Daniel lay curled up on the infirmary bed, one arm up across his eyes, blocking out the world, the other guarding his stomach, fidgeting miserably. Janet bustled over and laid a hand gently on his arm.
"Daniel" she said quietly,
"Heya" Daniel replied weakly, arm still over his eyes.
"How do you feel?" Janet asked gently.
"Like crap" Daniel admitted.
"Anything besides the stomach pain?" Janet asked as she eased his arm down from his face.
Daniel blinked in the light "Headache, sick, shivery, a bit shaky".
Janet felt his forehead. "You are definitely feverish" she confirmed. "Turn your head please". The thermometer in his ear only took a few seconds to register his temperature. "101" Janet read out making a quick note. She took his wrist, and felt the quickened rate of his pulse. "Hmm" she said with a frown. "So, let's talk about the pain. Have you taken anything for it?" Daniel nodded weakly. "What did you take?" Janet continued.
"Tylenol" Daniel said "Every couple of hours".
"Did it help?"
"A bit – not much" Daniel replied groaning slightly, rolling over as the pain intensified again.
Janet crouched down by the bed so that she and Daniel were at eye level and put her hand sympathetically on his shoulder. "On a scale of 1-10 how bad is it?" she asked.
"Umm, 5 or 6" he suggested, his voice catching. Janet frowned but wrote the figures down adding (8?) beside them.
"Can you describe it, sharp, dull, burning, squeezing?"
Daniel paused, eyes closed, waiting until he trusted himself to speak without retching or groaning. "Sharp, burning now, was just general achiness and cramps." He opened his eyes and looked at Janet "right-side, worse when pressure is released – it's appendicitis isn't it?"
Janet nodded with a rueful smile. "Quite probably – can you turn on to your back please so I can take a look?" She helped him over. Lying on his back made the pain instantly worse and Daniel let out a shaky breath, shutting his eyes tightly against the prickle of tears. He tried not to wince in anticipation as Janet hitch up his T shirt. She carefully poked and prodded him, noting the heat and rigidity.
"Are you going to do the rebound test?" He asked unsteadily.
"No" Janet said patting his arm and easing his T shirt gently back down. "Not since you've already told me it hurts worse when you release the pressure. I do need to ultrasound you though - just to make sure."
Daniel nodded weakly; "Thanks" he said, forcing a smile. "Wasn't looking forward to that". He gave a sharp intake of breath as he bit back another groan.
"First" Janet said decisively "let's get you some morphine."
Janet allowed the drug time to kick in before getting out the ultrasound. Once Daniel was able to uncurl and lie reasonably still without constantly shifting she lifted up his T shirt exposing his bare skin and eased the waist band of his boxer shorts slightly lower.
She placed her hand on top of Daniel's and shook him slightly to get his attention. "Ok, Daniel" she warned, "you are going to feel cold gel first and then I'm afraid there will be more prodding. The morphine will take the edge off but it will be uncomfortable. Ready?"
"Uh-huh" grunted Daniel from his druggy haze. As she pushed the scanner over the epicentre of the pain he registered it, but in a strangely far-off way. "Yup" he slurred "Definitely uncomfor'ble". As gently as she could, Janet eased the scanner off his stomach. Daniel yelped and tried to curl up as the sudden stab pierced through the drug's defences.
"Sorry Danny" Janet said squeezing his shoulder "no more poking now, all done." She put the machine away and went round to the pillow end of the bed. "Are you with it enough to listen?" Daniel nodded but the movement was difficult and his muscles felt clumsy.
"Right, it is definitely your appendix and I will scold you later for toughing it out and not coming back earlier!" She gave him a sympathetic frown and patted his hand. "You must have been feeling pretty awful for hours and you've missed your chance to try the antibiotic route. It needs to come out and sooner rather than later. Have you eaten anything today?"
Daniel shook his head. He hadn't really eaten much yesterday either. He hadn't trusted anything to stay put.
"Drunk much in the last four hours?"
Again he shook his head.
"Good!" said Janet. Then we can start right away.
