Another do I have to go to the ER question.

January 5, 2023 6:11 PM

I’m having pretty severe abdominal pain. I have a PCP appt at 8 am tomorrow. Help me figure out if it’s safe to wait til then? YANMD etc.

About a month ago, I went dancing. The next day I had a painful “stitch in my side” sensation on my left side at my waist. Went away after 24 hours, so I figured it was related to the exertion. Happened maybe twice more after dancing in December. Not sure if it’s related or not. Tuesday night I had lower abdominal pain, think gas pain or period cramps, plus that painful sensation you get at your anus when gas is building up pressure but can’t escape because constipation. I figured that was the problem, spent a tough night, pooped in the morning, and felt somewhat better Wednesday during the day. Wednesday night the pain returned, more intense. Couldn’t sleep because belly pain waking me up. Pain Continued all day today, and the pain is pretty intense. I’ve had unmedicated labor, this is on par. 6-8/10. Pain is somewhat concentrated on the left side at my waist and radiates across my lower abdomen. My cervix also feels uncomfortable. Poops are happening and appear normal; pooping doesn’t relieve pain. Urine is happening and is clear and not painful. No vomiting.

This evening now I have a low fever (99.9 f). I’m 50, female reproductive parts, regular period and no particular signs of menopause yet. LMP was on Christmas. Can’t be pregnant. Negative covid antigen test. Strong family history of ovarian cancer, hope this ain’t that!

So: what could this be? And, can it wait for medical care until morning? Opinions wanted; I know you’re not doctors and not mine.

posted by shadygrove to Health & Fitness (25 answers total)

Best answer: I have no idea what it could be, but it sounds incredibly painful, and they will be able to address the pain at the emergency room in addition to providing imaging. All things being equal I would go, myself. You poor person!
posted by chesty_a_arthur at 6:16 PM on January 5, 2023 [9 favorites]

If this was me, I would go to ER. As chesty says above, you will get the pain management plus testing and imaging available in one place. You wait for the regular doctors appointment tomorrow you’re gonna have to wait for any follow up testing or imaging somewhere else.
posted by gryphonlover at 6:21 PM on January 5, 2023 [3 favorites]

I would go to the ER. Be safe and advocate for yourself! You deserve to not be in pain and find out what is going on. Go!
posted by VyanSelei at 6:32 PM on January 5, 2023 [1 favorite]

As a person who has had (separately) an appendectomy, kidney stones, and diverticulitis, I say go now. Your PCP is absolutely going to want imaging of your abdomen, and that's gonna take time to arrange. Going to the ER now means you'll be able to access it more quickly.
posted by BlahLaLa at 6:33 PM on January 5, 2023 [17 favorites]

Best answer: Had a friend with a partial ovarian torsion that presented that way, and our online crew managed to talk her into the ER. It was in fact a medical emergency and it was a very, very good thing she went.
posted by restless_nomad at 6:41 PM on January 5, 2023 [13 favorites]

Just chiming in to say go to the ER.

And if "can't be pregnant" means anything other than "I haven't had sex with an anotomically male person on the past 9 months" then however unlikely it may be, consider the possibility. (Sorry, but this sounds like every episode of "I didn't know I was pregnant" I've ever seen.).
posted by If only I had a penguin... at 6:52 PM on January 5, 2023 [1 favorite]

If your PCP doesn't carry at the very minimum an ultrasound machine just go to the ER. Severe pain in the abdomen could a myriad of things and even if it's not an emergency emergency you aren't going to know until you get the tests, and then you can bring that to your PCP to figure out next steps.

Your PCP may very likely send you to the ER if you wait. Just go.
posted by AlexiaSky at 6:59 PM on January 5, 2023

Especially with a fever. Go to the ER.
posted by AlexiaSky at 7:00 PM on January 5, 2023 [6 favorites]

Best answer: Go to the ER. While it sounds like there might be something going on with your reproductive system because of the cervix pain, my first thought it -- could be appendicitis. You are probably thinking -- but it's not on the right! When I had a ruptured appendix that was not diagnosed properly (I did go to the ER with pain that was also on par with unmedicated childbirth), I learned a lot about appendicitis, including that something like half the people don't have the typical "rebound pain" symptom because it's further back in the body, but also that you can have chronic appendicitis that can come to a head months or years later, or that you can have left-sided presentation because some people have it on the left. So I would not rule that out, especially with a fever.
posted by virve at 7:05 PM on January 5, 2023 [7 favorites]

I hope you've already gone to the ER. Abdominal pain + fever = ER. Appendicitis? Acute gallbladder? Stones? Ovarian cyst? You need a good exam, labs and scans. It is a good sign that you are having normal poops - far less likely to be an intestinal obstruction. Clear and painless urine suggests your kidneys/bladder are probably not the culprit. Sending you internet support in that special MeFi dialect. Good luck!
posted by citygirl at 7:07 PM on January 5, 2023 [4 favorites]

If you can still drive, carpe roadem.
posted by amtho at 7:28 PM on January 5, 2023 [2 favorites]

Go to the ER, but take a good mask.
posted by praemunire at 7:29 PM on January 5, 2023 [2 favorites]

Please keep us updated! Hoping you can find out the issue and have the pain lessened.
posted by computech_apolloniajames at 7:53 PM on January 5, 2023 [7 favorites]

I've had pain like that, and when I went to Urgent Care? It turned out that my gallbladder was overfull with rocks, inflamed, and was - to quote the UC doc -"very angry".

