Dear doctor,



I am a 39 year old woman, 6ft height, 295 pounds (already undergoing a deliberate steady weight loss). I have no significant prior medical history.



After an 8 month history of abdominal pain that initially presented as (and was treated as) GERD, I was diagnosed at the beginning of April with acute cholecystitis secondary to gallstones and had a laparascopic cholecystecomy two and a half weeks ago. Persistent right upper quadrant pain after surgery was so severe that it contributed to atelectasis, which delayed my discharge by three days. I had a HIDA scan to rule out bile leakage and seemed to improve.



Two days after discharge, I represented to the ER with severe right upper quadrant pain radiating strongly to the back. The pain was so severe that my respiratory rate rose to 32 per minute. The ED doctor sent me for a CT scan to rule out PE; this was negative. Lab values were 'normal'. One liver enzyme was above normal (they did not inform me which) but apparently insignificantly so. I remained in hospital for pain control for 2 days and then was again discharged, told by the nurse practitioner discharging me that I'd 'had enough analgesia for a lap chole', this despite the fact that I'd needed IV morphine the same morning to control my pain. I was very much made to feel like a time waster who was only seeking attention and or pain medication. This, despite my background as a UK trained RN.



I gritted my teeth through severe pain for the rest of the week, just barely keeping myself out of the ER due to the level of severity. Two weeks post surgery, I had follow up with the surgeon, who told me that I'd had 'all the tests' and everything was normal.



In despair, I went back to my GI doctor, who - thank goodness - took me seriously and sent me for MRCP. The MRCP showed at least three filling defects assumed to be common bile duct stones and an ERCP is scheduled for next week.



In the meantime, as well as severe right upper quadrant pain, which worsens at night and when lying prone, I have begun experiencing moderate to severe LEFT upper quadrant pain at the same time. This pain also radiates to the back and frequently has a squeezing or crushing quality. I had mentioned this to my GI doctor when discussing the need to go for MRCP, but he didn't really tell me anything about it.



I do not feel seriously unwell and have no jaundice, fever, vomiting or tachycardia, but also have no appetite and frequently feel dizzy, fatigued, nauseous and hot/bothered (even when trying not to take analgesia). I'm concerned that this LUQ pain might be my pancreas. I have modified my diet to be as low fat as possible, but this has not reduced the symptoms.



Should I be concerned about this or just wait for my ERCP in four days? Thank you in advance for your time and help.