Hernia Pain

Kaizen:

• Only meals after going to Publix or walking to a new dog care place.
• Start OMAD or TMAD with a 3-egg omelet
• Do main dental care before bedtime

What I Need to Do:

• Daily exercise
• Build the blogs while I can
• Find online freelance work
• Use screenshots to outline the Kaizen book
• Make an exercise spreadsheet
• Make a spreadsheet for travel expenses in 2024
• Multiple walks

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Strikes me that the same blueprint could work for any popular software.

Others with 100M+ users 👇

• Notion
• HubSpot
• Shopify
• Airtable
• Figma

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She’s Earned $100K as a Freelancer on Upwork

Naailah Dawood posted this video back in January…

• How I made $100K as a Freelancer on Upwork |10 easy steps

Naailah lives in Jordan 🇯🇴 though it sounds like she’s from the UK originally 🇬🇧

She earned that $100K in less than 2.5 years.

Two services listed on her Upwork profile…

• Social Media Manager + Video editing + Graphic design – $40.00/hr
• Video Editor for YouTube, Facebook ADs and long form content – $40.00/hr

Apparently she wasn’t some kind of super-skilled expert when starting out, had just picked up bits and pieces in previous jobs 💪

Strikes me that this is still one of the most reliable ways to earn a living online: freelancing simple skills on platforms like Upwork.

Naailah started out charging $15/hour for the first couple of months, built up some experience and positive reviews, then raised her rate to $40/hour 🤑

How about giving this a try yourself?

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Sharp pain below the rib cage on the left side near the belt line, primarily when it occurs at night and is triggered by movements like getting out of bed, can have several possible causes. Some common explanations include:

1. Muscle strain or injury: If you’ve recently lifted something heavy or overexerted yourself, you might have strained muscles around the ribcage or abdomen. Muscle pain can worsen with movement, particularly when changing positions.
2. Gas or bloating: Trapped gas in the colon (splenic flexure syndrome) can cause sharp, intermittent pain under the left rib cage. If your digestive system slows down at night, allowing gas to build up, this pain may be more noticeable.
3. Costochondritis: Inflammation of the cartilage connecting your ribs to the breastbone can cause sharp pain. This pain can intensify with specific movements or positions.
4. Kidney stones: Although kidney stones often cause pain in the lower back or flank, pain can radiate significantly to the front or side when changing positions.
5. Gastroesophageal reflux disease (GERD): Acid reflux can sometimes cause sharp pain that feels like it’s originating near the rib cage. Lying down can exacerbate GERD symptoms.
6. Hiatal hernia occurs when part of the stomach pushes through the diaphragm. It can lead to intermittent pain, especially after eating or when lying down.
7. Spleen issues: The spleen is located on the left side, and an enlarged or injured spleen can cause pain in this area, though this is usually associated with other symptoms like fatigue or tenderness.
8. Pancreatitis: Though this would usually cause more constant and severe pain, inflammation of the pancreas can sometimes cause pain that radiates to the left side of the abdomen.

Since the pain is not constant and seems positional (triggered by getting out of bed), a musculoskeletal issue like a muscle strain or costochondritis could be the most likely explanation. However, it is always essential to consult a healthcare professional for an accurate diagnosis, especially if the pain persists or worsens.

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A hiatal hernia occurs when part of the stomach pushes up through the diaphragm into the chest cavity. The diaphragm is a muscle that separates the abdomen from the chest. It has an opening (the hiatus) through which the esophagus passes before connecting to the stomach. In a hiatal hernia, the stomach bulges through this opening, causing discomfort and other symptoms.

https://www.mayoclinic.org/diseases-conditions/hiatal-hernia/symptoms-causes/syc-20373379

Types of Hiatal Hernia:

1. Sliding hiatal hernia: This is the most common type, in which the stomach and a portion of the esophagus slide up into the chest through the hiatus. The hiatus can slide back and forth, meaning symptoms may come and go.
2. Paraesophageal Hiatal Hernia: In this less common type, part of the stomach pushes through the diaphragm alongside the esophagus while the esophagus stays in its normal position. This type is more likely to cause complications because it can pinch off the stomach’s blood supply (strangulation), which can be serious.

