Advice Please! Pain management & symptom management

I seem to constantly be bugging you all on this forum. It looks like I can't stay away, lol.

I have tried calling my doctor on this, but she is closed today & my GI hasn't returned my phone calls. I wasn't sure where else to turn, short of going to urgent care & I think that is excessive. I am sure you all have some good advice at how to make this all tolerable.

I started having hip/pelvic/lower back pain yesterday & I thought I would feel better this morning. Needless to say, I haven't felt any better, I just feel worse. The pain has gotten so bad. Yesterday I was thinking maybe I am just twisted & needed an adjustment, so I called the osteo & made an appt., but I can't get in until a week from Monday. I started wondering if this was related to the IBD so I called my GI but she was in procedures today, so the receptionist said that the nurse will call or maybe the GI later this afternoon. No call. Still waiting to hear back on that small bowel series. I already received the bill for the reading, but neither of my doctors will give me the results, even though I know they have them because the receptionist told me they do & the nurse would call me with the results. I am sure if there was something on the SBFT that they would have gotten with me about the results already, so I am not worried like I was. But that doesn't help me out with the pain... So what do I do?

I am having pain in my whole pelvic area, front & back. Groin pain, too. I haven't had much low back pain, this is new. My hips really hurt, too. I have had hip pain before, but the osteo said it was due to losing so much weight & being bony & the pressure on my hip joint was causing bursitis. But it is in both hips now. I am feeling very weak and extremely tired–I spent all day in bed, most of it sleeping. My Darvocet is not helping. I tried doing Yoga thinking that would help. It still hurts.

And I have some tummy grumbling & crampiness. I have so much pressure like I have to go, but with no luck. I don't know if the low fiber, low residue diet is helping or what, but the last couple days I have slowed way down on the BMs, which I figured was good. I only went once yesterday & haven't went at all today. I feel like I have to go, but nothing comes out. And I am very bloated & feel a bit nauseous now. It's only been a little over a day since I went, so I don't know if you would really call it constipation, although that's what it feels like. My husband thinks I should try an enema or something, but I think that is a bit early for that.

So what do I do? What can help relieve this pain, or is this not related to my IBD? What can you do about pressure & bloating? I welcome all advice and thoughts...

Hello,
I have to agree with Vicky, this may be a good time to go to urgent care but I would choose ER as you have a known disease.  Pain is considered an emergency so do not let anyone make you feel like you should not be at the ER.  Remember to advocate for you.

FYI, The Joint Commission has been accrediting hospitals for more than 50 years. Its accreditation is a nationwide seal of approval that indicates a hospital meets high performance standards.  This is the gold standard. Patients who feel they have not been treated according to the standards have the right to send a letter to Joint Commission and each concern is investigated.

Here is the Joint Commission ruling on pain management.............

The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) has developed new standards for the assessment and management of pain in accredited hospitals and other health care settings. These standards were endorsed by the American Pain Society. The new standards explicitly acknowledge that pain is a co-existing condition with a number of diseases and injuries, and requires explicit attention. The standards state, "Hospitals, home care agencies, nursing homes, behavioral health facilities, outpatient clinics and health plans will be asked to: recognize the right of patients to appropriate assessment and management of pain; assess the existence and, if so, the nature and intensity of pain in all patients; record the results of the assessment in a way that facilitates regular reassessment and follow-up; determine and assure staff competency in pain assessment and management.

Do not be put off.............you are in pain.  Take care of you.
Hugs

Kitt

Is it the same ER? I've had bad experiences in ERs too, but it reflects mostly on individual doctors. Most are generally quite compassionate. So one bad apple.. Yadda yadda You know.
At this point Urgent care will likely sent you there anyway, but go if you think they can.

Sincerely,
Matthew

Hi hukleberrie...during my 25+ yrs. of severe Crohn's Disease, the symptoms that you are describing were very common for me (I was never in full remission). It definitely sounds like you're having a flare-up. One thing that I need to mention...I had my first resection in '91 & two yrs. later, was diagnosed w/ a partial obstruction & ended up having a sub-total colectomy (90% colon removal). I experienced constipation/diarrhea simultaneously. Then again, severe inflammation in itself can cause your symptoms. I often had terrible hip, lower back spasms & horrific genital pressure. I don't know what drugs you're being treated with. The last drugs that I was on, prior to having an ileostomy, were 6-MP & Remicade. These drugs did help but they're very potent & after 3 yrs.. I was diagnosed w/ a rare eye cancer. Due to this diagnosis, I had to stop the drugs. I've had an ileostomy for just shy of 2 yrs. & was doing pretty well until 2 weeks ago when I experienced severe colorectal pain. Remarkably, prescription ibuprofen (800mg) seemed to help the pain...I think better than had I taken a narcotic. Regardless of what's going on, I'd go the ER route. I belong to an HMO & while I ended up being seen by a Primary Care Doctor & put on Cipro (which eventually fixed the problem...it was assumed to be a bacterial infection), had the bloodwork & exam shown anything thought to be more serious, I would've been sent to the ER, in Boston. I'm fortunate to live in a state (MA) which has some of the nation's best hospitals/medical care. If possible, I suggest that you go to an ER located at a top-rated hospital as opposed to a local community hospital. Lastly, I'd consider switching GI's if you're not receiving same-day callbacks. Please keep us up-to-date. Thinking of you...Fuzzy

It can't be an obstruction. I am sure it would be much worse. I think the pain is at a 7 or 8. If I move around I can find a comfy spot & feel tolerable for a few minutes, then it comes back. All I want to do is sleep.

