Saturday, March 04, 2006

Hypochondriasis

They say that docs make the worst patients.
I'm home on a Saturday night, almost doubled over with this gnawing, nagging epigastric pain.
Gastritis? Or worse, peptic ulcer disease? No reason to get pancreatitis (except for the, ahem, occasional resident-style EtOH binges).
A bit of knowledge is a dangerous thing. You tend to self-diagnose. And, if you're a hypochondriac like I am, imagination can sometimes take you places.

The last problem I had was when my right thumb swelled up. Tender, and I had difficulty flexing it. As it so happened, I was working at the thyroid clinic that week. Which made thyroid biopsies extremely painful for me as well as the patient. Had the lab draw up some tests, which were unremarkable. Tried to talk a rheumatologist colleague of mine to give me a cortisone shot for the inflammation. But no, she said it wasn't necessary. Just give the badminton a break for a few weeks. Sheesh.

And then there was the time when I had issues with recurrent severe pharyngitis/tonsillitis. The 2nd time I had to go to the ER I was convinced there was something else wrong with me, what with the pains, severe shaking chills. I had just finished call and dragged myself down to the ER. As it turned out, I was right; the CT showed a peritonsillar abscess. Which meant an I & D. Therein lies my mistake, I neglected to ask the ENT resident who saw me that September how senior he was (he was almost brand-new). He hurt me. After 4 attempted passes with the needle and one with a scalpel, he had to get his senior. It was so bad that after they were done, an older nurse came in and saw me in tears and asked me, "Oh you poor honey. Can I get you anything?"

To which I could only whimper, "Morphine. Please give me morphine" (I kid you not; the pain had me crying like a little girl. I still see that ENT resident occasionally, and we both just share a nod and an embarassed smile).
Morphine sulphate 4mg IV and 6 hours later (I spent the night in the ER observation unit) I was up in my scrubs pulling my IV pole to the computer so that I could follow up on my patients' labs.

Anyway. Back to my tummy pain. Hmm... perhaps endometriosis? Or, perhaps a leaky AAA? Ectopic? Gosh, maybe I should get myself checked out in the ER? Maybe someone ought to do a DRE.
(in all probability, it was just the fried rice noodle with salted fish I ate)

2 Comments:

Anonymous mayan said...

a CT for a peritonsillar abscess from the ER? gosh.. i'm impressed with the way things work over there.. when i covered ENT on-calls, i used to just aspirate them with a green needle & a 20-ml syringe after a couple of squirts of xylocaine spray! then it's IV BenPen & Fluclox for a few days then home on orals. Don't think they got round to CT-ing the patients routinely at all! anyway.. rehydrate yourself at home lah.. get ts to examine u lah.. between the 2 of u i'm sure u'll come up with a diagnosis! not sure he'll be to keen to do a DRE though! :)

12:08 PM  
Blogger saminkie said...

we got a joke in Iraq saying that: " a homosexual visited a doctor saying that he got pain in his ass. the doctor started to do a PR. HERE IS THE PAIN? the doctor would ask. NO DOCTOR DEEPER the homosexual would answer and the doctor goes deeper till the doctor finally said YOU GOT TONSILITIS!!".

7:22 AM  

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