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Suggest Remedy For Sleeplessness Due To Pain Caused By Multiple Surgeries
Posted on
Wed, 23 Sep 2015
Medically reviewed by
Ask A Doctor - 24x7 Medical Review Team
Wed, 23 Sep 2015
Answered on
Fri, 16 Oct 2015
Last reviewed on
Question : I have undergone Aorto Iliac Bifemural By pass Graft surgery as well as appendectomy, and gall bladder removal. When I lie down to sleep, if on my left side, a pane develops in my left lower back, to the left of the spine and about the heigth of the top of the pelvic bone . If I stay on the left side, the pain increases to an unmanageable leveI, I have to turn on my right side. If I am lucky enough to be in a deep sleep, it will wake me up and force to me get up from bed and sit in a recliner until it eases. I have lost months of sleep in the past 12 years. Sleeping in the recliner is the only solution. I have had CT, MRI, MRA, Xray, etc. No doctor has been able to find the source. A recent scan revealed "severe diverticulosis". Does that have any connection?
Brief Answer:
Chronic left lower Abdominal and back/spine Pain-/Under Investigation
Detailed Answer:
Brief Impression-
Chronic left lower Abdominal and back/spine Pain-/Under Investigation
Hi,Welcome with your query to HCM.
I reviewed your query with the facts detailed by you.
Causal factors for Chronic Abdominal / back pain while lying on left side-
Based on the facts detailed in your query-
You seem to have undergone Aorto-iliac-Bifemoral Bipass Graft Surgery 12 yrs back mostly for the atherosclerotic stenotic lesions.
The changed heamodynamics after surgery is mostly causing the pain while you are on the left side in the sleep.
And this needs to be investigated with CT angiography to study the mesenteric and organ ischemias ,which are mostly causal factors of left lower back/spine pains while you lie on the left side.
Barium Contrast enema with CT studies for severe diverticulosis would be needed to assess the severity of diverticulosis.Its role in left sided role up pain needs to be evaluated certainly but is of doubtful nature to explain when one considers the 12 years duration,during which it was not detected.(When was Sever diverticulosis deted and by contrast barium CT scan ?Whether it was supported with colonoscopy findings are not)
Second Opinion and Work up from GI And Vascular Surgeon Team-
For this to resolve I would suggest you to get Second opinion from your GI Surgeon and Vascular Surgeon who has done your Aorto-Iliac-Bifemoral Bypaas.
In my opinion-one has to investigate your complex problem of left side role up pain in lower back /spine by
a-Investigating with team of GI Surgeon working with Vascular Surgeon -who die your Aorto-Iliac-Femoral Graft bypass by CT Angiography to study the ischemic reasons ,which seems to be mostly contributing to 12 yrs history of this left lower abdominal pain.
b-And by investigating the confirmatory evidence of Sever diverticulosis with the help from Colonscopist and CT radiologist on the lines suggested above,which might be just a recent development/ and could not explain 12 yrs lower back pain in your case.
Plan to investigate the cause of your Chronic left lower Abdominal and back/spine Pain-
I would suggest you to work up with your Physician/Surgeon team who would guide you to work up with other team of doctors,so as to fix and resolve the issue of the unexplained Chronic left lower Abdominal/back pain.
Hope this would help you to resolve your complex health issue.
Welcome for any further query in this regard,before I would close this query at My end.
Will appreciate your writing your excellent feedback review comments to help needy patient visitors like you,at HCM.
Keep me updated on your progress,in time to come.
Good Day!!
Dr.Savaskar M.N. XXXXXXX Surgical Specialist,
M.S.Genl-CVTS.
Chronic left lower Abdominal and back/spine Pain-/Under Investigation
Detailed Answer:
Brief Impression-
Chronic left lower Abdominal and back/spine Pain-/Under Investigation
Hi,Welcome with your query to HCM.
I reviewed your query with the facts detailed by you.
Causal factors for Chronic Abdominal / back pain while lying on left side-
Based on the facts detailed in your query-
You seem to have undergone Aorto-iliac-Bifemoral Bipass Graft Surgery 12 yrs back mostly for the atherosclerotic stenotic lesions.
The changed heamodynamics after surgery is mostly causing the pain while you are on the left side in the sleep.
And this needs to be investigated with CT angiography to study the mesenteric and organ ischemias ,which are mostly causal factors of left lower back/spine pains while you lie on the left side.
