Is it liver failure, or is it a pulled muscle?
October 27, 2010 6:25 PM   Subscribe

I'm trying to figure out whether there's any possibility the pain in my right side is something dangerous, or whether it's likely a pulled muscle in my rib cage.

I have this terrible pain on the right side of my abdomen. Excruciating pain. The pain is worse when I inhale. I think it's a pulled muscle in my rib cage. I've had bloodwork recently, and everything was fine with my liver function. My eyes and skin are not yellow.

For about three months I have been taking medicine which contains acetaminophen. The maximum acetaminophen I take a day is 1500 mg. I've never been a big drinker, but I've had zero alcohol intake since I've been taking the acetaminophen.

My husband wants me to call the doctor. My doctor is big on testing everything, just to make sure. I don't want the hassle of the doctor visit and testing, unless there's a non-remote chance this is something dangerous. I have a regular appointment scheduled next week. I am comfortable waiting and seeing whether this gets better. But I don't want to die.

So, in your non expert experience with livers or with pulled muscles, should I call the doctor, or should I wait it out?
posted by faustessa to Health & Fitness (23 answers total)
TINMA. It could be neither liver failure nor a pulled muscle. It could be both. Pain on the right side of the abdomen could be anything from gallstones to pancreatitis to a range of maladies both horrifying and benign.

Call your doctor. If the pain is excruciating, I'd be considering the ER, personally.
posted by jingzuo at 6:32 PM on October 27, 2010

I think I meant either horrifying or benign. And since you asked for our non expert experience, I also wanted to mention that I had what sounds like (from your description) a similar pain. It was gallstones.
posted by jingzuo at 6:34 PM on October 27, 2010

The excruciating pain in my right abdomen was appendicitis. I'm just saying. Page your doc if that's possible, otherwise please go straight to the ER.
posted by BlahLaLa at 6:34 PM on October 27, 2010 [1 favorite]

If the pain is really bad, why not go to the ER? It sounds like it hurts even to breathe. Even if it ends up being nothing serious, that cannot be fun. I second ER.
posted by HabeasCorpus at 6:36 PM on October 27, 2010

This is ER-level stuff. You don't want to risk a ruptured appendix.
posted by PhoBWanKenobi at 6:40 PM on October 27, 2010

could be a pulled diaphragm. i've had those a few times. does it hurt if you don't move it? if it does. i second those above about gallstones and whatnot. but it it only hurts when you're breathing, especially deep breaths, it might be just your diaphragm.

not a doctor, just someone that's hurt sometimes.
posted by lester's sock puppet at 6:43 PM on October 27, 2010 [1 favorite]

The pain is not noticeable if I am still, or if I don't breathe. It's not localized to one spot; I feel it across my right ribs, sort of on the inside of the ribs if that makes sense. It is stronger on the back of the ribcage than the front. It's not tender to the touch at all.

I may have been practicing hyperbole when I said it was excruciating. It does hurt a lot, but to me this is in the pain ballpark of call the doctor during regular hours versus not call at all, rather than the ER ballpark. I'm not trying to be a tough guy about this; I'm just sorry that I was a little cavalier when writing my question, and it sounded a little more alarmist than I meant it to.
posted by faustessa at 6:57 PM on October 27, 2010

Last year, I had a bout of stomach problems that left my stomach tender on one side for days. It didn't hurt unless I touched it, but bad enough that after a few days, I went to an emergent care center.

The doctor examined me and said that in good conscience (and legal practice), he was obligated to recommend that I go straight to the ER to get a CT scan, on the chance that it was my appendix. Seriously, this isn't something to mess around with. You can't not breathe.
posted by PhoBWanKenobi at 7:01 PM on October 27, 2010

The pain is not noticeable if I am still, or if I don't breathe.

Unfortunately not breathing is not really an option, you know? Does your insurance have a nurse line you could call? They have always been very helpful in my experience, when you need help deciding how urgently to see a doctor.

Have you done anything strenuous lately that would make you think you could have pulled a muscle? Pain more towards the back makes me wonder if it mightn't be a kidney issue, but honestly random abdominal/thoracic pain that doesn't go away is usually a good reason to go to the doctor. If you can't remember injuring yourself, it seems likely that the cause is internal, which could be minor or serious. Only the docs can find out.

