Referred Pain Refers to Something Else

…on our last episode.


Yes, having referred-pain in the left should is suggestive of heart-involvement. And I’m only 46, but the ticker’s still rather healthy, thankyouverymuch.

It’s not my heart.

And it’s not my left shoulder.

Referred pain in the right shoulder, on the other hand (heh, that was funny right there), is suggestive of liver-involvement. There aren’t any sensory nerves in the liver, as such. Much as the brain, lungs, and several other internal organs don’t have mechanoreceptors. Instead, discomfort or injury to the liver is referred pain elsewhere.

“I’d like a CT…”, he started.

“…of my liver,” I finished.

About a half hour later, I was across the street at Samaritan Healthcare getting another dose of radiation in the CT scan. Then I’d have to wait another hour for the radiologist to interpret and report back to my physician. So, I just went home and resumed shivering and waiting.

No sooner than I got home, the phone rang. “Well, I know why you have a fever. You have a liver abscess.”

I remarked, “Well, that would explain a few things.” Yet, at the time, I still hadn’t fully comprehended how many things it would explain.

“We don’t have what we need to treat you here.”

Moses Lake had only barely reached the Level III trauma center designation. Samaritan in ML can stabilize a patient then transport them off to Wenatchee or Spokane.

He helpfully added, “I’ve already called ahead to Confluence [Wenatchee] and they’re expecting you. I can have you taken there by ambulance…”

“Uh, no, thanks. My checkbook is still reeling from the last emergency trip the other direction,” I jokingly said. “I’ll have Daisy drive me there as soon as she gets back from the pharmacy.”

…πŸš‘β˜’οΈπŸ“œ


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Adjusting Focus

…on our last episode.


Then, he asked a question, “Do you have any pain or discomfort, of any kind, even minor or trivial, anywhere?”

“No, nothing… but honestly, I think I slept on my shoulder wrong… but it’s probably nothing at all…”

“What kind of discomfort? Burning? Pressure? Tearing?”

“None of that,” I’d said, “It’s just a common myalgia — a muscle pain from over-use…”

And then, the very moment when I clarified where it was β€œ…in my right shoulder…” he and I both latched onto that one, single, clue.

…β˜’οΈπŸ“œ


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Segue on the Ongoing Migraine Rant

…on our last episode.


It’s normal to have a fever every now and again. Your body temperature will fluctuate naturally by about a degree — 36C – 38C every single day. A bit higher before bed. A bit lower in the morning. A bit higher after exercise. And so forth. Typically, it’s no issue and often unperceived.

Sometimes, you’ll get a fever while your body fights off some viral or bacterial infections: the “common cold”, flu, strep throat, chickenpox, pneumonia; dehydration; sunburn; some kinds of medications.

We first wait it out to see if it subsides.

If it doesn’t, then we start to look for causes.

I started having a fever. Low-grade. 38C. Wait it out a few days and see how it goes. Maybe it’s a common cold. Maybe it’s flu-season (not in August). Maybe I’m dehydrated (not more than I’ve been for decades, like most of us are). I live in a desert, but I rarely go outside or into direct sun (yes, telecommuter-life), so it’s not sunburn or heat-exhaustion or (worse) heat-stroke.

Still, we’ll simply wait it out for a few days before seeking medical assistance. It rose and stayed at about 39 to 39.5C.

We went through the same initial Q-A to see if we could find a clue. Any clue…

I hadn’t been traveling or out of the country since before the fall. I haven’t been exposed to anything. I live in A/C. I only go out in the early morning or late evening.

Ah, yes, it’s the annoying β€” dreaded, even β€” “fever of unknown origin”.

…πŸ•΅οΈβ€β™€οΈπŸ“œ


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Vision

…on our last episode.


This is where migraine symptoms become annoying.

Visual issues were part of the predictable prodrome.

I’d go through a visual aura phase that would last about half an hour. I’d have to just sit and wait for it to pass. Scintillating scotoma, I think it’s called. In a pattern of something of a fortification spectrum.

The issue would begin at the fovea, then progress across one half of my binocular field of view. Bilateral.

Did I have an abnormality in my optic chiasm? Probably not.

Certainly, I wasn’t having a stroke. I’d have lost much more than that, and with my physical condition and general health, it’s unlikely. I wouldn’t say “athletic”, but I would suppose it’s better than average. Yes, even after The Year Of Hell.

Eh, so the vision — ongoing. Occasional. In time, it became β€œnormal” for me. It also became annoying as hell. I would learn to live with it.

I mean, I’ve been living with low-grade discomfort or low-grade pain for so long that it was effectively a lifetime of normality.

…πŸ€’πŸ“œ


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The Myalgia

…on our last episode.


The sensation of headache pain, I’d sometimes have in muscles in my shoulders usually. But, head, neck, upper arms, flank.

Pain, yes, but not “weakness” as I’d have associated with myalgia.

Perhaps what I’ve been experiencing for so long was simply my own interpretation of the “weakness” part of myalgia.

…πŸ‘πŸ“œ


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