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<ul class="summary-list"><li>Angelina Wiley said she was shot four times on New Year's Day in Kansas City, Missouri. </li><li>In May, she made a TikTok saying a SKIMS bodysuit saved her life during the shooting.</li></ul><p>A Kansas City woman said a bodysuit from <a href="https://www.insider.com/photos-kim-kardashian-west-career-evolution-2019-2">Kim Kardashian's</a> shapewear company SKIMS saved her life.</p><p>On January 1, 2023, Angelina Wiley was shot in Kansas City, Missouri, while waiting for a Lyft in the early hours of New Year's Day, as CBS affiliate <a href="https://www.kctv5.com/2023/01/03/mother-outraged-following-new-years-day-shooting-westport/">KCTV5 reported</a>.</p><p>In a <a href="https://www.tiktok.com/@honeygxd/video/7234610033911172398?_r=1&amp;_t=8dz5nJKgUtG">TikTok</a> that has been viewed over 700,000 times since it was uploaded on May 18, Wiley, 22, said she was shot four times in the Westport area of Kansas City. KCTV5 also reported that an unnamed man was shot during the incident as well and sustained life-threatening injuries. </p><p>According to the outlet, Wiley was taken to the hospital in an ambulance.</p><p>Wiley said in a <a href="https://www.tiktok.com/t/ZT8d3ctMq/">TikTok</a> posted in March that the shooter was wearing a ski mask, which has made it difficult to identify them. As of July 2023, no one has been charged in the shooting, according to Wiley's TikTok. When reached for comment, Kansas City Missouri Police Department did not immediately respond to Insider's request for further details.</p><p>Wiley's mother told KCTV5 in January that the incident left her daughter with a ruptured bladder and cracked pelvis. And according to a <a href="https://www.gofundme.com/f/tvtrm3-ninas-road-to-recovery?utm_campaign=p_cp+share-sheet&amp;utm_medium=copy_link_all&amp;utm_source=customer">GoFundMe</a> page Wiley linked to in the caption of her TikTok, and which she most recently updated on July 8, Wiley still has a bullet lodged in her abdomen as a result of the shooting. </p><p>Wiley said in the TikTok video that the injuries sustained in the shooting would have been much worse if she hadn't been wearing SKIMS that night. </p><p>"Kim Kardashian saved my life," Wiley said in her video. "This New Year's, I got shot four times. The night I got shot, under my dress, I was wearing a SKIMS shaping bodysuit."</p> <p>Wiley didn't specify which SKIMS bodysuit she was wearing. The brand sells nearly 19 different <a href="https://affiliate.insider.com?h=6c26ea27d8d0304ab207f8751f05962db6be9b8cb047960ecd3f35f66ed79693&amp;postID=64b15f5c506ab843d65011f4&amp;site=in&amp;u=https%3A%2F%2Fskims.com%2Fcollections%2Fshapewear-bodysuits">bodysuits</a> as of July, ranging from catsuits to thong bodysuits that cost between $68 and $128. </p><p>"It was so tight on me that it literally kept me from bleeding out," Wiley went on to say of the bodysuit. "I recommend it. I'm definitely gonna buy some more. I mean, I should wear it every day. It's like body armor for women." </p><p>"Call it fate or Jesus, but Imma call it Kim," Wiley added. Wiley also thanked Kardashian in the caption of her video, writing, "no but fr, thanks kim." (Wiley did not immediately respond to Insider's request for comment.)</p><p>Although bodysuits are popular, it is not safe to wear them for extended periods of time, as the medical director of the Be Well Medical Group Dr. Lisa Ashe told <a href="https://www.shefinds.com/we-asked-a-doc-are-bodysuits-dangerous-to-your-health/#:~:text=%E2%80%9CIt%20can%20also%20lead%20to,and%20ensure%20regular%20bathroom%20breaks." target="_blank" rel="noopener">SheFinds</a> in 2016. Ashe told the outlet that their compression can cause acid reflux, stress incontenence because of the pressure they place on the bladder, and swelling from water retention because people sometimes avoid going to the bathroom when they wear them. Dr. Wakim-Fleming also told the <a href="https://health.clevelandclinic.org/a-doctors-advice-on-wearing-shapewear/" target="_blank" rel="noopener">Cleveland Clinic</a> that if shapewear is too tight, it can cause nerve damage or irritate your skin. </p><p>Ashe recommends wearing a bodysuit for no longer than six hours a day and encourages taking ample bathroom breaks when wearing one, even if it's annoying to take on and off. </p><div type="image" title="skims" height="1656" width="2208" msid="101767253" hostid="261" sizebytes="181046"></div><p>As of July 2023, Kardashian and SKIMS have not publicly commented on Wiley's experience. Representatives for both did not immediately respond to Insider's request for comment. </p><p>Kardashian founded SKIMS in 2019, and the successful shapewear company helped propel her to becoming a <a href="https://www.businessinsider.com/kim-kardashian-net-worth-officially-billionaire-forbes-list-2021-4">billionare in 2022</a>.</p><p>Wiley left a comment on her <a href="https://www.gofundme.com/f/tvtrm3-ninas-road-to-recovery?utm_campaign=p_cp+share-sheet&amp;utm_medium=copy_link_all&amp;utm_source=customer">GoFundMe</a> page on July 8 to give an update on her recovery. </p><p>"I've gone through ups and downs as I hopped, scooted, and rolled around everywhere when I couldn't walk," she wrote. "I continue to have a lot of struggles with my hip ever since the fracture as well as many other pains. The bullet still in me causes random pains and honestly I struggle with severe ptsd ever since the shooting. It has made returning to work full time difficult."</p>

A woman says wearing a bodysuit from Kim Kardashian's SKIMS saved her life when she was shot 4 times

