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Ask Dr. R. Bora Your Own Question

Dr. R. Bora
Dr. R. Bora, Doctor
Category: Health
Satisfied Customers: 5227
Experience:  14 years experience in the emergency room.
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I am a Registered Massage Therapist in BC, Canada. So my anatomical

Customer Question

I am a Registered Massage Therapist in BC, Canada. So my anatomical knowledge is pretty sound. For the record, my GP is sloughing off any gravity to the pain I have been having.

History: pain began in thoracolumbar fascia august 2012 after raspberry picking 4 hours a day for a month. constant position was lateral flexion to right side, so all mm of left flank were in constant contraction to maintain position. trouble sleeping on left side due to deep ache in left flank. pain never subsided even after picking season ended.

Then, an ectopic pregnancy was found, jan 2013. methotrexate subCut administration (caught early), no surgery. post ectopic, left flank pain continued (not just in thoracolumb. fascia and lats anymore). Pain expanded to anterior abdomen, pain increased by lat flex to right, and making sleep on left side near impossible due to deep ache. relieved by sleeping on right. tender point in abdomen medial to rib 9 costal cartilege, just lateral to linea alba. hypertonic to touch.

now, the pain comes and goes, feels like im bloated. pain is fairly local to inferior to rib 9 (the tender point), and radiates to base of rib 10/11/12 and all along left flank. it likes to travel, sometimes giving rise to iliac fossa referral.

i have had all bloodwork come back normal, i have had a vaginal ultrasound x 2 and regular ultrasound x 3, and all have come back normal.

my gp seemed to think at first it was costochondritis, and now seems to think its scar tissue from the ectopic. but im not so sure... its not getting worse, but its not getting better. any ideas? sometimes the pain is pulsing, and it comes in waves. i have NOT had xray. i also have a duplicate ureter on left, as well as ureterocele. and from all ultrasounds, kidney appears fine and well functioning.

all issues in my body have been on my left. left duplicate ureter with ureterocele. left ectopic. left ovarian cysts (family history). im at a loss, and am wondering if i should demand an xray. my gp keeps downplaying it, but i KNOW something is up in there. any suggestions??
Submitted: 1 year ago.
Category: Health
Expert:  Dr. R. Bora replied 1 year ago.

Dr. R. Bora :

Hello and welcome, I am happy to help you today.

Dr. R. Bora :

Dr. Das is offline. I am DR. BORA. would you like to chat with me?

Dr. R. Bora :

Please enter chat to interact with me.

Dr. R. Bora :

hello?

Customer:

Hello

Dr. R. Bora :

Yeah, how severe is the pain on a scale of 1 to 10?

Dr. R. Bora :

Use the reply button.

Customer:

On a constant basis, it fluctuates. But during the day, it is at about a 3, which increases to a 5 sometimes after i eat a lot of food.

Dr. R. Bora :

Alright.

Customer:

During sleep, it goes away, but it wakes me up about 3 to 4 times a night.

Dr. R. Bora :

Have you undergone an IVU test ?

Customer:

repositioning helps, usually to the right side, or on flat back with a small pillow under left flank

Dr. R. Bora :

Have you undergone an IVU test ?

Customer:

is ivu an intravaginal ultrasound? if so, yes. twice.

Dr. R. Bora :

To check your kidney function?

Dr. R. Bora :

IVU is intravenous pyelography.

Dr. R. Bora :

Urography.

Dr. R. Bora :

Is there any positioning of the left kidney along with duplication of left ureter?

Customer:

No, i have not. I am unsure what would qualify my doctor to order that test. All urine tests have come back normal, so I suspect he would only order it if i had abnormal urine

Dr. R. Bora :

No, this test is done to check your kidney functioning as you have a congenital history of ureterocele and duplication.

Customer:

the left kidney has appeared to be a bit larger, but both the ultrasound tech and gp have never given it a second thought. its why i am stumped. no painful urination, no blood in urine. however, i have had two kidney infections in my life.

Dr. R. Bora :

Yeah, so kidney infection on your left, I assume.