Barium Contrast enema with CT studies for severe diverticulosis would be needed to assess the severity of diverticulosis.Its role in left sided role up pain needs to be evaluated certainly but is of doubtful nature to explain when one considers the 12 years duration,during which it was not detected.(When was Sever diverticulosis deted and by contrast barium CT scan ?Whether it was supported with colonoscopy findings are not)
Second Opinion and Work up from GI And Vascular Surgeon Team-
For this to resolve I would suggest you to get Second opinion from your GI Surgeon and Vascular Surgeon who has done your Aorto-Iliac-Bifemoral Bypaas.
In my opinion-one has to investigate your complex problem of left side role up pain in lower back /spine by
a-Investigating with team of GI Surgeon working with Vascular Surgeon -who die your Aorto-Iliac-Femoral Graft bypass by CT Angiography to study the ischemic reasons ,which seems to be mostly contributing to 12 yrs history of this left lower abdominal pain.
b-And by investigating the confirmatory evidence of Sever diverticulosis with the help from Colonscopist and CT radiologist on the lines suggested above,which might be just a recent development/ and could not explain 12 yrs lower back pain in your case.
Plan to investigate the cause of your Chronic left lower Abdominal and back/spine Pain-
I would suggest you to work up with your Physician/Surgeon team who would guide you to work up with other team of doctors,so as to fix and resolve the issue of the unexplained Chronic left lower Abdominal/back pain.
Hope this would help you to resolve your complex health issue.
Welcome for any further query in this regard,before I would close this query at My end.
Will appreciate your writing your excellent feedback review comments to help needy patient visitors like you,at HCM.
Keep me updated on your progress,in time to come.
Good Day!!
Dr.Savaskar M.N. XXXXXXX Surgical Specialist,
M.S.Genl-CVTS.
Above answer was peer-reviewed by :
Dr. Neel Kudchadkar
1. The original surgery was done September, 1997. The pain started 12 years ago.
2. The original surgeon is in M<i8chigan while I now live in Florida. I contacted his office and they now longer have the records.
3. Th severe diverticulosis was discovered February 28, 2012
2. The original surgeon is in M<i8chigan while I now live in Florida. I contacted his office and they now longer have the records.
3. Th severe diverticulosis was discovered February 28, 2012
Brief Answer:
?Mesenteric Artery Ischemia causing left lower abdominal /back/spine Pains
Detailed Answer:
Brief Reply(after the updates)-?Mesenteric Artery Ischemia causing left lower abdominal /spine Pains
Hi,Thanks for the updates.Reviewed this data with your query and my last reply.
Based on these facts,In my opinion- your left lower abdominal / back pains for last 12 yrs, seems to have started after the Aorto-Iliac-BiFemoral Bypass Graft,as confirmed from the updates and query facts.
Accompanied with this,appendectomy and gall bladder surgeries done at that time, causing natural adhesions, add up to the mesenteric artery ischemia which was created due to the changed hemodynamics after Aorto-Iliac-BiFemoral Bypass Graft.
This post-by pass reduced pressure in the pre-bypass segment of the aorta,thus has been causing comparative ischemia/a functional ischemia,and which is mostly causing the lower abdominal /back pain while you are on the left side in the lying position.
Hope this reply would help you to understand the probable cause of your left lower abdominal/back pain for last 12 yrs.
This reply also would guide you and help you to plan needful treatment with your Vascular and GI surgeon.And this would help to resolve your problem in near future.
Welcome for any further query in this regard,before I close this query from my end,as I replied your query totally.
Will appreciate you, writing excellent review feedback comments,to help the needy patient visitors like you,at HCM services.
Wishing you early and fast recovery from this complex pain in time to come.
Keep Me updated on progress.
Contact if need be,by a direct question to Me at HCM,I would love to help you out to come out of this complex pain,not understood by your doctors so far.
Good Day!!
Dr.Savaskar M.N.
M.S.Genl-CVTS XXXXXXX Surgical Specialist
?Mesenteric Artery Ischemia causing left lower abdominal /back/spine Pains
Detailed Answer:
Brief Reply(after the updates)-?Mesenteric Artery Ischemia causing left lower abdominal /spine Pains
Hi,Thanks for the updates.Reviewed this data with your query and my last reply.