<ul class="summary-list"><li>The most common cause of low back pain on the left side is a muscle strain. </li><li>Other causes of lower left back pain include a kidney infection, herniated disc, and pregnancy. </li></ul><p>A stabbing or throbbing pain on the lower left side of your back can sideline you from exercise and basic activities for days. The good news is that it's probably because you've strained some of your back muscles or ligaments, which will heal over time.</p><p>But in some cases, unilateral back pain, like on just the left side, signals a serious issue like an infection or injury that needs medical care.</p><p>Here are nine <a href="https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Low-Back-Pain-Fact-Sheet" target="_blank" rel="noopener">potential causes</a> of pain on the left side of your lower back, when to consult a doctor, and how you can treat it yourself.</p><h2>1. Muscle strain</h2><p>The <a href="https://www.aans.org/en/Patients/Neurosurgical-Conditions-and-Treatments/Low-Back-Strain-and-Sprain#:~:text=Lumbar%20(lower%20back)%20muscle%20strains,in%20moving%2C%20twisting%20and%20bending." target="_blank" rel="noopener">most common cause</a> of lower left back pain is an injury to the muscles, tendons, and ligaments supporting the spine such as: </p><ul><li>A fall or other accident causing back trauma</li><li>A sudden twisting movement </li><li>An uneven distribution of weight, such as when you're carrying a heavy bag on one shoulder</li><li><a href="http://insider.com/how-to-fix-posture" target="_blank" rel="noopener">Poor posture</a></li></ul><p>Signs your back pain is due to a muscle strain is if you feel sore, stiff, experience a stabbing pain, or have muscle spasms, says <a href="https://apps.smhs.gwu.edu/smhs/facultydirectory/profile.cfm?empName=Michael%20Rosner&amp;FacID=2061076978" target="_blank" rel="noopener">Michael Rosner</a>, MD, a neurosurgeon at <a href="https://smhs.gwu.edu/" target="_blank" rel="noopener">George Washington University's School of Medical and Health Sciences</a>. </p><h2>2. Infection </h2><p>An untreated UTI can lead to an advanced <a href="https://www.niddk.nih.gov/health-information/urologic-diseases/bladder-infection-uti-in-adults/symptoms-causes" target="_blank" rel="noopener">bladder</a> infection or left <a href="https://www.niddk.nih.gov/health-information/urologic-diseases/kidney-infection-pyelonephritis/symptoms-causes" target="_blank" rel="noopener">kidney</a> infection which can cause a constant, aching pain that radiates through your left lower back.</p><p>The best thing to do is to prevent UTIs by staying hydrated and peeing after sex, and treating symptoms right away using <a href="https://www.insider.com/guides/health/treatments/how-to-treat-a-uti-at-home">home treatment methods</a> and/or antibiotics. </p><p>If you have left lower back pain and also have symptoms such as burning urination, fever, or chills, see your doctor as soon as possible to check for an infection, says <a href="https://www.uofmhealth.org/profile/777/anthony-e-chiodo-md" target="_blank" rel="noopener">Anthony Chiodo</a>, MD, clinical director of Spinal Cord Injury Medicine at the University of Michigan.</p><h2>3. Kidney stones</h2><p><a href="https://www.insider.com/guides/health/conditions-symptoms/what-causes-kidney-stones" target="_blank" rel="noopener">Kidney stones</a>, which are mineral build ups in your urinary tract, can cause sharp, intense pain through the lower left side of your back as well as pain in the lower abdomen, groin, and below the ribs. Another common symptom is bloody urine. </p><p>Some of the <a href="https://www.insider.com/guides/health/conditions-symptoms/what-causes-kidney-stones">major risk factors</a> for kidney stones include genetics, diet, geographic location, and other underlying medical conditions. </p><p>Smaller stones can pass through the urinary tract without treatment, but a urologist may need to remove larger stones <a href="https://www.niddk.nih.gov/health-information/urologic-diseases/kidney-stones/treatment" target="_blank" rel="noopener">via surgery</a> or by <a href="https://medlineplus.gov/ency/article/007113.htm" target="_blank" rel="noopener">using shock waves</a> to break them up. Or, you could always try <a href="https://www.businessinsider.com/roller-coaster-riding-might-help-people-pass-kidney-stones-2016-9">riding a roller coaster</a>. </p><h2>4. Endometriosis</h2><p>Endometriosis is a condition where tissue similar to the uterine lining grows outside the uterus. It <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7573391/" target="_blank" rel="noopener">can cause low left back pain</a>, along with <a href="https://www.insider.com/home-remedies-for-period-cramps" target="_blank" rel="noopener">intense cramping</a> during menstruation and <a href="https://www.insider.com/guides/health/sex-relationships/why-is-sex-painful" target="_blank" rel="noopener">pain during intercourse</a>.</p><p>Endometriosis is a common condition that affects <a href="https://www.businessinsider.com/do-i-have-endometriosis-2018-2">1 in 10 women in the US</a>, and can lead to complications with fertility. The gold-standard of endometriosis diagnosis is laparoscopic surgery, so doctors can see where the tissue has spread. </p><h2>5. Stress fracture</h2><p>Overtime repeated physical activity, such as lifting weights or playing sports like <a href="https://fittoplay.org/body-parts/back/low-back-stress-fracture/#:~:text=The%20injury%20is%20most%20common,the%20main%20activity%20takes%20place." target="_blank" rel="noopener">tennis, rowing, and gymnastics</a> can strain the spine, resulting in a <a href="https://www.ncbi.nlm.nih.gov/books/NBK554538/" target="_blank" rel="noopener">stress fracture.</a> </p><p>The area may hurt when you touch it, and the pain may be too severe to respond to over-the-counter treatments. Most cases heal on their own in six to eight weeks, but the only way to get a proper diagnosis is through medical attention.</p><h2>6. Pregnancy</h2><p>More than two-thirds of pregnant women <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7053516/" target="_blank" rel="noopener">experience lower back pain</a>, most often in the form of what is called <a href="https://www.cedars-sinai.org/health-library/diseases-and-conditions/b/back-pain-during-pregnancy.html" target="_blank" rel="noopener">posterior pelvic pain</a>. </p><p>Posterior pelvic pain is a deep, throbbing pain that you either experience on one or both sides of your lower back.</p><p>You will also probably experience general muscle soreness in your back as the baby grows larger. That's because the baby's weight can throw off your <a href="https://www.cedars-sinai.org/health-library/diseases-and-conditions/b/back-pain-during-pregnancy.html" target="_blank" rel="noopener">center of gravity</a>, which may require you to compensate by working different muscles in your back.</p><h2>7. Sacroiliac joint dysfunction</h2><p><a href="https://pubmed.ncbi.nlm.nih.gov/23253394/" target="_blank" rel="noopener">Sacroiliac joint dysfunction</a> is when the joint that connects the hip bones to the lower part of the spine moves abnormally, becoming inflamed.</p><p>Inflammation in the left hip joint can cause a dull, aching pain in the left lower back, often accompanied by pain in the buttocks, or in the back of the left upper thigh. </p><p>The condition can be chronic or a result of temporary stress. Risk factors include <a href="https://www.insider.com/what-is-si-joint-pain-2018-2" target="_blank" rel="noopener">pregnancy</a>, uneven leg length, or impact from an accident like a fall.   </p><h2>8. Herniated disc </h2><p>Lumbar disks, the cushion of tissue between each vertebrae in the lower spine, can bulge or compress under stress, causing a <a href="https://www.mayoclinic.org/diseases-conditions/herniated-disk/symptoms-causes/syc-20354095" target="_blank" rel="noopener">herniated disc.</a></p><p>Most people have no symptoms from a herniated disc, but some develop pain and numbness on one side of their lower back, depending on where the disc is located. In rare cases, disks break or rupture, causing severe pain and requiring surgery to prevent permanent nerve damage. </p><p>"If you have radiating leg pain or increasing leg weakness, or bowel or bladder dysfunction, go to the emergency room," Chiodo says.</p><h2>9. Tumor</h2><p>While <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2078307/" target="_blank" rel="noopener">rare</a>, <a href="https://www.hopkinsmedicine.org/health/conditions-and-diseases/spinal-cancer-and-spinal-tumors" target="_blank" rel="noopener">spinal cancer or a spinal tumor</a> can cause back pain on the left or right side of the back.</p><p>Other symptoms may include unexplained weight loss, fever, numbness, weakness, or difficulty walking. However, it's important to note that this is a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2078307/" target="_blank" rel="noopener">rare cause of back pain</a>. </p><h2><strong>How to treat low back pain</strong></h2><ul><li><strong>Over-the-counter pain medications</strong> such as acetaminophen, aspirin, ibuprofen, and naproxen to relieve pain and inflammation. </li><li><strong>Prescription drugs</strong> like <a href="https://medlineplus.gov/ency/article/007486.htm" target="_blank" rel="noopener">muscle relaxants</a> or pain relievers can provide short-term relief.</li><li><strong>Over-the-counter </strong><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6481750/" target="_blank" rel="noopener"><strong>topical creams, gels, patches, or sprays</strong></a> with lidocaine, menthol, or <a href="https://insider.com/is-healthy-food-good-for-you" target="_blank" rel="noopener">capsaicin</a> stimulate nerves in the skin, dulling pain. They can be <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6481750/" target="_blank" rel="noopener">particularly helpful</a> for localized pain due to sore muscles. </li><li><strong>Hot or cold pads</strong> may help ease pain, reduce inflammation, and improve mobility.</li><li><strong>Core exercises</strong> that strengthen your <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4174027/" target="_blank" rel="noopener">abs and muscles</a> lining the spine may help take the stress off the back, Rosner says. Check with your doctor before beginning any exercise program to make sure the exercises are right for your condition. </li><li><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3336928/" target="_blank" rel="noopener"><strong>Mindfulness-based stress reduction</strong></a><strong> (MBSR),</strong> an eight-week program of meditation and gentle yoga, can <a href="https://pubmed.ncbi.nlm.nih.gov/27002445/" target="_blank" rel="noopener">improve chronic lower back pain</a>. </li></ul><h2><strong>Insider's takeaway </strong></h2><p>Pain on the lower left backside is a common ailment and is usually the result of a soft tissue injury. Most back pain can be treated at home and should go away in a matter of weeks.</p><p>Having additional symptoms like fever or severe pain that persists for more than a few days may be a sign of a more serious underlying cause, such as a disk rupture, fracture, or an infection. </p><p>Consult your doctor as soon as possible if your arm or leg feels numb, you have problems walking or standing, or if you lose control of your bladder or bowels. </p>

