Question
QUESTION: On January 25, 2008, I was sitting in a chair when I got a severe pain in my upper left abdomen.  It has NEVER gone away.  As I sit here writing, I have learned to sit VERY STRAIGHT to not move out of position.  I cannot lay down, the pain is enormous.  I have slept in a chair for months at a time until my body gets so many spasms, I have to try to lay propped up in bed with 9 pillows around me, so I do not roll over, as the pain will be more severe.  The nausea is the worst in my life, from the pain.  I have search for help and been seen by over 30 doctors, all have a different opinion yet I am still in the same pain.  I have had 2 catscans, several xrays, upper and lower GI's.  I have BEGGED for an MRI, but no doctor will approve.  I 'tape my rib cage' with a weight lifting belt EVERYDAY in order to breathe and reduce the pain, or I could not live.  I am getting very tired of being ill with this and not able to find a doctor to help.  Riding in a car, when I hit a bump makes the pain worst, if it is a long time, I will be so nauseous by the time we get there, I cannot think from the pain.  I can longer attend dance classes, or exercise classes.  I cannot bend to clean my house or wash my feet as the pain is so bad.  Six month prior to this date, I fell off a ladder while painting.  An MRI was done after two months of complaining to my doctor of the pain in August 2007. A disc bulge and small tear was noted but the MRI only went from T-12 to L-1. I did exercise and my back was not hurting when this new pain started in my upper abdomen 6 months later.  When I was sent to a Chiropractor by referral from on of my doctors in March 2009, he said my rib cage was detached from a vertebrate in my back at T-10, but would not order an MRI to confirm and the pain got worst and worst for months and my referring doctor cancelled my referral.  My present doctor will also not order an MRI, I fear I will be changing my doctor again at the end of month, still begging for help.

ANSWER: Hello Bobbie,


I am sorry to hear of your injury of January 25, 2008, and that you are still hurting- over
1.6 years later.

Xrays and CT scans look at 'hard tissue'- osseous tissue- bone tissue.  Xray and CT are not the best when looking for soft tissue injury.  I would certainly hope that an MRI is performed of the painful area.  I do not understand why your doctors do not want to order an MRI.

You need an MRI to fully evaluate the area of pain.

"I  have BEGGED for an MRI, but no doctor will approve. "- get a different doctor.  I do not understand this.


"An MRI was done after two months of complaining to my doctor of the pain in August 2007. A disc bulge and small tear was noted but the MRI only went from T-12 to L-1. ....", this MRI pre-dates your CURRENT complaint, you were fine after this MRI, so this MRI is really not significant to your CURRENT condition, except perhaps for comparison.
         I do not understand why the MRI evaluated between T12- L1.  This is highly unusual.  USUALLY an MRI will be of an entire 'area'; for instance a lower back MRI will include T11 or T12 down through S1, even S2- depending upon the patient's size.  If you do a neck, a cervical MRI will include C1 or C2 through T1 or T2 depending upon the size of the patient.
         Are you sure they only looked at T12- L1 ?

"When I was sent to a Chiropractor by referral from on of my doctors in March 2009.....", the Doctor of Chiropractic does not need a referral by a Doctor of Medicine.  If you are not happy with your current Doctor (of Chiropractic)- then switch doctors!

"....Chiropractor by referral from on of my doctors in March 2009, he said my rib cage was detached from a vertebrate in my back at T-10,.....", this could be the cause of your problems.  Did you get any treatment, since the pain is so severe and so long in duration you would need a treatment regimen of four weeks or more (3x per week for 3- 4- 5 weeks) before making great headway,,, did you give the doctor that time?

".....but would not order an MRI to confirm and the pain got worst and worst for months and my referring doctor cancelled my referral......";  I do not understand your situation; Why do these doctors have differing opinions, no one agrees, so one will order an MRI to evaluate the pain area, and why do you need an MD referral to a DC ?

"....My present doctor will also not order an MRI, I fear I will be changing my doctor again at the end of month, still begging for help.....", you are not getting any satisfaction; from your description- you are not being evaluated fully;  I would switch doctors also.