It got taken out quickly after that. If I would have waited, it could have been a lot more disasterous.

My advice: Get thee to an ER, or a 24 hour Urgent Care with imaging equipment.
posted by spinifex23 at 8:19 PM on January 5, 2023 [6 favorites]

Go to the ER. Any pain on par with labor is ER pain.

I once had extremely intense abdominal pain, but insisted on not going to the ER. I could just see the regular doctor tomorrow, right? Well, I was forced to go the ER by the people I was with, and thank god, because it turned out to be an emergent situation requiring surgery. I will never again be flippant about serious pain.

Keep in mind, it is NOT normal to experience extreme pain. That may sound stupid, but since you have a cervix, I imagine you were socialized as female, and people with that socialization often downplay pain, or rationalize that "everyone feels this way sometimes." Not true. Your level of pain demands the ER, especially in combination with elevated temperature. The temp could be unrelated, but it's not worth playing around with any of this.
posted by desert outpost at 8:32 PM on January 5, 2023 [16 favorites]

My first thought was torsion as well. Go to an ER.
posted by Ardnamurchan at 10:08 PM on January 5, 2023

Rooting for you to feel better soon! I also think the ER is the place to be - pain that extreme, fever, and a history ramping up to this most-extreme presentation all give me reason to want good doctors and nurses to check you out and get you the help that you need.
posted by rrrrrrrrrt at 12:00 AM on January 6, 2023

Go to the ER. Abdominal pain can be a sign of something serious that needs immediate attention. I've written about this here before, but I once had abdominal pain that turned out to be peritonitis, requiring an emergency 5-hour operation by the time I finally went to a hospital. The doctor told me that if I had waited much longer I would have been on a colostomy bag for the rest of my life or, worst case, dead.

The infection could have been treated with drugs and the operation avoided if I had just gone to the doctor earlier, but I kept telling myself that the fact that all I wanted to do was lie flat on my back in bed was a sign that I was "lazy", not ill, and that I should just get over myself. Never again: I take signs of potential illness seriously now.
posted by mydonkeybenjamin at 12:21 AM on January 6, 2023 [6 favorites]

One more vote for the ER. They can do imaging and stat labs. A PCP or any other doc can't help if they do not have the tools to exclude something major. Those tools are available in the ER.
Standard disclaimer this is not meant as medical advice just common sense guideline - the ability of outpatient clinics to help is limited by the tools they have.
posted by M. at 3:18 AM on January 6, 2023 [1 favorite]

I hope you’re doing OK and your pain is controlled and you have answers!
posted by chesty_a_arthur at 3:36 AM on January 6, 2023 [1 favorite]

So last month I showed up to ER with that sort of pain, with initial diagnosis being kidney stones. Turns out, 24 hours later I was diagnosed with shingles on my right hipbone. Anti-virals for Shingles are most effective in the first 72 hour window of onset of symptoms so I am glad I went to the ER when I did (I had shingles before a decade ago and hadn’t known of 72hr window then and it was a much more unpleasant experience that this time around, which aside from the pseudo kidney stone pain was mostly a non-event and over in a week.

Therefore, I hope you went to the ER. Healing thoughts to you!
posted by carabiner at 7:04 AM on January 6, 2023 [1 favorite]

Response by poster: I didn’t actually go to the ER, but I am at the doctor and she’s done all my labs and an exam and is sending me for a ct scan. Thank you all!
posted by shadygrove at 7:14 AM on January 6, 2023 [11 favorites]

Best answer: Good luck! I hope it’s nothing serious and am impressed at your tolerance for pain!
posted by chesty_a_arthur at 7:17 AM on January 6, 2023

My first thought was torsion as well.

Mine too, based on actually having had torsion. The only difference is that it sounds like your pain came on more slowly than mine, but my own case of torsion was apparently pretty major (instead of just partially twisting around, it twisted around THREE FULL TIMES and everything was SUPER messed-up). So I wouldn't be surprised if you had a less severe case - the fact that you're saying this is as bad as labor is ringing my alarm something fierce.

If that's what it turns out to be, I can update about post-surgery recovery tips and what-not, and offer general commiseration. Please let us know.
posted by EmpressCallipygos at 8:06 AM on January 6, 2023 [2 favorites]

Hey, at risk of being nosey (I’m incredibly nosey) I’d love to know how you’re doing!
posted by chesty_a_arthur at 10:20 AM on January 9, 2023 [4 favorites]