Discussions By Condition: Gastrointestinal conditions

Hiatal Hernia (possible mild strangulation?)

Posted In: Gastrointestinal conditions 3 Replies
  • Posted By: Anonymous
  • November 20, 2008
  • 10:27 AM

I'll start with a nonrelated problem, because it will come up later.
I have esoniphilic esophagitis caused by eating milk whey-protein. Also from stomach acid, on occasion when it has opportunity to stay in my esophagus for long enough, such as sleeping flat. Milk-EE problem had been occuring long time (dozen years), but never figured out what the problem was, so I didn't go to a doc. Later had the Gerd-EE start up, (never had a problem before). Figured out the trick of putting 4inches of boards under the head of the bed. Around the same time I isolated whey protein as my milk allergen and started isolating milk products with whey from those without. Problems all gone. JAN/FEB 2008: Went to a doc. Got a diagnosis, via endoscopic procedure involving a biopsy. Doc says biopsy positive, esophagus looks great, stomach is great, duodenal bulb inflamed, but no infection or obvious cause for the duodenal bulb inflamation. I had no problems at that point with either type of EE, because i'd avoided the causitive factors and all is well.

fast forward...

Late MAY 2008: repeat a half a dozen times. A few hours later I was at work. Had some chest pain, seemed like it was upper right side of chest, radiating and electric in the variation and on/off type of nature. Lasted 10 seconds or so.
About 30 minutes to an hour or so later I felt dizzy when standing and then like my brain turned off and then back on and then instant high intensity panic. I had a coworker call me a ride to the hospital.

When asked if I had any current symptoms by the people that seen me at work, I had mentioned a very very light pressure on/behind the sternum, so light that it might not even be real, might be just because im thinking about it. Turns out i'd have that (24 hours a day) for 2 months and get better aquainted with it.

They ran some bloodwork (one of which was d-dimer), chest xray, ekg. All negative. I told them I was ok currently but that I had felt dizzy/faint and panic. That was stupid, since they used that to classify me as Panic Disorder.

Went back to work... I think that I had some mild anxiety over the next day. The day after My head got real heavy when I stood up to leave work, I sat back down. It stayed that way. I left to go home, at some point it went away or more likely I adjusted to it. At home I made something to eat and it felt like it got stuck in my esophagus or struck something causing pain and that phantom sensation of it remaining stuck. It turns out to be the latter, since I have some background on getting food stuck due to the EE, I could tell it was a fake sensation. My face and lips went numb though, and I felt strangely super tired as if I needed to concentrate or move to not go under. The urge felt strange, or I wouldn't noticed or mentioned it, but It wasn't terribly hard to resist, because I did.

I went in to lie down 2 or 3 hours later, on the bed. laying down produced instant strange head sensations and chest sensations behind the sternum and a throbbing 70 beats per minute pulse in my mid left side (which is apparently where the stomach is according to online anatomy pictures), and anxiety. I got up and went back to the chair. It doesn't recline. I had to make do sleeping on it, sitting up. Anxiety started up upon trying to sleep. I believe that happened every night for two month since, including an anxiety feeling i'll call surety-of-death-by-morning, and night sweats.

Weekend approached, got in the car to go to my parents house 1.5 hours away from my place and my work (with no intent on coming back). Driving made the chestpain slightly worse, the chestpain made the anxiety worse. I got 30 miles and pulled into a hospital that is on the route. I couldn't resist because of the current feelings and the memory of the night before's feelings. They gave me a chest xray, ekg, blood test, ct scan (I believe of my head, maybe they shoulda did the chest.). Sent me on my way.

I can't remember the next few weeks in accurate order. But I stayed either at my parents or my grandmothers house, for a week or less. With headaches, chestpain sternum area, anxiety. Went to a doctor between my workplace & home and my parent & grandparents home. It's near the hospital that I had stopped at on the way through. I don't remember the content of my first visit to him, that whole two weeks is blurry, I think this is when he reccomend a heart test or two, and set them up for a couple weeks later (thank goodness he isn't the one that fears death nightly).

He also put me on some ppi's when he knew that so many months back I'd been diagnosed with EE. He said that I should have taken it for GERD which causes EE. I told him that I rarely my entire life except 3 times early in the year every had any GERD symptoms. He still reccommended them for no other reason than that I had had an edoscopic procedure, and he thinks that I should have been on them for a certain amount of time after that. I didn't mind, so I took a bunch of samples.

