Loss of an acquaintance

In the summer of 2009, who was admitted in a tertiary hospital in Panchkula (Chandigarh,India).an acquaintance of mine, Mr P, called me to take advice regarding his father

Mr P's father was a 78 year old gentleman who complained of difficulty in breathing (dyspnea) and some discomfort in the chest during the previous night for which he was admitted in the hospital the next morning. The emergency physician diagnosed it as due to some heart problem and sought a cardiologist's opinion. The cardiologist also agreed and posted the patient for Angiography (and proceed according to the findings thereafter). Meanwhile, Mr P rang me up for advice.

On initial discussion, the breathing difficulty and the chest discomfort looked a bit atypical. I advised Mr P to take a second opinion but on his insistence, I agreed to pay a visit.

I saw Mr P's father in the evening. As mentioned earlier, the symptoms didn’t seem like to be originating from the heart. On probing, the discomfort looked more in the upper abdomen (tummy) rather than the chest and the tummy also seemed a bit distended (bloated). On further inquiring, it was revealed that the patient had been suffering from severe constipation and had not passed motions for the last 5 days. The distension of the tummy and the breathing difficulty had been progressively increasing since then. I immediately did a per rectal examination and found the rectum fully loaded with tons of motions (fecal matter) ! Obviously, he was suffering from fecal impaction- a common condition in the elderly age group people who eat less fibre and move even less.

I immediately ordered a rectal enema and got it repeated at regular intervals till the impaction finished. The patient's symptoms and distension disappeared. He was sent back home with in 24 hours and was advised high fibre diet and ambulation (walking) on discharge.

I permanently lost an acquaintance that day and gained a very close friend !