abdominal pain, do I need a laparoscopy?
Posted , 5 users are following.
For nearly two years I have had lower abdominal pain and after numerous examinations the diagnosis seems to be adhesions due to old abdominal operations. The surgeon says he will do a laparoscopy if I want, but doesn't promise any cessation of the pain. Has anyone had this procedure recently and what will they do if no adhesions are found, just sew me up and send me on my way?
The alternative seems to be grin and bear it or take even more pills, none of which have done any good whatsoever!
2 likes, 8 replies
shinerweb
Posted
The one downside of a laparoscopy is that even that relatively minor procedure could cause more adhesions or add to the internal scar tissue so I'd definitely consider that side as it may well add to your woes.
Have you ever tried any pain management options? (i.e. exercises and manipulation technques - and I don't mean the regular gym/running/fitness/pilates type exercises that GP's/Physio's might throw at you. More like a targetted approach.
(After 30+ procedures on a spinal injury, I can vouch that understand just how bad adhesions/scar tissue can be and the frustrations in trying to explain it to some in the proffession. If they can't feel it or see it, you feel like you have to spend months trying to convince them it's real and not 'in your head'.
Regardless, you should never have to just grin and bear it !!
Chris
jenny
Posted
I know only too well how the doctors look at you as if you are the world's biggest hypochondriac.No one actually said anything, but the implication was there. That and the fact that I thought ageism was coming into it, upset me more than the pain.
I have had pain management before after a bad R.T.A caused numerous problems with my spine and head, but that was mostly tranquilisers to knock out the nerve pain and they made me so drowsy that I spent most of the time asleep. Is this the same sort of pain management you are describing?
This is not an option now as I have to look after my husband , who has Alzheimer's and I need to be on the ball and alert at all times. My patience sapped by pain is sometimes lacking so I need to do something soon.
Needless to say my children think I should go for the laparoscopy to at least eliminate adhesions, but I am not keen to do anything to make the pain worse!
Jenny
jjeremy
Posted
shinerweb
Posted
(this is rather a long reply - apologies... no simple way to put it all across !!).
By pain management I am referring more these days to the "cognitive psychology" approach in conjunction with physical exercise. I have done the 6 week residential pain management course at Guys & St Thomas' but that was rubbish compared to what I learnt on a local course last year.
The Guy's approach was your pain can't get any worse, you can learn to ignore it and your life will return. (That is a rather over generalisation of the course, but it’s how you perceived the course to be at the time. What they taught on the course was 100% true, but was too generic and not targeted towards specific cases/individuals).
These days, pain management is taught differently by a lot of people, I just happen to have lucked out by meeting a great team at the Pain management clinic at the North Hants Hospital (in Basingstoke).
Their way of thinking is much more modern and is:
1. You think you are in pain, therefore you ARE in pain. End of discussion, not up for debate.
2. There was an old you and there is a new you, the you right now. The old you could do this that and the other, the new you can only do what the new you can do.
(You might have to read that a few times !)
If you start from that point, and then by doing exercises, both physical and mental, you'll gradually find that the new you will be able to do more.
You should never say, but I want to be the old me, because you can't.. you are a new you...
Stress can increase your pain... In your case, you have your own level of pain which you try to manage. You are also looking after your husband who has Alzheimer's and if that is not a source of stress, I don't know what is. You are not only looking after yourself, but you are looking after you husband so you have both the physical and emotional aspects of that to deal with on top of your own pain.
That alone will cause a perceived increase in your pain levels.
So what I meant by trying 'pain management techniques' prior to considering surgery, was to basically do everything else possible before you consider surgery. If surgery can be avoided, that is always the best course of action. Unfortunately, us chronic pain sufferers can often fall into the trap of “there is that one more surgery that will fix us” syndrome which is what some (but not all) doctors also believe and instantly dismiss us.
If you can find exercises that will help break up any pre-existing scar tissue, or loosen any adhesions, and if you can reduce your stress levels, if you can keep more positive, it is a proven scientific fact that your pain levels will reduce. We still cannot say they will go away, but they will reduce. A reduction is a positive, a positive is a good feeling, a good feeling helps our pain reduce further.
And the new way of thinking by a lot of pain management consultants is “if you need medication to support your pain management, then you need medication”. Unfortunately, we are still in the cross over phase where some will throw pills at you until you rattle in order to get you to go away, without actually doing a targeted approach.
I used to be on a list of pills as long as your arm, from anti-depressants to narcotics.
I now take the bare minimum of Morphine + paracetamol + ibuprofen and I’ve been at the same level of morphine for over 3 years. Previously, if my pain increased, I increased my morphine which got to quite high levels and caused more hassles than the original chronic pain.
I believe that you like myself, suffer from a mixture of chronic pain AND acute pain. You have chronic pain as a result of previous injuries/surgeries but, because of the adhesions/scar tissue, certain movement will cause you acute pain.