I don't have insurance. I can't afford another $3,000 bill. And the last time I was at the ER with dehydration & low potassium & sinusitis & migraine because I couldn't hold my head up they automatically thought I was on drugs or something & that really offended me. Then they wouldn't even look into the GI issue at all. They just checked my heart, gave me IV with potassium & did a CT scan of my head & sent me home. So if I go now, that's all they are going to do again & it's not worth the $.

I have pressure like when your in labor & the baby's head moves down. That's the pressure I feel. I have tried & tried to have a BM with no results. I even tried with the finger to see if something was there that couldn't come out but nothing. I did pass gas 2 times yesterday, so it can't be an obstruction.

I still don't really know if it's CD or UC. The GI said it is for sure IBD, but she needed to do more tests to find out which one. She was very compassionate & took a lot of time with me, so I really like her. I just don't understand why I am not getting a call back... And the SBFT test probably didn't show anything anyway because there was that blob of barium there & the radiologist said he had a hard time seeing so the test was inconclusive as to which IBD I had. I am sure if there was something on that test that it would have shown up. And I am sure they would have told me the results by now since it has been 9 days.

I just thought maybe you all would have some ideas of how to deal with the pain or any homeopathic therapies I could do.... I can't afford another trip to the ER....

I am not vomiting either, so that's good. But this pain is not good. I had thought about calling the emergency # for the gastro, but it's not an emergency, so I guess I am going to go to urgent care. I don't want to because I think that they don't know as much as my gastro, but I am not sure what else to do. I will not go to the ER & I am lost. I will post when I get back.

I'm so sorry to hear that. Constipation would'nt be high on my list, although it's a possibility. I think rather than doing
an enema, I think I would try something that will help clear you from top to bottom. If you can tolerate it, they now sell
miralax OTC, it's a little more potent than maalox.
I hope your problem solves itself quickly, with no other serious problems. Good luck...

Honey I really don't know what it is, I'd only be guessing. If you can eat and drink without vomiting, then that would
indicate that you don't have a obstruction. However, there could be inflammation that's enough to stop you going
normally. My concern is that you've now been feeling like this for a while and things are not changing for you, this
isn't normal. Try whatever you have handy, IF you think you are constipated, IF after that, you still feel the same
or worse, please see someone who knows what they're doing. Keep us posted...

Okay, here's new info. I woke up at 4:30 this morning by a noisy tummy. It was so loud, it woke me up! My hips & pelvis & low abd/low back were hurting. So I got up & took another Darvocet. (helps only slightly). I went back to sleep & woke up a half an hour later & finally had to go! This stool was hard, but passed easily. Then back to bed, then back up again. This time softer. Then again, this time I know it was what I ate at dinner last night (I said screw it & ate a burger with sesame seeds on the bun - I know, I know. NO SEEDS, but I have been following that diet to a T & just needed a little break....) so I know I am all cleaned out. So constipation, if that's what it was, is over. But, I am still hurting!!! So now what? It wasn't obstruction, it wasn't constipation, so what is causing the pain?

Matthew, I was just at the only local hospital in the county (don't know if it is really a "community" hospital) & they sent me a big fat bill for my time in there with dehydration/low potassium/migraine/sinusitis. $3200 for 7 hours. Grrrr.... And when I was there, they said I would have to get with my GI doctor about my weight loss & GI issue. They didn't even want to talk to me about that. So, going to the ER and Urgent Care are useless for me. I will always just wait to get with my PCP or GI. How did you get your debt forgiven? Did you have to bug them about it?

I would love to have you go into the ER and just make sure it's not something serious. Explain that you have no insurance and ask if there is some assistance. Take care of yourself!

I wish you luck!!

Wanted to correct my wording on last post........I did not have an obsruction. Had an impacted bowel. Sorry when reread it found that I had it wrong

Hi hukleberrie...I'm sorry but I just want to SCREAM reading through this topic! If you are in moderate to severe pain then you need to get checked-out by a professional & not cause further damage by trying all these OTC remedies  . It sounds like typical IBD inflammation but could also be a bacterial infection (I have an ileostomy & still developed an infection in my 10%colon/rectum...I recently ended a 10 day course of Cipro for this (& it was prescribed by a Primary Care Doctor, not my GI nor my usual PCP)). Also, the only drug you've mentioned is Darvocet: I don't know what the reason is that you're taking this but do know that it can cause upset to the GI tract. Are you on any drugs for the IBD? Prednisone? My nephew is uninsured & has been treated for IBD...he just doesn't follow-through w/ the treatments & instead, ends up in the ER every so often. In my state, we have what's called MassHealth...this covers non-working, uninsured people. My nephew has access to all the top doctors, in the best hospitals & only pays $1 for his prescriptions. I'm on disability, pay for basic Medicare + Premium HMO coverage (I barely get by but need the extra insurance). I don't know your situation, as far as work & the programs offered in your state but you can't be turned away from an ER for lack of insurance. Regardless...no, the ER isn't the best place to get treatment for IBD as they don't know your medical history & aren't treating you on a regular basis. See your GI, ASAP (PCP if he/she's readily available & knows how to treat IBD). Sounds like you need a lower GI & certainly, a colonoscopy. When is the last time that you had one? Please seek treatment...let the bills pile up...like Mathew said, there's always a way to work out the financial part. Do you know if you're eligible for some type of government program? I'm not trying to come down on you but am concerned that you're not getting the proper treatment. Please keep me posted!...Fuzzy