I went to the emergency room with abdominal pain a couple of weeks ago and was told I had an ovarian cyst after they did a CT scan. He said that the cyst shouldn't cause a lot of pain or rectal bleeding. (from what I've read cysts do cause extreme abdominal pain contrary to what the ER doctor told me). I was told to follow up with the local clinic since I don't have health insurance.
When I went to the clinic, I was told that I actually had bilateral cysts and one of them had ruptured (the one on my left). I guess the ER doctor didn't tell me the whole story because from what I have read, the standard for a ruptured cyst is to get an ultrasound. Is this not true? The nurse practitioner I saw at the clinic said I needed an ultrasound, a papsmear and a colonoscopy (I also had rectal bleeding. The nurse did a rectal exam and told me the the bleeding was coming from the inside). She referred me to a gastrointestinologist. I repeatedly explained that I don't have insurance but she insisted I needed to go for tests.
Because I have no insurance, I believe the ER doctor just wanted me out of there hence his reason for telling me a half truth.
I have been in pain for weeks (on Vicodin for pain). I have epilepsy which is usually under control with medication but I had one in my sleep last night. I also got my period two weeks early. I'm getting really concerned in terms of what I can do. I feel like my body is breaking down and I am powerless to do anything.
I am an independent contractor for a very unstable company. I don't make a lot of money plus I have taxes to pay being I'm on an independent contractor status. What i make each week varies depending on how busy the office is (if we're not getting any sales, my boss will ask us to leave early as a result). I make barely enough money to pay my bills and eat. I have mounds of credit card debt and owe over 100k in student loans. I will have to file my taxes and I don't even know how I am going to pay for that.
Tomorrow I am meeting with someone from the clinic to apply for MediCal (California's "medicaid") which would be the answer to my prayers. However, I already know that the threshold for acceptance is extremely low and single people like me with no dependents, rarely qualify. Also, the state of California is bankrupt so, from what I understand, it's very difficult to get approved for MediCal.
Any advice? What is the protocol for treating a ruptured ovarian cyst?
Last edited by TopamaxKillsMe; 08-28-2009 at 08:04 AM.
Now, to prevent further advancement of your polycystic ovarian syndrome (PCOS), you need to get blood work done to check your hormone levels and a pelvic ultrasound to find out how many cysts you have and how big they are.
Usually people with this disease tend to be over weight, have facial hair, irregular and widely spaced out periods. If any of these apply, then you definitely have PCOS. A new treatment for this is a drug called Metformin. Traditionally it is used in people who are at risk of diabetes type II, but it has proven to be very effective in POCS as well. It will reduce the cysts to minimal and eventually regulate your periods. It has no significant side effects and is very cheap. Of course, you will need to be properly diagnosed before a doctor writes you a script for this drug; however after that you won't be paying too much for the meds.
GI bleeding: There are many forms of GI bleeding and different reasons. If the blood is bright red and coats your stool, then it's probably from hemorrhoids. That's just veins in your rectum area that get engorged with blood when you strain in the bathroom and then they bleed. In this case, eat more fiber. Take 2 doses of Metamucil a day or just add a salad to your daily diet. This will soften stool and there will no longer be bleeding.
If you are not experiencing this due to constipation, then blood in stools could be due to a few other reasons, some of which can be a little more complicated. Reasons could be, duodenal ulcers, polyps, ulcerative colitis, or mekels diverticulum. You can google more about each of these and their symptoms to see if they fit you and be sure to check what the consistency of your blood is to relate it to the disease. Fresh red blood is usually from hemorrhoids or polyps.
About the doctor who saw you at the ER. I believe standard protocol in ER is to treat patients regardless of whether they have insurance or not. The doctor doesn't get paid by you, he gets paid by the hospital. Whether he treats you or not, he still gets paid. If you feel that you were mistreated then you should take it up with the hospital.
Hope this helps
Last edited by mod-anon; 08-29-2009 at 01:15 PM.
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Thanks. I had a rectal exam by someone at the clinic and she said that the bleeding was coming from inside the anus. It could be an "internal hemorrhoid" but I needed to have a colonoscopy as it could be something more serious. I am not constipated...just bleeding consistently from my rectum. In fact, I noticed that I have been getting a bit constipated from the vicodin and since then, the bleeding has stopped. I take stool softener with the vicodin.
My menstrual cycle has been wacky. I've been bleeding more often than not.
I hope I get approved from Medi-Cal. They can't really do much of anything unless I get approved for some sort of financial assistance that would enable them to run the tests they need to (ultrasound and colonoscopy).
A pelvic ultrasound is not very expensive so I would recommend that you try to have this done in order to find out what kind of cysts you have on your ovaries. If you have a simple fluid filled cyst on each of your ovaries (ie. bilateral) and they are less than 5 cm in diameter then most likely these are normal functional cysts. Women develop cysts on their ovaries every month and the most dominant follicle is the one that burst open to release the egg into the fallopian tube. Then they recede back into the ovaries and the whole process begins again at the start of your menstrual cycle. Try to go for an external ultrasound around the start of your period (or during your period) as this is when you are most likely not to see those functional cysts.
As for the rectal bleeding, I think that this is of more concern. If you absolutely cannot afford a colonoscopy, perhaps the doctor can do a sigmoidoscopy which I am certain is much less expensive (no sedative is required and the test takes about 10 minutes). This examines the lower third of the colon, which is where the greater percentage of bleeding problems tend to occur. At the end of the test, the doctor can also take out something called a rectoscope and examine the interior of your rectum for things like internal hemorrhoids or fissures, both of which cause bleeding. A rectal exam is quite useless unless you have a huge growth in there that can be felt. You will need to clean yourself out (when I had my sig, my doctor had me do a couple of enemas an hour before going in .. super easy and not at all uncomfortable, like the prep for a colonoscopy) so that the scope can look at the walls of the colon (otherwise they are covered in you know what and that obscures the examination). Ask about the sigmoidoscopy at least and be sure to try to follow up on this and get to the bottom of why you are having rectal bleeding.
I hope you get the medicaid that you are applying for. Tell them that you are facing a medical emergency and that you need a rush on this (although I imagine they might hear this all the time). You may also try to find a women's wellness centre or a clinic that charges on a sliding scale. All the best to you.