Posted 8/21/2017 1:54 AM (GMT 0)
Ziggs:
Your medical team is doing you a disservice by not considering adhesions as a primary source of your pelvic pain.
Laproscopic surgery is surgery. You may not have to heal a long vertical incision, but the same resection "work" of your large intestine was performed with your laparoscopic complete colectomy as is the case with an open approach.
That you have/had ulcerative colitis indicates a high level of inflammation and systemic inflammatory blood markers prior to your surgery. Inflammation of your large intestine was severe enough to warrant an ileostomy. Inflammation does not magically disappear after surgery for ulcerative colitis. Inflammation is a natural accompaniment to any healing process. The post operative inflammatory state lends to the development of adhesions. Adhesions are not inherently bad. Adhesions are the body's natural response to wound healing that has continued beyond the point where it is advantageous.
So, yes . . You will have adhesions. And I betcha' that adhesions/ scar tissue is the root source of your persistent pelvic pain.
Simply look at the corollary. You mention that your pelvic pain has been present and annoying for about the past year. Your colectomy was 10+ months ago. You mention how the pain is worse with body movement and radiates - all common findings with adhesions.
Adhesions are scar tissue that tethers or adheres to the fascia of
the abdominal wall; tethers one portion of the small intestine to another segment of small intestine; tethers to the fascia coverings of organs in the abdomen and pelvis (stomach, spleen, ovaries, Fallopian tubes). The pelvis is particularly affected because the pelvis is a small and contained space (about the size of a tea cup) through which essential nerve and vascular branches pass on route to innervate the lower extremities. These scenarios hold explanation for your increased pain during your menstral cycle (when the endocrine demands of the ovaries are heightened and the ovaries are enlarged during ovulation) and your sensory symptoms in your legs and lower back.
The good news is that adhesions are more apt to form during the first 8-10 months post surgery. Adhesions are less likely to develop after the 10 month mark.
I hear you when you write that stretching causes your pain to intensify, sending you to bed with a hot pack. But stretching and connective tissue mobilization is the prescription that you need to ease the severe pain that you do.
Start slow. Listen to your body. Talk any one yoga pose or posture to a point of mild discomfort. Hold the position for a solid 60 seconds (or longer to 2 minutes as tolerated). Slow and sustained stretching is the method you need to adopt. Ballistic or bouncy-bouncy or rapid and random movement is not advised. Ballistic movement causes micotears on muscle and connective tissue that is damaging and that lends to the formation of more scar tissue.
Massage, especially deep tissue massage, can be quite restorative in easing the bind that is characteristic of scar tissue.
I am in the hospital now, actually, with a complete small intestinal obstruction due to adhesions. I am typing on my iPhone. This is not my first rodeo with adhesions nor will it be my last.
Personally, I think you can ease your concerns of endometriosis. Your surgeon would have seen visual evidence of endometriosis during your lapropscooic procedure.
A referral to a physical therapist for deep tissue mobilization and an individualized stretching program would give you a guiding hand. There is a therapeutic speciality called the Graston Technique that is particularly helpful in easing adhesions. The release of adhesions is analogous to untangling a ball of knotted yarn or clearing tall overgrown beach grasses or brushing a long-haired dog's matted coat.
I perform 30 minutes or so of yoga 1-2 times a day. Every day. Like brushing my teeth. But adhesions still affect me. As with other chronic health matters, do the best that you can do.
I sincerely hope that you begin to find your preferred method of stretching and tissue massage to ease your personal pain and distress.
Karen
Karen