Worry, Part 1

A guest had stumbled in the shower and thrown out her back. Could I make a visit to decide if she needed hospitalization?

Going to the hospital with back pain is a bad idea; even if you’re in agony, no doctor will admit you without evidence of nerve damage such as paralysis or inability to urinate. He will order x-rays (worthless for acute back pain but an ER tradition), explain that you will recover in a few days, and prescribe pain medication.

My examination showed no nerve damage, so I explained that she would probably improve in a few days. I handed over pain pills, adding that, while it wasn’t essential, I could give an injection that would help for several hours. She agreed, so I gave it. 

 “Not so good,” she replied when I called to ask how she was doing. She had been vomiting since the injection, and each vomit hurt her back. That’s an occasional side-effect. I assured her it would pass, but I worried.

She was marginally better the following morning and the morning after that. She wanted to fly home. Could I provide medical clearance? Visits for “medical clearance” are a lucrative perk of hotel doctoring, but I resisted the temptation, explaining that there’s no medical reason why someone with back pain can’t travel. If she could hobble onto the plane, she should go.

Could I give a “mild” injection so she could move more easily. No such injection exists. I suggested she try the pain medicine.

Later, the lady reported that the medicine made her dizzy. What should she do? I told her it would pass. Rest is not helpful for treating back pain. She should try to make her plane. When I called later she had checked out. I worried that I might hear from her, but I didn’t.