Tuesday, April 20, 2010

Allow Our Youth to Digest Properly

High schooler came in with abdominal pain, and vomited 3 times.  Context:  started as she was finishing running the mile during PE class, continued even after she stopped.  On further questioning, she had finished eating lunch less than 30 minutes before she had to do this.  She really has to run it hard, because, as an athlete who runs track (shorter distances), if she slacks, the teacher dings her ("takes off points.")

Convinced myself not a coincidental early appendicitis or other serious condition, saved her the blood draw, gave her some Maalox and a Pepcid.

As an ultrarunner, I have to learn to eat and run-- literally.  And I guess someone has to take gym right after lunch.   But I commiserated-- this is nuts!  Mom agreed too.

Offered to write her a PE note.  Tried to figure out how best to word it--  needed to give her results.  Obviously, gym teacher's a hard-ass.  After about 15 seconds deliberation (patient's were piling up) I decided to lend some credibility to my note my dropping the running thing.

"As a board certified emergency physician and competitive USATF ultradistance runner, I do not recommend forcing strenuous physical activity within an hour or two after meals."

...next patient...


Ewa said...

Hmm... what kind of coach/gym teacher would not know that? I knew one needed time to digest when I was a kid and that was 40+ years ago.
Great wording, btw. I probably would not be so diplomatic.

Lori said...


Glad you got to her before some overeager 3rd year med student could get their grubby hands on her and torture her w/ questions about her LMP while mashing on her belly in hopes of eliciting peritoneal signs.

Love your assessment and recommendations.

(You really are my hero!!!)

Anonymous said...

Well done!........................................