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Old 08-20-2008, 04:27 AM   #1
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Yesterday's visit - back to the drawing board...

Yesterday's visit was pretty much a bust. The doc has no idea what is causing the pain. He did do 5 trigger points in the rib area with cortisone, I don't think it will do anthing for the pain, but the cortisone may help the bad case of poision ivy I've got. He is sending me back to my PCP, he thinks I should have a bunch of GI tests, and have my gallblader checked. I'm 99.9% certain that it isn't GI or gallbladder. I don't think either of those would cause continous muscle spasms in the muscles OVER the ribs, and I don't have any symptoms that would indicate a GI problem. My hubby is ready to drag me off to Mayo. The attitude was pretty much that I didn't fit into the box of give some injections and out the door, so we really don't want you here. He obviously hadn't looked at the chart, he went back to the what about this that and the other anti-depressant and anti-convulsant too, it does say on my chart that I cannot take them doesn't it? They simply will not use opiates for anything except post-procedure pain as far as I can tell. I have to wonder what they tell terminal cancer paitients - try some ice or a tens unit for that?

Cmpgirl, from the information you posted it sure sounds like myofacial is a real possibility. It's more likely than a lot of other things since a pinched nerve in the thorasic/lower cervical has been ruled out. Not that this is a diagnosis I want, I just want to know what is going on so I can get on with my life, even if I can't do everything I used to do. I need to find a PM doc who thinks outside the box. I think my next stop after my PCP will likely be the big university hospital here. Maybe there's some young Dr who want's a challenge and can figure out what's going on. If they can't figure it out I'm pretty sure hubby will drag me to Mayo whether I want to go or not.

Tigg.

 
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Old 08-20-2008, 05:22 AM   #2
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Re: Yesterday's visit - back to the drawing board...

tigg have they done a rheumatoid arthritis panel yet on you? What about ana antibodies? If you have some imflamation in the lungs it can most certainly help with the pain and calm down the spams. While they might of sounded non supportive at least you didn't have to go to a hospital facility for the injections or did you? Please keep us updated on this thinking about you and hope you find some answers soon. I would look into an r a doc next step

 
Old 08-20-2008, 06:39 AM   #3
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Re: Yesterday's visit - back to the drawing board...

Tigg, I know this will sound kind of strange, but when looking for a different PM, try to find one who had his training/education and/or residency at Albany Medical College (Albany, NY).

This is where my PM works out of and teaches as well. I know that any young doc (especially physiatrist/PM&R) who was taught by my doc and especially those who did their residency with him, would more than likely have the same perview and ideas about PM as he does. And he is the absolute best! And he is very knowledgeable about CMP. He diagnosed me!

It may take a little extra research to find out about their education background, but it is usually listed in most AMA directories. I've often said that I wish I could clone my PM and send him to everyone who needs a kind, understanding and open-minded doc. So maybe the next best thing would be to find someone who was taught by him.

Sorry this visit was a bust. How unreal is it to have a physician boot a patient because they aren't a candidate for only one modality of PM??? I wish you the best of luck in your search, my friend. If there is anything more I can help with, just ask, OK? Hugs and Prayers, CMP/MM

 
Old 08-20-2008, 06:48 AM   #4
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Re: Yesterday's visit - back to the drawing board...

Quote:
Originally Posted by tiggertoo2174 View Post

The attitude was pretty much that I didn't fit into the box of give some injections and out the door, so we really don't want you here.
Sure sounds like this to me as well. I'm sorry this is happening to you.

Quote:
They simply will not use opiates for anything except post-procedure pain as far as I can tell. I have to wonder what they tell terminal cancer paitients - try some ice or a tens unit for that?
I would go back to my GP and first see if he could help on a short term basis, and then I would ask to see a new PM Doc. You may just have to keep trying.

Best of luck to you. Again, I'm sorry.

Regards,

Ex

 
Old 08-20-2008, 12:30 PM   #5
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Re: Yesterday's visit - back to the drawing board...

Quote:
Originally Posted by cmpgirl View Post
Tigg, I know this will sound kind of strange, but when looking for a different PM, try to find one who had his training/education and/or residency at Albany Medical College (Albany, NY).
CMP,

I'll look, but here in fly-over country it's mostly KU or MU, but there are a few transplants. Thank you for your help! I think maybe I should be looking for a physical medicine Dr. rather than an anasthesiologist (sp?). I'm going to see how these trigger points do until Monday, and if it's not significantly better I'll be calling my PCP. I have an appt with her Sept 18, for a physical, but if I'm still hurting I'll go in earlier for the ribs. She is the one who prescribes my meds right now anyway. I'm pretty sure I'll be in for some tests to rule out other problems.


