Anthony Bray, MD : Hello!
Anthony Bray, MD : well as a nurse you know what we mean by a " surgical abdomen" right???
Anthony Bray, MD : If you have signs of irritation of the peritoneum then it could be very serious and warrant you being checked out at ER....
Customer: I was at the er earlier because of the blood in my vomit and stool. He said i was fine
Anthony Bray, MD : Fever?? Nausea?? Abdomen distended ?? If you listen with your stethoscope do you hear bowel sounds?? ( no would be worrisome for ileus or lack of bowel activity... >>> these would be serious signs....
Customer: No yes no yes
Anthony Bray, MD : Well in such a situation you know that the condition of a patient and in this case yourself may change over time... We don' t ever throw judgment out the window!!
Anthony Bray, MD : Ok I think I follow your answers above>> no fever// yes nausea// abdomen not distended// yes to bowel signs.... Right?? This would tend to be reassuring...
Anthony Bray, MD : Well I think that you might discuss double the dose of Aciphex --- clear this with your GI--- I think warranted based on your history if trouble....
Anthony Bray, MD : As you know I happen to be a fan of Carafate with active ulcers... You can ask????
Customer: But why does my whole abdomen hurt
Anthony Bray, MD : i think symptom wise that some viscous lidocaine to mix with Mylanta would give you short term relief...
Anthony Bray, MD : well I have no doubt that part of it is your ulcer disease but I don't know at this time why it would be more generalized...
Anthony Bray, MD : have you had diarrhea??
Customer: My whole abdomen deels like its on fire
Anthony Bray, MD : Viscous lidocaine would be helpful in this scenario from a diagnostic standpoint too...
Anthony Bray, MD : wonder if you might have some fo of inflammatory bowel disease and not simply peptic ulcer disease ( hope not and doubt it but...)
Anthony Bray, MD : you have not been drinking anymore have you???
Customer: Not today
Anthony Bray, MD : thank you for starting new thread!!
Anthony Bray, MD : Yes you need to stay away from that for a long time at least!!!
Anthony Bray, MD : pain radiate to back?
Customer: After what happened last night i really need to stay away from it
Anthony Bray, MD : I doubt this would be the case but flare of pain and its distribution does concern me for possible complications such as erosion of ulcer-- perhaps to pancreas-- 2ndary pancreatitis--- I doubt this scenario as you would probably be driven to ER due to severe severe pain....
Customer: It just hurts
Customer: Do you get sick of helping me
Anthony Bray, MD : No not at all. Wish I could be more helpful to you!!