The following post is a personal story. Often I find myself on the treating side of a physician-patient relationship. In this case I found msyelf on the patient side of things — as the family member of the patient. It’s a story about my wife and her two year ordeal with abdominal pain and the long road to a diagnosis and treatment.
It all started just over two years ago. At the time, my wife and I were still dating. It was Mother’s Day 2012 and we were both spending time with our respective mothers. I received word that Allison found herself in such agonizing abdominal pain that her family was all shocked. You see, she has a fairly high pain tolerance. But this pain paralyzed her and she found herself sobbing on the couch because of it. Her family took her to the local emergency department. There, they were able to control the pain with pain medications. Whatever scans they did (I never figured out if it was an ultrasound and/or CT scan), they were negative. The labs were normal. So they sent her home with a presumed diagnosis of gastric ulcer. She was instructed to follow up with a GI doctor to see whether an esophagogastroduodenoscopy (EGD) would be warranted.
When she followed up with the GI doctor as an outpatient they decided against an EGD at that time. The plan at that time was to carry on with life and only proceed with an EGD if the pain returned. Over the next few years she would have occasional abdominal pain. There was no pattern. Often it would be in the middle of the night. It would last anywhere from minutes to hours. However it would resolve on its own. The episodes were also very spread apart.
I suppose the episodes of pain, being so rare and spread out, were easy to ignore. Especially with the hustle and bustle of life. When the episodes first started, Allison was in her final year of nursing school. After graduation she found herself working on a busy cardiac unit in LA County while serving as a nurse manager for a non-profit women’s clinic. On top of that, we both would try our best to see each other on our free time. And so, life moved on. We both did. And eventually we got married in February of 2014.
After we got married, Allison moved in with me in Redlands. She continued with both her jobs in LA County making the early-morning, hour-plus, traffic-laden commute from the Inland Empire into LA County three times a week. Two times a week she commuted 45 minutes to women’s clinic. To say the least, it was a very tiring time.
Three months after our wedding she had a major attack. She had woken up before 5 AM to get ready for work. Half-asleep, I remember her leaving the bedroom. The next thing I remember she was back at my bedside, on the floor in tears because of intense abdominal pain. I had never seen her like this before. She was barely able to move. I quickly got out of bed and got dressed. And off we went to the Emergency Department.
As we checked in and she had her vitals taken, she mentioned that the pain had some radiation to her chest. They quickly took her back to get bloodwork and an had an EKG done. As expected the EKG was normal. Her bloodwork also came back normal. The sent her for an ultrasound of her abdomen. That came back normal as well.
All the while, they tried to treat her pain. They first tried a GI cocktail1. That did nothing. They tried an IV medication called toradol2. That had little effect. Finally they pulled out the “big gun” and gave her dilaudid. This finally provided her some relief to the pain but it caused nausea which required an anti-emetic medication.
The ED doctors didn’t have much in the form of answers. They noted all the tests were normal. We had discussed my wife’s history of abdominal pain and they felt further evaluation by a GI specialist was in order. I was ahead of them, though. While we were waiting for results I had already called over to the GI Clinic and set up an appointment with one of the GI attendings.
Unfortunately that appointment would not be for another 3-4 weeks.
As the acute pain had passed, broken by administration of some high-powered narcotic, we were discharged home. After all, with all the tests coming back “normal,” there was no signs of an acute issue that needed emergent care or intervention. On the way out we received prescriptions for an anti-acid medication, an oral pain medication, and some stool softeners (as oral pain medications often cause constipation).
Tired, frustrated without a clear diagnosis but relieved that the pain had passed, we finally went home. We were also eager to get to the GI appointment.