9 reasons your lower left back hurts and when to see a doctor

<ul class="summary-list"><li>As more states restrict <keyword id="11901426" type="UNKNOWN" weightage="60" keywordseo="abortion" source="Orion">abortion</keyword> access following the overturn of Roe v. Wade, OBGYNs are expressing concern.</li><li>Children who give birth can face potentially fatal conditions like chronic infections and preeclampsia.</li></ul><p>After Indiana Attorney General Todd Rokita announced plans to<a href="https://www.politico.com/news/2022/07/13/indiana-doctor-10-year-old-rape-victim-00045764"> investigate a doctor</a> who performed an abortion on a <a href="https://www.dispatch.com/story/news/2022/07/13/columbus-man-charged-rape-10-year-old-led-abortion-in-indiana/10046625002/">10-year-old rape victim,</a> reproductive <keyword id="11894571" type="UNKNOWN" weightage="100" keywordseo="health" source="Orion">health</keyword> experts issued warnings about the life-threatening consequences of young girls giving birth.</p><p>In a June 13 <a href="https://cm.indystar.com/offers-reg/?return=https%3A%2F%2Fwww.indystar.com%2Fstory%2Fnews%2F2022%2F07%2F13%2Fohio-man-charged-rape-10-year-old-led-indiana-abortion%2F10048529002%2F">story published in The Indy Star</a>, Dr. Caitlin Bernard said she provided an abortion to the 10-year-old, who traveled from Ohio based on a referral from a doctor who specializes in child-abuse cases. Bernard told the outlet that the girl was six weeks and three days along in her <keyword id="6357793" type="UNKNOWN" weightage="60" keywordseo="pregnancy" source="Orion">pregnancy</keyword>. In Indiana, abortion is illegal after 22 weeks. In Ohio, the procedure is illegal after six weeks, with no exceptions for <keyword id="11911221" type="UNKNOWN" weightage="60" keywordseo="rape" source="Orion">rape</keyword> or <keyword id="14335892" type="UNKNOWN" weightage="60" keywordseo="incest" source="Orion">incest</keyword>.</p><p>In response, Rokita said he would investigate whether Bernard committed a crime because she helped an abortion seeker who crossed state lines.</p><p>"If Dr. Bernard has failed to file the required reports on time, she has committed an offense, the consequences of which could include criminal prosecution and licensing repercussions," Rokita wrote in a letter to Indiana Gov. Eric Holcomb, according to The Indy Star.</p><p>Gynecologists are more concerned about the potentially fatal consequences of a child giving birth, like days-long labor, preeclampsia, eclampsia, chronic infections, and pelvic inflammatory disease. An estimated 770,000 girls under 15 <a href="https://www.who.int/news-room/fact-sheets/detail/adolescent-pregnancy">give birth every year</a>, according to the World Health Organization. <a href="https://www.who.int/news-room/fact-sheets/detail/adolescent-pregnancy">Pregnancy is also one of the top causes</a> of death for girls between 15 and 19.</p><p>According to the American College and Obstetricians and Gynecologists, pregnancy is safest <a href="https://www.acog.org/womens-health/faqs/having-a-baby-after-age-35-how-aging-affects-fertility-and-pregnancy#:~:text=A%20woman's%20peak%20reproductive%20years,is%20unlikely%20for%20most%20women.">after a person's teenage years</a>. A woman's <a href="https://www.acog.org/womens-health/faqs/having-a-baby-after-age-35-how-aging-affects-fertility-and-pregnancy#:~:text=A%20woman's%20peak%20reproductive%20years,is%20unlikely%20for%20most%20women.">peak reproductive years</a> are between her late teens and late twenties, the ACOG website says.</p><h2>Young mothers don't have fully developed pelvises, which causes an extremely difficult birth</h2><p>Since a child's pelvis isn't fully developed, they may be too small to give vaginal birth, even if the fetus is small, <a href="https://people.com/health/new-study-highlights-gaps-in-womens-healthcare/">Dr. Mary Jane Minkin</a>, a board-certified OBGYN at Yale University School of Medicine, <a href="https://people.com/health/when-girls-under-15-experience-childbirth-the-consequences-to-their-bodies-can-be-devastating/">told People</a>.</p><p>As a result, labor could last for five days. After that, the baby usually dies, Dr. Shershah Syed, a gynecologist and expert on maternal mortality in Pakistan, <a href="https://www.nytimes.com/2022/07/18/health/young-girls-pregnancy-childbirth.html">told The New York Times</a>.</p><p>During this labor period, the fetus could press down on a girl's bladder and urethra, leading to <a href="https://www.insider.com/guides/health/conditions-symptoms/pelvic-inflammatory-disease">pelvic inflammatory disease</a> or tissue rupturing between her vagina, bladder, and rectum, Dr. Ashok Dyalchand, who's provided healthcare to pregnant adolescent girls for 40 years, told <a href="https://www.nytimes.com/2022/07/18/health/young-girls-pregnancy-childbirth.html" target="_blank" title="(opens new window)" rel="noopener">The Times.</a></p><p>While pregnant, girls below child-bearing age are more likely to develop <a href="https://www.insider.com/guides/health/reproductive-health/what-is-preeclampsia">preeclampsia</a>, a condition that causes high blood pressure and kidney and liver damage, Minkin told People. Untreated, preeclampsia can lead to seizures in the mother and death of the fetus.</p><p>Girls are also more likely to need Cesarean sections when giving birth than women of child-bearing age because of their body-development differences. And since girls are already going through so many body changes without pregnancy, carrying one could lead to extreme mental torment, Minkin continued.</p><p>"Pregnancy can be tough to deal with for a 24 or 34-year-old woman, let alone a 10-year-old child," Minkin told People.</p><p>If the baby does survive, they <a href="https://www.who.int/news-room/fact-sheets/detail/adolescent-pregnancy">tend to have low birth weights</a> and can face conditions like <a href="https://www.cureus.com/articles/100936-maternal-and-neonatal-outcomes-of-adolescent-pregnancy-a-narrative-review">poor blood flow, trouble breathing, stillbirth, and early death</a>.</p>

Gynecologists warn that girls under 15 who experience childbirth can face life-threatening consequences as legislators continue to restrict abortion rights

14 causes of blood in your semen, from STIs to cancer treatment, and when to call a doctor

