Susan … 3 months out of work.
Susan’s pain started with a stabbing sensation in the upper left abdominal quadrant, usually 15-30 minutes after she would start eating - not when the meal was over. It happened at every meal for 3 weeks, after which the pain became constant. She went to urgent care where they did a gastric cocktail test (which made the pain much worse), blood work, urine test, and a CT scan. The doctors happened to find an ovarian cyst and a lesion on her liver.
The urgent care doctor sent her to her GP -> her GP wasn't sure what was going on -> she referred her to a gastroenterologist. In the meantime, she tried to go back to work but unfortunately, that made the pain worse. She ended up at the ER because the pain was so bad she had trouble breathing. They did some blood and urine tests; they gave her IV morphine, Zofran, and Pepcid. The morphine didn't help, so they tired Dilaudid. It helped with the pain, but made her really nauseous.
The GI doctor thought an endoscopy would be a good idea. Unfortunately, however, the procedure didn't reveal a cause for the pain. Susan was given two options: long term pain control or exploratory surgery. Neither of these were acceptable options so she returned to talk with her GP. He prescribed both an MRI and an ultrasound to check the ovarian cyst but no new information was revealed. Susan found another gastroenterologist who ordered a gastric emptying study, which also came back normal. He then recommended that she at least meet with the general surgeon to see if he had a new perspective and fresh ideas. Unfortunately, the surgeon only suggested surgery.
By the time Susan contacted us, she had been unable to work for almost 3 months. In response to her email, Dr. Hausman-Cohen called her and did further inquiry of her symptoms. Doctor Hausman-Cohen felt that the pain was acting like mesenteric ischemia. That meant that there was not enough blood flow to the vessels that support the intestines and stomach. This would explain why eating made her symptoms worse as digestion takes a lot of work. Normally this condition is seen in older individuals at risk for heart disease. And while Susan did have a family history of heart disease, given her age and health history, Dr. Hausman-Cohen really did not feel this was a likely cause.
They discussed the possibility of an impingement; something catching the blood vessel and causing the pain. Rather than going for exploratory surgery as a first measure, Dr. Hausman-Cohen thought it was worth having Susan work with a well trained and experienced therapist for visceral manipulation and told Susan how to find someone certified in her area. She also gave her the option of coming to Austin where her associate, Carol Bilich would be happy to see her. Susan visited with a visceral therapist in her area but expressed that she did not really get much benefit. She decided to come to Austin to work with Dr. Hausman-Cohen and with Carol. Dr. Hausman-Cohen conducted a full exam and determined that food sensitivity testing might also be of value as it might help reduce her pain levels as well.
Upon Susan’s first visit with Carol, Carol was able to determine that her omentum (the lining of the gut that has the mesenteric arteries in it) was caught under her ribcage. She surmised that it likely happened while Susan, a veterinarian technician, was bending over and holding large dogs at work. Carol was able to release the caught tissue. On her way out Susan reported she was already 70% improved. Before her visit she was unable to bend forward more than 15 degrees without pain. Immediately afterward, she actually spent some time gathering fallen pecans from the yard around Carol’s home studio! She was ecstatic. Carol saw Susan twice more and the following week she flew back to her home and got back to work. No further expensive testing or surgeries were needed.
There are often structural components that Dr. Hausman-Cohen’s examination can point to that require the hands-on skills of a versatile, well trained, integrative therapist. Together, Dr. Hausman-Cohen and Carol Bilich work to solve the complex issues of their patients.