An Untypical Case of Stomach Flu

I once cared for a Fiji Airline flight attendant suffering stomach flu. These are miserable episodes of cramps, vomiting, and diarrhea that rarely last long. She was better the following day, but on that day I returned to the hotel to see another flight attendant with similar symptoms.

In the hotel room, I repeated my stomach flu exam, delivered the usual advice, and handing over medication. She asked if the medication was safe if she were pregnant.

Doctors are human. Having made a diagnosis, my inclination was to stick to it, but I asked a few questions. Her period was overdue. She admitted that her nausea, although worse today, had begun a week ago. Her cramps, also worse today, had also been present.

One of many rules medical students learn is that when a young woman has abdominal pain, one always considers an ectopic pregnancy. That’s usually a pregnancy in the fallopian tube which, unlike the womb, had no room for the growing fetus.

I told the flight attendant that she needed a test to see if she had an ectopic pregnancy which is an emergency. She did not disagree. I phoned the agency that handles airline crew. Their medical department agreed that this was appropriate, and it turned out positive.

An Unsatisfied Customer

A Quantas flight attendant was vomiting, so I drove 49 miles to the Radisson in Newport Beach.

Fortunately, she was already getting better. She hadn’t vomited in six hours but was still queasy. I told her that she should continue to improve and advised her to suck on ice chips. I went to the ice machine and filled a tub. Normally, I would have left antinausea pills, but she was pregnant. She thanked me effusively as I left.

Soon after, a nurse from the airline phoned. Tactfully, she explained that the Quantas crew member had expressed concern. In her original call, the crew member had requested medicine for vomiting. A doctor had come but left without giving anything.

I explained that she was recovering and didn’t need medicine. In any case, she was pregnant, so taking drugs was not a good idea. The nurse expressed complete sympathy.

Later, the director of the housecall agency phoned. Tactfully, he explained that a nurse had passed on some concerns expressed by a flight attendant. I repeated my explanation, and he expressed complete sympathy. The following day he phoned again to assure me that I had done the right thing and that he was working hard to make Quantas see the light.