Stomach Pain - when to go to doctor?

Discussion in 'Medical Topics' started by Undisclosed, Nov 7, 2017.

  1. Undisclosed

    Undisclosed Guest

    Hi,

    I've had some mild stomach pain (say 1 to 2 out of 10) on and off for the past year. No recent changes. I think it could be related to stress of a new job and financial difficulties.

    I had some medical issues a few years ago, and it was a huge pain with many doctors and doctor's notes and forms to get back to flying status. So, I've tried to only see doctors if it's something that is rather benign (like a wart, weird bump), unless it requires an emergency room visit.

    I don't want a doctor to say that I have IBS if I really don't.

    I also live in Australia, whose regulatory authority (CASA) can be rather draconian.

    Thoughts?
     
  2. Rushie

    Rushie Pattern Altitude

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    Could be anything. Mild gastritis maybe the doctor will give you an antacid. OR could be early signs of something very serious like for example pancreatic cancer. You should not let fear for your flying stop you from seeing a doctor although I certainly understand why you feel that way. Draconian regulation tends to affect how people behave.
     
  3. 455 Bravo Uniform

    455 Bravo Uniform Pattern Altitude

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    I can understand. But is flying that much more important that you would choose a short period of flying with a risk of debilitating illness/death, or a short period of inconvenience and a lifetime of flying? I don't mean to preach, I'm as guilty as many others. Go get it looked at and catch something early, PITA as it may be. Don't hide from it. No deferred maintenance...
     
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  4. Zeldman

    Zeldman Final Approach

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    When I had chest pain I went to the emergency room ASAP. I did not give a thought about if I would ever fly again or not. Health first.
     
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  5. SkyDog58

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  6. Zeldman

    Zeldman Final Approach

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    Thanks....Me too..!!!

    I really felt bad for my mom. She lost two husbands to heart problems, then I have the attack.
     
  7. SkyDog58

    SkyDog58 Ejection Handle Pulled

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    Damn, I feel bad for her as well. That's rough.
     
  8. Cluemeister

    Cluemeister Pre-takeoff checklist

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    Did you eliminate other issues, i.e. types of food, fiber intake, etc?
     
  9. SkyDog58

    SkyDog58 Ejection Handle Pulled

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  10. comanchepilot

    comanchepilot En-Route

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    Taking it to the other side - my mother had mild belly pain on and off pain for 2 years - despite my telling her to go see the doctor she blew it off because a) she was stubborn and b) she was a cancerphobe.

    Died 7 years later from metastatic colon cancer, after 2 rounds of chemo, resection of her bowel, removal of a tumor spread to her liver, and then removal of part of a lung.

    Pain is telling you something is not as it should be. Has stress previously resolved itself in your midsection? I don't carry it there - some do. But you generally do not change where you get stress pains over your life.
     
  11. lbfjrmd

    lbfjrmd Pre-takeoff checklist

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    Hippocrates: assume nothing! check everything!
     
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  12. Zeldman

    Zeldman Final Approach

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    A friend of mine, his wife had mild belly pain. She went to several doctors before one finally said lets have a look.

    She is part of the very small percentage to survive pancreatic cancer.
     
  13. wrbix

    wrbix Pattern Altitude

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    A better description would help (although no one should claim to diagnose from a distance):
    - location/radiation
    - nature - sharp/dull, constant/intermittent, cramps, etc
    - exacerbating/ relieving factors - eating/fasting, activity, relation to bowel function, relation to fat content of meals, lactose content of meals, alcohol intake, etc
    - associated symptoms - change in bowel habits, nausea/vomiting, fever/chill, dyspnea, etc.

    When you do go to physician, he/she should pursue such questions - if their first response without a proper History and Physical is to order a CT scan, I would respectfully suggest finding a real doctor.
     
    Last edited: Nov 8, 2017
  14. Rushie

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    The OP seems to fear a diagnosis of IBS. But digestive symptoms are nonspecific, you can't diagnose online and even the doctor cannot diagnose without imaging, ultimately. He can treat your "indigestion" or "bathroom issues" for a couple months but if it continues he will have to investigate further.
     
  15. wrbix

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    WAY too many physicians these days rely on "imaging" too heavily in their diagnoses - the tried and true History and Physical Exam has been all but abandoned - to the detriment of the patient IMHO.

    .....and I do agree with the OP that IBS is the easy way out for poor diagnosticians. One of many "waste basket diagnoses", again IMHO.
     
  16. wrbix

    wrbix Pattern Altitude

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    Didn't think this sounded right, being attributed to Hippocrates:

    "Assume nothing, question everything."

    James Patterson
     
    Last edited: Nov 8, 2017
  17. Rushie

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    I agree IBS is not really a diagnosis at all. It's what you have left over after everything else is ruled out and they can't find a cause. Kind of like fibromyalgia.

    I also agree physicians are abandoning history and physical exam way too much, and you shouldn't jump to imaging immediately unless there is good cause. But there are some things you're not going to find without imaging. I'm thinking of my friend with the non-specific digestive complaints who when he didn't respond to first and second line treatments finally got the imaging and it was a big mass on the pancreas and several more in the liver. Of course I'm harping on the one disease that likes to hide out until the last minute.
     
  18. wrbix

    wrbix Pattern Altitude

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    Rushie - right on (and agree re fibromyalgia; and also add chronic fatigue syndrome - suspect anytime the best treatment for a physical ailment is antidepressants, then it's probably not an organic etiology; but I digress).
    You would also agree though that the H&P should guide imaging.
    I suspect that in a very large majority of cases of belly pain, the eventual diagnosis is highly suspected after a good H&P.
     
