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Anthony Bray, MD
Anthony Bray, MD, Doctor
Category: Health
Satisfied Customers: 10341
Experience:  14 years as clinician in the field of Family Practice
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I also have an IVC filter that was inserted almost 5 years

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I also have an IVC filter that was inserted almost 5 years ago when I failed anticoag therapy following an episode of pulmonary thromboses in both lungs with no cause found. For the last year, I have experienced intermittent pain on my right side, just under the rib cage, sometimes quite acute, but most often a dull ache about a 7 on a scale of 1 - 10. The pain is getting worse and more diffused. The pain is sometimes more towards the right side of my back, but most often it feels like a stomach or abdominal pain. Could my filter have migrated and/or perferated, and would this be causing my symptoms? I have had an ultrasound to rule out gallbladder issues, and a pelvic ultrasound to rule out ovarian issues and both were normal. W
Anthony Bray MD : Hello!


Anthony Bray MD : neurosurg was not available at this time--- I will be happy to try and help you -- if you wish me to opt out and leave question for your doctor of choice to perhaps pick up later then let me know and I will opt out of the question ....

I think only a vascular surgeon might be more helpful, but I'm interested in what you think.

Anthony Bray MD : The pain on the right upper quadrant sounds more potentially suspicious for liver inflammation,
Anthony Bray MD : this type pain may also be right upper quadrant and radiate to back....
Anthony Bray MD : so checking your liver enzymes should be a part of your work up I think...

would it be this uncomfortable? I can certainly request that. Not urgent, as in I can wait until tomorrow?

Anthony Bray MD : The IVC filter may be if potential concern( hopefully the pain is not related to this) an abdominal CT may be helpful in determining the cause....
Anthony Bray MD : The stomach or duodenum with gastritis or ulcer disease is another possible cause of pain in this distribution ... If due to ulcers or related process then certain foods may aggravate the pain>> orange juice, alcoholic drinks, anti- inflammatory MEDS >> these may be aggravating factors if you had gastritis or ulcers as the cause ...

unlikely. Not taking any meds, no juice or alcohol. The pain doesn't seem to change with food or activity.

Anthony Bray MD : Yes I think it may wait until tomorrow but let's clarify the pain--- on my scale I advise people that a 6/10 is so bad that you can't sleep due to it .... A 10/10 being so bad as to compare to being dragged being an 18 wheeler!!
Anthony Bray MD : If your pain is greater than a six on this scale then you may need to be seen at ER ...
Anthony Bray MD : In other words very severe abdominal pain itself may be considered emergent>>>

Very descriptive. Maybe I'm a 5...I can sleep with it if I'm really tired. It's been at this level several times in the last 8 - 10 months. Having had the pulmonary emboli, my pain scale is a little different than some. I tolerate it pretty well, but it's been particularly bothersome today.

Anthony Bray MD : As the pain has no apparent change with eating then this would raise concern as the cause may be liver related>> or possibly related to IVC>> although this would not be common but I can 't say impossible either>> you raise a legit concern....
Anthony Bray MD : Gall bladder problems or pancreatitis would be expected to be worse after fatty meal >>>

Some days I only notice it when I move a certain way, or if I really focus on it. Others, like today, it's been uncomfortable all day long.

Anthony Bray MD : If ulcer related or gastritis then Mylanta may help in relieving it...

Just not sure what the symptoms are for a "relocated" filter, and since the pain comes and goes, I haven't wanted to bother with the ER.

Anthony Bray MD : Ok ---I see--as your pain has been present over time then I think it OK to check on this tomorrow... Try to see your doctor for further evaluation....
Anthony Bray MD : Checking the blood for the liver enzymes, bilirubin, pancreas enzymes and H. Pylori ( common cause of ulcers) would be helpful tests for you I think....

ok, I'll check with her again, and give her this info. Thanks for the chat.

Anthony Bray MD : Also helpful to have CBC with differential ( complete blood count with breakdown of the white cell subtypes) inflammatory markers
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