<ul class="summary-list"><li><strong>Causes of pelvic pain can include STIs, cysts, endometriosis, and UTIs.</strong></li><li><strong>Some conditions that cause pelvic pain may get worse if left untreated.</strong></li><li><strong>Connect with your doctor to get help for severe, sudden, or ongoing pelvic pain.</strong></li></ul><p>Many people live with pelvic pain, which affects the lowest part of the abdomen between the belly button and the groin. The pain can range from mild to severe, and its intensity might fluctuate over time. </p><p>You can often <a href="https://www.uofmhealth.org/health-library/tv2262#tv2295" target="_blank" rel="noopener">treat minor pelvic pain</a> at home with a heating pad, warm bath, or OTC medication like ibuprofen or acetaminophen.</p><p>However, "prolonged, chronic, and sharp pelvic pain, or random pelvic pain that can be debilitating, is not normal. It could indicate a serious underlying condition," says Thaïs Aliabadi, MD, an OB-GYN with her private practice <a href="https://www.draliabadi.com/" target="_blank" rel="noopener">Dr. Thaïs Aliabadi</a>. </p><p>While pelvic pain can suggest <a href="https://www.insider.com/how-to-tell-if-you-have-an-std-2018-10" target="_blank" rel="noopener">sexually transmitted infections</a>, <a href="https://www.insider.com/do-i-have-endometriosis-2018-2" target="_blank" rel="noopener">endometriosis</a>, or several other conditions, it doesn't always have a clear cause.</p><p>Pelvic pain can also be confused with <a href="https://www.insider.com/what-causes-lower-left-back-pain" target="_blank" rel="noopener">different types of pain</a>, including pain that affects your bowels or bladder. </p><p>Below, we'll cover eight common causes of acute and chronic pelvic pain, plus offer some guidance on when it's best to connect with your doctor. </p><h2><strong>1. Pelvic inflammatory disease and sexually transmitted infections</strong></h2><p><a href="https://www.insider.com/pelvic-inflammatory-disease" target="_blank" rel="noopener">Pelvic inflammatory disease</a> (PID) can cause pain in your pelvis or lower abdomen that comes on suddenly. Other symptoms of PID include:</p><ul><li>Fever</li><li>Pain during sex</li><li>Unusual vaginal discharge or bleeding </li></ul><p>PID is <a href="https://www.cdc.gov/std/pid/stdfact-pid.htm" target="_blank" rel="noopener">typically caused</a> by sexually transmitted infections (STIs) like gonorrhea or chlamydia that have gone unteated. PID <a href="https://www.mayoclinic.org/diseases-conditions/pelvic-inflammatory-disease/symptoms-causes/syc-20352594" target="_blank" rel="noopener">can also develop</a> if bacteria enter the reproductive tract after miscarriage, an abortion, or giving birth, or during your menstrual period, but this is less common. </p><p><strong>How to treat it: </strong>The sooner you treat PID with broad-spectrum antibiotics, the greater chance you have of preventing <a href="https://www.cdc.gov/std/pid/stdfact-pid-detailed.htm" target="_blank" rel="noopener">complications</a>, including infertility and chronic pain. These antibiotics require a prescription from a doctor or other prescribing clinician. </p><h2><strong>2. Endometriosis </strong></h2><p><a href="https://www.insider.com/what-does-endometriosis-feel-like" target="_blank" rel="noopener">Endometriosis</a>, a chronic condition affecting the reproductive system that can make it difficult to become pregnant, is commonly associated with pelvic pain. </p><p><strong>How to treat it: </strong>This condition can't be cured, but <a href="https://www.insider.com/do-i-have-endometriosis" target="_blank" rel="noopener">common treatments</a> to mitigate the pain include: </p><ul><li><a href="https://www.insider.com/acetaminophen-vs-ibuprofen" target="_blank" rel="noopener">Nonsteroidal anti-inflammatory drugs</a> (NSAIDs) such as ibuprofen</li><li>Hormone therapy, including oral contraceptives to prevent ovulation and reduce menstrual flow</li></ul><h2><strong>3. Ectopic pregnancy</strong></h2><p>An <a href="https://www.insider.com/ectopic-pregnancy" target="_blank" rel="noopener">ectopic pregnancy</a> occurs when an embryo implants and grows outside the uterus, often in a fallopian tube. Common symptoms include:</p><ul><li>Severe pain and pelvic cramps, typically on one side </li><li>Nausea</li><li>A missed period or light spotting only</li><li>Vaginal bleeding</li><li>Dizziness</li></ul><p><strong>How to treat it: </strong>An ectopic pregnancy is a medical emergency and requires immediate medical aid, since it can cause life-threatening bleeding if left untreated. <a href="https://www.mayoclinic.org/diseases-conditions/ectopic-pregnancy/diagnosis-treatment/drc-20372093" target="_blank" rel="noopener">Treatment options</a> for ectopic pregnancy include medication and/or surgery. </p><h2><strong>4. Ovarian cysts</strong></h2><p>Twisted or ruptured <a href="https://www.insider.com/ovarian-cyst" target="_blank" rel="noopener">ovarian cysts</a> can also cause significant pelvic pain that typically occurs on one side. The pain can be sharp or dull and may only occur during vaginal intercourse.</p><p>While ovarian cysts are generally harmless, a ruptured cyst can cause: </p><ul><li>Sudden and severe pelvic pain</li><li>Weakness</li><li>Rapid breathing</li><li>Fever </li></ul><p>A cyst may also lead to a <a href="https://www.yalemedicine.org/conditions/ovarian-torsion" target="_blank" rel="noopener">twisted ovary</a>, which can cause similar symptoms. </p><p><strong>How to treat it: </strong>If you suspect you have a twisted ovary or ruptured cyst, connect with your doctor as soon as possible. Your doctor can recommend tests, like an <a href="https://www.insider.com/transvaginal-ultrasound" target="_blank" rel="noopener">ultrasound</a>, to help diagnose a cyst, plus offer guidance on treatment options. </p><h2><strong>5. Urinary tract infections</strong></h2><p>UTIs can develop when <a href="https://www.cdc.gov/antibiotic-use/uti.html" target="_blank" rel="noopener">bacteria enter the urinary tract</a> through the urethra and multiply in the bladder.  </p><p>Along with pain or pressure in the pelvic area, a UTI might also cause the following symptoms:</p><ul><li>A persistent urge to urinate</li><li>Trouble urinating</li><li>A burning sensation during urination</li><li>Blood in your urine</li></ul><p><strong>How to treat it: </strong>While <a href="https://www.insider.com/how-to-treat-a-uti-at-home" target="_blank" rel="noopener">some UTIs are safe to treat at home</a>, prescription antibiotics are generally the first line of treatment. Once you start treatment, pelvic pain and other symptoms often clear up <a href="https://medlineplus.gov/ency/article/000521.htm" target="_blank" rel="noopener">within a few days</a>.</p><h2><strong>6. Uterine fibroids</strong></h2><p>While uterine fibroids <a href="https://www.acog.org/womens-health/faqs/uterine-fibroids" target="_blank" rel="noopener">don't always cause pain or noticeable symptoms</a>, they can sometimes trigger: </p><ul><li>Discomfort in the pelvis or low back</li><li>Pain during vaginal intercourse </li><li><a href="https://utswmed.org/medblog/heavy-periods-and-pelvic-pain-arent-normal-uterine-fibroids-might-be-blame/" target="_blank" rel="noopener">Heavy periods</a> with severe cramping</li><li>Pressure or a feeling of heaviness in your bladder</li></ul><p><strong>How to treat it: </strong>Fibroids that cause no symptoms <a href="https://www.acog.org/womens-health/faqs/uterine-fibroids" target="_blank" rel="noopener">may not need treatment</a>, but if you're experiencing a lot of discomfort, your doctor might recommend the following treatments:</p><ul><li>Medication, including gonadotropin-releasing hormone (GnRH) agonists</li><li>Birth control pills or an IUD</li><li>Surgery to remove fibroids</li></ul><h2><strong>7. Pelvic girdle pain from pregnancy </strong></h2><p><a href="https://www.insider.com/pregnancy-symptoms" target="_blank" rel="noopener">Pregnancy</a> can sometimes cause pelvic pain and increase your risk of pelvic floor dysfunction, which could lead to painful vaginal sex and incontinence. </p><p>"Pelvic girdle pain is a subset of pelvic pain that more commonly comes on in a first pregnancy in the late second or third trimester. If this was an issue in previous pregnancies, it's likely to come on much earlier in subsequent pregnancies if not addressed — as early as the first trimester," says <a href="https://fusionwellnesspt.com/about-fusion-wellness/about-heather" target="_blank" rel="noopener">Heather Jeffcoat</a>, doctor of physical therapy and President-Elect of the Academy of Pelvic <keyword id="11894571" type="UNKNOWN" weightage="100" keywordseo="health" source="Orion">Health</keyword> Physical Therapy. </p><p><strong>How to </strong><a href="https://www.nhs.uk/pregnancy/related-conditions/common-symptoms/pelvic-pain/" target="_blank" rel="noopener"><strong>treat it</strong></a><strong>: </strong>Many pregnant people experience mild pelvic discomfort from the growing uterus and stretching of the round ligaments. This typically doesn't require medical treatment but you may be able to mitigate the pain with the following:</p><ul><li><a href="https://pubmed.ncbi.nlm.nih.gov/31020812/" target="_blank" rel="noopener">Manual therapy</a> from a chiropractor or physiotherapist</li><li><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6428920/" target="_blank" rel="noopener">Core stabilizing exercises</a>, which can help strengthen hips, stomach, and back muscles along with pelvic floor muscles</li><li><a href="https://www.insider.com/working-out-while-pregnant-2019-2" target="_blank" rel="noopener">Exercising</a> in water</li></ul><h2><strong>8. Gastrointestinal conditions</strong></h2><p>Your pelvic floor muscles play a <a href="https://www.mayoclinic.org/medical-professionals/physical-medicine-rehabilitation/news/treating-patients-with-pelvic-floor-dysfunction/mac-20431390" target="_blank" rel="noopener">key role </a>in bowel function. And if bowel function is disrupted from gastrointestinal conditions like constipation, <a href="https://www.insider.com/do-i-have-ibs" target="_blank" rel="noopener">irritable bowel syndrome</a>, ulcerative colitis, and Crohn's disease, it can trigger cramps and pain in the lower abdomen or pelvic area. </p><p><strong>How to treat it: </strong>Treatment really depends on your underlying condition. If it's just a bout of constipation, consider your diet over the next few days and opt for <a href="https://www.insider.com/foods-that-make-you-poop" target="_blank" rel="noopener">foods that help ease constipation</a> like prunes and whole grains. </p><p>If you're experiencing additional symptoms like diarrhea, bloody stool, and unexplained weight loss, then you may have Crohn's disease or another underlying condition. Keep a log of all your symptoms and when they typically occur — for example, after eating or first thing in the morning. </p><p>Depending on the underlying condition and severity of your symptoms, a doctor may recommend <a href="https://www.niddk.nih.gov/health-information/digestive-diseases/crohns-disease/treatment#:~:text=Doctors%20treat%20Crohn's%20disease%20with,to%20keep%20you%20in%20remission." target="_blank" rel="noopener">medication or surgery</a>.</p><h2><strong>9. Cancer </strong></h2><p>Persistent pelvic and back pain, along with vaginal bleeding and discharge, can also be <a href="https://www.cdc.gov/cancer/gynecologic/basic_info/symptoms.htm" target="_blank" rel="noopener">early signs of gynecological cancers</a>. </p><p>Gynecological cancers include:  </p><ul><li>Cervical cancer</li><li>Ovarian cancer</li><li>Uterine cancer</li><li>Vaginal cancer</li><li>Vulvar cancer</li></ul><p>Gynecologic cancer often runs in families. If you have a family history of cancer, plus unusual vaginal bleeding and discharge, it's best to connect with your doctor as soon as possible to discuss best treatment options.  </p><p><strong>How to </strong><a href="https://www.insider.com/getting-wrong-about-cancer-2019-2" target="_blank" rel="noopener"><strong>treat it: </strong></a></p><ul><li>Surgery </li><li>Radiation therapy</li><li>Immunotherapy</li><li>Chemotherapy</li></ul><h2><strong>When to connect with your doctor</strong></h2><p>Many conditions that cause pelvic pain <a href="https://www.insider.com/pelvic-inflammatory-disease" target="_blank" rel="noopener">can get worse without treatment</a>. So, it's essential to get medical attention for serious pelvic pain that doesn't improve in a day or so, or has additional symptoms including:</p><ul><li>Fever</li><li>Dizziness or weakness</li><li>Severe or chronic nausea </li><li>Abnormal vaginal bleeding or discharge </li><li>Severe or chronic itching or burning in the genital area</li><li>Severe pain on one side of your abdomen</li></ul><p>Your doctor can use a number of <a href="https://www.hopkinsmedicine.org/health/conditions-and-diseases/pelvic-pain" target="_blank" rel="noopener">tests</a> to help identify the source of pelvic pain. </p><p>After ruling out pregnancy, ectopic pregnancy, and major illnesses like <a href="https://www.insider.com/signs-of-appendicitis-2019-2" target="_blank" rel="noopener">appendicitis</a>, they might recommend: </p><ul><li>Blood or urine tests</li><li>Ultrasound</li><li>Laparoscopy</li><li>A culture of cervical cells to rule out STIs</li><li>X-ray</li><li>A CT scan or MRI</li><li>Colonoscopy</li><li>Sigmoidoscopy </li></ul><p>It's always wise to schedule an appointment with your regular doctor or clinician for pain that doesn't improve within several days. They can offer referrals to specialists, like gynecologists, gastroenterologists, and physical therapists, if needed. </p><p>In some cases, your care team may not be able to identify what's causing your pain right away. They might recommend pelvic floor physical therapy, or additional testing to determine the cause of chronic pelvic pain.</p><p><strong>Important: </strong>If you have severe, sudden pelvic pain that quickly gets worse, it's usually best to visit an urgent care clinic or emergency room. </p><h2><strong>Insider's takeaway</strong></h2><p>Pelvic pain can have a range of causes, from a medical emergency like an ectopic pregnancy to something less severe like an ovarian cyst.</p><p>If the pain is severe, comes on suddenly, or doesn't improve within a day or so, contact your doctor immediately. Also, watch out for other symptoms to help you figure out the possible cause. </p><p>Your doctor can help you identify the underlying cause and explore treatment options for pain relief.</p>

