How JustAnswer Works:

  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.

Ask Dr. Tim, MD Your Own Question

Dr. Tim, MD
Dr. Tim, MD, Board Cert. OB/GYN
Category: OB GYN
Satisfied Customers: 868
Experience:  General OB/GYN, complicated obstetrics, complicated GYN
62949540
Type Your OB GYN Question Here...
Dr. Tim, MD is online now
A new question is answered every 9 seconds

I got PID from my normal vaginal flora. I have been under a

Resolved Question:

I got PID from my normal vaginal flora. I have been under a ton of stress and the bad bacteria wiped out the good bacteria and I had an IUD removed which made me scream because it literally felt like they were pulling my uterus out. I am still in pain and still having symptoms. I have been treated with doxycycline, now on flagly and one other antibiotic. This has been going on for two months now, the lower back and pelvic pain. The fact that the PID is unrelated to Std's seems to be making it harder for them to treat me. Am I always going to live in this horrible pain?
Submitted: 1 year ago.
Category: OB GYN
Expert:  Dr. Tim, MD replied 1 year ago.

Dr. Tim, MD :

Hello, I would be happy to help you today with your question.

Dr. Tim, MD :

Please give me several minutes to review your question.

Dr. Tim, MD :

How long was the IUD in place?

Customer:

A year and a month. I believe that my extreme stress level threw my good bacteria and bad bacteria off, and my immune system is down. I have lost ten lbs due to stress with nursing school. All Std tests were negative.

Dr. Tim, MD :

Please describe the IUD insertion itself. Was it painful?

Customer:

Yes, insertion was quite painful. I have had the IUD put in three times and all times painful. This last removal was the only time I even felt it come out.

Dr. Tim, MD :

Did any of the cultures performed come back positive for anything?
Why do they think you have PID exactly?

Customer:

No, the only things that grew out of the cultures were normal vaginal bacteria. I went to the ER with severe abdominal pain and back pain. The DR that examined me said that I had cervicitis. My cervix was inflamed with a mucopurulent discharge. He gave me a shot of Rocefin and a week's worth of doxycycline. I went to my Obgyn... Pain was subsiding, but not gone. I have pressure in my abdomen still etc. She gave me another week of doxycyline and left the IUD in at this point. I went on exercising and living my life and still in pain, so got the IUD out.

Dr. Tim, MD :

Have you ever had an ultrasound of your uterus?

Customer:

Yes.. Normal.. this has been very frustrating and painful

Dr. Tim, MD :

Okay, here is what I think - please give me several minutes to type:

Dr. Tim, MD :

1. An IUD insertion should never be painful - I have put in 100's of them and I would describe the experience of the patient as "minimal discomfort".
2. This makes me think that there was either something about the persons inserting the IUD (inexperience) or something about your uterus that makes insertion of the IUD difficult
3. Given the exam in the ER describing a mucopurulent discharge, obviously you have an infection
4. The infection is NOT related to stress or a suppressed immune system - it is simply related to a difficult IUD insertion and "draggin" of the normal vaginal bacteria into the cervix with the insertion itself
5. It is concerning that you have now had pain for 2 months with a poor resolution of your symptoms and a poor response to antibiotics

Dr. Tim, MD :

Do you have an OB/GYN currently?

Customer:

I do, but I also have had three IUD inserts and all of them painful. The IUD was in over a year. I believe that with my immune system being down, the normal bacteria turned pathogenic on me. I have talked to Dr's about this, but since my IUD was put in so long ago with absolutely no problem, I don't see that as being the cause. I know you are the Dr, but I do know a good deal about this and have spoken with quite a few Dr's. What would be the best type of antibiotics to cure a hard to treat infection caused by my own normal flora? Doxycycline didn't work, but I think my vigorous exercising didn't help either. No one told me to rest. :( I am seeing an Obgyn. She does not know why my probs persist and I am going for a second opinion next week.

Customer:

Ahhh.. My uterus does not lay the correct way.. Not sure if it's retrograde or not, but that could cause it to be a bit more painful/

Dr. Tim, MD :

Okay - I have some thoughts for you, but first - why exactly do you think that your immune system is 'down'?

Customer:

I'm in nursing school. I work fifty hours a week and have two kids. I had a panic attack and lost ten lbs in about three weeks so that I could keep my A's in school. I'm not eating right or getting enough sleep. Stress has thrown my body totally out of whack.

Dr. Tim, MD :

When exactly was the ER visit?

Customer:

I quit my job so that I only work on Saturdays now. ER visit was about 4 weeks ago. I think the IUD should have been taken out then. I am assuming only a laproscopy will lead me to the answer I need :/

Dr. Tim, MD :

Okay, here is my honest opinion - again, please give me a minute to type:

Dr. Tim, MD :

You are a 32 year old who had multiple prior difficult IUD insertions and an even more difficult IUD removal, who was seen in the ER and diagnosed with PID based on a cervical purulent discharge and pain. You have been diagnosed with PID that is NOT responding to antibiotics. I will state emphatically that even with the stress of two kids and a demanding job / school does NOT cause PID. You have PID because something went wrong with the IUD insertion itself. The IUD was NOT in the correct location and the infection is a real and dangerous issue in your case. Your doctors keep treating you but are not really addressing a potentially bigger problem. With as little as you have told me, you need:

1. A CT scan of the abdomen and pelvis to rule out a pelvic abscess
2. Probably a laparoscopy to look at the uterus and pelvis

PID that is not responding to antibiotics is often treated as an INPATIENT. I have been consulted on more than a few botched IUD insertions and in the interest of future fetility and pain problems, you need to get this sorted out as soon as possible!!

Dr. Tim, MD :

Does this answer your question?

