Saturday 13 June 2009

You're going to stick that WHERE??


I had a patient this week who came in with a history of what looked to be IBS...intermittent diarrhoea for several months...and it reminded me of a little problem I had a few months ago when I experienced (what is called by surgeons) a sudden and sinister change in bowel habits.

Now most of you know how full of crap I am…. but Lordy, even I was amazed by what was coming out…I’m sure that I even saw my tonsils at some stage-which was a bit of a surprise as they were removed 40 years ago!

But at least I didn’t need to floss for a few days such was the pounds-per-square-inch pressure in my rectum ...
(Wrecked him doctor? It darn near killed him)

And, Oy! Not to talk about the pain…now I know the answer to the old medical conundrum of, which is more painful?? To give birth, or to be kicked in the testicles??
Well I can tell you with some authority that the “giving birth” thing, wins hands-down !!
Lord only knows how I managed to persaude my ex-wife to have sex with me again after the birth of Number One Daughter...never mind actually have a second child!

And so after a weekend of magic and wonder…. wondering if the only way I was going to stay alive was through magic I dragged my tried and desiccated arse off to the GP .
(Now for the foreign readers amongst us, here in the UK, you have no choice over your doctor…. you basically sign up at the GP surgery in your Post Code area)

Well typically my luck has held and I’ve been assigned to a practice of Mittel-European skivs who between the lot of them have more gold teeth and less medical qualifications than the entire cabinet of any 10 African dictatorships

Except that day of course…. that Monday, I got the little female doctor who looks like she has stepped from the pages of Playboy-a magazine I once read at the dentist, and only for the wine column I hasten to add.

Still I thought, she’s a professional and will probably be able to contain her lustful feelings when she is exposed to the legendary Lucien 'abs-of-steel'………

(A pause here for laughter)

Fortunately it wasn’t necessary
Having explained that I had had this sudden change in my motions, accompanied by the most dreadful abdomen pains, she proceeded to examine my abdomen through the twin layers of my T-shirt and denim shirt .
Outstanding!!

Even the non-medical amongst you will be able to detect the fatal flaw here…and there is an old maxim in medicine that says, “if you don’t put your finger in it, then you’ll put your foot in it”
(Oddly not a phrase that I have ever used successfully on a date. Anyway)

Well I don’t think there’s anything wrong, she said

"Oh? Ok? Really?"

Possibly some D&V bug…. maybe Diverticulitis…maybe cancer

"OK…humm…Diverticulitis"

Yes, it’s a disease in PEOPLE OF YOUR AGE

(Well what does that mean exactly? MY age? I’m 16.Well in my head I’m 16)
(Couldn’t I have got something more interesting like Green Monkey disease or leprosy…even herpes?)

"So let me get this right…I may have cancer…probably have D&V…but really you think I have a common-and-garden gut disease of old age? "

Yes, she says, smiling, but its probably cancer given your age. So what you need to do is go away and if there are no changes in 6 weeks then come back and well put you on the 2 week fast-track for a colonoscopy

"OK. So that’s basically in 2 months time then…so if I’m not dead of dehydration, or my stomach doesn’t explode like the guy in the Monty Python skit, or in fact, (say it quietly) cancer, then I can come back and be rushed through the surgical gut team "

Yes, she says, and please don’t let the door hit your arse on the way out

Well in truth you do have to leave things for a couple of weeks. Bugs like camphylobacter take a good eight days to resolve…needless to say, it didn’t settle down.

And so I saw another doctor who put me on fybogel

An interesting drug with the side effect of wind…. indeed, lets not be coy, flatulence. Huge amounts. Indeed at one stage I was farting with the speed, fluidity and desperation of an ack-ack gunner trying to shoot down a kamikaze airplane .

In fairness the fybogel did take away the abdominal pain but not the underlying symptoms

And so, let me say this…for any of you who do not believe that money makes a difference to your quality of life, then pay close attention

I contacted my private health insurance. Now when I took out the insurance my colleagues fell about laughing. Why, they asked, as they rolled on the floor in mirth, tears streaming from their eyes, would you need private health care when you can just go along to the NHS?
Well, you cant actually rely on the NHS…. its to busy giving IVF to asylum seeking lesbian dwarfs to take care of middle-class, middle aged (did I write that) men.

And so miraculously, I was delivered into the hands of the private health economy.
Ja, well.
Fortunately all of this was happening whilst I was on Annual Leave.

Anyway, so I met with the surgeon.

The first thing I noticed was that he had big fingers, a crucial thing to note.

The second thing I noticed was that he was English. Now, no offense, but that’s not something that you look for in a surgeon.
I want my surgeon to have felt kilometers of bowel during his training, feeling blindly for the stab wound or bullet hole.
I want him to be more familiar with the bowel’s of strangers than he is with his own. I want someone …not to put to fine a point on it…. who has cut up lots of people. Bizarrely, not something they do very often here, the rise in knife culture notwithstanding.

And, thirdly, he was wearing a tie. Now I know-from a professional view how close he’s going to be getting to my bum and frankly I prefer my surgeon to wear a bow tie. Still, at least it looked like silk

So…that’s an interesting accent, he said

"Ja. I’m from Joburg"

Oh…what work do you do?

"I’m a trauma nurse "

Oh, he said, his face lighting up, did you ever work at the Johannesburg Hospital

"Uh...JAH!!"

O.K. ..do you know Ken Boffard?

"Oh jah"

And then the heavens opened and God’s glorious light bathed me and rescued me.

Well , he said, I did my surgical training in Joburg in the mid-90's because I wanted the best training. Did you ever work in the “Pit” at Bara?
(The surgical resuscitation area at Baragawanath hospital, still the largest in the southern hemisphere)

Verily there were choirs of seraphim singing at that stage!!

"Yes" ,I responded. "Thank you Lord, yes I did "

And so, my mind once more at peace, he started to examine me.
At the end he mentioned a couple of possible procedures that he could do but suggested the ever popular combo of a flexible sigmoidoscopy followed by a CAT scan

This sounded like a plan ...

Good he replied,what are your plans for this morning?

"This morning ???"

Well, he said,you’re the only surgical patient at the clinic this morning and the scope room is free,so why don’t we just crack on?
(Crack-on! Geddit?)

And so we did. Really glad that I wore my khakis’ that day then.

And so dear reader, in a matter of moments I found myself lying on my side with a BEEEEEEG pipe being inserted…and naturally discussing the rugby world cup...

To be honest it’s not as bad as it sounds ...
As the bishop said to the actress

But I have to say that lying bollock-naked on a bed on a Monday morning, and seeing your sigmoid colon on a 24-inch TV monitor is a slightly surreal experience. Particularly when they start to alternate with flushing the gut with the water (cold) and the air (even colder)
And then he found some diverticular pockets and so got all excited...


Yeah for fybogel!!
Viva Bara Viva!!

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