just minishorts.

My doctor friend Gerrard is back again… haven't you heard of the dude? He's a gem. Now you've got to tell him to blog more. Please go and do so. Link.

A lolly and a second hand tickle-me-elmo toy for Claire for rescuing me from the bowels of the malaysian blogosphere yet again and giving me the opportunity to showcase my pseudo-talent for spewing rubbish to the general public. My last guest post on cervical cancers/pap smears was unyielding; meaning there was not a single request for me to perform a pap smear. Boo hoo. Boo hoo. And one more for the hattrick, boo hoo.

Anyway.

After spending 4 months of relative hell in the orthopedic emergency service at the accident and emergency department, by far and wide the most common so called emergency we encounter is…..back pain. Broken hips from frail geriatrics falling like bowling pins are a close second. So you've got some back pain, but before you decide to be all pussy-wussy ala Pee Wee Herman's grandmother and demand medical attention, stop, have a coffee, masturbate, call your mum, relax and then ask yourself these important screening questions:

Can I walk?
In general, there's nothing more deserving of a knuckle sandwich to the groin and a rusty iron rod shoved up the anus of a patient walking into the consultation room/cubicle complaining of severe back pain. Of course, there are exceptions.

Can I pee and shit properly?
Problems with shitting and peeing indicate spinal cord involvement. come to the emergency department and announce with pride, "I have back pain and I cannot shit and pee right!", and you'd be seen by your friendly doctor very soon. Say, 30 minutes after he grabs a snack, as opposed to a few hours.

Am I feeling numb or weak anywhere below the tummy?
Again, this indicates spinal cord involvement. Do as per above, but replace "I cannot shit and pee right!" with "I have numbness and weakness!". Pat on the back for you.

Does my family love me?
A surprising number of back pain complaints come from the families of patients, whom are usually unsuspecting old ladies with wet unchanged diapers. These are social admissions which we, rather surprisingly, have low tolerance for. So if your family doesn't love you, chances are that your mind will make the back pain seem more sinister than it is and you'll end up begging us for an admission to the wards where beautiful nurses will succumb to your every whim and fancy, unlike your family.

Am I an intravenous drug abuser?
High risk of dodgy infections should the offending organism decide to migrate and raise a family in your spine and it's surrounding structures. these kinds of back pain are a pain in the ass for your doctor and you, because it never goes away with regular analgesia.

Do I have cancer?
If you know you have cancer, and you have back pain as a bonus, please don't be shy to shout out, "i have back pain and cancer!". You'll be seen in minutes and probably started on steroids whether you like it or not.

So if you can walk, can pee and shit right, not feeling numb or weak, not an ivdu, do not have cancer and have back pain, chances are that it's not sinister enough to warrant urgent attention. Continue chatting to your mum, continue with the coffee, play with your belly button lint or whatever, just don't hurry in the emergency department complaining of back pain.

However, if you're an ivdu with cancer crawling in your own puddle of shit and pee because you can't shit and pee right and can't feel a damn thing and your family doesn't love you and you have some sort of back pain, feel free to seek medical intervention immediately. We'll embrace you with open arms and chuck you into the ward.

And of course, I think I should remind everyone that the above is just an extremely light hearted view of back pain management. Please visit your local friendly doctor for real advise instead of taking the rubbish i've written as gospel.

Phew.

Now i think i deserve a lolly too.