Customer:

Are there any antibiotics that will help at this point? And yes, this is what I figured needed to happen.

Dr. Tim, MD :

Upon review of the antibiotics that you are on, in a patient such as yourself, a regimen of Augmentin and Flagyl would be appropriate while you wait to get this sorted out.

Dr. Tim, MD :

You should talk to your OB/GYN as soon as possible about a CT scan and possible surgery.

Customer:

Thank you...and I agree, now I just wish I could get an Ob/Gyn to listen to me about all of this. I am getting brushed away, because it is not a typical case, and I should be "cured." :(

Dr. Tim, MD :

I get so frustrated by hearing about OB/GYN's that do not listen and are not willing to take responsibility for problems that they might very well have been responsible for!! So frustrating. You have to be an advocate for yourself. It is no longer personal - it is about your health and remind them that YOU are the customer. We get paid well to take care of patients like you, but they must be willing to take care of the problems that arise too!! You probably need to find a new OB/GYN and keep pursuing this further. If you have to go to the ER to get attention, then so be it.

Dr. Tim, MD :

I really wish you the best of luck.

Dr. Tim, MD :

If you are satisfied, please provide a POSITIVE RATING. It has been a pleasure to help you with this question!!

Dr. Tim, MD, Board Cert. OB/GYN
Category: OB GYN
Satisfied Customers: 868
Experience: General OB/GYN, complicated obstetrics, complicated GYN
Dr. Tim, MD and other OB GYN Specialists are ready to help you

JustAnswer in the News:

 
 
 
Ask-a-doc Web sites: If you've got a quick question, you can try to get an answer from sites that say they have various specialists on hand to give quick answers... Justanswer.com.
JustAnswer.com...has seen a spike since October in legal questions from readers about layoffs, unemployment and severance.
Web sites like justanswer.com/legal
...leave nothing to chance.
Traffic on JustAnswer rose 14 percent...and had nearly 400,000 page views in 30 days...inquiries related to stress, high blood pressure, drinking and heart pain jumped 33 percent.
Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
I will tell you that...the things you have to go through to be an Expert are quite rigorous.
 
 
 

What Customers are Saying:

 
 
 
  • I feel so much better today, and upon further investigation believe that there is a chance that the responses I got saved me from a serious, even life threatening situation. I am very grateful to the experts who answered me. Susan O. USA
< Last | Next >
  • I feel so much better today, and upon further investigation believe that there is a chance that the responses I got saved me from a serious, even life threatening situation. I am very grateful to the experts who answered me. Susan O. USA
  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
  • I thank-you so much! It really helped to have this information and confirmation. We will watch her carefully and get her in for the examination and US right away if things do not improve. God bless you as well! Claudia Albuquerque, NM
  • Outstanding response time less than 6 minutes. Answered the question professionally and with a great deal of compassion. Kevin Beaverton, OR
  • Suggested diagnosis was what I hoped and will take this info to my doctor's appointment next week.
    I feel better already! Thank you.
    Elanor Tracy, CA
  • Thank you to the Physician who answered my question today. The answer was far more informative than what I got from the Physicians I saw in person for my problem. Julie Lockesburg, AR
  • You have been more help than you know. I seriously don't know what my sisters situation would be today if you had not gone above and beyond just answering my questions. John and Stefanie Tucson, AZ
 
 
 

Meet The Experts:

 
 
 
  • Dr. C.

    Board Certified

    Satisfied Customers:

    1618
    28 years of experience and an award-winning educator.
< Last | Next >
  • http://ww2.justanswer.com/uploads/DR/DrCollins/2013-11-3_1283_Cascade669.64x64.jpg Dr. C.'s Avatar

    Dr. C.

    Board Certified

    Satisfied Customers:

    1618
    28 years of experience and an award-winning educator.
  • http://ww2.justanswer.com/uploads/drhearne/2009-11-8_74742_monika_hearne2.jpg Monika Hearne, M.D.'s Avatar

    Monika Hearne, M.D.

    Board Certified OB/GYN

    Satisfied Customers:

    5745
    With experience and compassion, I treat my patients like family.
  • http://ww2.justanswer.com/uploads/jmcjrmd/2009-6-26_4212_Joepicture_Edited.jpg Dr. Charles's Avatar

    Dr. Charles

    OB/GYN (Doctor)

    Satisfied Customers:

    140
    Board Certified. Solo practice for 8 years; delivered more than 1300 infants and performed more than 800 surgeries.
  • http://ww2.justanswer.com/uploads/DR/DrK99/newpic2.64x64.jpg Dr. K.'s Avatar

    Dr. K.

    MD

    Satisfied Customers:

    1503
    Board certified OB/GYN with 20 years of experience.
  • http://ww2.justanswer.com/uploads/drprabirkumarda/2010-08-07_144928_Photo-0010_1.jpg DR PRABIR KUMAR DAS's Avatar

    DR PRABIR KUMAR DAS

    CONSULTANT GYNAECOLOGIST

    Satisfied Customers:

    1352
    MBBS(CAL)MD(G&O)
  • http://ww2.justanswer.com/uploads/jbbrowndoc/2009-09-29_180651_headshot.jpg Dr.JBB's Avatar

    Dr.JBB

    Board Certified OB/GYN

    Satisfied Customers:

    1293
    15 yrs experience in Women's Health, Pelvic reconstruction and Incontinence
  • http://ww2.justanswer.com/uploads/RP/Rpjtlawr/2012-9-5_16443_Robportraitadjusted.64x64.jpg Dr. Lawrence's Avatar

    Dr. Lawrence

    OB/GYN

    Satisfied Customers:

    442
    Board Certified OB/GYN and accomplished educator