Abdominal Pain update

[Paul Laycock1]

I have been to several hospitals in Mukdahan, I have ended up with Morphine patches, each patch lasts for three day’s. The doctor would only give me three.

His thoughts are it’s my spine after X-rays and  CT Scan, had a ultra sound scan as well that shows everything as normal. He recommended going to Bangkok for surgery which I don’t want to do.

What other strong non addictive medicines are available that don’t make you scratch yourself to the point of bleeding. Today I will use my last patch so three more day’s with a little pain relief. Anyone any ideas.

[giddyup]

If you don't rectify the cause of the pain you will need to stay on painkillers permanently?

[Paul Laycock1]

giddyup, what non addictive painkillers and ones that don’t continually make me want to sleep and scratch, god knows how people get addicted to morphine.

[giddyup]

1 minute ago, Paul Laycock1 said:

giddyup, what non addictive painkillers and ones that don’t continually make me want to sleep and scratch, god knows how people get addicted to morphine.

What I was asking was do you intend to stay on painkillers permanently? I don't know of a strong painkiller that isn't addictive.

[Paul Laycock1]

I hope not but as the doctor said go to Bangkok for surgery. I have also been offered surgery for my gal bladder to be removed but the current doctor/hospital said after an ultra sound and ct scan nothing is wrong in that department.

[Sheryl]

Non addictive pain medications would be NSAIDs. Whether or not these (1) are advisable/safe in your case and (2) likely to help depends on what is wrong with you which is entirely unclear.

Tramadol is less addictive than morphine but if you react badly to morphine you might not react well to tramadol either.

In pain so severe that high doses of narcotic wete resorted to the priority is not to find more alternative pain killers but to identify snd treat the cause.

In your prior thread you said you were diagnosed with an inflammed gallbladder.

If I understand correctly this has now been ruled out and abdominal ultrasound and CT showed nothing that would account for the pain, which raises the question of how/why the previous diagnosis was made.

What sort of surgery were you you now told to go to Bangkok for if all tests were negative? What dort of doctor were you told to consult? Why do they think you have a spinal problem if all tests were normal? This is simply making no sense at all.

It certainly sounds like you do need to seek a higher level of care/better doctors but I don't have a clue what to suggest in the absence of more information.

Please provide the complete history and full description of the pain.

Sent from my SM-J701F using Thailand Forum - Thaivisa mobile app

[carlyai]

I would guess that back trouble would probably not just cause pain localised to your stomach. Maybe legs and arms problems as well depending which level of your back is affected.

Scratching is a problem, me too. Try to vary the dose, so some days you only take penadol.
Also you can try Headspace meditation app, where you just note the itching as a feeling, and move on. Every time the itching feeling pops up, you note it as a feeling, don't scratch, and move on. It's not like you have to scratch. Scratching is not life threatening. Yep you feel like a scratch, OK it's a feeling that will go, don't scratch and move on.
Tramodol does the same to me.



Sent from my SM-J700F using Tapatalk

[Paul Laycock1]

My history as best I can remember. No medical issues or problems in the UK.

Two years after I moved here I started feeling nauseous with headaches, went to my local hospital and diagnosed hypertension due to very high blood pressure.

They decided that my best bet was to go to another hospital, chose a private hospital in Mukdahan and admitted same day. 

 

Next day had had two strokes in quick succession, rushed for a head scan which confirmed this. On further inspection I was told I had DVT.

 

came home a few day’s later with medications. Nothing else happened for a few years until I had a fall over a plastic garden chair.

 

Went to several hospitals but ended up in Ubon Ratchathani where I had hip replacement surgery. I never been the same since and resigned to the fact I will be disabled for the rest of my day’s.

 

Thats about all but if you have further questions please ask.

Many thanks.

[Sheryl]

2 hours ago, Paul Laycock1 said:

My history as best I can remember. No medical issues or problems in the UK.

Two years after I moved here I started feeling nauseous with headaches, went to my local hospital and diagnosed hypertension due to very high blood pressure.

They decided that my best bet was to go to another hospital, chose a private hospital in Mukdahan and admitted same day. 

 

Next day had had two strokes in quick succession, rushed for a head scan which confirmed this. On further inspection I was told I had DVT.

 

came home a few day’s later with medications. Nothing else happened for a few years until I had a fall over a plastic garden chair.

