Just finished seeing a young lady for lower abdominal pain. I think we may be the clearing house for females with pelvic/abdominal pain of unclear etiology. I’ve slowly accepted this with teeth-gritting reluctance. But I still groan inwardly when I see the chief complaint on the board. The conversation usually involves me, spending a crap load of time and effort explaining why I’d like to not irradiate the patient’s ovaries, and them, ignoring the last 15 minutes. If the patient’s aunt’s hairdresser’s ex-boyfriend’s ex-girlfriend is an EMT and thinks a CAT scan should be got, then there ain’t nothin’ I can do to change that. Occasionally, I’m fortunate enough to stumble across a diagnosis. Usually, I spend a bunch of taxpayer dollars and chase my tail for a while, then spend another eternity telling them I don’t have a clue why they hurt. A fair number of those folks go on to have hoards of testing and an eventual diagnosis of “chronic abdominal pain of unclear etiology”, every ER doc’s fav.
I have a friend who had to go to the ER a while back for lower abdominal pain. She is a doctor, so her initial thought was “Oh crap! I’m not one of those girls, am I?”
Turns out her IUD had perforated her uterus. Probably the happiest person ever to find out that she has a hemorrhaging puncture wound of her insides.
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