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Chronic Chest Pain
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Nivakon posted:
Hello, I'm 19 years old, and I've been suffering from chronic, constant, every single day, pain in my chest for over five years now. I'm sort of running out of options, the pain is seriously disrupting my daily life and activities now.

It all started when I was in 8th grade. In April, five years ago, my left hand turned blue. (I know this sounds crazy.) It wasn't my entire hand, just my thumb and index finger and the area in between. After some labs, and seeing a doctor we discovered I had a severe case of strep that only infected my throat for a few days before moving on to my kidneys and hand. It's rare, but I was told it can happen. The doctor said it was an unusual manifestation of the infection, but that similar cases had been seen. Anyways, by the time I had been diagnosed my body had pretty much fought off the infection so I was never given antibiotics. Shortly after having this, a pain began in my chest. At first, I thought nothing of it.

But some time passed and I grew angry and irritable all the time because there was a constant dull ache in my chest. When I got upset, or stressed, or if I did strenuous activity where my heart rate and breathing increased the pain would go from a mild 4 to a horrific 10. After a couple months, my parents took me to the doctor. He said it was likely a pulled muscle, and prescribed maximum strength ibuprofen. Did nothing. No relief. So we went back. Same doctor gave me different medication naproxen. When that didn't work and I went back complaining of the pain he recommended I see a cardiologist. So I did. We discovered I had mitral valve prolapse and I had suffered minor regurgitation. The cardiologist gave me a beta-blocker suggesting it could relieve my pain. It didn't. By this time, two years had passed. I had a few x-rays done, and they of course found nothing.

So I was referred to a pulmonologist. I took a breathing testing and a methocholine(spelling?) challenge to check for asthma. Came back clean. By this time, I had given up entirely. A year later, I donated blood to discover I had inherited Hep C from my biological mother.

Last May the drug known as telaprevir was approved by the FDA and I started my treatment for my hepatitis. I endured six months of chemotherapy, finishing December 23rd, 2011 - all the while having this chest pain. I had a wonderful GI who treated me, and prescribed me hydrocodone for both the bone aches from my treatment and my chest pain. However, the hydrocodone did not relieve my chest pain.

I still suffer from this pain. I'm at a loss as to what to do. I've had multiple x-rays, a CT scan, I've seen a cardiologist, pulmonologist, as well as a massage therapist - and no one can offer relief or even an answer.

The pain is directly behind the heart and resonates to the front. It is a constant dull ache. When I inhale, the pain worsens. The deeper I inhale the worse it hurts. Any sort of physical exercise where my heart rate/breathing increases agitates the pain and it usually hurts worse for the rest of the day. At the very least, once a day when inhaling there is a strange cracking noise. My parents have heard it, my husband has heard it. Most days it happens 5+ times...but there are days where it only happens once.

I married my husband because he endured the challenge of being sick with me, he has helped me through difficult times in my life and he loves me as much as I love him. But this pain prevents me from enjoying physical intimacy with him. I can't be intimate for longer than 10 minutes with him, because shortly in my chest pain becomes worse and worse as I breathe harder.

I feel anxious and have been increasingly depressed about this pain. I just want help. I want it to stop. I appreciate all answers and any support offered. Thanks in advance.
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Nivakon responded:
I also forgot to include the list of medications I have tried for this pain:

Naproxen
Ibuprofen
Tylenol
Hydrocodone
Nexium (yes, for acid reflux)
Low-dosage muscle relaxer (don't remember the brand)
Bystolic (the beta-blocker)
and Paxil (lowest dosage)
 
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Peter Abaci, MD responded:
It sounds like you have persevered through a long and arduous medical journey. I think when patients have a pain and they don't know exactly why it is there or what is causing it, then that can become a very anxiety-provoking situation. Not only that, but living with this unknown situation can be just as exacerbating as the pain itself. It may help to know that you aren't alone in this regard, and that there are many folks (and their doctors) out there who don't know why they have the pain that they have. Modern medicine is knowledgeable, but it simply doesn't know everything nor does it have all of the answers.

I think it would be helpful to start to learn some tools to help you better manage your pain. This can be empowering, especially when traditional treatments don't have all of the solutions. Better understanding the mind/body connection and how to use it to better manage the way you feel is an important step in this process. Some things to look into that can help may include consulting with a pain psychologist, mindfulness-based meditation courses, and finding a practitioner who can help you become more physically active, even with the pain problem. If possible, consult with a specialist who has a background in integrative approaches and treating pain to help guide you.
 
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HelloTNOM responded:
Hi Nivakon,

I'm sorry to hear all that is happening with you. Sounds like a much rougher road than I've experienced. Anyway, I can completely relate to the part where your frustration turns your pain up a couple of notches. I had shooting pains throughout my body that caused me to respond the same way. The expert advice that has been offered on this page is dead on as far as helping yourself. What would happen with me is that I would become afraid of my pain, which would push me into a pit. Then I would get mad at myself for being into the pit. I discovered that the thoughts of fear and anger were definetly adding gasoline to the fire. I then learned to use "Self Talk" which is a technique used to manage our thought and emotions. "Self Talk" is something that most psychotherapists teach to help someone maintain a good state of mind. It took some time to master this practice. But was worth the while.
Things will be fine.
 
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annette030 responded:
I strongly recommend cognitive behavioural therapy. You can learn this from a book of a psychotherapist. It is often used to help manage many kinds of chronic pain.

Best of luck to you.

Take care, Annette
 
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Nivakon replied to annette030's response:
Hello Peter. I appreciate you input, and you put my feelings into words exactly. The frustration of not knowing is half the battle. I think I would be better of if I did /know/ what caused my pain. Up until recently, I had actually been great at coping with this pain. Daily walking and hiking were my forms of exercise, and I had become especially happy after finishing chemo. My life was finally putting itself back together. But, it's been hard not being able to be with my husband. He is military, and in a week he's going to deploy. So, as you can imagine it's difficult not being able to be with him. Which is only added fuel to the fire for me recently. After four years of this pain, I sort of learned to compartmentalize. Put it away. Probably not the healthiest thing for me, but it's worked thusfar minus the ability to go for jogs, and whatnot. I led a pretty active lifestyle until the pain. I've managed to stay healthy considering all things, and despite not really being able to exercise.

Anyways, thank you so much for your suggestions. I will definitely talk to my doctor and perhaps start seeing a psychologist regularly.

Tnom, thank you so much for you reply. I am really glad people have responded. Just knowing that people give a crap can actually help quite a bit in itself. Heh. I'm sorry that you've suffered pain yourself, but you seem to have come above it. For that, I'm glad because it's good for you but also you're able to offer me some advice to maybe help with my pain. And I'm sure you can understand how valuable that may be to me. After five years, you become willing to try just about everything. I will definitely have to check this out. (: Thank you again.

Annette, thank you for your input. I'll have to see how that works out for me. I appreciate your response.

Regards - Niva


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