 

Went to several hospitals but ended up in Ubon Ratchathani where I had hip replacement surgery. I never been the same since and resigned to the fact I will be disabled for the rest of my day’s.

 

Thats about all but if you have further questions please ask.

Many thanks.

While it is useful (and possibly relevant) to know you have a history of DVT, what I meant was the history if your current problem.

 

When did it start?

What exactly are the symptoms? (describe all)

Pain exactly where in the abdomon?

What is the pain like? (sharp/cramping/burning, constant, intermittent etc).

Bowel movements normal?

Pain affected by eating? (describe if so - worse before or after, what foods)

Anything else seems to make it better or worse?

 

Exactly what tests have been done so far? You mentioned Xray, ultrasound and CT, was this barium swallow/enema or just plain Xray? Have any endoscopies been done?

 

Who where you reocmmended to go see in Bangkok? What type of doctor?

 

Exactly what did the doctors say re your spine and need for surgery? Your posts (this thread and prior) seem to have said that you were given a definitive diagnosis of gallbladder disease and recommended - even scheduled - for surgery, then later that no indication of GB disease was found on the tests that would have to be done before  such a diagnosis and recommendation could be made. And now seem to say that a definitive recommendation for spinal surgery was made.

 

If your doctors have really first recommended and scheduled GB surgery without even having done an ultrasound and now tell you you need spinal surgery without even a consultation with an ortho specialists then you are getting very sub-standard care to say the least. Please clarify. Is this really what the doctors have said or is there a communication problem?

 

By the way upcountry private hospitals are almost always best avoided. For Mukdahan the nearest good  option is  the main government hospital in Ubon Ratchathani, a 1,000 bed  regional level facility with wide range of specialists.

[Swimman]

5 minutes ago, Sheryl said:

While it is useful (and possibly relevant) to know you have a history of DVT, what I meant was the history if your current problem.

 It seems that extracting a coherent medical history via the internet is as difficult(in some cases) as it is in a real clinical setting!

[Sheryl]

P.S. Are you on anticoagulants since your DVT?

I ask because sudden severe abdominal pain which is out of proportion to findings on clinical exam can sometimes be due to blood clots in  the mesentary (the tissue around the intestines) cutting off or reducing blood supply to the intestines, and in early stages CT will still be normal. It is  a very serious condition.

 

I understand that you are primarily focused on pain relief but abdominal pain of such severity that morphine is needed  for days or weeks on end,  is absolutely not normal and a serious warning sign. the priority has to be finding out what the pain is from, nto masking it.

[Paul Laycock1]

Sheryl, thanks for your time and reply.

I was taking Warfarin/orfarin 3mg for my blood clot or thrombosis, I stopped about 18 months ago. Bowl movements are non existent at the moment, apetite zero. Pain has been 24/7 although not as extreme after the morphine patches.

My current patch is my last so in two day’s it will be back to agony.

The pain is sharp and severe, any movement is painful, a sharp stabbing pain.

Advice on any alternatives would be appreciated.

My sister in law does try her best to care for me but I need to move on.

I can’t drive and she is my lifeline to getting to hospital for medication.

 

[Sheryl]

Paul,

 

You have not said where exactly the pain is but assuming somewhere in the abdomen, I am very concerned that you may have a blood clot in the mesentery (mesenteric ischemia).

 

You should at once  either:

 

1. Go to the emergency room of Ubon Ratcahani regional hospital.

 

2. Come at Bangkok and go to the emergency room of either St Louis (Sathorn Road) or Bangkok Christian Hospital (Silom Road). (I am assuming you have no insurance. If yo udo have insurance then go to Samitivej Hospital).

 

Bring all medical records with you especially blood test results, ultrasound (pictures as well as report), CT (CD rom or pictures, not just the report).

 

Be sure to tell them:

- you have a history of blood clots but stopped your anticoagulant medication more than a year ago

 

-you have developed extremely severe abdominal pain and are not moving your bowels

 

Do not delay. If there is diminished blood flow to your intestines you could die.

 

 

 

 

 

 

[ThaiPauly]

Paul has not responded in nearly 2 weeks.

 

I hope he is OK?

 

What you said Sheryl is very frightening, so I hope he has taken heed and is now incomunicardo because he is in hospital, which he should be with all those ailments.

[Sheryl]

While he has not posted, he has logged on in the past 24 hrs, so presumably OK.