Bums

I have never been unfortunate enough to need to have a doctor put his finger up my bum. I hope I never need to, but the thought of me having to do that to someone else isn't much better.

I nearly had to do my first rectal exam today - I managed to go the loo at an excellent time and so my clinical partner was landed with it. He was told to "Go and do a rectal" on an constipated alcoholic patient. The SHO told him that it had to be done "To see if there is poo in his rectum"

WTF???? Of course there is going to be poo in there! If he hasn't poo-ed for four days, where is it going to be, other than in his rectum?

I kind of hovered around the bed whilst my clinical partner got his gloves ready. The SHO told him what to do and so, after covering himself and the bed in KY jelly, he did the deed. Although we had the curtains around the patient, The SHO managed to shout really loudly "Put your finger in and tell me if there is hard faeces there" The other patients sniggered and the visitors around the next bed went very quiet.

My clinical partner didn't say much for the rest of the day and struggled to eat his free curry (Drug reps are wonderful people!)

It's hard to think that these things will soon become as routine as taking blood - just part of the everyday routine. The funny thing is that if I was training to be a vet, I don't think that I would have any worries about sticking my finger up a dogs' bum. It just seems a dreadful thing to have to do to a man. I wander too, how necessary some of the rectal exams are. I can understand their need to assess prostate size and prescence of malignany, but I am not too convinced about doing them for constipation, like the one today. I asked the SHO why this was needed for constipated patients and he really couldn't answer me, only to say that "This is how we assess the level of constipation"

Oh well - I expect this time next week, I will no longer be a rectal exam virgin!

When will the penny drop??.......

I really don't understand people. The older that I get, the less I understand people.

Take Mr A. He is a 57 year old male who came into hospital a week ago after experiencing numbness down his right side whilst working in the garden. I first saw him two days after his admission on the ward round. His numbness had subsided but not completely gone away and so he was advised that he had suffered a stroke (If his symptoms had completely gone away within 24 hours it would have been a TIA)

The consultant sat down with him and went through his risk factors for stroke. He had smoked 20-30 a day since the age of 20. His cholesterol was reasonable at 5.4 mmols / l and his blood pressure a little raised at 140/92. His father had died from an MI aged 62.

The consultant explained to him that he had had a mild stroke and was at quite high risk of having another one in the next month. He told him that now was a good time to give up smoking and explained how this mild stroke was a warning sign which needed to be heeded. The consultant also said that he was worried that Mr A might have furred up carotid arteries and arranged for a scan to assess the level of furring.

Mr A was clearly terrified and I really felt for him. I visited him after the consultant had left and we chatted about what had been spoken about. His main fear was about his neck arteries being clogged up because he was scared of the treatment that might be needed. We agreed that it was good that this stroke was a mild one, because he was not going to be left with any impairment and so it could be taken as a warning sign.

Next day and Mr A went off for his scan. It was good news.....his carotid arteries were not furred up and so no treatment was needed. Mr A was a happy bunny. So happy, in fact that he took himself straight off to the car park and.....yes, you guessed it, got his fag packet out and started to smoke.

My colleagues and I sat in the canteen and watched him smoking. We were pretty dumbstruck to be honest. When does the penny drop? When do you throw your arms in the air and say "You know what, I have smoked for 37 years and I have just had a stroke that I have completely recovered from. I am a lucky bastard because I have had a warning sign that things need to change"

Instead Mr A's arm in the air moment was "I am a lucky bastard. I have smoked for 37 years and don't have any furred up arteries. I haven't done myself any damage......bring on the fags"

People are funny buggers.

Men I would leave my husband for (Part two)

Christian Ronaldo is the newest addition to my list.

My husband and I both have a list of people who we would leave the other for. This might shock people but bearing in mind that my list is Ronaldo, Patrick Dempsey and Jay-Z and my husbands list is Pamela Armstrong and Carmen Electra (He wanted to add Gemmma Atkinson to his list but I dug my heels in) I don't think any of us are going to be packing our bags any time soon!