Thank you very much for the additional information. It is helpful and appreciated. I apologise for my delay in responding today, I just got off work very late but wanted to check on any responses here at JustAnswer.com before retiring.
The discomfort under the shoulder blade does not sound typical of cardiac pain, although I am glad they did a CT of the chest because constant pain like that does worry me for aortic problems. I wonder if the CT images reached down to the level of the kidneys at all? The hematuria is difficult to assess over the discussion here, because it requires all the technical terminology, other labs, imaging, and physical examination findings in order to diagnose ... sometimes even more invasive studies such as ultrasound or CT guided biopsy are needed.
The other pain, the one that radiated around and under the rib area, also sounds atypical for cardiac pain, but again is very hard to discern through discussion here. Cardiac pain in women is sometimes very atypical, and causes many physicians to write it off as something else. Although you work out three times weekly, it would be reasonable to have a stress test evaluation to evaluate your exertional tolerance and stress EKG. The same process that causes atherosclerosis in the aorta takes place in the coronary arteries, cerebral arteries, and other major arteries throughout the body.
Some questions to address with your physician:
Could it be pain from chest or abdominal adhesions following your surgery (possible)? Could it be related to the hematuria (quite possible, kidney stones?)? If it was right-sided, could it be gallbladder or gallstones (possible, plus this pain often radiates to the back and/or shoulder ridges)? Did your physician do liver function labs? Did your labs include tests for inflammation of the pancreas (which can radiate toward the back and between the shoulder blades)?
These are just some of the immediate thoughts going through my mind as I read your additional information in the context of your initial information. There is a lot of ground to cover here. I would prioritise things as such to evaluate the hematuria promptly and to make sure your heart is healthy and able to well-withstand a stress EKG study. Along the same timeline, I belive that the other issues raised in the questions above could be evaluated if they have not already been completed.
Evaluate the hematuria - more tests
Evaluate your heart under stress - Treadmill stress EKG
Discuss the role of medications like statins for atherosclerotic plaque stabilisation (and cholesterol regulation) depending on the exact findings of the CT scan, treadmill stress test, and blood lipids.
Evaluate the pain under the front rib area ... related to hematuria, gallstones, liver problems, pancreas, adhesions, etc.?
That would be my work-flow in your scenario. Most of this is just me typing out loud, but I do want you to be aware of what crosses my mind as I think about all of these issues. I am a little overprotective of all of you, my little flock of Internet information seekers, but I am proud of you for having excellent insight and seeking information in order to be an informed patient. While I am not privy to all the information that your physician is, this information may help you to ask the right questions and to address your concerns clearly and concisely to your doc.
In the end, all I hope for is that I have helped you in some way, shape, or form. I wish you well. I would greatly appreciate updates and progress notes on how you are doing and what you are finding out. You can pop in here and drop me a note any time. I am at your service!
XXXXX XXXXX, MD