Story Time: A painful ER visit

ID: Chrys, a black woman, in a selfie wearing a mustard yellow blouse with white stripes. She is wearing pink wireless headphones and has tortoise brown glasses. Her hair is out. She is wearing dark lipstick; however, she is not smiling.

ID: Chrys, a black woman, in a selfie wearing a mustard yellow blouse with white stripes. She is wearing pink wireless headphones and has tortoise brown glasses. Her hair is out. She is wearing dark lipstick; however, she is not smiling.

The photo above is a selfie I took in the airport on December 27th, 2018, before I traveled to my hometown in NYC to bring in the New Year with my family. I had absolutely no idea that I was about to undergo a painful diagnosis.

This time last year, a friend of mine picked me up from the airport and we went to the city for dinner and a movie. Before the movie however, I had this sudden urge to urinate. There was so much pressure on my bladder. You’d think I was holding my bladder for hours. As I left the restroom the pressure increased and pain began. I had been experiencing several pain episodes before this and was aware of the two large cysts on each of my ovaries so I didn’t think much of this pain. We went into the theatre and the pain increased. I thought it could have been gas pains or a bad reaction to the dinner we had but, my friend was not experiencing any symptoms and we had the same meal. Luckily we left in the middle of the movie. As we headed out I was beginning to become doubled over with the pain. My friend suggested grabbing a ginger ale from a corner store across the street before we headed to Brooklyn to my parents’ house.

The pain continued to increase and had become a sharp and stabbing pain. By the time we got to the house, the pain was so bad that my friend had to escort me inside because walking had become very difficult. I laid on the couch in my living room because I couldn’t walk any further to my room. Thankfully my sister and her children were visiting. She woke up and came to check on me. By this time I was crying out in pain. My mother eventually came into the living room and suggested going to the emergency room. I refused and told her I’d be okay and that I just needed to lay down. The only pain relief I experienced was laying flat in one specific position: on my right side.

My mother insisted that we’d go to the hospital in the morning if the pain continued. When she checked on me around 4AM the pain had not improved at all. At 5AM she decided that we were going to call a cab and head to the hospital. She and I got in a cab and headed to a hospital. I was called into the triage room almost immediately; however, it was difficult for me to sit upright to answer the nurse’s questions. They decided to get a stretcher for me to lay on as they took my vitals and asked me questions.

Eventually, I was transferred to one of the beds in the emergency room (ER). I was seen by the ER doctor around 7AM. She asked about my cysts which I was able to tell the nurses about during triage. Thankfully our university’s health system has an online portal which allowed me to show the ER doctor the notes from the different ultrasounds I had a couple of months ago. She said she’d have the nurses check in on me and they’d get me some pain medications soon. The ER doctor contacted the gynecology department for a consult because she suspected that one of my ovaries might have twisted (ovarian torsion) or one of the cysts may have ruptured.

As I waited for the GYN consultation, I became very anxious about what might be happening. I lied there on my side in my perfect position to keep the pain at a manageable level. I probably saw the two GYN residents around 11AM. They informed me that I’d have to have a pelvic and transvaginal ultrasound done in order for them to determine what needed to be done. I cried at the thought of having to undergo either of those ultrasounds while facing this pain. My nurse asked how that would be possible if I could not even lay flat on my back? She also asked them about the pain medication. They said the attending GYN would have to give the okay about pain killers.

Without any pain medications, I had both ultrasounds done. It took both GYN residents, the ER doctor, and a couple of nurses to hold me flat to complete the pelvic ultrasound. At this point, even the mere touch of my gown against my abdomen was painful, so the ultrasound probe being pushed along my pelvic area was extremely painful. The GYN residents called again to the attending to ask if I could be given pain killers before the transvaginal ultrasound because otherwise it might be impossible to get done. She told them specifically, “No. I need to see exactly how much pain she is ACTUALLY in first.” She told them she would be down soon and encouraged them to do their best and get the transvaginal ultrasound done. Again, all of them were holding me down at this point and holding my knees still and apart. I just laid back and cried. The attending walked in as they were trying to do the ultrasound and said, “oh wow. She’s actually in a lot of pain huh? Give her some morphine.” She then got the information about my previous ultrasounds and looked at what they could see or not see from the ultrasounds they attempted to perform. Apparently, they could not locate my right ovary. They decided that emergency surgery would be my best bet.

At this point, I was exhausted from the pain and the overall experience. I was hurt because I did not understand why the attending kept refusing their requests to offer me pain relief. I had described my pain as a 12/10. All of the nurses and the ER doctor were well aware of how much pain I was experiencing, yet one doctor had to be the judge of my pain and warrant my right to pain relief. Incredible! By the time the attending had come, it was almost 2PM. I had been in pain since 8:30pm the night before. Although I did not want to consider it, I wondered whether I was denied pain relief because I was a young black woman. Besides, the thought of racial discrimination against a black woman in a health care setting would not be unusual. Either way this experience was upsetting.

I eventually went into surgery around 3PM. Thankfully there was no ovarian torsion. My right ovary was sort of tucked behind my uterus due to the size of the cyst and adhesions due to endometriosis. One of the cysts was leaking which they said was the cause of the pain. They drained it and confirmed that the two ovarian cysts were endometriomas. They also noted a lesion on my small intestine. They did not remove either of the cysts, which led the doctors I saw this year to ask, “why didn’t they try to remove any of it?”

While the outcome of the surgery was disappointing, I was glad to be okay and to finally be able to name what has been plaguing my life for years. There’s no way to determine if it has always been endometriosis for the past 16 years (ages 12-28), but it is very likely. No one thought to consider endometriosis until last year, when one GYN took my period pain complaints seriously.

That was just the beginning of the journey. Since the first surgery in December, I continued to experience pain a bit more intense and often, which led to my second surgery this past July. Time will tell if the July surgery was worth it, but for now it is difficult especially considering the pain flare ups I have been experiencing especially this month.

This month I have been incredibly anxious especially leading up to this “anniversary” of my emergency surgery. I have been experiencing pain flare ups again this month, despite maintaining the same drug combo regimen that has been keeping my pain flares at bay until this month. With the pain flares there is much anxiety because a lot of the pains are familiar. My mind and body realize that these pains are similar to ones that I was experiencing this time last year. Recognizing the pain makes me anxious mostly because I can not afford to have another ruthless emergency room visit this year. I can’t afford it both mentally and financially, but I can’t dwell on my fears. Instead, I must continue to be hopeful.

 

What I’ve learned?

  • I need to take my pain seriously before I expect others to take it seriously

  • As much as it is important that I take my pain seriously, it is equally as important that healthcare workers listen to the pain complaints of women (and anyone else with a uterus), especially black women Black women

Check out these resources regarding pain discrimination in minorities:



Chrystelle Vilfranc