I just remember that I used the excuse during that trip and that I was halfway to my place with a stopover at the midway point to make an effort to get back to my place so I could attend work and stay at my house, etc.

Needless to say I had convinced myself with the help of that doc and the ER visits that nothing was wrong with my heart or anything bad like Lung-PE or anything that would drop me dead instantly, and decided to look up some of my symptoms at the library, and noticed that there were some things that about all 5 top things that fit my symptoms that it said at medical sights aren't easily noticeable with just an xray and ekg and general blood tests. One fit my symptoms really well (in that my chestpain behind the sternum area felt better upon standing and worse while sitting, actually felt worse when I called it an evening and tried to sleep while sitting and better in the morning.) and was heart valve related and that you can drop dead any second from that one. haha.

The anxiety and chestpain that has been 24/hr a day thing and still was there caused me along with my realizing that I'm not neccessarily free of having a real problem caused me a real panic attack and I knew it. So I tried to walk it off in and outside of the library and sit it out in the car. 2 hrs passed by without my heart coming back down or panic feeling leveling off (I didn't agree with 'it', but it didn't listen to me. I've noticed from these experiences that panic and anxiety are completely dissassociated from self, often they've started before I knew why, or even in the absense of a why, and in this case I knew the why) and ultimately I drove myself to the hospital. I hoped to get some more tests, turns out I was able to talk them into keeping me overnight. It was the best nights sleep I had in awhile.

I called in for some anti-panic/anxiety medicine to my doc, left a message, never got a return call back. Turns out he called it in to the place near my apartment that I had requested by phone but didn't mention to me that he did so. haha.

This will become a book if I don't abbreviate the rest and since my memory is poor anyway that will make the job easier. The hospital released me the next day. and scheduled the same tests that the other doctor scheduled, but in a week from current. I intended on getting time off work and staying with my family so I turned down that offer and stayed on schedule for my current doctor's tests.

Worked a week or so. Had symptoms constantly. Also had Esophagitis symptoms, with no causitive factor. The worse symptom was and has been the Chestpain that was 24/7 got worse on sitting and worse on a slight sleeping recline in a chair. (Turns out it caused the anxiety & panic & nightsweats & fear of death, because much months later I managed to get the chestpain to lessen significantly.) Got time off of work. (ended up being 2 and a half months or thereabout)

Heart tests were all negative. Esophagitis got worse, lost 10 pounds in a week, 20 in two weeks. Inability to swallow with increased salivation and anxiety that is specific to these symptoms. Its hard to sleep when you feel like your going to gag on your own saliva. I had to stay awake all night finally when it got real bad and drive into the doctor. I asked for and received some anti-panic/anxiety (klonipin, not sure of spelling) medicine.
I ended up needing this at night just before sleep. Sometimes I couldnt sleep without it. Inability to sleep from the anxiety would make the anxiety worse, and it always was worse when sleeping. I think it was the angle of recline that made it worse. Degree of recline made all difference in these symptoms. Standing was mild, sitting was much worse, anything greater than 90° like reclined sitting 110-135° was causing my night sleeping pain and panic and anxiety that I wouldn't wake up the next morning. 180° laying down caused what I described way back up there, such symptoms that I hadn't slept laying down for months, and still to this day haven't except for one more attempt later.

I forced him to schedule me a test: he scheduled me a barium swallow for so many days into the future. Turns out I had a hiatal hernia and esophagal spasms, and he thinks this is what was causing the reoccuring uncontrolled EE, in this case GERD EE, because Hiatal Hernia was pushing stomach acid into the esophagus consistantly enough to cause a prolonged reaction. The PPI pills that he had given me weeks earlier actually hadn't felt like they had participated in that until just before the barium swallow. I got lucky that he had prescribed them to me for no specific reason earlier.

I also had been taking daily 330mg aspirin because even though one of the ER's had told me there isn't any problem with me they had suggested that I take 330mg aspirin daily when they kicked me out.