Zoey,

I had some screening done a few years ago during a bad bout with my lumbar spine, but I'll ask my PCP about it. Blood work is probably the least she will want me to have.

Thank you all for your input, I really appreciate it.

Tigg.

 
Old 08-21-2008, 07:17 PM   #6
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Re: Yesterday's visit - back to the drawing board...

tigg, I am so sorry, since I have the same & my PM cant answer thus far what is going on in the rib area. Can you please list in detail your symptoms again for me. I know for me I am gettting alot of chest pain & what used to be only rib pain in one area under the breast has spread to encompass pretty much the whole rib area & has made its way into the back, both shoulders & is rapidly progressing. That area seems to be difficult for the doctors, if they rule out thoracic outlet & cant find any other internal causes all of them I have seen are at a loss, I agree with CMP, I think its myofascial. I am still getting the thoracic looked at but I have to think it makes sense that if my rib is hyper mobile which the Pt said it definantly is then the fascia must be involved. Mine sticks out at times below the sternum. Does any of this sound familier to you? I worry about you. I started out with one small area, now look at me.
I can say it unbearable at times & the spasms can be constant or hit me so fast that it takes my breath away. I can make it hard to get an inhalation in. It has to be something, Any movement at any time can trigger it. I know it sounds painful but I wear a binder. When the PT suggested it I said no way, I cant even wear a bra, wh explained that because the pressure would be evenly distrubted it would not be the same. Since I was desperate & she was desperate to help me I agreed to try it. It took me days to get use to it, but for some reason it cut down some on the spasms & pain.
She wanted me in it because she thought the rib was moving up & she wanted to try to prevent that. I just know something is wrong, & it scares me, so I know how you feel. Keep looking, maybe calling & asking for a PM that deals with Myofascial damage. Have you asked you GP if he thinks this could be the case? I just feel so bad for you.
I think its a shame that they will not treat you. It worries me that I may not find out what is causing this all.
I would go to Mayo if that is what it takes. You just cant let it go. Please keep me informed. I will be thinking of you & keeping you in my prayers. Sammy

 
Old 08-22-2008, 04:50 AM   #7
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Re: Yesterday's visit - back to the drawing board...

Sammy,

I'm going to write the whole thing up and put it in the "stories" section as soon as I can, hopefully today. I had shoulder and neck pain for about 2 years after rotator cuff surgery to remove a bone spur. The PT I just finished with has resolved most of that. I still have major pain in the ribs on the right side, from around the bra line to about the waist. There is a good amount of swelling right below the bra line, and the muscles are very knotted and tender, as are the ribs themselves. The knotting is somewhat better since my PCP changed me from baclofen to flexeril. I was having constant muscle spasms in the area, I still have some but not anywhere near as much. The pain is over or in the ribs, not under them. I do sometimes get what I would think is nerve pain - quick almost electric "zaps" of severe pain and pain that shoots from the back to the front, occasionaly it feels like someone is sticking a knife in my ribs. Usually it's a constant pain though. If I move around too much it gets worse, I can do some ordinary chores like quick grocery trips and cooking something simple without it increasing it too much. I give all the credit for this to the flexeril stopping a lot of the spasms. So far all the trigger points have done is make me hurt worse, but as a side benefit the poision ivy is better! I went ahead and made an appt for my PCP, I see her on Sept. 3. I'll probably be in for some more tests, but I think I can ask her about myofacial. Hopefully she will be able to come up with something.

Tigg.

 
Old 08-22-2008, 12:12 PM   #8
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Re: Yesterday's visit - back to the drawing board...

Tig, I get that zap of pain you are referring to in the chest & smack in the sternum. It feels like being repeatably stabbed over & over.
It does sound like what CMP describes as the myofascial. Its a shame that the medical community cant get it together & agree. If you think about it whats the difference really. We know that like everything else muscle can be damaged beyound repair, so what is the point of refusing to treat it. I hope that makes sense, but it sure sounds like that could very well be the myofascial damage with you. How ironic that I started with the shoulder & went throught the surgery to, although I had the decompression & bursectomy. You know if you really think about it all of it is connected through muscles & tissue. Makes me wonder, escpecially with the simularties, even if they are not identical, still very ironic. I would really try to get a direct answer from your GP. At least as much a he/she can give you. Perhaps the GP can try to help you find a PM that does deal with myofascial, beyond trigger point injections that is. After all its not just you, look at CMP & me & I am sure others. I want you to know I will be thinking of you. God bless, Sammy

 
Old 08-23-2008, 12:01 AM   #9
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Re: Yesterday's visit - back to the drawing board...

Tigg, just wanted to stop in and say I'm sorry things aren't going better for you on the PM front. I hope both you and Sammy get some much needed relief soon!

 
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