Listen to me, Tisha, just stand by her the best you can---you do know only part of the story---and even if it is in response to outside factors, the pain to HER is still real.

I've included a link that might help.
http://my.clevelandclinic.org/disorders/factitious_disorders/hic_munchausen_syndrome.aspx

My sister Margie, was diagnosed with Manchausen's years ago by one of the many Dr's she saw sometime after our Mom died. We know she did have Lyme's Disease from a tick bite she got in Ct. while delivering a horse----down here in the South----it had barely ever been heard of at that time---the aches and hurting joints all played their part in her suffering, though.
Margie, after years of missing Mom so much, (They were celestial twins in the universe. They loved and fought each other more than anyone else on earth..) she began to rely more and more on painkillers---her husband would call and I would go over and try to help, but finally gave up----she was too much out of control and would go into screaming frenzies---we were never very close and that made it easier for me to just stay away from her.
Margie's husband called early one morning to say she had died sometime in the early morning hours in a bathtub, with a syringe with partially dissolved painkiller medication in it.
We went to St. Mary's Hosp. in Richmond to see her.
I walked in the room with my family and and it was the FIRST time I'd seen peace on her face since our
Mom died in 1984.
Margie died July 27, 1997.
I was relieved to see peace, not pain. She had a wisp of a smile on her face----the same sweet smile she had when she was a little girl....

I'm telling you this because you will always be plagued with questions. You will NEVER know the whole truth.
It's her journey, Tisha and you can only help so much.
Someday, you might not be able to help at all.

What you CAN do is try your best to support her,
even if it's a 'Thinking of You Card' in the mail--it's something positive for her to connect with....being remembered.
Just let her know you still care about her.

---And you can pray for relief and support for her, and guidance and patience for you.

One thing that has gotten me through some rough times is the uncanny way 'Lucky Pennies' would always show up when I needed a boost. I would be doing some dirty job, tired and worried----and suddenly, there would be a Lucky Penny, right in front of me, waiting.
I always heard the words, 'I Am with you' in my heart, with each penny I picked up out of the dirt and grime.
It helped immensely.

It never hurts to say a little prayer.
I send you warm support, prayers, and a great big hug to help you along, Tisha.

I think you're right to be worried.

Migraines can be triggered by stress, & pain can "transfer" from one nerve site to another, which might explain the ovarian cyst hurting on the opposite site.

When you have a horrible sinus headache or a toothache, it may transfer to adjacent nerves, giving you a terrible earache as well.

I also don't have any confidence in a doctor who would express disapproval of another doctor's years-ago decision to remove an ovarian cyst;

"why the h#!! not remove it?" would be my question.

I've had ovarian cysts, & those things will take over your life.

They *hurt*.

When mine acted up, I'd be absolutely disabled, couldn't walk without limping (a good example of transferred pain; my leg would hurt all the way to the arch of my foot-the same thing Fran Drescher had that her doctor ignored as some sort of hysterical emotional female nonsense until it turned out that she had ovarian cancer. She also did some research & discovered that leg pain was a common symptom in women who had ovarian cancer).

Some people are also just extremely sensitive to pain;
what would irk you or me is excruciating to them.

Your friend may indeed have Munchausen's-
Munchausen's people are very convincing, & they tend to have "episodes" when some dramatic event takes the spotlight off them-
but stress will trigger migraines & ovarian cysts will cause pain-
& it sounds like your friend's doctors have written her off as someone who's at fault for her own problems, & they aren't trying to figure out if she's in pain or not.

Maybe she needs a thorough work-up by a gifted diagnostician who's also familiar with Munchausen's & with extreme sensitivity to pain.

I wish you, & your friend, the very best.

Lupus and Fibromyalgia also cause sensitivity to pain.

I'm taking the other side here...

I can imagine that each time she must build some sort of explanation for you as to why she's always sick, never better, losing ground, and not fighting, she grows even more determined.

The simple fact is you cannot save her if she does not wish to be saved. She and her Dr. ought to be just as worried as you are, and if they aren't, then you shouldn't be.

She's has become the fear of her family, yours, and others...afraid of what she'll do, afraid of what may be wrong that you don't know about and can't fight, afraid not to call her every day to make sure she's among the living, afraid there's really something desperately wrong with her or she WOULD be fighting...it becomes they way some folks get attention, stay in the loop, controlling all those around them and bending all their effort in their direction.

Just walk away..

Leave it that she will call you if she needs anything, and
invest your time and energy more positively.

Up and down your street there must be 10 older folks who simply would love to have someone to share a meal with. Some are so alone and so lonely they haven't talked to anyone since their partners died, or their kids last made it home several years ago.

Invite them to supper... a different one each week... an extra potato in the pot... an hour's worth of conversation and a hot meal... they would so grateful...and it never hurts for you to see a happy face.

I can imagine the emotional roller coaster you've been on all these years.You said she is your best friend which means if you don't love her,you are close to it and this relationship goes back almost a quarter of a century. At this point does it really do any good to question any of it? In my opinion there isn't anything you can do,but you can just be the Trisha you've always been..grounded,solid and there for her if and only if she needs an ear,or whatever it is she needs and you are comfortable giving. I think just writing this all out and having us share our feelings...you'll be able to step back and see what does and doesn't feel right to you as far as how you want to handle the issues that obviously will coming up with her.It's a tough situation.

Marda, you need to hang out a 'shingle'--no lie!
What you have is a rare gift, being able to connect the dots, but not seal it with ink, or maybe heart's blood, would be a better word.
(I hope you give yourSELF enough appreciation each day!!!!)

One of my daughter has the gift of acknowledging and mirroring a persons' feelings, while my other daughter has the gift of trying to make things clear. Doesn't always work, but her heart is in the right place.

I've got it made! :o)

Thanks for the replies, everyone. Not an hour after I posted this, I got the call from Keith that his dad was gone. I'll have time tomorrow, to read everything again. I'll reply then.

Thanks.