Causes:

Hiatal hernias can be caused by various factors, including:

• Aging: The diaphragm can weaken with age, increasing the likelihood of developing a hernia.
• Increased pressure in the abdomen: This can occur due to obesity, pregnancy, chronic coughing, constipation (straining during bowel movements), or heavy lifting.
• Injury: Trauma or surgery involving the abdomen may weaken the diaphragm.
• Congenital defect: Some people are born with an unusually large hiatus, making them more prone to hernias.

Symptoms:

A hiatal hernia often doesn’t cause symptoms, but when it does, it can mimic other conditions like acid reflux or heart problems. Symptoms may include:

• Heartburn: A burning sensation in the chest caused by acid reflux. This is the most common symptom and often occurs when lying down or after meals.
• Regurgitation of food or liquids.
• Chest pain: Sometimes mistaken for a heart attack. The pain can radiate to the back or neck.
• Difficulty swallowing (dysphagia).
• Belching or bloating.
• Shortness of breath: In larger hernias, part of the stomach can press against the lungs.
• A feeling of fullness after eating a small amount.

Risk Factors:

• Age over 50.
• Obesity.
• Smoking.
• Chronic coughing or straining.
• Pregnancy.

Diagnosis:

Hiatal hernias are often diagnosed through:

• X-rays of the upper digestive tract.
• Endoscopy, where a flexible tube with a camera is inserted down your throat to visualize the stomach and esophagus.
• Esophageal manometry, which measures muscle contractions in the esophagus.
• pH test, to check for acid reflux.

Treatment:

Treatment depends on the size and symptoms of the hernia:

1. Lifestyle changes: Mild symptoms can often be managed by:
   • Eating smaller, more frequent meals.
   • Avoid lying down immediately after eating.
   • Elevate the head of your bed to prevent acid reflux.
   • Avoiding trigger foods (spicy, fatty, or acidic foods).
   • Losing weight if overweight.
   • Quitting smoking.
2. Medications:
   • Antacids: To neutralize stomach acid.
   • H2 blockers or proton pump inhibitors: To reduce acid production.
   • Prokinetic agents: To help strengthen the esophageal sphincter and improve gastric emptying.
3. Surgery: Surgery is considered when:
   • There is a large hernia or strangulation risk.
   • Medications and lifestyle changes don’t alleviate symptoms.
   • Severe complications like strangulation or obstruction occur. The most common procedure is Nissen fundoplication, where the stomach is wrapped around the lower esophagus to strengthen the lower esophageal sphincter and prevent reflux.

Complications:

• Strangulation (rare in sliding hernias but possible in paraesophageal hernias), where the blood supply to part of the stomach is cut off.
• Severe acid reflux which can lead to esophagitis, Barrett’s esophagus, or even an increased risk of esophageal cancer over time.

Managing a hiatal hernia typically focuses on relieving symptoms, particularly acid reflux, through a combination of lifestyle changes, medications, and, in severe cases, surgery.

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Yes, it’s possible that the pain you’re experiencing could be caused by costochondritis following recovery from broken ribs. Costochondritis is the cartilage inflammation where the ribs attach to the sternum (breastbone), and it can cause sharp or aching pain in the chest area. It’s often triggered by physical activity, certain movements, or changes in position, which aligns with your description of pain occurring when you get out of bed.

https://www.mayoclinic.org/diseases-conditions/costochondritis/symptoms-causes/syc-20371175

In your case, the trauma from the broken ribs could have caused lingering inflammation or irritation in the rib joints and surrounding tissues. Even after the ribs themselves have healed, this inflammation may persist and lead to intermittent pain, particularly with certain movements that stress the chest wall, such as getting up or twisting.

Common signs of costochondritis include:

• Sharp pain around the rib cage, especially in the front and sides, which can sometimes radiate.
• Pain that worsens with movements like deep breathing, coughing, or changing positions.
• Tenderness when pressing on the area where the ribs meet the sternum.

Given that you had a rib injury before, it’s worth discussing these symptoms with a healthcare provider to rule out other potential causes and to see if this might be related to costochondritis or another issue stemming from your recovery.

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