Incidentally, the maximum acceptable daily dose of acetaminophen is 4000 mg, and although the FDA is planning to lower that amount, it doesn't sound like you're really taking enough to cause sudden liver damage.
posted by vytae at 7:15 PM on October 27, 2010

I am not a proponent of recommending people to go to the ER in a random online forum. However, if you are in "excruciating" pain that you cannot control at home, and doesn't go away in a short amount of time, and you cannot identify why, you probably should go get checked out.
posted by ruwan at 8:13 PM on October 27, 2010

The pain is not noticeable if I am still, or if I don't breathe.

This sounds a lot like a broken or separated rib. Which can snap under the stress of surprisingly common events, like a huge sneeze, violent coughing, or diving for a basketball. That said, why not got to the doctor?
posted by centerweight at 8:13 PM on October 27, 2010

So two data points: I've been in the beginning stages of liver failure from high, prolonged doses of antibiotics and it does not hurt. It's horrifyingly awful--you are ill beyond your wildest dreams--but for me it wasn't painful.

Secondly, I once had excruciating pain in my right side that turned out to be an ovarian torsion. My fallopian tube had twisted and it required emergency surgery. Yes, it's dangerous.

I know it's a giant hassle to get things checked out but I would really, really recommend that you go to the doctor. Like, tonight. At the very least, call a nurse line and explain what's going on.
posted by corey flood at 9:15 PM on October 27, 2010

I was just at the doctor today, and he poked me in a particular spot right underneath my ribs on the front-right side to ask if it hurt, and identified that it was my gall bladder that was hurting, and that I should probably get some tests done. If you also happen to feel some pain between your shoulder blades and sort of over to the right in that area, it could be gall bladder-related.
posted by so_gracefully at 9:52 PM on October 27, 2010

Thanks everybody. Will go to doctor if it's not better first thing.
posted by faustessa at 10:50 PM on October 27, 2010

I've had this before, where I can't breathe because it causes pain on my right side. It usually goes away in no more than a few hours for me. The first time this happened, I was at Sea World when I was a kid. I remember staring at the "a white shark can smell you from here" sign. And then I'd muster up the ability to go a bit farther, and then "a white shark can [sense]" you, and so forth. Occasionally (once or twice a year?) it comes back, and it never lasts for very long. I just assumed it was a different variety of asthma attack. I plan to look into lester's sock puppet's idea of pulled diaphragms.
posted by aniola at 10:51 PM on October 27, 2010

I'm a first aider, I can't do first aid over the Internet, and I find your question very upsetting.

I have no idea what could be causing your "excruciating" pain, but if you're in that much pain, of course you should seek medical advice. And "first thing" when? If it is your appendix (for example), how do you know you'll still be capable of dialling 911 by the time "first thing" rolls around?

Please, please seek urgent medical help. Please don't ask us because we have no possible way of helping you, and the idea that we can help you is only going to make your situation worse.
posted by tel3path at 1:48 AM on October 28, 2010 [1 favorite]

That sounds like when I dislocated a rib. The doctor snapped it back into place (which actually didn't hurt at all). I spent the next few days on Vicodin.
posted by Green Eyed Monster at 2:27 AM on October 28, 2010

It might be gallstones, this sounds exactly like the kind of pain I had. But I only got the pain some time after eating. I wouldn't have called it excrutiating, but it was quite unpleasant. Deep breaths made it worse. I was undiagnosed for about 5 years until a specialist picked it up right away.

See your doctor. Best of luck, and let us know what s/he says.
posted by humpy at 2:41 AM on October 28, 2010

Oh good lord. No one but a doctor examining you in person is able to guess what you have. To give you perspective on how urgent this might be, if you walk into an ER and sign in with the symptoms "chest pain that hurts when I breathe" you'll be seen by a doctor in SECONDS. If you have insurance, I can't think of a sensible reason why you're not at the ER right now.
posted by ImproviseOrDie at 4:48 AM on October 28, 2010

Stomach ulcer?
posted by MeiraV at 6:04 AM on October 28, 2010

Only imaging (MRI/ultrasound/whatever) can reveal what the problem is.

GO TO A DOCTOR NOW. And, don't ever fear "being a hassle" when YOUR LIFE COULD BE IN DANGER.

I hope it's nothing. But find out ASAFP at an emergency room!!!
posted by Citrus at 10:18 AM on October 28, 2010

It was a pulled muscle.
posted by faustessa at 3:38 PM on October 28, 2010

Thank God, faustessa! Thanks for checking back in, you really scared me.
posted by tel3path at 3:51 AM on October 29, 2010

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