Based on these facts,In my opinion- your left lower abdominal / back pains for last 12 yrs, seems to have started after the Aorto-Iliac-BiFemoral Bypass Graft,as confirmed from the updates and query facts.
Accompanied with this,appendectomy and gall bladder surgeries done at that time, causing natural adhesions, add up to the mesenteric artery ischemia which was created due to the changed hemodynamics after Aorto-Iliac-BiFemoral Bypass Graft.
This post-by pass reduced pressure in the pre-bypass segment of the aorta,thus has been causing comparative ischemia/a functional ischemia,and which is mostly causing the lower abdominal /back pain while you are on the left side in the lying position.
Hope this reply would help you to understand the probable cause of your left lower abdominal/back pain for last 12 yrs.
This reply also would guide you and help you to plan needful treatment with your Vascular and GI surgeon.And this would help to resolve your problem in near future.
Welcome for any further query in this regard,before I close this query from my end,as I replied your query totally.
Will appreciate you, writing excellent review feedback comments,to help the needy patient visitors like you,at HCM services.
Wishing you early and fast recovery from this complex pain in time to come.
Keep Me updated on progress.
Contact if need be,by a direct question to Me at HCM,I would love to help you out to come out of this complex pain,not understood by your doctors so far.
Good Day!!
Dr.Savaskar M.N.
M.S.Genl-CVTS XXXXXXX Surgical Specialist
Above answer was peer-reviewed by :
Dr. Neel Kudchadkar
What is "changed heamodynamics" mean?
I am currently scheduled for a angiography to address the left and right lateral iliac arteries that were not addressed in the original bypass graft. This is to remedy the pains in the buttocks area when working outside and bending a lot.
Does one have to do with the other and can the back pain issue be addressed during this other procedure?
I am currently scheduled for a angiography to address the left and right lateral iliac arteries that were not addressed in the original bypass graft. This is to remedy the pains in the buttocks area when working outside and bending a lot.
Does one have to do with the other and can the back pain issue be addressed during this other procedure?
Brief Answer:
Ans to Changed Hemodynamics?
Detailed Answer:
Ans to Changed Hemodynamics?(3rd answer)
Hi,
Thanks for your query.I would reply it in brief for you.In your case,it means,
Changed perfusion in the mesenteric aretery supplied bowel after bypass graft of the stenotic Aorta and Iliac areteries.
You can ask further technical details to your doctor,on the technical words used in the reply,which your doctor would explain you at lenght.
Hope this reply would resolves your query with full satisfaction to you,for solving the question which was not understood by your doctors for last 12 yrs.
Will appreciate you, writing excellent review feedback comments,to help the needy patient visitors like you,at HCM services.
Regarding the 4th query and the 5 th subquery,I can only say that it is a subject of the New query and If you don't mind, would keep it as a subject of the next session.
It would be My pleasure to attend to it in our next session,after I get your permission to continue this discussion.
Awaiting your feedback comments and your permission to continue further discussion.
Good Day!!
Dr.Savaskar M.N.
M.S.Genl-CVTS XXXXXXX Surgical and Cardio-vascular Specialist.
Ans to Changed Hemodynamics?
Detailed Answer:
Ans to Changed Hemodynamics?(3rd answer)
Hi,
Thanks for your query.I would reply it in brief for you.In your case,it means,
Changed perfusion in the mesenteric aretery supplied bowel after bypass graft of the stenotic Aorta and Iliac areteries.
You can ask further technical details to your doctor,on the technical words used in the reply,which your doctor would explain you at lenght.
Hope this reply would resolves your query with full satisfaction to you,for solving the question which was not understood by your doctors for last 12 yrs.
Will appreciate you, writing excellent review feedback comments,to help the needy patient visitors like you,at HCM services.
Regarding the 4th query and the 5 th subquery,I can only say that it is a subject of the New query and If you don't mind, would keep it as a subject of the next session.
It would be My pleasure to attend to it in our next session,after I get your permission to continue this discussion.
Awaiting your feedback comments and your permission to continue further discussion.
Good Day!!
Dr.Savaskar M.N.
M.S.Genl-CVTS XXXXXXX Surgical and Cardio-vascular Specialist.
Note: For further inquiries on surgery procedure and its risks or complications book an appointment now
Above answer was peer-reviewed by :
Dr. Sonia Raina
Answered by
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