The hardest part for you and me is to convince them that we do have acute pain and it’s not 100% chronic pain.
Unfortunately for me, I am at the point whereby they know what is causing my acute pain, but to fix it requires an operation that carries an 80% chance I will be left paralysed. No matter how bad my chronic pain is, I do not want to be paralysed. That would be many times worse what I experience now, both for me and my wife (a nurse by the way !!).
You may well be at the point whereby, yes, a laparoscopy may well fix your acute pain, but it may also increase your chronic pain (going forward), or lead to further acute pain.
So you really need to pin your surgeon down as to how successful they think it will be.
There are some things they are always going to state because they have to. Separate to my main spinal injury, I’ve also just had a full hip replacement (I’m 45 btw), and these days, it’s a relatively safe operation. I was in on the Saturday and they wanted to release me on the Sunday (and this was NHS !). I ended up coming home on Monday much to the amazement (and annoyance) of my wife who had not got the house ready thinking I’d be away longer.
But prior to that operation the surgeon still had to warn me of the dangers of a 1001 things that could potentially go wrong.
The hardest part for you and me is to get the surgeon to ignore those standard warnings and state, “in MY case, with respect to MY pre-existing condition, do you think the chances of decreasing my acute pain levels outweighs the possible negative outcomes?”. Getting them to carry out every possible test to help them decide is again hardest.
Once a surgeon commits to surgery, they will always “go in” with 100% confidence of fixing you 100%, because they have to have faith in their ability to achieve those aims or they wouldn’t be able to do the operations at all. But in reality, each of us are so different, achieving a 100% fix, especially in someone that already has chronic pain, is very rarely achieved and that often sways surgeons away from further operations. Getting them to do as much diagnostic work as possible to support your argument is paramount AND it can have the positive effect of helping to manage the situation.
I’d perhaps ask your surgeon if there are scans (high definition ultrasound) that can be used to identify the adhesions /scar tissue which would give him a better indication of the chance of success. Laparoscopy is less invasive and therefore the chances of any new damage being caused is low, but I will still say it is only worth going down that road if your surgeon is going in to definitely fix something rather than on the chance he will find something to fix.
What ever happens, try to look at the big picture and what ever happens, stay positive. You obviously care so much about your husband and want the best for him, but don't forget to look after yourself first. If you need help, go get it. You will be no good to yourself, let alone your husband if you boom and bust and increase your pain.
Chris
jenny
Posted
That is an incredibly helpful answer you sent and thank you so much for taking the trouble to reply in such depth.
You and I seem to be one of the band of chronic pain sufferers and most of the time I laugh it off, just sometimes it gets to me. All my working life I worked for the NHS as a diagnostic radiographer so I know about pain and suffering and have no intention of letting it push me under.
My husband has always been my backstop and support through over 50 years of pain, never sympathetic, but always there to pick up the pieces and deal with four small children. It is that I miss so much now and the feeling conveyed( rightly or wrongly) that I don't matter when I attend the hospital.Perhaps I am oversensitive, but can't help comparing treatment now to how it used to be!
Having said that I have had every test going( some twice) as I was fast tracked at the start of all this. Nil sinister found just the normal things that come with getting older like prolapse ,various coeles, small amount of diverticulae etc
I will certainly look into the pain management you mentioned and have six weeks to come to a decision. Why is it that every appointment is six to eight weeks away from the last? They just about get the referral letters back before you are due again.
I do hope you sort your problems out, by all accounts you have much more to worry about than me. Good luck and thank you.
Jenny
shinerweb
Posted
With Chronic pain my problems are no less than your problems, no matter what the underlying condition is.. Pain is personal.. We are both chronic pain sufferers, therefore equals...
You just have to remember to look after number 1, yourself. (Even putting yourself above your husband because if you are not as fit as you can be, you won't be any good for your husband).
I have 3 children, eldest 18, youngest 12 and luckily, they all understand my condition and are extremely supportive. I'm 6'4, 17st, my wife is 5'2 and 7st when wet and that is relevant because without her support, I would be nothing and nowhere. She is my rock ! It has also helped her in her nursing as she didn't understand pain as much as she does now. She is always sympathetic to a patients pain needs first and foremost and that makes a big difference.
Hopefully you get support from your lot with your husband because you do need a break too...
Anyway, good luck and I mean that about providing an ear !!
Chris
boyzmummy jenny
Posted
How are you now? Did you have the laparoscopy?
I have been booked in this week to have one, the surgeon said he was looking for adhesions but he may not find anything! I had my Gallbladder removed in 2014 and ever since have suffered pain, vomitting and weight loss. I too tried pain management but being a walking Zombie was awful being a self employed mother of 3.
Aprehensive about the surgery as it might not even find the problem, please update me on if you proceeded with it or not.
take care
Luffy89 jenny
Posted