8 conditions that could be causing you pelvic pain and how to treat each one

<ul class="summary-list"><li>The most common cause of low <keyword id="6391809" type="UNKNOWN" weightage="60" keywordseo="back-pain">back pain</keyword> on the left side is a muscle strain. </li><li>Other causes of lower left back pain include a kidney infection, herniated disc, and pregnancy. </li><li>To treat lower left back pain, take OTC pain relievers, improve your <keyword id="52694" type="PERSON" weightage="60" keywordseo="posture">posture</keyword>, and apply heat.</li></ul><p>A stabbing or throbbing pain on the lower left side of your back can sideline you from exercise and basic activities for days. The good news is that it's probably because you've strained some of your back muscles or ligaments, which will heal over time.</p><p>But in some cases, unilateral back pain, like on just the left side, signals a serious issue like an infection or injury that needs medical care.</p><p>Here are nine <a href="https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Low-Back-Pain-Fact-Sheet" target="_blank" rel="noopener">potential causes</a> of pain on the left side of your lower back, when to consult a doctor, and how you can treat it yourself.</p><h2>1. Muscle strain</h2><p>The <a href="https://www.aans.org/en/Patients/Neurosurgical-Conditions-and-Treatments/Low-Back-Strain-and-Sprain#:~:text=Lumbar%20(lower%20back)%20muscle%20strains,in%20moving%2C%20twisting%20and%20bending." target="_blank" rel="noopener">most common cause</a> of lower left back pain is an injury to the muscles, tendons, and ligaments supporting the spine such as: </p><ul><li>A fall or other accident causing back trauma</li><li>A sudden twisting movement </li><li>An uneven distribution of weight, such as when you're carrying a heavy bag on one shoulder</li><li><a href="http://insider.com/how-to-fix-posture" target="_blank" rel="noopener">Poor posture</a></li></ul><p>Signs your back pain is due to a muscle strain is if you feel sore, stiff, experience a stabbing pain, or have muscle spasms, says <a href="https://apps.smhs.gwu.edu/smhs/facultydirectory/profile.cfm?empName=Michael%20Rosner&amp;FacID=20610769786978" target="_blank" rel="noopener">Michael Rosner</a>, MD, a neurosurgeon at <a href="https://smhs.gwu.edu/" target="_blank" rel="noopener">George Washington University's School of Medical and Health Sciences</a>. </p><h2>2. Infection </h2><p>An advanced <a href="https://www.niddk.nih.gov/health-information/urologic-diseases/bladder-infection-uti-in-adults/symptoms-causes" target="_blank" rel="noopener">bladder</a> infection or left <a href="https://www.niddk.nih.gov/health-information/urologic-diseases/kidney-infection-pyelonephritis/symptoms-causes" target="_blank" rel="noopener">kidney</a> infection can cause a constant, aching pain that radiates through your left lower back.</p><p>If you have other symptoms such as burning urination, fever, or chills, see your doctor as soon as possible to check for an infection, says <a href="https://www.uofmhealth.org/profile/777/anthony-e-chiodo-md" target="_blank" rel="noopener">Anthony Chiodo</a>, MD, clinical director of Spinal Cord Injury Medicine at the University of Michigan.</p><h2>3. Kidney stones</h2>Related Article Module: The major causes and risk factors for kidney stones<p><a href="https://www.insider.com/what-causes-kidney-stones" target="_blank" rel="noopener">Kidney stones</a>, which are mineral build ups in your urinary tract, can cause sharp, intense pain through the lower left side of your back as well as pain in the lower abdomen, groin, and below the ribs. Another common symptom is bloody urine. </p><p>Smaller stones can pass through the urinary tract without treatment, but a urologist may need to remove larger stones <a href="https://www.niddk.nih.gov/health-information/urologic-diseases/kidney-stones/treatment" target="_blank" rel="noopener">via surgery</a> or by <a href="https://medlineplus.gov/ency/article/007113.htm" target="_blank" rel="noopener">using shock waves</a> to break them up.</p><h2>4. Endometriosis</h2>Related Article Module: Symptoms of endometriosis and how you can manage the pain<p>Endometriosis is a condition where painful lesions grow on the outside of a person's uterus. It <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7573391/" target="_blank" rel="noopener">can cause low left back pain</a>, along with <a href="https://www.insider.com/home-remedies-for-period-cramps" target="_blank" rel="noopener">intense cramping</a> during menstruation and <a href="https://www.insider.com/why-is-sex-painful" target="_blank" rel="noopener">pain during intercourse</a>.</p><h2>5. Stress fracture</h2><p>Overtime repeated physical activity, such as lifting weights or playing sports like <a href="https://fittoplay.org/body-parts/back/low-back-stress-fracture/#:~:text=The%20injury%20is%20most%20common,the%20main%20activity%20takes%20place." target="_blank" rel="noopener">tennis, rowing, and gymnastics</a> can strain the spine, resulting in a <a href="https://www.ncbi.nlm.nih.gov/books/NBK554538/" target="_blank" rel="noopener">stress fracture.</a> </p><p>The area may hurt when you touch it, and the pain may be too severe to respond to over-the-counter treatments. Most cases heal on their own in six to eight weeks, but the only way to get a proper diagnosis is through medical attention.</p><h2>6. Pregnancy</h2><p>More than two-thirds of pregnant women <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7053516/" target="_blank" rel="noopener">experience lower back pain</a>, most often in the form of what is called <a href="https://www.cedars-sinai.org/health-library/diseases-and-conditions/b/back-pain-during-pregnancy.html" target="_blank" rel="noopener">posterior pelvic pain</a>. </p><p>Posterior pelvic pain is a deep, throbbing pain that you either experience on one or both sides of your lower back.</p><p>You will also probably experience general muscle soreness in your back as the baby grows larger. That's because the baby's weight can throw off your <a href="https://www.cedars-sinai.org/health-library/diseases-and-conditions/b/back-pain-during-pregnancy.html" target="_blank" rel="noopener">center of gravity</a>, which may require you to compensate by working different muscles in your back.</p><h2>7. Sacroiliac joint dysfunction</h2><p><a href="https://pubmed.ncbi.nlm.nih.gov/23253394/" target="_blank" rel="noopener">Sacroiliac joint dysfunction</a> is when the joint that connects the hip bones to the lower part of the spine moves abnormally, becoming inflamed.</p><p>Inflammation in the left hip joint can cause a dull, aching pain in the left lower back, often accompanied by pain in the buttocks, or in the back of the left upper thigh. </p><p>The condition can be chronic or a result of temporary stress. Risk factors include <a href="https://www.insider.com/what-is-si-joint-pain-2018-2" target="_blank" rel="noopener">pregnancy</a>, uneven leg length, or impact from an accident like a fall.   </p><h2>8. Herniated disc </h2><p>Lumbar disks, the cushion of tissue between each vertebrae in the lower spine, can bulge or compress under stress, causing a <a href="https://www.mayoclinic.org/diseases-conditions/herniated-disk/symptoms-causes/syc-20354095" target="_blank" rel="noopener">herniated disc.</a></p><p>Most people have no symptoms from a herniated disc, but some develop pain and numbness on one side of their lower back, depending on where the disc is located. In rare cases, disks break or rupture, causing severe pain and requiring surgery to prevent permanent nerve damage. </p><p>"If you have radiating leg pain or increasing leg weakness, or bowel or bladder dysfunction, go to the emergency room," Chiodo says.</p><h2>9. Tumor</h2><p>While <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2078307/" target="_blank" rel="noopener">rare</a>, <a href="https://www.hopkinsmedicine.org/health/conditions-and-diseases/spinal-cancer-and-spinal-tumors" target="_blank" rel="noopener">spinal cancer or a spinal tumor</a> can cause back pain on the left or right side of the back.</p><p>Other symptoms may include unexplained weight loss, fever, numbness, weakness, or difficulty walking. However, it's important to note that this is a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2078307/" target="_blank" rel="noopener">rare cause of back pain</a>. </p><h2><strong>How to treat low back pain</strong></h2><ul><li><strong>Over-the-counter pain medications</strong> such as acetaminophen, aspirin, ibuprofen, and naproxen to relieve pain and inflammation. </li><li><strong>Prescription drugs</strong> like <a href="https://medlineplus.gov/ency/article/007486.htm" target="_blank" rel="noopener">muscle relaxants</a> or pain relievers can provide short-term relief.</li><li><strong>Over-the-counter </strong><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6481750/" target="_blank" rel="noopener"><strong>topical creams, gels, patches, or sprays</strong></a> with lidocaine, menthol, or <a href="https://insider.com/is-healthy-food-good-for-you" target="_blank" rel="noopener">capsaicin</a> stimulate nerves in the skin, dulling pain. They can be <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6481750/" target="_blank" rel="noopener">particularly helpful</a> for localized pain due to sore muscles. </li><li><strong>Hot or cold pads</strong> may help ease pain, reduce inflammation, and improve mobility.</li><li><strong>Core exercises</strong> that strengthen your <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4174027/" target="_blank" rel="noopener">abs and muscles</a> lining the spine may help take the stress off the back, Rosner says. Check with your doctor before beginning any exercise program to make sure the exercises are right for your condition. </li><li><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3336928/" target="_blank" rel="noopener"><strong>Mindfulness-based stress reduction</strong></a><strong> (MBSR),</strong> an eight-week program of meditation and gentle yoga, can <a href="https://pubmed.ncbi.nlm.nih.gov/27002445/" target="_blank" rel="noopener">improve chronic lower back pain</a>. </li></ul><h2><strong>Insider's takeaway </strong></h2><p>Pain on the lower left backside is a common ailment and is usually the result of a soft tissue injury. Most back pain can be treated at home and should go away in a matter of weeks.</p><p>Having additional symptoms like fever or severe pain that persists for more than a few days may be a sign of a more serious underlying cause, such as a disk rupture, fracture, or an infection. </p><p>Consult your doctor as soon as possible if your arm or leg feels numb, you have problems walking or standing, or if you lose control of your bladder or bowels. </p><a data-type="6081e55d3966fa147c786d48">10 common causes of lower back pain and tips on how to relieve it</a><a data-type="6054d0dbc47d9c375f164223">6 easy exercises to relieve low back pain and improve posture, according to a physical therapist</a><a data-type="5fa2d36e1ad83a43d90fbf70">5 of the best stretches to relieve lower back pain - and how to do each correctly to prevent injury</a><a data-type="5fdce260935fea0b247d3e36">5 exercises to fix your posture - and why good posture is crucial for your health</a>

