few things out about myself.
>First, why does your surgeon doubt that the pain in your right side is
>due to crohn's, when this is the area it typically presents pain in? Was
>it because the biopsies did not show crohn's in this area? Is this the
>area that you are still having pain in, while the other areas are
>improving on the medication?
>I can't remember the history you gave when you joined the forum. Was
>this right side the area you had adhesions in? How do you know you still
>have adhesions? (I'm assuming you had a lysis done)
>Why don't you think that your spinal problems (which you know you have)
>can be causing the right sided pain? This is the area that I had the
>severe pain in during the time I was taking the step aerobic class. I
>would have described it as a crushing, burning diffuse pain in the right
>lower quadrant, nothing that I could trace. It might be helpful if you
>kept a diary of your activities and degree of pain. It might also be
>helpful if you stopped playing tennis and see if the pain improves any.
>I know I have not had one of these pain attacks since I stopped the
>aerobics. I would think that if you have spinal arthritis you are going
>to have pain after a sport like tennis and it is common for that pain to
>be referred into the pelvis. They might tell you this at the pain
>management clinic as back problems seem to be a big part of their
>business.
>
>Chris S.

Hi Chris,

The biopsy did not show inflammation of the terminal ilium which is typical with right sided pain and Crohn's. Because of the "burning,tearing" sensation he believed the pain was adhesion related instead. I have had the adhesions lysed in the past and they were in the right abdominal area and covered the appendix as well. I do not have the "rubber band" type adhesions in this area like I do from my surgical scar areas but the web type that can from an infection. I guess the other reason he made this assumption is because of the point specific pain and guarding of this area on my right side when he pressed. Yes, I have found relief of my other symtoms with the medication, but nothing is touching the right side pain. I have not ruled out spinal problems and Crohn's as the cause, and I'm not sure he has either and that is why he is going to discuss my case with my PCP and GI and is considering the pain clinic instead of surgery. I don't want surgery again and he is only considering it as a possibler alternative, not for relief of the pain, but to see what, if anything else they may be dealing with (ie the regrowth of adhesions) Like I mentioned before, he doesn't seem to be too hot on surgery for adhesions if that is the problem. When you have the right side pain, do you have a specific point that they can touch in your abdominal area that will duplicate the pain? I am going to take your advice regarding a diary of the pain (advice another good friend also gave me) and of my diet to see if I can really detail what aggravates the situation. I think it will be good therapy for me as well. I am open to all ideas and appreciate your input (and your right, I may have to give up the tennis). Take care. Ginny


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