Post-Surgical Pain and Adhesions: Seeking Guidance
Female, around 40 years old – minimal prior medical issues aside from a few recent operations. On December 24, I underwent a laparotomy intended as a laparoscopic procedure for a high anterior resection. However, the situation inside was quite complex. Surgeons had to disentangle several organs that had adhered due to inflammation of my intestines, resulting from serious diverticulitis. Additionally, a colovesical fistula was repaired during the operation. As a result of these complications, I lost an ovary, the left fallopian tube, a portion of my colon, and part of my rectum, while also needing kidney stents. During the procedure, there was a significant bleed that necessitated a transfusion of two liters of blood. The incision made was a vertical cut ranging from my ribs down to my groin, directly through the area of my belly button. I dealt with a considerable seroma for over two months, which required a vacuum pack to facilitate drainage from the area beneath my navel; this finally closed approximately two weeks ago. Post-surgery, I experienced intense pain that gradually subsided around three weeks after the operation. I began to move about more normally over time, feeling like I was recovering and reestablishing my daily routine. However, three weeks ago, I faced a medical emergency resulting in the removal of my gallbladder due to the risk of rupture from obstructed bile ducts filled with stones. Given the recent surgery I had in December, the surgical team resorted to making multiple small incisions in my abdomen to accommodate cameras. Their notes indicated that I had significant banding and adhesions in the area around my umbilicus. Following this latest surgery, I was placed in the ICU due to low oxygen levels and my overall weakened condition. I have since been recuperating at home, but I now endure immense pain localized on my lower right side. The pain is sharp and pulling, manifesting as both muscular and agonizing – peaking at a level of 10 out of 10, surpassing even labor pain. I suspect it might be related to adhesions? The discomfort becomes unbearable when I bend, stand, or walk. I find it challenging to accomplish anything; sitting in my desk chair for more than thirty minutes is intolerable, and laying flat on my back offers the only relief from the severe pain. My primary care physician has expressed uncertainty about the cause of my pain and suggested opioid pain relief, which I’m reluctant to accept. Currently, I’m attempting daily massages in the painful area, which provide minor relief, but the next day the pain returns unchanged. I'm reaching out for any advice or suggestions that might help in this difficult situation. Thank you in advance for any assistance.
Answers (1)
3/20/2025, 2:01:06 AM
OpenHealth AI
I understand that you are experiencing significant pain and discomfort after multiple surgeries, particularly from adhesions and other complications. The sharp, localized pain you describe can indeed be related to adhesions, which are bands of scar tissue that can develop after surgery and may cause discomfort or pain, especially during movement.
Explanation
Post-surgical pain can arise from several factors, including:
- Adhesions: Scar tissue that forms between internal organs, causing them to stick together. This can lead to pain, especially with movement.
- Muscle Strain: The physical strain on your abdominal muscles, particularly after a major surgery, can contribute to discomfort.
- Nerve Sensitivity: Surgery can also lead to nerve irritation or damage, resulting in heightened pain perception.
Next Steps
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Pain Management: While you are hesitant about opioid medication, it is vital to manage your pain effectively. Consider discussing with your physician alternatives such as:
- Non-opioid Analgesics: Options like acetaminophen or NSAIDs (if not contraindicated) can help manage pain.
- Topical Treatments: Creams or patches containing lidocaine may provide localized pain relief.
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Gentle Movement and Stretching: Although pain makes it difficult, gentle stretching and movement can help reduce muscle tension and improve overall function. Focus on:
- Gentle Walking: Short, frequent walks can be more beneficial than long, intense sessions.
- Stretching Exercises: Consult a physical therapist, if possible, to develop a safe exercise program tailored to your needs.
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Physical Therapy: A physical therapist can provide specialized exercises to alleviate pain caused by adhesions and improve your mobility. They may also employ techniques such as manual therapy to release tension and improve circulation.
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Heat Therapy: Applying a warm compress or using a heating pad to the affected area may help relax muscles and alleviate pain temporarily.
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Monitor Symptoms: Keep a daily record of your pain levels, triggers, and any activities that provide relief. This information can be useful for your healthcare team in determining the next steps.
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Follow Up with Specialists: If the pain persists or worsens, consider asking your primary care physician for a referral to a specialist, such as a pain management doctor or a gastroenterologist, who can evaluate for underlying issues like significant adhesions that might require intervention.
It’s understandable to feel overwhelmed given your recent medical history. Focus on your recovery at your own pace, and don't hesitate to reach out for support from healthcare professionals if you need more tailored advice or interventions. You're doing great by seeking help, and taking these steps can hopefully lead to better pain management and improved quality of life.
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