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  • Part IISometime into Late JULY I coughed away the chestpain one night while sleeping in a recliner at my grandmothers. In somewhere between 2 and 4 coughs (try telling that to a doctor). No other way to describe it than to say it felt like obstructed blood was flowing or clot was gone or some type of sensation like that (since all this time has passed I wonder if it was a pinched vein in the stomach, due to the hiatal hernia). What was sternum chestpain that really hurt became a strange dispersed chest sensation the rest of the night, and was gone completely by morning. All the non EE symptoms 80% disappeared. No more nightsweats, chestpain (it was lessened considerably.), panic, fear of death while trying to sleep at night. I think some anxiety was still there, but not much. The anxiety and chestpain since this point in time I think was always when I was reclined while sitting. I still get anxiety, not very often, now NOV 2008, sometimes while trying to sleep at a slight recline. Also sometimes a twinge of pain in my head and a twinge of pain in my chest near where I think my hiatal hernia while sitting. I ended up having to buy a recliner that is cheap and don't recline too far, just to go back to my house, so that I could go back to work. When I had felt very good in Late July / Early August, and thought all was well, I tried one more attempt at laying down. I was still staying at my parents house, it was night my mother was asleep, my father was expected back in 1-2hrs from a trip. I went in to bedroom that was in the garage/entryway, locked the door, didn't take a phone with me (I had been having a phone next to me while sleeping in the living room on the couch-recliner up to that point) I decided to lay down and read until I felt comfortable that I had no symptoms. I layed down on my side on one elbow (turns out this position was an untried position and not a good test), I decided after getting tired and decent amount of time had passed to lay down on my back and go to sleep. I went under immediately. I woke up (prob 15-30minutes later give or take, based on the time I expected my father to come home) in a panicked state, but not knowing why. I suspected that I was experiencing a symptom but took me a bit to notice, my heart rate was sky high, it was the only noticeable symptom. I assumed it triggered the panic and one or the other or both together woke me up. I then felt like I was lightheaded and approaching passing out. I decided that i needed to get into a seated position quickly. I was able to, but it didn't immediately change the feeling that I was about to pass out, and then naturally i'd be in a laying position which isn't a good thing in my case apparently, and with no phone and behind a locked door haha. I got up and was dizzy, and made my way to the door, figured I could pass out by the entrance to the kitchen and be noticed by my father shortly when he came home, but was able to make it to the living room which is close to my mothers bedroom. Once I had been standing long enough to get to the living room the heartrate had went to normal and the dizziness had subsided. So I went to my normal sleeping spot on the end of the couch where either end of the couch has a built in cheapo recliner that don't lean back far, and went to sleep there. (with the phone handy.) Turns out I skipped a heart test in there somewhere, came back negative. I skipped a GI doctor that I went to that has office near the other doctor, but he was a complete idiot and only gave me 5 minutes of talk time, I didn't get past EE into the reason for the visit, when he stopped listening to me and scheduled some esophus related tests (esophagal motility disorder test, due to the spasms registered on the barium swallow test earlier by other doc), also later a allergy refferal, that I decided would be good for informational purposes but nonrelated for why I was there. I never went back to him after getting those tests. The funny thing is after we discussed EE and he asked what it was, and he called the doctor that had diagnosed me in JAN, he later called me after making a test appointment for the esophagal motility test to find out why I had specifically esophagal spasms, and it came back negative and then he mentioned that I noticed that I have been diagnosed with EE and asked why i hadn't mentioned to him that I had that. What a nut. I haven't went back to that doctor since. I want my money back. I also hadn't been back to my other doctor since. He hadn't noticed that I had lost 20 pounds in a couple weeks, thinks all my non EE symptoms were in my head, and also hadn't notice that I lost 40 pounds between another visit, forgot why I had been there everytime I seen him. Now i've lost 60 pounds total in about 3-4 months, and I don't think he would notice the difference if I visited him again. I wish I knew a smart doctor that don't have so many patients that he can focus on the ones he has enough to be useful. I can potentially have an enlarged spleen, or pancreatic cancer, or a messed up Gallbladder, or a stomach/intestinal bacterial infection or fungal infection, or liver problems. Any of these can present with similar symptoms I suppose. My friends dad lost 100 pounds in a year or so had digestive issues with liver and gallbladder and died. A lady at work's sister lost 50-70 pounds, no desire to eat, pain in the right side of her chest, and has pancreatic cancer. I assume that I had prob just had a hiatal hernia but with mild