15 Years of Intense Abdominal Pain: A Medical Mystery Solved

Transcript

• 00:05- It's hard to have a condition and then so consistently have normal test results.
• 00:09But then, to have the stark pain every day as a reminder,
• 00:12no, there's something very wrong here.
• 00:14Especially when you don't know what you have, it's a nightmare.
• 00:17- It's really frustrating for patients to be treated as a medical mystery.
• 00:23While all of this investigation is going on,
• 00:25they're disabled and suffering this whole time that they're waiting for a diagnosis.
• 00:31- Just being sick is terrible.
• 00:32You feel like this body that you have trusted your whole life has betrayed you in this really major way
• 00:38and now, nobody can tell you what that major way is.
• 00:50- [Courtney] I've seen a lot of different specialists.
• 00:52Easily over 50 different physicians in the last 15 years.
• 00:56I would wait sometimes months for an appointment and I would be in constant pain.
• 01:03- Patients don't want to be sick.
• 01:05They don't want to have these symptoms.
• 01:07I think it's our obligation to try to figure out,
• 01:09to the best of our ability,
• 01:10which patients have some underlying condition that needs to be diagnosed and treated.
• 01:17- In medicine, we treat patients.
• 01:20We do not treat images, radiographic findings or lab tests.
• 01:26Patients can have abnormalities
• 01:28and not every abnormality needs to be fixed.
• 01:32This is the importance of the diagnosis.
• 01:36- [Dr. Sanders] Suffering for 15 years is a terrible thing.
• 01:39I don't know how common it is, it shouldn't be common at all.
• 01:42- Beginning in second year of high school,
• 01:44she developed this intense abdominal pain every time she exercised.
• 01:48- I would literally feel like something was writhing around inside of me.
• 01:51I would feel like there was a snake in my abdomen.
• 01:53- [Dr. Inzucchi] So she would run, perhaps 100 yards, and get tremendous abdominal pain.
• 01:58- [Courtney] I just sorta got used to it.
• 01:59But I would still have the attacks of much more intense pain.
• 02:03- Abdominal pain has a lot of different reasons.
• 02:06So, it's not uncommon for us to see complicated cases.
• 02:09Whenever we see those, there's always communication with different specialists
• 02:13to make sure that we're on the right track and we're treating the right condition.
• 02:16- The intensity of her pain and the fact that it had always occurred with exercise,
• 02:21I mean, that was the clue.
• 02:22- I did a lot of research on my own trying to figure out what was wrong with me.
• 02:26As a scientist myself, it was really important for me to get something quantifiable to hold onto.
• 02:33- Courtney was frustrated.
• 02:34She was disabled from the condition
• 02:35and she just wanted to get treatment started so she could function in everyday life.
• 02:40- Her abdominal pains went back during childhood, she had migraine history.
• 02:46People who have had migraines have that symptom elsewhere.
• 02:50- And abdominal pain is something that we`common see in the headache world.
• 02:58A bell definitely went off when I saw that there may be a family history of migraine
• 03:03because there's certainly a connection between the gut and the brain.
• 03:07- Your brain and your stomach have a lot of the same neurotransmitters,
• 03:12so a lot of the things that effect your mind can also effect your stomach.
• 03:16- I diagnosed Courtney with chronic migraine and abdominal migraine.
• 03:21Abdominal migraine is a type of migraine disorder
• 03:24that, most commonly, effects children and adolescents.
• 03:28We often see classic migraine or chronic migraine with abdominal migraine
• 03:34and so, when we think of treatment options,
• 03:36we try to think of treatment options that target both.
• 03:43- [Courtney] After about eight weeks, I just woke up one morning and my pain just wasn't there.
• 03:48That was something that I had dreamt about
• 03:50but it was something that I didn't ever actually know was going to happen.
• 03:54- [Dr. Inzucchi] Courtney's case is a great example of multidisciplinary medicine.
• 03:57Starting with the primary care doctor, seeing an endocrinologist
• 04:01and also a vascular surgeon
• 04:03and ultimately gastroenterologist and neurologist coming up with her diagnosis.
• 04:08- They took the condition seriously
• 04:11and so, regardless of what they personally thought
• 04:14about my symptoms or about me,
• 04:16they took their responsibility to figure out what was going on very seriously.
• 04:20- When a patient comes to see a doctor,
• 04:22it's really the meeting of two experts.
• 04:25There's no way for the patient to know what I know,
• 04:28but there's also no way for me to know what the patient knows
• 04:31except to ask them and to listen to them and to believe them.
• 04:35- Not being believed by doctors is perhaps one of the worst feelings I've ever had,
• 04:39besides the actual phyical pain.
• 04:41It's a terrible thing to have someone say,
• 04:43'you know, you say that narcotics only work so you're probably just looking for drugs.'
• 04:47- No one else can tell you,
• 04:49no test can tell you how this patient feels.
• 04:53- Getting to know the patients on a person level,
• 04:56what they cherish, what they enjoy doing in the life on a daily basis,
• 04:59is very important because by knowing the patients,
• 05:02you will be able to achieve your goals of treatment.
• 05:06- This is why we do medicine.
• 05:08When somebody comes in with a symptom for 15 years and
• 05:11you help them and they're pain free,
• 05:14it feels fabulous.
• 05:16- Her life has been completely changed since receiving the diagnosis.
• 05:19She's had a happy ending.