21/04/08
Could you be Dr House and diagnose me? -
Categories: It's been quite a few days - beginning on Thursday morning with a trip to A&E. It was half a day of lying on a hospital trolley, two days of worry, four days of terrible pain, and a fair amount of chess. But generally the weekend played out like an episode of House. I had a medical conundrum that no one could work out. So my first question to you is this: are you a fan of TV show House? If so, and you don't get embarrassed or awkward about reading a stranger's (or friend's, depending if you know me) medical history, then read on, and see if you can work out what was wrong with me...
Thursday morning I awoke with agonising pain in my abdomen. I had got through a bottle of wine the night before, so wondered if it could be something hangoverish. But this was properly agonising, so pretty soon I thought it can't be that.
Six years ago I was rushed to hospital with peritonitis, which is a pretty bad condition, which in my case resulted from a rupture in my bladder. It was very dangerous, and only thanks to immediate surgery did I get through it. That too began with a sharp agonising pain in my abdomen, so when this new pain appeared last Thursday, I panicked a little. The main difference is that six years ago it was just on the right side, and Thursday's pain was all across from right to left, and a little higher. Could it be some internal rupture, just a bit higher up?
My other pondering was that it could be related to lower back pain I had two weeks ago: same region of the body, only the back pain was around the back and the front pain was, well, around the front, obviously. I went to the GP then and he diagnosed it as mechanical back pain (common for tall men) and gave me a course of Diclofenac - a hefty ibuprofen-based painkiller. So that seemed to sort the back pain from two weeks ago, but could he have misdiagnosed me? Could Thursday's new abdomenal pain be this same back pain, only... moved round the front?
A&E couldn't work out what it was. I had an X-ray, blood tests, wee tests, and my poor parents and girlfriend kindly wondered in to see me lying on a hospital bed in A&E wearing a hospital gown with a needle in my arm and an oxygen mask around my mouth (I was feeling a bit faint from the pain). Bless 'em. In the mean time, a surgeon visited me to see if I should have surgery, as I did with the peritonits 6 years ago. He decided not. He concluded a few things were behind it, including a wee infection among other things. So he gave me some antibiotics, some new painkillers, and sent me home with them.
So what was wrong with me? We think we know now (although it will take another few days to know for sure, till the correct drugs kick in), and it was solved by my GP, and my mum chatting with a roomful of nursing friends. But do you know? It can be solved from the above information, and you don't need to be overly medical to work it out. If you need some more thinking time, have a quick re-read. For the answer is in the next few paragraphs. In the mean time, here's our Graham with a quick reminder...
Would you have done surgery?
Would you diagnose a wee infection?
Would you suspect the evil peritonitis (internal rupture) from 6 years ago had come back?
Was it the back pain from 2 weeks ago, making its way to the front for some reason?
Or something else?
Right. Time's up. Let's see if you're more like Hugh Laurie as Dr House, or more like Hugh Laurie in Blackadder. If you've seen House then you'll know it follows a pretty familiar formula. Well the history of the bladder rupture - that's the early diagnosis, and the red herring that a House episode would feature about 15min in. That was enough to panic me, but the pain from last Thursday was higher and not just on one side, so nope - similar feeling but not the same. So if you opted to do surgery on me - you're wrong. Or you're sick and twisted. In which case you're still wrong, just in a different way.
The A&E doctor suggested a wee infection. Also wrong, because if so, I'd have had the pain lower, ie. where the wee is. And what about the back pain from 2 weeks ago? Related? No, that was just back pain from bending over in the wrong way. But me having the back pain is related to it...
The drugs the GP gave me two weeks were a course of Diclofenac - an ibuprofen-based painkiller. As you may know, ibuprofen is the one that you have to take with food, otherwise it enrages your stomach. Well, I had been, but it's still a pretty heavy-duty painkiller, and to have a course of it is a little bit excessive. But I obey the GP, so even though it had fixed my back, I was still finishing the course. Which didn't make my tummy very happy. It gets pretty acidic, and you can change the 'pretty' to 'really very very' if you add something else acidic and silly to the stomach like, say, a bottle of wine... which I did mention I had the night before the pain. So, bottle of wine, plus stomach of unneccessary ibuprofen, equals much abdomenal pain.
It's still there, but at least I know what caused it now. Oh, and if you guessed right, well done, you have now graduated medical school. And you're better than the doctor in A&E...
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