<ul class="summary-list"><li><strong>Geralyn Ritter survived the <keyword id="11898131" type="UNKNOWN" weightage="60" keywordseo="amtrak" source="Orion">Amtrak</keyword> train crash in 2015 that killed eight and injured over 200.</strong></li><li><strong>Her family was told she wouldn't make it, but after 31 surgeries, she has rebuilt her life.</strong></li></ul><p><em>This as-told-to <keyword id="11898458" type="UNKNOWN" weightage="60" keywordseo="essay" source="Orion">essay</keyword> is based on a conversation with Geralyn Ritter. It has been edited for length and clarity.</em></p><p>The morning was completely ordinary. That is what always haunts me — how a totally ordinary Tuesday and a business trip that I had taken more than 100 times ended in catastrophe.</p><p>I live in New Jersey and took an early train that morning to Washington, DC, for a work meeting. On the train home, I stopped in Philadelphia to speak on a panel for a women's alumni group for my alma mater, <a href="https://www.businessinsider.com/guides/learning/duke-free-online-courses">Duke University</a>. After the event, I dashed to the Philadelphia station to continue my journey home. I just made the <a href="https://www.insider.com/historic-train-travel-photos-2022-1">train</a>, took my seat in the business-class car, and texted my husband: "Leaving Philly. Home soon."</p><p>Only, I wasn't.</p><p>My husband and three sons — ages 8, 12, and 15 — spent the night searching hospitals to find me until they were finally notified about a "Jane Doe" who was flown via helicopter to Penn Presbyterian, Philadelphia's newest Level I trauma center.</p><h2>I was in the Amtrak accident</h2><p>In the moments before the <a href="https://en.wikipedia.org/wiki/2015_Philadelphia_train_derailment">accident</a>, I had stood up to get something to read out of my briefcase on the luggage rack above my head. As I stood, I noticed that the train seemed to be going much faster than usual right out of Philadelphia. I was momentarily pleased that I might get home ahead of schedule.</p><p>Then the rocking started.</p><p>I held on to the luggage rack to keep my balance and was annoyed that I couldn't let go to get what I wanted out of my bag. Suddenly, I felt myself tipping forward, still holding on to the luggage rack above my head with both hands. I remember clearly thinking it wasn't possible that the train was tipping — trains don't tip. In an instant, I realized we were indeed tipping over. The sound of my own scream is the last thing I remember.</p><p>I woke up on Friday in the hospital. I was on a ventilator and unable to speak, in a cervical collar and unable to move my head, and immobilized with my left leg in traction. I remember opening my eyes and seeing my youngest brother. It was like I was in a dream. I had been having vivid dreams of memories from my childhood, interspersed with dreams of being under harsh lights with masked doctors hovering over me, being rolled down a hallway.</p><p>I tried to speak with my brother, but he told me that instead, I should blink once for "yes" if I understood him and twice for "no." He asked me whether I wanted to know what happened. I blinked once. He proceeded to start to describe my injuries, but I think I fell back asleep or passed out before he finished. I was in and out of consciousness for several days.</p><h2>My family was told I was not going to make it</h2><p>Initially, I was not expected to live. The list is long, but I can divide my injuries into two categories — damage to my internal organs and orthopedic injuries to my bones.</p><p>I was apparently thrown from the train with such force that my abdominal organs burst through my diaphragm, the thick leathery muscle that separates the lungs from the abdominal cavity. My stomach was above my heart, my colon was under my armpit, my spleen was destroyed and bleeding uncontrollably, my intestines were perforated and lacerated, my bladder was ruptured, and my lungs collapsed. I had six surgeries in the first two weeks, some of them marathon sessions where multiple procedures were done back-to-back.</p><h2>I was in overwhelming pain</h2><p>Returning home was a welcome change from the in-patient rehabilitation hospital where I was transferred after being discharged from the intensive-care unit and regular hospital. Given the severity of my injuries, and that my chest was crushed but needed to move constantly for me to breathe, my pain was overwhelming.</p><p>I was on medically prescribed high doses of fentanyl and OxyContin for many months.</p><div type="image" title="Geralyn Ritter's pain medications" height="1512" width="2016" msid="92732708" hostid="261" sizebytes="220958"></div><p>When my doctors decided it was time to start the weaning process, I suffered terrible side effects. My pain level increased as a result of my not-yet-healed injuries, and I suffered the typical withdrawal symptoms of chills, nausea, shakiness, and inability to focus.</p><p>At home, I felt more comfortable and more in control of my surroundings, and I welcomed the time with my boys. At the same time, I wrestled with the fact that nothing was the same.</p><p>It would be a full year until I could climb the stairs and sleep again in our primary bedroom. I was in a wheelchair and not strong enough to even roll up the newly installed ramp to our front door. I couldn't get out of bed by myself, make food for myself, or use the restroom by myself. This is when I crashed and the gratitude for my survival turned into grief for the life I had lost.</p><div type="image" title="Geralyn Ritter posing at the beach" height="3024" width="4032" msid="92732710" hostid="261" sizebytes="279218"></div><p>I've had a total of 31 surgeries, some planned and some later related the accident. I joke that I am like an old car that needs regular maintenance. My next surgery is next month.</p><p>I returned to work part time about two years after the accident, and I'm an active mom. I wouldn't say I have recovered. I will never be grateful for the accident. I am grateful, however, for the gift of my survival.</p><p>My goal is to live and work with purpose. I have promised myself and God that the instant I am not doing that, I will change course. I have no time for things that do not matter.</p><p><em>Geralyn Ritter is the author of "<a href="https://affiliate.insider.com?u=https%3A%2F%2Fwww.barnesandnoble.com%2Fw%2Fbone-by-bone-geralyn-s-ritter%2F1141661263">Bone by Bone: A Memoir of Trauma and Healing</a>."</em></p>

I survived the 2015 Philadelphia Amtrak train crash. I had 31 surgeries, a pain-medication dependency, and depression.

