Diagnose me (yes, I am going to a doctor) TMI alert

TMI alert, if describing normal female bodily functions grosses you out then please don't read and/or comment, as you have been warned about the contents of this post.

I started new birth control pills two months ago, loestrin Fe.  On Wednesday August 10th I got my period, as expected.  That same night I went to deliver some leftovers across the street to my mom when I suddenly felt a sharp pain in my lower back on the right side making it very difficult to walk.  I assumed it was a pulled muscle or a pinched nerve.  That Saturday I went to the chiropractor, she said it appeared to be my SI joint.  I was still in pain, but it seemed to be getting slowly better (emphasis on slowly) until the next Saturday, August 20th.  

Saturday night, the 20th, the pain got real bad, and spread to the front, I was almost in tears.  The pain would be best described as stronger than menstrual cramps, but slightly less painful than contractions.  

Sunday morning I woke up doubled over in pain in my left front hip area, to the point that I was actually worried that it might be my appendix (I have two separate relatives who actually had burst appendixes because they thought it was a pulled muscle and tried to tough it out).  I went to urgent care.  They gave me a shot of morphine which dulled the pain, but I was still very uncomfortable.  They ran a pregnancy test, negative.  The doctor almost immediately ruled out appendicitis, he thought it was a kidney stone, which I felt it was too low to be (I had kidney stones years ago).  They sent me for a CT which came back as no appendicitis, no kidney stone, and no diverticulitis.  The doctor decided that it is a pulled muscle and gives me naprosen and flexeril, but they barely make a dent in the pain.  At this point I am in so much pain that I am taking my husband's tramadol (I know, bad me taking someone else's meds, but I seriously cannot deal with this pain), the tramadol barely helps and mostly just puts me to sleep.  The pain isn't constant, it comes and goes, but never goes away 100%, and when it comes back it is unbearable, I am almost in tears and can do nothing other than lay in bed with a heating pad.  

Then yesterday I started spotting.  This may be totally unrelated to the pain, and I was told that it was common for the first three months of being on the pill, but then again it might mean something.  At this point I realized that the doc said the CT ruled out kidney stones, appendicitis, and diverticulitis.  He never mentioned my ovaries.  They're probably fine, but just because he didn't mention them doesn't prove that they're fine.

I'm calling my midwives in the morning (I see them instead of a Gyn) but if they come up empty I'll call my regular doc, though I'm starting to get disheartened that I am in such severe pain with (so far) no real relief or answers other than "pulled muscle."  I've had pulled muscles before, I even dislocated a rib once, and it never felt like this.

Any insights into this?  Anyone experience something similar?

You should be going to an emergency room. Do not delay. Go now.

Since you mentioned ovaries, could it be an ectopic pregnancy?

Symptoms of an Ectopic Pregnancy

Light vaginal bleeding
Nausea and vomiting with pain
Lower abdominal pain
Sharp abdominal cramps
Pain on one side of your body
Dizziness or weakness
Pain in your shoulder, neck, or rectum

shoshannah said:

You should be going to an emergency room. Do not delay. Go now.

I went to urgent care, they said it was a pulled muscle, and that the CT scan showed nothing wrong.

kthnry said:

Since you mentioned ovaries, could it be an ectopic pregnancy?

Symptoms of an Ectopic Pregnancy

Light vaginal bleeding
Nausea and vomiting with pain
Lower abdominal pain
Sharp abdominal cramps
Pain on one side of your body
Dizziness or weakness
Pain in your shoulder, neck, or rectum

They did a pregnancy test at urgent care before allowing me anywhere near the CT scanner.

I have been getting something very similar much more frequently lately around ovulation- consistent with your report of it coming about 10 days into your cycle.  It could be something gut-wrenchingly painfully but harmless- Mittelschmerz. I get it so bad (complete with naseau and vomiting) that I am lying on the floor of the bathroom crying a few hours every few cycles. It subsides usually after a few hours and then goes away mostly for a month or longer.

Another option is a cyst forming or leaving/braking up- BC pills are supposed to have an impact of breaking up those fibroid cysts (again harmless and not something you need to rush to the emergency room for).

For a ruptured cyst or an ecoptic pregnancy I would guess the pain would not subside.

But I'd agree that if its been going on that long, that severe, you need to get back to a doctor and probably have a pelvic and transvaginal ultrasound asap.

Does age contribute to the likelihood of fibroids or ovarian cysts?  I'm 43, so gynecologically speaking I am "up there" in years.

you can start by calling the pharmacy and ask if they know if that is a possible side effect...if you can't confirm its the pill, if you can't make an emergency call to your midwife, then I would go to the ER

it could be possible that you dropped a pill when you went to take it and didn't even realize it, and that could cause spotting..but not the extreme pain

conandrob240 said:

I have been getting something very similar much more frequently lately around ovulation- consistent with your report of it coming about 10 days into your cycle.  It could be something gut-wrenchingly painfully but harmless- Mittelschmerz. 

She's on bc pills. She doesn't ovulate.

An urgent care center doesn't do the same type of work-up as an ER. Does this sound like a pulled muscle to you? 

Could be ovarian torsion.

According to the Loestrin website:

"What are the possible side effects of Lo Loestrin Fe?The most common side effects reported by women taking Lo Loestrin Fe in a study were nausea/vomiting, headache, spotting or bleeding between menstrual periods, painful menstruation, weight change, breast tenderness, acne, abdominal pain, anxiety, and depression."