  19. Rushie

    Rushie Pattern Altitude

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    Agree, although I think almost all disorders, including psychological ones, have organic etiology, but many are as yet undiscovered. When we haven't yet identified the mechanism or simply can't see any mechanism we tend to assume it's psychosomatic or emotionally driven. Centuries ago we assumed the devil or punishment from God. I think the future holds many new discoveries about genetic tendencies and effects from food or pathogens, causing biochemical changes that end up being what we now think are purely emotional, behavioral or psychological problems. Fibromyalgia and CFS is a good current example. There is a school of thought that both are manifestions of a myalgic encephalopathy that may actually be a post viral immune response. Very difficult to nail down markers though.

    I indeed agree H&P should guide the decision to do imaging but I fear that while a lot of imaging is unnecessary, other times it's not done soon enough. Cost should be no factor, but it is a factor in the real world. Doctors who own an interest in the MRI machine might refer too much or, what I think is a worse evil, managed care doctors may have incentives to limit your care. I'm sure both happen.
     
  20. Rushie

    Rushie Pattern Altitude

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  21. denverpilot

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  22. Rushie

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    Yikes how did I miss that?? Thanks for pointing that out. I don't suppose the situation has improved since then?
     
  23. denverpilot

    denverpilot Taxi to Parking

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    Can’t really say but my wife worked for a single practitioner (old WWII guy, flew the Polesti raid and was part of that madness before he survived and came home to become a Doc on his GI Bill) and his practice was going the way of the DoDo bird back then also.

    Seems like nowadays the big difference is Docs banded together into medical office groups that have some staff to continually fight with the insurance companies for all of the Docs in the group, and/or the entire medical group is now owned by a large healthcare org that fights with the insurance companies on a massive large scale.

    In other words, they changed tactics. No single human Doc could possibly keep up with the amount of bureaucratic BS an insurance company with piles of high school kids in call centers could easily and cheaply dish out, in the beginnings of managed care.

    Now the Docs have their own high schoolers backed by a few crabby angry nurses who have no compunction about telling off an insurance wonk or 20-something reading from a script. “Can you read the chart? If not, could you put someone on the phone who can? Because I’ve been doing this for 30 years young lady!”

    That’s a pretty good gig for a nurse who can’t stand all day anymore but who knows their stuff to get into. Read charts, yell at insurers, get paid to be patient advocates.

    Often the tech has gone up since the 90s where the nurse can do it from the comfort of their own home, too. Or even traveling, as long as they have good internet.
     
  24. Rushie

    Rushie Pattern Altitude

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    Ah I see. You're right about them banding together and sharing a big staff. Another tactic that very good high demand doctors use is to demand cash and not file for you at all. And also now they're starting the concierge model where you pay out of pocket to get the kind of attention we used to get 40 years ago. I'm glad doctors are finding ways around this degradation. At least for the best doctors and the patients that can afford to do it this way.
     
  25. comanchepilot

    comanchepilot En-Route

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    If docs could never examine a patient and treat everything with an Rx pad. . . .

    Lawyers have a saying - the practice of law would be simple without clients . . .
     
  26. wrbix

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    Careful now - that's a mighty broad brush with which you're painting .... lest not you offend someone here (me).
     
    Last edited: Nov 10, 2017
  27. Zeldman

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    :lol::lol::lol:

    Thinking about it.....the airline business would be much simpler without passengers....
     
  28. AggieMike88

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    Likely some memo out there somewhere referring to us as "self mobile cargo"
     
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  29. murphey

    murphey Final Approach

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    My severe chest pains turned out to be gall stones. Not fun when it happened at Airventure.
     
  30. bbchien

    bbchien Touchdown! Greaser!

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  31. denverpilot

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    Ive always heard that as “Self-loading cargo” haha

    I’m an FAA standard 170 lbs person whenever I fly commercial! :)
     
  32. patlaw

    patlaw Filing Flight Plan

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    I shudder to think how many pilots are avoiding healthcare because they don't want to be flagged on their medicals.
     
  33. James331

    James331 Touchdown! Greaser!

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    It's like the saying, "if you have to ask"

    Seeing the aftermath of people waiting too long, just go in now

    Just give a BS name and pay cash of your worried, but just get seen, seriously
     
  34. Rushie

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    I wish it were that easy. Don't you have to show ID now at most doctors offices? Some won't even see you without taking your insurance info up front. Although OP is in Australia, they have some kind of single payer system, not sure if they can go private or how that gets into the record.
     
  35. patlaw

    patlaw Filing Flight Plan

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    Plus, if you don't report the visit and the outcome, you're violating FAA regulations for which there are consequences.
     
  36. James331

    James331 Touchdown! Greaser!

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    Lots of illegals tend to get stitches and such just fine...



    Who doesn't love a good saber rattle!


    Long and short, report or don't, whatever, just get checked out and make sure it's not some crazy AA or something.
     
    Last edited: Nov 11, 2017
  37. SkyDog58

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    Dude, eat a burger. You are underweight. ;)
     
  38. Clark1961

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  39. denverpilot

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    Uhhh no. You missed the joke. It’s the only time in 20 years I get to say I’m a 170 lb human. LOL.
     
  40. Clark1961

    Clark1961 Touchdown! Greaser!

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    But, but, but, Lyle Lovett wanted a cheese burger...