Sunday, July 20, 2014

Don't Get on the Plane!

“My flight leaves tonight” is a phrase I like to hear because it means the guest will return to the care of the family doctor. Until then he or she is my responsibility. Now and then, I don’t like to hear it. 

A guest awoke feeling well but after a few hours noticed some abdominal pain.

When I hear “abdominal pain” I ask about vomiting and/or diarrhea and hope it’s present. That points to a stomach virus, usually a short-lived and not very serious problem.

Abdominal pain alone can mean a stomach virus, but I also consider serious conditions (gallstones, diverticulitis) and potentially fatal ones (ectopic pregnancy, blood clots). I prefer to send these guests directly to an emergency room, but sometimes I end up at the hotel.

This guest thought over my question before deciding that he had diarrhea. Maybe… My abdominal examination turned up nothing requiring urgent attention. He was not elderly, so several life-threatening problems were unlikely. The pain itself was unpleasant but not excruciating.

It was a difficult decision, but doctors are paid generously to make difficult decisions.

I told him that he probably had a stomach virus, but I couldn’t rule out something serious. I would give him something for the diarrhea and check back in a few hours. I added that he might need some tests and that he must not get on the plane if the pain persisted.

When I phoned after three hours, he had checked out.

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