I really don't feel this is an ER situation.  While I am in pain, it isn't as bad as it was Sunday morning when I did feel the need to go see the urgent care people.  Major things were ruled out (appendicitis, diverticulitis, kidney stones).  I'm not confident in the "pulled muscle" diagnosis, but the pain right now isn't acute enough to warrant an ER visit.

I'm basically looking for experiences from others so if I hear "it's a pulled muscle" again I can ask "could you please rule XYZ out first before deciding on the pulled muscle diagnosis."

shoshannah said:

Could be ovarian torsion.

Wouldn't that have shown up on the CT scan?  I will call the urgent care people in the AM and ask that they forward the report to the midwives, but I don't know what does and does not show up on a scan.

Urgent care is good for minor things not the sort of "mystery" pain you describe. They are limited by their experience and equipment as to what they can do.  Do yourself a favor and get to the ER to get thoroughly checked out.  A pulled muscle can be very painful and immobilizing but it is also quite possible that this is something far more serious.  Don't guess.  Don't self medicate. Get yourself the help you need now. You feel much better physically and emotionally once you do.

joan_crystal said:

Urgent care is good for minor things not the sort of "mystery" pain you describe. They are limited by their experience and equipment as to what they can do.  Do yourself a favor and get to the ER to get thoroughly checked out.  A pulled muscle can be very painful and immobilizing but it is also quite possible that this is something far more serious.  Don't guess.  Don't self medicate. Get yourself the help you need now. You feel much better physically and emotionally once you do.

I agree with this.  Alternatively, get an urgent appointment with your primary care doc.

joan_crystal said:

Urgent care is good for minor things not the sort of "mystery" pain you describe. They are limited by their experience and equipment as to what they can do.  Do yourself a favor and get to the ER to get thoroughly checked out.  A pulled muscle can be very painful and immobilizing but it is also quite possible that this is something far more serious.  Don't guess.  Don't self medicate. Get yourself the help you need now. You feel much better physically and emotionally once you do.

I agree with this.  Alternatively, get an urgent appointment with your primary care doc.

joan_crystal said:

Urgent care is good for minor things not the sort of "mystery" pain you describe. They are limited by their experience and equipment as to what they can do.  Do yourself a favor and get to the ER to get thoroughly checked out.  A pulled muscle can be very painful and immobilizing but it is also quite possible that this is something far more serious.  Don't guess.  Don't self medicate. Get yourself the help you need now. You feel much better physically and emotionally once you do.

I agree with this.  Alternatively, get an urgent appointment with your primary care doc.

Ovarian cyst...might have burst..get thee to an er or gyn asap.

I agree with those that say go to the ER.  Urgent care can be great but not for everything.  You need to find out just what is going on.  It can be many things and you need to find out before something gets worse.  Talk to your midwives if you must but go the ER.   

Strangulated Fallopian tube? At any rate agree, go to ER.

busted ovarian cyst. 

I agree it doesn't sound like a pulled muscle at all. As for CT scan, over all the years I've had cysts and other issues, they've never used that. It's always been Ultrasound with an occasional MRI. And I don't think it sounds ER worthy either. But get into your OBGYN as soon as possible.

You can still get ovarian cysts while on the pill. This is no pulled muscle.

Ovarian cysts can cause pretty severe pain, nausea, dizziness. Going to ob/gyn is a good idea. If it's a cyst, it will probably be better soon although sometimes they need to be removed.

I have found heating pad and big doses of Advil to help. I've actually had to take 4 Advil a few times for the pain. I'm not suggesting you take that many, although it is safe. Try 2 or 3 perhaps with heat.

I had full pelvic xrays after a very similar episode and a number of negative pregnancy tests.  

5 weeks later the pregnancy tests told a different story.  I was pregnant with child #3.

You should have an ultrasound and full pelvic exam.  

kmk said:

I had full pelvic xrays after a very similar episode and a number of negative pregnancy tests.  

5 weeks later the pregnancy tests told a different story.  I was pregnant with child #3.

Hmm, maybe this before taking big doses of Advil

"Saturday night, the 20th, the pain got real bad, and spread to the front, I was almost in tears."

this indicates it is ER worthy if you can't get in touch with your midwife...there are conditions where the pain subsides as it worsens (after something bursts)...causing poison to leak throughout the body.

jmitw said:

"Saturday night, the 20th, the pain got real bad, and spread to the front, I was almost in tears."



this indicates it is ER worthy if you can't get in touch with your midwife...there are conditions where the pain subsides as it worsens (after something bursts)...causing poison to leak throughout the body.

Yup. A burst appendix will be less painful than an inflamed appendix. A negative CT scan does not necessarily rule out appendicitis. There are limitations to these tests.

I'm also thinking ovarian torsion. Pain that takes your breath away bad. The is ER visit, stat. Don't leave until they figure it out!

If it was ectopic pregnancy the test would be positive. They should recheck.

I'm not diagnosing just commiserating. What we go through! I hope you get answers and practical solutions soon. There's almost no pain like it.

(Sounds like my historic ovarian cysts, complicated with a little twisting Fallopian tube, possibly some endo or a fibroid... Which is why they've finally decided that for me, age 60 is enough and in a few weeks they'll ablate. ("Well, you don't need it any more do you??") I'm not sure that'll stop the pain, I still think it's endo external to the uterus. )

Ruptured ovarian cyst or ovarian torsion. That they even suggested a pulled muscle is appalling. Go to the ER, please.

I agree you need an extensive diagnosis. You need to rule out all kinds of things, even cancer.