strangulation, light pressure of a stomach vein, symptoms changed based on position and was much worse initially but had changed based on some hard well placed/time coughs (sounds funny, but i swear it was an accidental cheap cure. It was instantaneous and unquestionably related to the chestpain immediately changing to a widely dispersed strange flowing sensations I described earlier followed the next day by no/significantly lessened pain). according to medical websites coughing can cause/interact-with a hiatal hernia. Obesity can too, and losing considerable amount of weight due to it, would have made it easier to clear up. I know sneezing and coughing can make a big drop or surge in bloodpressure, but I don't believe I had any clot related problems, which could have been cleared in a similar manner. I still have a hiatal hernia, or I wouldn't still have uncontrolled EE / and GERD. But the other problem, which I believe may fall under the Strangulation category is significantly lessened. I'd say gone, but laying down would prove me wrong and I won't do that. I want to have another endoscopic procedure done for observational diagnostic purposes, but I don't know how to enforce my wishes of being within a certain sitting angle during the procedure. You know they wouldn't honor it, once the anesthesiologist has me under. I don't trust them to let anyone to be let in to monitor or for them to have the guts to speak up to overrule the docs if they fail to abide. I guess I could write my family or friend out of my will if they screw up. :P In the meantime I'm hoping i'm good and nothing changes for the worse and that no current stomach damage exists or is occurring, and that i'm not wrong and have something else that could be worse. Anyone want to diagnose me, (guess it would be too much to ask that a knowledged doctor would be looking through these message boards on his off days ) I prefer for you to avoid, Panic Disorder, I can pay any straight-C Student turned Doctor out here 60$ to say that. :P Plus my Work Psychologist Doctor that I had to talk to before being approved to get time off of work, said that Panic Disorder is absolute B.S. for my symptoms. (this is my abbreviated approximation of his doctor speak)
    Anonymous 42789 Replies
    • November 21, 2008
    • 01:12 AM
    • 0
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  • One thing you might check into. I have hiatal hernia, GERD and all the symptoms you have. I was also diagnosed with sleep apnea. It has allowed me to sleep easier once treated. I still get panic attacks associated with the hernia, but I frequently am able to sleep, even if on an incline due to GERD/hernia. When apnea hits, you can't breathe and your body tries to compensate by speeding up the heart. It is usually the rapid heartbeat that wakes you, and that may be what initiates nighttime panic attacks.
    Anonymous 42789 Replies
    • February 3, 2011
    • 06:01 AM
    • 0
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  • Shoulda called PARTII (The Sequel) so I could call the PARTIII (The Finale or The Trilogy)Thanks for replying. I had posted commentary in two different health message boards back in 2008. I had tried placing a closing comment in one of them once the problem had been resolved in Jan/Feb 2010, and it had already been closed out so that I couldn't comment further. I had forgotten about this site until my email alerted me to your response. All of what I posted so far concerned 2008 year. At the end of that year my stomach had become less and less squeezed into a tiny ball and I was able to eat. You can thank the PPI medicine for that. At start of this I was around 220lbs. I bottomed out at 150lbs near end of 2008. Near the end of 2008 a doc had given me a Chest CT scan due to my mentioning to him that I had lost 70 or so pounds and couldn't afford to lose any more. He said my liver has lesions but otherwise didn't notice anything else. He didn't concern himself with the liver lesions, just gave me a test to eliminate liver cancer. I also asked for a hida scan to eliminate gallbladder as a possible symptom cause due to noticing similar symptom arrangement based on message boards and a friends dad having had similar symptoms. Doc suggested instead a gallbladder ultrasound so we did that and he ruled out that as a problem.All through 2009 I gained a new symptom to replace those that I had lost in 2008. It was extremely painful but in some ways preferable to the others. Stomach pain would start up some several hours after a meal in my stomach and spread until it engulfed the whole stomach and then until it felt like it was the whole abdomen/chest and would last 6 hours and then go away. It was the top of the pain chart type of pain. After that would happen enough times you start looking for relief. I doubled my gerd medicine, tried pink-bismuth, advil, etcetera, to no pain benefit. I wanted to avoid aspirin because it thins the stomach lining. Wanted to avoid the advil because of the liver lesions. Ultimately I found something dorky that worked for me somewhat. I melted menthol cough drops by placing them in room temperature water (anti inflamatory, anesthetic, anti infective, not sure which property was the winner) in water and drank them down. If I did so late taking about a dozen, I found I could shave 2 hours off the pain time window; sometimes if I drank some 1 or 2 pills worth during a meal the pain would go away as soon as it began. By the end of 2009 even that wasn't working and I had to endure 3 days