Medical Questions > Conditions and Diseases > Abdominal Pain Forum

30 years old and, it's been over a month, I can't work!

I am at my wits end. On September 28th, I began feeling ill. I had a low grade fever, nausea , vomiting and diarrhea. I called into work. That following Monday, I still wasn't feeling well so I went into the urgent care center and was diagnosed with viral gastroenteritis, and told it would run it's course. A few days later I developed pain in my lower right abdomen so I called my PCP. She saw me within an hour and sent me to the ER for possible appendicitis. CT scan came back showing my appendix was fine, and my blood work was normal. Again, I was told it was a virus, it should run it's course and to follow up with my PCP if not feeling better in 3 days. So 3 days later, still wasn't feeling well. Followed up with my PCP and she noticed the CT report mentioned a cyst on my right ovary. She referred me to my ob/gyn who wasn't able to see me for another week and a half. That weekend (we're now about 2 weeks into this ordeal), I suspect the cyst ruptured. I was fine one minute and on the floor crying the next. Back to the ER. Blood still looks normal, must STILL be a virus, go home. Finally get into the the gyno, cyst no longer present, start birth control to prevent you from ovulating. 3 days later my fever (which has been hovering around 99.7-99.8 this whole time) spikes up to 100.3 and my neck starts killing me. BACK to my PCP who sends me BACK to the ER, this time for a lumbar puncture. It's NOT meningitis, but I spend the weekend battling the most horrid spinal headaches until I land BACK in the ER again. At this point, my symptoms have multiplied and now include low-grade fever, swollen lymph node on left side of neck and right side of groin, CONSTANT goosebumps and chills, dizziness upon standing, nausea, vomiting, diarrhea (and hemorrhoids as a result) and I'm fatigued to the point that I'm awake for about 4 hours a day and sleeping the rest of the time. I've also missed an astounding amount of work. Get a call from my gyno that my pap was abnormal, they need to do a biopsy. Scary, but maybe it'll result in some answers. Nope. Biopsy was completely normal. However, I asked the gyno about my other symptoms since nobody else can come up with anything and my PCP just seems to want to pass me off to the ER, and she suggests I see an endocrinologist and a rheumatologist. After examining the hemorrhoids, she also suggested I see a colorectal surgeon. After about 15 minutes after leaving the office I started having some pretty bad right flank pain, but figured, I just had tissue cut out of my body and I've been sick for about a month at this point. The next day the flank pain gets worse. I call the gyno, they say it's not normal, try a heating pad and if it's not better the next day to call back. I put a heating pad on my back and slowly the pain migrates to my lower right abdominal area. Move the heating pad, pain moves back into my flank. I keep this up for about an hour until the pain is now steady and sharp in both locations. It's after hours at this point, and I'm fed up with feeling so horrible, so it's back to the ER. Once again, normal CT scan, but there's blood in my urine, here's an RX for pain pills and antibiotics. At this point, I've missed a month of work and I'm getting worse and not better, and I'm getting passed around instead of getting any answers! My fiance' and I have decided the best option is for me to quit my job, since I'm unable to be a reliable employee, move back in with our old roommate to reduce our cost of living (which we are doing this weekend), and then show up at either my PCPs office or the ER and tell them that I refuse to leave until I have an answer! At this point, my symptoms are CONSTANT low grade fever (has not been under 99.4 since 9/28 and I normally read at 97.whatever), pretty constant chills with goosebumps (sometimes only on the right side of my body) abdominal tenderness (sometimes just sore feeling, sometimes sharp right lower abdominal pain), constant nausea, loss of appetite, off and on vomiting, constant diarrhea, hemorrhoids, occasional hot flashes, swollen lymph node in right groin, swollen lymph node in left neck, headaches, sever fatigue, sweating anytime I sleep (to the point of waking up having sweat through my clothes and needing to move the blankets around so I'm not covered with a wet blanket), dizziness when standing or laying. I'm 30 years old and I was healthy prior to this. I don't track my weight regularly, but my PCP has been concerned that I am underweight. I'm 5'3. In June I weighed about 126 lbs or so, now I'm at 103 lbs. I feel hopeless. I don't think I can stand to be passed off to another doctor or told it's just a virus it will run it's course. My quality of life has been affected to the point that I CANNOT work, and I LOVE my work. We're giving up our apartment and moving in w/ roommates... it's been over a month. THIS IS NOT A VIRUS! IT IS NOT RUNNING ITS COURSE! Someone, please help point me in the right direction!
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First Helper User Profile Gaelic
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replied November 7th, 2012
Especially eHealthy
DianeCasey,