Customer:

i am disappointed my gp has not requested this test. :( do you think I should request one?

Dr. R. Bora :

Yes, this is a very important test because an ultrasound does not check for kidney functioning .

Customer:

It is that it has persisted for many months now, and I understand that kidney infection can be quite acute, and does not fluctuate. renal calculi was my first thought, but again, I am not showing signs of fever or painful urination or blood in urine

Customer:

Alright. Can I receive this reccomendation from a walk in clinic doctor? I seem to have more success from them than my own gp.

Dr. R. Bora :

Renal calculi can be easily seen on an ultrasound.

Customer:

Thats what I thought, too.

Dr. R. Bora :

Yes, of course you can get that from a walk in clinic.

Dr. R. Bora :

If the IVU is normal, you can totally exclude kidney issues.

Dr. R. Bora :

One more possibility is colitis.

Customer:

Ok, so you believe this may have something to do with kidney function... I wondered about that. it is following the sclerotogenous referral pattern for kidney...

Dr. R. Bora :

Yes, I do agree with you.

Customer:

Colitis. Would this not be accompanied by blood in stool?

Dr. R. Bora :

No, not always.

Dr. R. Bora :

Colitis can cause loose stools and pain.

Customer:

I have noticed it increases if I eat too much.

Dr. R. Bora :

Yes, so a relation exists with your food habits.

Dr. R. Bora :

Did you get a stool culture.

Customer:

And it is directly between base of rib 12, iliac crest, and is most definitely more medial to midline.

Customer:

No stool culture yet. Will get on that, and the IVU promptly.

Customer:

Relation with food, yes, but not always. it is intermittent. its puzzling.

Dr. R. Bora :

Yeah, so in that area the descending and sigmoid colon are more likely to be inflamed.

Dr. R. Bora :

Do not b puzzled.

Customer:

...which could explain the palpable tenderpoint near midline close to rib 9

Dr. R. Bora :

So, two things for you to get done:1. IVU 2. Stool culture.

Dr. R. Bora :

The tenderness could be an inflamed part of the colon .

Customer:

I appreciate your input. Although this is not crippling on a daily basis, it is disconcerting and does affect my daily life. oh, i forgot to mention, it is aggravated with excercise.

Customer:

exercise that involves me side bending to right, holding in isometric contraction

Dr. R. Bora :

Ok. IBS is another close possibility with colitis,common in females.

Customer:

my mother has it, but i

Dr. R. Bora :

Yeah, I get that.

Customer:

i believe hers is a sensitivity to wheat and beef. she eats it anyways. silly woman

Customer:

okay, thank you very much.

Dr. R. Bora :

Make sure you take small meals and those which are palatable to your intestines.

Customer:

You are an american physician?

Customer:

Sounds good. I should likely cut out grains.

Dr. R. Bora :

No, I am Indian.You are welcome!

Customer:

?Wonderful! but i was meaning, you are from the US

Dr. R. Bora :

Yeah, cut out grains and make a list of those foods that aggravate your symptoms.

Customer:

Thank you so much for your input. I appreciate. it.

Dr. R. Bora :

No, I am from India.

Dr. R. Bora :

Pleasure is mine!

Customer:

Oh! thats where you are currently living?

Dr. R. Bora :

Yes.

Dr. R. Bora :


I hope my answer has helped you.


Please remember to rate my service positive once you have all the information you need. If you have any other questions, please ask me – I’ll be happy to respond. Thank you!

Customer:

Wow! Sure will, and thank you!

Dr. R. Bora :

Do not be stressed about your problem and I am sure you will be fine!

Dr. R. Bora, Doctor
Category: Health
Satisfied Customers: 5227
Experience: 14 years experience in the emergency room.
Dr. R. Bora and 3 other Health Specialists are ready to help you
Expert:  Dr. R. Bora replied 1 year ago.
Thanks Lindsay (nice name!)

if you have any new and follow up questions, please request me as DR. BORA in the opening statement.

Good luck!

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