pain continuously since hysterectomy worse over years

by ruth
(st albans)

Pain continuously since hysterectomy worse over years.

I am 49 year old woman who had a full hysterectomy. Since then i began to have lower central and left hand side abdominal pain. I went to see a gynae doctor who said he was sure it was adhesions and the best thing was to do laproscopy key hole to remove them.

He removed two large ones, but within three weeks the pain was horrendous so i returned he did an ultra sound and when i had this an he went across the scar i cried as it was so painful.

He wrote to my doctors saying he thinks it was a tumor scar that was growing but should leave it alone for the time being rescan in two months and then he would have another look, but i didn't get a scan due to lack of communication between hospital and my doctors.

I went back to get another scan and they said no sign of a hernia and said they could not see anything abnormal but were sympathetic when i told them how much pain i have been in.

I have now been off work four months due to chronic pain it is so intense some days, i am having pain management injections, because one doctor reckons i have the ilinguigal nerve nicked or something. Then another doctor said i have endometriosis another said adhesions.

When I go for small walks, I have pains. If I have sex I am in agony so that causes pain. If i carry or lift something, I am in extreme pain. If I bend I am in agony. If I stretch i am in pain. If someone touches there the pain is, it is awful.

Since having the operation i have not felt well. I also looked like i am about five months pregnant, when i get a full bladder it hurts and when i need to open my bowels, the pain only subsides with 6oomg or gabapentin. I have been told i can go higher but this makes me dizzy.

I need someone to see what is going on i had nerve block last month also has not worked, i have a slight lower back pain at times but and opening my bowels every day and water works are OK. I am desperate for some one to tell me what is wrong why my stomach is always swollen why i have so much pain and why after an operation that is being performed every single day that i have so many problems and mine was not a success.

---

Dear Ruth,
I heart sincerely goes out to you as I read your story. I completely agree with you that hysterectomy is a surgery performed so easily every day. To have to undergo the type of pain you've described here is certainly quite unfortunate.
But, don't despair.
Your condition does sound like a case of severe abdominal adhesion from your surgery. That is the likely explanation for the pain, abdominal bloating, pain when you get a full bladder or when you need to open your bowels.
You could also develop endometriosis.
Solutions. I think at this stage, we have to look into how your pain can be dealt and get you to at least near normal life. Apart from Gabapentin, what other medications are you taking? You will need a regular intake of a few pain killing medications.
Could you discuss the option of trying a combination of:

1. Butrans patch 5microgram per hour patch - use one, every 4 to 7 days
   
2. Paracetamol tablets. Take Two 500mg tablets four times daily
   
3. Vimovo Tablets (a combination medicine containing Naproxen 500mg plus esomeprazole 20mg). You can only take this if you do not suffer with asthma or peptic / stomach ulcer and you are not on warfarin. Off course you need to discuss the suitability of all the medicines here with your doctor before going on them, as we all have different medical history and tolerance.
   
4. Gabapentin or Pregabalin.


That is the first step.

It sounds like you have been referred to the pain team. That is excellent. I believe they will do their very best to help control your pain. is there any chance of being referred to see another gynecologist? Any chance for a private consultation?

You may need another diagnostic laparoscopy to help ascertain what exactly is going on. If endometriosis is contributing to your pain, this can be treated.

If the main problem is from a post hysterectomy adhesion, doing more surgery is a huge gamble. There is no guarantee that it will cure you of the pain, and could actually worsen it. A sure diagnosis however will help us know and plan what to do.

What do you think, Ruth?


So, my suggestion will be:


• Discuss with your GP about the possibility of trying the above combination of medications
  
• Continue pain clinic consultation and treatment regime
  
• Ask for or go for further diagnostic assessment
  
• Be cautiously optimistic, yet do not be despaired. All that you may realistically achieve is better pain control rather than a cure. But try all you can and see how far this condition could be brought under control.


Please let us know how you went.

Best Wishes.

Abdopain.com