Have you seen the specialists which were recommended? The ER is not going to be able to help you. They are not designed to do complicated evaluations and work ups. The ER is basically for major trauma, heart attacks, knife and gunshot wounds, problems which they can resuscitate and have another service take over the care of the patient in the hospital. Other problems are stabilized and referred to outside physicians for outpatient work ups. So, the ER will most likely not be able to do anything for you.

This is also most likely beyond the scope of care for a primary care physician. Again, the PCP can get the baseline studies and if anything pops up, great. But, if everything keeps coming back normal, there is nothing for him/her to treat.

Then, it becomes a complicated diagnostic problem. And, "House" is not a real doctor. Complicated problems are not solved in one setting. You may have to see several specialties until something is found, especially with nonspecific symptoms which could be caused by a whole host of problems, from inflammatory, metabolic, gastrointestinal, rheumatological, infectious disease, immunological, and the list goes on.


See if you can get the first referral from your PCP, to whatever specialty that he/she thinks would offer the best chance of detecting something. Keep a journal of your symptoms, along with any medication (prescription, herbal, over the counter, etc) that you take. Record your temperature twice a day, at the same time each day. "Fever patterns" can often detect a certain disease, just from the way the temperature rises and when.

But, be prepared for a long investigative process. You might get lucky and have the first specialist you see come up with the answer, but more often than not, it does not work that way.

In the mean time, try to do as much for yourself as possible. While rest is necessary, too much just makes the body weaker. Be sure to do as much light activity as possible. Eat a well rounded diet, with the extra nutrients your body needs right now, such as protein and calcium. Stimulate the mind, with reading or social activities, so that you do not become too depressed. Stay well hydrated. Treat your symptoms as best you can.


Wishing you the best. Good luck.
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replied November 7th, 2012
I've done all the follow up that's been suggested up to this point with the exception of my gynecologist's suggestions, and those appointments will be scheduled after this weekend's move. My PCP has not proved very helpful as she is the one that has been sending me to the ER rather than giving any referrals or pointing me in any directions. I think that's where my frustration lies at this point. I know the ER is there to ensure that I'm not in a life threatening situation (e.g. appendicitis or meningitis). I know I've been in the ER a lot lately. All my visits have been due to my PCP sending me there or returning (as instructed) when specific symptoms arose (such as the spinal headaches after the lumbar puncture) or returned/worsened (right lower abdominal pain w/blood in urine). I appreciate your post. It's reassuring to know that I'm not just going crazy or being passed off for no reason. It's just frustrating. I generally eat a healthy diet high in nutrients. I have actually worked in the medical weight loss field for 2.5 years. I've worked on the holistic end, and more recently for an amazing bariatric surgeon. Nutrition has always been a high priority for me, and I've been lucky enough to work for some great doctors that I've learned volumes from when it comes to nutrition. I think it's all been a bit overwhelming to have been side-lined so quickly, and to still feel so horrible over a month later, and to be no closer to an answer of any sort. I'm not accustomed to not working, and that's driving me a bit crazy as well. I appreciate your reply. It helped a lot to kind of re-center myself, I guess you would say. I've been so physically uncomfortable on a constant basis for a while now. I guess it's starting to send my mind whirling as well.
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replied November 8th, 2012
Especially eHealthy
Diane,

It sounds like it is time to get a different primary care physician. While it is not uncommon for physicians to just tell a patient in distress to go to the ER, in case it is something surgical in nature, in a patient who has a long history such as yours, it is usually better to see the patient first. But, some physicians are not really comfortable with things that come up unexpected ally or when they have to make quick decisions (which is why they gravitated to the family medicine type of practice, rather than a surgical or intensive care type of practice).


So, again, it may be time to find a good internist or another primary care physician. But, do keep looking. You just have to find that one provider that has an "Aha" moment, and finally figures out what is going on.

Hang in the there. Good luck.
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Users who thank Gaelic for this post: DianeCasey 
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