<p class="source"><span>US Army</span></p><p class="caption">A military working dog surrounded by a soldier's gear</p><ul class="summary-list"><li>The Department of State has decided to temporarily stop sending bomb-sniffing dogs to Jordan and Egypt after multiple investigative reports revealed that many dogs had died as a result of poor treatment while others were living in unhealthy conditions.</li><li>After a report in September failed to convince the department to put a hold on the program, a follow-on report from the Office of the Inspector General explained that it had "received notice of additional canine deaths that warrant immediate department action."</li><li>The new report, which was released Friday, revealed cases where canines died from things like heat stroke and insecticide poisoning.</li><li><strong><a href="https://www.businessinsider.com/?hprecirc-bullet">Visit Business Insider's homepage for more stories</a>.</strong></li></ul><p>The US has made the decision to temporarily stop sending explosive-detection dogs to Jordan and Egypt after discovering that a lot of the animals had died as a result of poor treatment, a report from the Department of State's Office of the Inspector General <a href="https://www.stateoig.gov/system/files/esp-20-02.pdf">revealed</a>.</p><p>The department watchdog, which had previously pushed the Department of State to stop sending dogs to these countries after an earlier investigation uncovered a number of animal deaths and other serious problems, wrote that it had "received notice of additional canine deaths that warrant immediate department action."</p><p>The report released Friday said that two dogs sent to Jordan died in June and September of this year of "non-natural causes." Specifically, one died from hyperthermia (heatstroke), and the other died after being poisoned by insecticide that was sprayed in or near the kennel.</p><p>Another dog was found in October to be suffering from leishmaniasis, a preventable disease transmitted by sand flies.</p><p>The Office of the Inspector General also found that three of the ten dogs provided to Egypt, which has been uncooperative with department officials, died from lung cancer, a ruptured gall bladder, and hyperthermia.</p><p>The latest report follows an IG evaluation released in September that examined the state of the program in Jordan, a US ally in the counter-terrorism fight.</p><p>That report, which <a href="https://www.businessinsider.com/us-bomb-sniffing-dogs-sent-to-jordan-dying-improper-care-2019-9">characterized the conditions the animals were living in as "disturbing</a>," found that "at least 10 canines had died from various medical problems from 2008 through 2016 while others were living in unhealthy conditions."</p><p>At that time, the Office of the Inspector General recommended that the Department of State put a hold on the Explosive Detection Canine Program (EDCP) for Jordan until the country could demonstrate that it was able to provide proper care, but the department refused, citing national security concerns.</p><p>The Department of State assured inspectors that it was taking steps to improve the situation and provide better care for the dogs. "The death of two canines from non-natural causes - namely, hyperthermia and poisoning - since June 2019 raises serious questions about the Department's contention that it has taken adequate steps to protect their health and safety," the latest Office of the Inspector General report said.</p><p>The IG report also noted that the previously-unreported deaths in Egypt, which barred State Department officials from visiting the areas where the dogs were living and working, were also cause for concern.</p><p>While the Department of State initially refused to stop sending dogs, the latest findings by the department watchdog appear to have led the department to change its mind.</p><p>In August, the Department of State repossessed ten dogs from Morocco because they were not being used for their intended purpose, the IG report revealed.</p>            <h3>NOW WATCH: <a href="https://www.businessinsider.com/how-marines-battle-their-fear-of-heights-at-boot-camp-2019-12">How Marine recruits battle their fear of heights on a 47-foot-tall tower at boot camp</a></h3>

The US has decided to stop sending bomb-sniffing dogs to two Middle Eastern countries after many of the animals died

<p><div class="image-container float_right"><div class="image"><p class="source on-image">AP</p></div></div>After more than 20 hours of standing and talking on the <keyword id="6355284" type="ORGANIZATION" weightage="60" keywordseo="senate">Senate</keyword> floor, <a href="http://www.businessinsider.com/ted-cruz-filibuster-defund-obamacare-senate-government-shutdown-2013-9http://www.businessinsider.com/ted-cruz-filibuster-defund-obamacare-senate-government-shutdown-2013-9">Ted Cruz is still going strong</a>, but how badly does he have to pee?</p>
<p><a href="http://sciencefocus.com/qa/how-long-can-human-go-without-peeing">According to Focus Magazine</a>, the average human bladder can hold about 400 to 600 milliliters of urine. The average person produces about 1,500 ml of urine every 24 hours, so<strong> it only takes nine or 10 hours before you're filled up and you've gotta go - bad.</strong></p>
<p>How long that takes depends on your hydration level - if you don't have a lot of extra liquids in your system, your kidneys won't be creating as much pee.</p>
<p>The 9-10 hour figure is for a normally hydrated person.<a href="http://www.businessinsider.com/ted-cruz-filibuster-to-defund-obamacare-bathroom-breaks-2013-9">We don't know if Ted Cruz has prepared</a> for the bladder-holding task in any way, say, not drinking water before he took the floor.</p>
<p>Others have <a href="http://www.businessinsider.com/ted-cruz-filibuster-to-defund-obamacare-bathroom-breaks-2013-9">used catheters to empty their bladders</a> during filibustering.</p>
<p>There's currently no official record set for the longest someone has gone without peeing, but holding it in is not advised. According to <a href="http://healthyliving.msn.com/diseases/urinary-health/can-your-bladder-really-burst-1">msn.com</a>, no serious <keyword id="6354750" type="CITY" weightage="60" keywordseo="health">health</keyword> problems have been linked to holding urine too long. The idea that your bladder will burst is a myth - your bladder will simply override your willpower and your brain's attempt to delay urinating, and you'll simply wet your pants.</p>
<p>Of course there is the <a href="http://healthyliving.msn.com/diseases/urinary-health/can-your-bladder-really-burst-1">story of Tycho Brahe</a> who supposedly died in the 1600s at a banquet from a ruptured bladder because he held it in too long, but it was more likely an infection that caused his death. </p>
<p>Holding it in won't kill you, it just might make you <a href="http://www.huffingtonpost.ca/2012/02/27/holding-your-pee-health-_n_1299435.html">more prone to urinary tract infections</a>, according to the Toronto Naturopathic Health Clinic.</p>

How Long Can You Go Without Peeing?

