At just 11 years old, Forest’s life was put on pause by debilitating abdominal pain that started after a GI virus and never went away. He was diagnosed with conditions like gastroparesis and celiac disease.
Still, nothing explained the constant, localized pain that kept him from walking, going to school, or living like a normal kid.
Everything changed when he met Dr. Tim Tollestrup, who diagnosed him with Anterior Cutaneous Nerve Entrapment Syndrome (ACNES) — a treatable nerve condition. One specialized surgery later, Forest was pain-free and finally able to return to school, play, and be a kid again.
If your child is living with unexplained abdominal pain, this story may provide the answers you’ve been searching for. 👉 Learn more about ACNES and Dr. Tollestrup’s work: https://nevadanervesurgery.org/anteri… #AnteriorCutaneousNerveEntrapment #ACNES #PediatricPain #ChronicPainInKids #DrTollestrup #AbdominalPainRelief #MedicalMysterySolved #NervePain #SurgerySuccess #BackToSchool #ChronicIllnessRecovery #HopeForHealing #KidsWithChronicPain #Gastroparesis #CeliacDisease #painrelief
Forest’s Patient Testimonial – Dr. Tollestrup
My pain started with a GI virus. But even when the GI virus went away, the pain stayed. I had gastroparesis and couldn’t walk much without the pain getting worse. I was hospitalized twice for weight loss and diagnosed with celiac. I was told I would get better on a gluten-free diet, but that was not the case.
My pain was located about an inch from my lower right quadrant, an inch from my belly button, and it was constant.
Dr. Tollestrup (Narrating): He was the first one to understand how he was in pain and give a diagnosis, and say he could help. Whether it was a nerve injury initially or some illness that caused the vomiting and other symptoms, either way, he ended up with an injury to a nerve called the anterior cutaneous nerve. These are terminal branches—the very ends—of the intercostal nerves. They come from the spine, wrap underneath the ribs, and then enter the abdominal area to innervate the anterior abdominal wall. There’s an anatomical relationship between these nerves and the ones that innervate the internal organs—they originate from similar levels of the spine. So, I think there can be a referred phenomenon that causes nausea and other symptoms. I was 90% sure he had Anterior Cutaneous Nerve Entrapment Syndrome (ACNES) just based on the summary his mother sent. It was an excellent, detailed summary. The location of his pain, how it was triggered by physical activity or any tension on the abdominal wall, or just compression, simply pushing on that one spot, was such a focal pain in the same area that it never moved. That’s classic for ACNES.
Surgical Procedure
(Dr. Tollestrup): When treating actual anterior cutaneous nerve entrapment, you generally make an incision right over the point of maximal tenderness. Then, you do a very careful, meticulous dissection down through the subcutaneous tissue using bipolar cautery, so there’s really a bloodless field. That’s key—because if things get blood-stained, you can easily miss the nerve, or you can’t tell the difference between a nerve and a small vessel. You go down and find the nerve. Very often, there’s a small vessel traveling with it. You follow it back to its point of exit from the rectus sheath. You open the rectus sheath and dissect the nerve into the rectus muscle. You must ensure you’ve gone past any nerve scarring to the surrounding muscle or rectus fascia. Once that nerve is gliding freely, you disconnect it. You excise the distal portion and bury the proximal end deep into the central substance of the rectus abdominis muscle.
Patient: It’s like getting a cavity filled. You go in with this horrible, aching pain, get the problem resolved, and come out pain-free. That’s pretty much how it is with these surgeries. There’s a little discomfort from the surgical incision itself, but most of the time, patients know right away—within a day or two, if not immediately—that their original pain is gone.
Closing: Dr. Tollestrup was the only one who truly understood how I was in pain and told me he could help. I went from being in constant pain, unable to participate in anything and lying down all day, to being completely pain-free and doing normal activities again. If no doctor has been able to tell you the cause of your pain, don’t let them push you into just living with it. Keep searching for someone who will help—like Dr. Tollestrup. Thank you, Dr. Tollestrup. You gave me my life back.
