Tuesday, July 15, 2008

Having a laugh

I've just seen Doug. Doug is 79 and has COPD. But that isn't why he came in today.

Doug has had non-specific back pain for some time. No worrying features, other than the fact it isn't resolving. He tends to manage it with simple analgesics.

He has seen a chiropracter recently. The chiropracter thinks Doug may have osteoporosis, based (I assume) on the X-rays that he took. So I'm arranging a DEXA scan to see if he does. He doesn't have any risk factors, but its possible.

The chiropracter also found what he thinks is an abdominal aortic aneurysm. I hadn't had reason to examine Doug's belly before, so I did so today. Sure enough he has a small pulsatile mass just below the belly button.

The trouble is, Doug is tall and skinny, So I'm not sure that this mass is of any significance. S I've requested an abdominal ultrasound scan. I explained what I'd found and why I think we should scan it. I also advised him that I might want to refer him to our excellent local vascular surgery clinic if the result shows it is larger than 5cm.. If not, I will just keep an eye on it myself. For the time being anyway.

Then Doug said something which surprised me a little: "Well, that's a relief."

I asked him what he meant. I thought perhaps that I'd explained something badly. But I needn't have worried.

"I thought you were going to tell me I was pregnant!"

We shared a snigger. He left happy.

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