<p><div class="KonaFilter image-container display-table"><div><div class="image on-image"><p class="source"><span>REUTERS/Henry Romero</span></p><p class="caption">Excess natural gas is being flared, or burnt off, at a flare stack at the refinery in Tula, in Mexico's Hidalgo state, November 21, 2013.</p></div><p></p></div></div></p><ul><li><strong>Oil theft has become increasingly common in Mexico.</strong></li><li><strong>As organized-crime groups have pursued oil theft, oil workers have become targets for bribes, intimidation, and violence.</strong></li><li><strong>There is little sign local, state, or the federal government in Mexico are able to mount an effective response.</strong></li></ul><p><br />Mexico's oil industry has gotten increasing attention from criminal organizations, including powerful groups like the Zetas and Jalisco New Generation cartels.</p><p>The number of illegal taps found on state oil firm Pemex's 14,000-kilometer pipeline network has surged, rising from <a href="http://www.businessinsider.com/mexico-oil-price-budget-cuts-and-theft" target="_blank" rel="noopener">132 in 2001</a> to 3,348 in 2014. In 2017, Pemex reported <a href="http://www.pemex.com/acerca/informes_publicaciones/Paginas/tomas-clandestinas.aspx" target="_blank" rel="noopener">9,509</a> such taps - an all-time high.</p><p>Oil thieves have siphoned away billions of dollars from Mexican state coffers. But their enthusiasm for Mexico's energy industry is also taking a deadly toll on the workers who keep it running.</p><p><span>"They said they knew who I was and where I lived," Alberto Arredondo, a pump technician at an oil refinery in the central Mexican city of Salamanca, <a href="http://www.businessinsider.com/r-special-report-mexicos-drug-cartels-now-hooked-on-fuel-cripple-nations-refineries-2018-1" target="_blank" rel="noopener">told Reuters</a> of the first call he received from the La Familia Michoacana cartel in February 2015. "They wanted information."</span></p><p><span>He hung up, but they called back, demanding to know when fuel would be pumped and though which pipelines. He would be hounded, kidnapped, pistol-whipped, and stabbed so severely that surgeons removed his gall bladder before he finally left the country in December 2016, heading to Canada, where he is seeking asylum.</span></p><p><span><div class="KonaFilter image-container display-table"><div><div class="image on-image"><p class="source"><span>REUTERS/Edgard Garrido</span></p><p class="caption">A sign at Mexican national oil company Pemex's refinery in Salamanca, in Guanajuato state, September 19, 2017.</p></div><p></p></div></div></span></p><p>Criminal groups "go in and they get some of these Pemex employees, and they intimidate them [into] giving them information as to the routes that some of the petroleum is going to be taking, the timelines, how many people are working at these refineries, the amount of crew members ... they get all the details," Mike Vigil, former chief of international operations for the US Drug Enforcement Administration, told Business Insider.</p><p><span>Fuel theft is not new, nor is it limited to organized criminal groups. Rural residents have <a href="http://www.businessinsider.com/mexico-oil-price-budget-cuts-and-theft" target="_blank" rel="noopener">often pilfered fuel</a>, using it for their own needs or reselling it locally. Many locals are happy to buy cheap, illegally obtained fuel, as national energy reform has <a href="http://www.businessinsider.com/mexican-gasolinazo-gas-prices-backlash-and-violence-2016-12" target="_blank" rel="noopener">gradually increased prices</a> at the pump. (Higher prices have also <a href="http://www.businessinsider.com/r-special-report-mexicos-drug-cartels-now-hooked-on-fuel-cripple-nations-refineries-2018-1" target="_blank" rel="noopener">drawn in</a> more criminals.) In some places thieves <a href="https://www.nytimes.com/2017/04/26/world/americas/mexico-fuel-theft-crisis.html?_r=1" target="_blank" rel="noopener">are praised</a> for boosting economies in impoverished areas.</span></p><p><span>But competition between criminal groups, and their brutal tactics, has added to the <a href="http://www.businessinsider.com/mexico-violence-most-killings-in-decades-2017-2018-violent-start-2018-1" target="_blank" rel="noopener">violence plaguing much of Mexico</a>.</span></p><p><span>In Salamanca - site of Mexico's second-oldest refinery - the number of homicide cases opened by authorities has risen each year since 2013, President Enrique Peña Nieto's first full year in office.</span></p><p><span><div class="KonaFilter image-container display-table float_right"><div><div class="image on-image"><p class="source"><span>Christopher Woody/Mexican government data</span></p></div><p></p></div></div></span></p><p><span>In Guanajuato state, where Salamanca is located, authorities opened 1,096 homicide cases in 2017 - a 14% increase over 2016 and 71% more than in 2013.</span></p><p><span>The state's homicide rate has increased each year since Peña Nieto took office, rising from 11.21 in 2013 to 18.55 last year.</span></p><p><span>There were also 1,696 illegal fuel taps in Guanajuato last year - the most in the country, according to Pemex.</span></p><p>Reuters <a href="http://www.businessinsider.com/r-special-report-mexicos-drug-cartels-now-hooked-on-fuel-cripple-nations-refineries-2018-1" target="_blank" rel="noopener">found press records</a> of at least seven alleged murders of Pemex employees around Salamanca since 2012. The state attorney general's office said it had records of three suspected murders of Pemex employees in recent years.</p><p>In 2016, as Arredondo, the pump technician, faced continued attacks and threats from oil thieves, two colleagues at the refinery were killed. Family members of the victims told him they had contacted police about threats from those thieves.</p><p>In October that year, Arredondo was stabbed outside a bar. After recovering for two months, he returned home and again found gang members there. "I realized that this was never going to end," he told Reuters. That night, he left for Canada.</p><p>Gangs and fuel thieves "kidnap some of these employees and then they intimidate them, and they tell them their either going to kill them or they're going to kill their families," Vigil said. The employees "go along with it because they're fearful for their lives and the lives of their families."</p><p>One day after Reuters published its report in January detailing Mexican criminal influence in the oil industry, Capt. Tadeo Lineol Alfonzo Rojas, the head of security at the refinery in Salamanca, was <a href="http://www.animalpolitico.com/2018/01/asesinan-jefe-seguridad-refineria-pemex-guanajuato/" target="_blank" rel="noopener">shot and killed</a> while driving in the area. One of his sons was wounded in the attack.</p><p><span>Pemex, the state oil firm, <a href="http://www.pemex.com/en/press_room/press_releases/Paginas/2018-005-national.aspx" target="_blank" rel="noopener">condemned</a> the attack, but authorities have made little headway against the gangs. Police there frequently seize vehicles - delivery trucks, ambulances, even school buses - rigged to carry stolen fuel.</span></p><h2><span>'Some people use drugs, but everybody uses petroleum'</span></h2><p><span><div class="KonaFilter image-container display-table"><div><div class="image on-image"><p class="source"><span>Thomson Reuters</span></p><p class="caption">Pemex's oil refinery in Salamanca, in Guanajuato, Mexico, February 8, 2016.</p></div><p></p></div></div></span></p><p><span>For major cartels, Pemex's oil dealings - which generated revenue of about $52 billion in 2016 and provided about 20% of government income - are an appealing target.</span></p><p>The illegal oil trade doesn't have the same risks as moving illegal drugs through Mexico and over international borders, Vigil said. "Keep in mind that only some people use drugs, but everybody uses petroleum, and so it's become a very lucrative business."</p><p>The illegal fuel trade could not function without official complicity. Between 2006 and 2015, <a href="http://www.eluniversal.com.mx/articulo/nacion/seguridad/2017/01/9/dossier-seguridad-robo-de-hidrocarburos-desde-pemex" target="_blank" rel="noopener">123 Pemex workers</a> and 12 former employees were arrested for suspected participation in fuel theft, according to documents obtained by El Universal in early 2017.</p><p><span style="font-weight: 400;">"A lot of Pemex employees are in collusion with these cartels," Vigil said, "and they become affluent as a result of that."</span></p><p><div class="KonaFilter image-container display-table float_right"><div><div class="image on-image"><p class="source"><span>REUTERS/Daniel Becerril</span></p><p class="caption">Workers clean up oil leaked into the San Juan River after thieves ruptured a pipeline, in Nuevo Leon state, Mexico, August 22, 2014.</p></div><p></p></div></div></p><p><span style="font-weight: 400;">Illicit proceeds also enable payoffs - graft among police in Salamanca became so rampant that <a href="http://www.businessinsider.com/r-special-report-mexicos-drug-cartels-now-hooked-on-fuel-cripple-nations-refineries-2018-1" target="_blank" rel="noopener">the state fired</a> the entire local force and replaced it with state officers.</span></p><p><span style="font-weight: 400;">State and local governments are often unequipped or unwilling to address fuel theft and organized crime. The federal government has stepped in, often relying on the military, which is not equipped for law-enforcement duties.</span></p><p><span style="font-weight: 400;">In spring 2017, it <a href="https://www.nytimes.com/2017/04/26/world/americas/mexico-fuel-theft-crisis.html?_r=1" target="_blank" rel="noopener">deployed</a> about 500 troops to an area in Puebla state called the "Red Triangle," through which a major pipeline passes and where oil theft is common. In May, videos emerged appearing to show military personnel <a href="https://www.insightcrime.org/news/analysis/execution-highlights-mexico-inability-combat-fuel-theft/" target="_blank" rel="noopener">executing</a> suspected thieves.</span></p><p><span style="font-weight: 400;">The recent announcement that more troops would be <a href="http://www.businessinsider.com/mexico-sends-more-troops-to-fight-crime-after-year-of-record-violence-2018-1" target="_blank" rel="noopener">deployed around the country</a> in response to record violence in 2017 indicates the government has not backed off this militarized approach, and national elections this summer are likely to draw lawmakers' attention away from security policy in the near-term.</span></p><p><span style="font-weight: 400;">"The revenue that's being generated by the petroleum [theft] is making a lot of these cartels much more powerful" and is likely to bolster many smaller groups, Vigil said. "Petroleum theft is becoming more and more prevalent as time progresses."</span></p>    <div class="margin-top">        <h3>NOW WATCH: <a href="http://www.businessinsider.com/helima-croft-rbc-commodities-emerging-markets-oil-demand-growth-2017-7">RBC commodity chief: India and China will dictate oil's future</a></h3>        <div>                    </div>    </div>

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