If you have additional info, please RE-contact me here at ALLexperts.com : http://www.allexperts.com/ep/965-100794/Chiropractors/Victor-Dolan-DC-DACBSP.htm

I would look for a doctor that has a good reputation, that I have confidence in, that gave me a thorough in-office exam, and either ordered an MRI to evaluate the area --OR-- explained why the MRI was NOT needed.


Thank you for the question.

Good luck in getting to the bottom of your complaint,

Your Staten Island Chiropractic Expert,

Dr. Victor Dolan, DC
Email newsletter: . . . . http://drvictordolan.chiroweb.com


---------- FOLLOW-UP ----------

QUESTION: Thank you for your caring response. To answer your questions:
I have a copy of the MRI from my fall in 2007, and it states T-12 to L-1, and noted small tears, disc bulge, etc. all in the 'L region'.
My insurance REQUIRES me to get referrals to go to a DC and the one they sent me to made adjustments 3x a week for two weeks, then 2x a week for 8 weeks and the pain never completely stopped, could never lay down. I sleep in a chair with rib cage wrapped, and that is the ONLY TIME I CAN TAKE A FULL BREATHE OF AIR. And finally, I have CHANGED DOCTORS several times during these almost 2 years and gone to Emergency 3 times.  These doctors has done several test over the years including: 2 colonoscopy, 2 upper scopes, 2 uppper GIs, 2 lower GIs, XRAYS, pelvis ultrasounds, abdomen ultrasounds, kidney ultrasound, 2 CT Scans (one Feb 2008, one Jan 2009) Now this Friday, I will have a CHEST CT SCAN focus on ribs.  As I stated, I have asked everyone of these doctors for an MRI, and they always refuse saying it will not show anything.  I have learned to sit PERFECTLY STRAIGHT, to walk SUPER UPRIGHT, to sit EXTRA EXTRA SLOWLY, never lean forward in a chair, never sit back in a chair, sleep in an anti gravity chair with 6 pillows around me so I do not move, but still wake dozens of times every night.  My real life is gone and I do not like this one enough to stay like this.

Answer
Hello Bobbie,


Thank you for your comments/ further information.

"....I have a copy of the MRI from my fall in 2007, and it states T-12 to L-1, and noted small tears, disc bulge, etc. all in the 'L region'....", these disc tears, disc bulges can be the cause of your complaints; re-read the report, it may even say left sided bulge or left sided tear, which would correlate perfectly with your pain.


"....My insurance REQUIRES me to get referrals to go to a DC and the one they sent me to made adjustments 3x a week for two weeks, then 2x a week for 8 weeks and the pain never completely stopped, could never lay down.....",  there are many insurances that cover chiropractic without the need for referrals; for back pain, spine problems, disc problems- I admit I am biased towards the 'spine specialist'- the Doctor of Chiropractic; see if you can switch your health insurance coverage to include more freedom for yourself (less referral needed) and more Chiropractic coverage for your back complaints.  The visit schedule was a fair one, if you were compliant (went for the treatments); 8- 10 weeks of care should have decreased your pain markedly.

"....I sleep in a chair with rib cage wrapped, and that is the ONLY TIME I CAN TAKE A FULL BREATHE OF AIR....."- breathing problems?= you have to evaluate your heart and LUNGS as well as your chest wall- the ribs.  I am glad to hear you are having your chest evaluated -> "Now this Friday, I will have a CHEST CT SCAN focus on ribs....".

"My real life is gone and I do not like this one enough to stay like this....."- this is a troubling statement.  I know pain can lead to deep depression, which then becomes a problem in itself!  If you are feeling this down, I recommend you visit a Psychologist, Psychiatrist, Psychotherapist, perhaps a Certified Social Worker , , ,  someone to help you with the (understandable) emotional component of your problem.

Thank you for the further information.

Good Luck in returning to Good Health!!!

Your Staten Island Chiropractic Friend,

Dr. Victor Dolan, DC, DACBSP
Email newsletter: . . . .  http://drvictordolan.chiroweb.com