It sounded like Tom had appendicitis and the ER was just sending him home.
He had messaged me Sunday morning that he was heading to the ER with abdominal pain. “Keep me up to date on what happens,” I responded.
A couple hours later he messaged “It’s Epiploic appendagitis.” Huh? I figured he had misspelled something, and I had no idea what “epiploic” meant, so I did what any good doctor does… I Googled it. It sounded like his appendix had twisted and was dying. But they were sending him home without a surgical consult? That didn’t make sense to me.
We had a couple secure text messages back and forth, and finally I asked him to have the ER doctor call me. Within about five minutes, the mystery was solved. The ER doc said they see this about twice per year, so he’s not surprised I’ve never heard of it. It’s diagnosed by CT scan. There are small outpouchings of fat on the outside of the colon. If the blood flow is cut off, it can cause rather severe abdominal pain, like Tom had. Treatment is pain control and time.
I love the secure texting app, Spruce, which helps me stay in such easy contact with my patients when needed. It’s all part of my DPC (Direct Primary Care) practice, where patients pay a monthly fee in exchange for unlimited office visits and communication.
Medicine the way it should be!