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Hernia or pulled muscle?
I received three totally different diagnosis from three different specialists. I hurt my abdomen doing pull ups in September. At the moment, I felt a clear pull to the left of the umbilicus, an acute localized immediate pain inside the navel, and also something liquid down to the inguinal channel and the left testicle. Probably it was an intra abdominal excess pressure single event that left me with several small tendons teared and at least a major strained muscle. I stopped sports activities and switched to rest and walking. The muscles slowly healed over the next 12 weeks but an intermitent pain remained inside the navel. The feeling is that something is loose there and easily irritates.I feel it mostly at night (it wakes me daily at 3am) and when I exercise. I also developed an intolerance to any pressure at the waist. The umbilical region is always very tender, even a blanket seem to irritate it. I began wearing bigger clothes and no belts.
There is no bulge nor visible sign of swelling or hiperemia. No response to Valsava. I’m 41, athletic (CMI 23) and in good health.
The three specialists I consulted were:
1) Gastro surgeon with 30 years of experience who operated my brother in law’s inguinal hernia: with the tip of the finger he sensed a fatty tissue where it was not supposed to be, below the umbilical scar, and said it was a hernia with less than 1cm that should be only a nuissance. He also said the situation presents zero risk in the near future and I should only watch. He said surgery now would be premature because the defect can stabilize. He would wait and see. He didn’t felt necessary to do a US but I did one anyway in a specialized gastro clinic. After insisting many times about the exact point where I have pain and several passes, the doctor found nothing. He even said my musculature had regenerated well im the last three months.
2) Traumatologist: he examimed me and saw the US. Very dismissive, he said I should wait some weeks because probably thing will accomodate. The sensitiviness I was having could not be explained by my clinical condition. It would be impossible for such a small hernia to give me so much pain and discomfort in that specific region. He said surgery would be unwise, considering potential sensitiviness I was already experiencing.
3) Pain specialist: he did a complete anamnese and concluded I unleashed a somatization process. I am experiencing central sensitivization and alodinia due to anxiety and psychosomatic disorder. The pain is 80% neuropathic. I should first treat my anxiety and defuse the hyperalgesia mechanisms, otherwise even surgery will be disastrous in the post-op stage. He thinks once I deal with my head, maybe the hernia will be menageble. He also examined me and found nothing. He saw the US result and suggested possible obsessive-compulsive disorder related to hypocondria. I should also seek psychiatric help.Conclusion: I am really eager to go to surgery but everyone around me says I should wait. Surgery would not be convenient now because I am moving out to another country in the end of Jamuary. But is has been difficult, Im experiencing restrictions to exercises, pain, anxiety and some depression.
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