of straight pain. I had gone to dozens of doctors throughout 2009. The Internal Medicine docs I went to gave me common bloodtests and chest x-rays (something I had a million times), and did nothing further like checking symptoms against diseases to form some hypothesis to check further with specific diagnostics rather than simple common blood count type tests. Got a GI doc to try some diagnostics. Stomach scan said stomach muscles working improperly 'Gastroparesis'. Liver scan said liver lesions and Liver mildy enlarged. Liver/Spleen scan said Spleen mildy enlarged. Doc said nothing to worry about on all of them and didn't suggest anything further. Had been to the emergency room when the stomach pain went for 12hours once after a meal, 6 hours was getting hard to stand, 12 hours sucked. Was told essentially pain isn't real stop coming back. Doc actually said 'aww do you have a tummy ache little boy'. This was the facility that I had been to twice in 2008. As I mentioned earlier at the end of 2009 after eating stomach pain and back pain for 3 straight days. I tried masking the pain or drowning out the pain by sleeping in front of a fireplace on the burn tiles under the door with the blower on full, standing in hot shower and sleeping on heat vents. I only got 1 hour of sleep at a time. I didn't want to have to go back to that one emergency room and tell him I got tummy pain again. :) Thought occurred to me that one other facility that I had been to about 45 minutes away for some of my diagnostics seemed like a nice hospital and the thought hadn't occurred to me to try their emergency room. So I did. They said that I had a fever, gallbladder necrosis & infection, 200+ heart rate, jaundice. They diagnosed via guesswork based on symptoms + having a look via making the laparoscopic incisions. Then they decided needed to do full open gallbladder surgery. Also afterward they tried to enlarge bilary duct exit below the stomach in duodenum area since they suspected gallstones were stuck. That didn't go so well. Ended up bleeding from that in my GI Tract for days, and also got stomach spasms and vomited blood. Mmm Yummy. For the record it looks like dark black coffee with coffee grounds. Ended up being their 12 days and getting 4 bags of blood. Good thing I didn't try the other facility again. Nice to find a real hospital. Also this hospital--(though I only was allowed solid food for probably 2 days)--had great pot roast, never had better beef anywhere. I don't have great luck apparently because I had some post operative sharp pain in my side where the drainage tube was that didn't show itself until they had me up walking around several days later. It was also during the time period where I was bleeding in my digestive tract which they hadn't been aware of. Perhaps the combination, though maybe it was just the pain. I passed out from a really large spike in shooting pain in the drainage area while walking and cracked my head on the concrete/marble hallways. haha, I have great luck. Didn't break anything but now I have a harry potter scar over one eyebrow (plus a doctors bill for them stitching that up) took a long time (days or weeks) for my face on that side to stop being numb.Since then the GERD has came down significantly even to the point where I am sure I will be rid of it for good before end of year. (Good thing too since my health insurance increased my rates purely for being a person with GERD. I told them i'm a person temporarily afflicted with GERD as a side product of a Gallbladder that decided it had been around long enough. They weren't real keen on taking my word for it. Hopefully when I go off drug permanently they will reevaluate.) I'm completely symptom free now. And shortly after I got out a cousin of mine who was older than me (me in late 30's, he in mid 40's) came to me and told me he had a bunch of symptoms for a long time now and doctors been treating like nothing obvious was wrong and subtly suggesting him to go see a psych, and his dad my uncle had years ago had a bad gallbladder taken out, and him noticing that being my problem wanted me to run my symptoms by him. His symptoms were every bit as varied and weird as mine (including sleepwalking, anxiety, panic, high heart rate when laying down, having to sleep in a chair to alleviate the weird laying flat symptoms, an acquired milk problem, variety of chest pains). I recommended 'Hida Scan' and told him do not let them talk you into a CT Scan or a Ultrasound in place of one of those. Turns out his was bad and still early enough to come out via laparoscopic surgery and so he was able to do the in and out outpatient type of thing and he is symptom free as well now.The moral of the story is Docs don't seem to have the time or interest to diagnose a problem on symptoms and likely distrust a patient is being honest about symptoms when they got many other paying customers who have simple issue that resolves itself or can be diagnosed via the diagnostic crutch of the common bloodtests and can be in and out in under 5 minutes. Anything taking logical problem solving type of thought would take longer but not yield more money, since a doctors visit in 5 minutes is more lucrative than one lasting an hour. Insurance companies are probably as much to blame for this as well, since they will only reimburse a doctor for what other doctors in his area would charge for a similar visit and so begins the race to the bottom.
    Anonymous 42789 Replies Flag this Response
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