fandom_clinic | (no subject)

(ooc-jumping over here, hope that's all right?)

Walking into the room, Wilson finished flipping through the chart and looked up to Parker with a warm smile.

"Good evening, Parker. Lily tells me you're having acute stomach pain. What else can you tell me? Is it localized in one spot? Does it come and go or is it constant?"

As he asked the questions he walked over to the exam table and set the file down. Turning towards Lily he asked.

"Did you take a temp?"

"It's been off and on the last few days." Parker is too unhappy to tease the cute doctor. "And localized. Here," she pokes herself right below her stomach, over her intestines. "I feel like I'm getting *stabbed*, damnit. Ow, ow, ow."

God, she'd kill for a cigarette right now.

Wilson made a mental note of the temp (http://www.livejournal.com/community/fandom_clinic/23784.html?thread=803816#t803816) and motioned Parker to lay back. Reaching with gentle hands, he began to examine her abdomen.

“I saw on the chart that you’ve been nauseous and had decreased appetite? Have you actually thrown up any? How about your energy level? Tired? I hate to do this but tell me if this hurts more, less or just the same…”

With that last bit, he pressed gently on her abdomen in the upper right quadrant.

"I didn't throw up today." Parker rolls her eyes, then winces. "Saturday. I threw up on Saturday, but I thought it was just because I binged on chocolate and cookies and some alcohol after a lousy Homecoming." She grits her teeth, and clenches her hands into fists.

"Same. Same. OWWW! (http://hcd2.bupa.co.uk/fact_sheets/html/Peptic_ulcer.html) Damn, there!"

He pulled a bit of a face as she reeled off her dietary intake from Saturday.

"Uh, yeah that would definitely cause an upset stomach."

Though Wilson would have liked to make another run over the area, he'd picked up enough of...well...not what he'd been initially expecting that he quickly racked his brain across the PDA and picked out a question to help him work the differential.

"Okay have you tried any antacids? Also, the pain would you describ it as focused downwards, between here and your naval or more like it's up towards your sternum?"

Parker thought about it, shifting in discomfort. "Sternum. I guess." She rolled her eyes. "Doctor, I've been popping antacids and ibuprofen and aspirin for *weeks*. I've been managing the stupid campaign. I don't even notice I'm doing it any more."

Her response caused him to nod and set his hands on the table beside her rather then continuing to invade her personal space.

“Well, I have good news and bad news. Good news is, I don’t think you’re suffering from an acute appendicitis. Bad news is, it sounds like you have an ulcer.”

Reaching for her chart, he reached for a pen stuffed into the side pocket of his slacks.

“Your diet of NSAIDs and well…your diet along with what I imagine has been an extremely stressful time has probably brought it along quite rapidly. Alcohol consumption and…do you smoke? Drink lots of coffee or soda? Because those also factor in to it.”

"Ulcer?" Parker sat up, looking aghast. "I... Yes, I smoke. About half a pack a day, more or less. More. Maybe. Coffee, and soda, both. Mochas. Frappachinos. Alcohol, not so much, maybe once a week...."

"They gave me an ulcer?" Parker looked like she wanted to kill something. "This stupid freaking campaign has burned a hole in my *stomach*?"

Wilson had years of practice at keeping a straight face; though the young woman’s ire did amuse him he felt it better to keep that amusement to himself for the time being as he explained.

“Well, it is possible that the ulcer is being caused by a Helicobacter pylori infection, which would have made you susceptible to the other aggravating factors. However, given what you just told me, that you’re popping aspirin and ibuprofen both of which alone are incredibly tough on your digestive track, without even being aware of how much you’re taking them…coupled with smoking, stress and a rough diet, I’m thinking this one grew on it’s own without help. Well...if you don't count the campaign.”

Flipping the chart open, Wilson had to hold his hand at an awkward angle to make his notes…ah the joys of being a lefty.

“For the moment, let’s assume it’s not complicated by an infection and try the direct route. I’m going to prescribe an antacid for the next four days. That should help alleviate the pain. The big one is, of course, stop smoking.”

Somehow he just had a feeling that suggestion was going to be dismissed before the words finished leaving his mouth so he simply continued.

“Also try to eat smaller meals more frequently rather then big meals haphazardly. Try to cut back on the coffee and sodas, go easy on milk products, stay away from spicy foods and stop the NSAIDS. If you have to take something for a headache, make it Tylenol.”

Now came the fun part, ah well…it had to be addressed.

“If after you finish the four days antacids the pain hasn’t decreased come back in and we’ll test for the infection as well as do some more invasive checking. Also if you notice blood in your stool or it becomes tar-like or you have constipation, come in immediately.”

Finishing up with his notes he flipped the file closed and looked at her.

"Any questions?"

"No smoking? Oh, no WAY...."

Parker spluttered through the rest of his explanation, stuck back on her nicotine, then focused on the others. "I can still have coffee though, right? Right? And okay, Tylenol. That's fine. But.... no smoking?" She tried a hopeful, charming smile. "You mean just less smoking, right? Because I can cut back. The campaign's over. I won't need to smoke as much. I'm okay with that. And how the hell can smoking do anything to an ulcer?"

At the rest of it, she looked vaguely nauseated again, but nodded.

Leaning back against the counter, Wilson crossed his arms across his chest tapping his hip with the file.

"You're asking an oncologist to sign off on the idea of moderate smoking vs quitting all together? I'm realistic about the chances of your quitting but I left compromising my stance on cigarettes in my other pants.

Though he was serious in his words, he didn't try to jam it down her throat or come across as patronizing. He knew enough about patients to know they would do their own thing and all the pushing, shoving and insistng in the world wasn't going to mean shit.

"You're going to find yourself listing to your own body for all of these factors. Right now, since you didn't report the bloody stool or blood in your vomit, I feel safe in saying the ulcer hasn't ruptured...yet."

Parker bit her lips at that "yet", and pinched the bridge of her nose. "Okay. Okay. Point made, understood." She sighed, wincing. "I just like my vices, damnit."

She took a couple moments to think, then uncovered her face. "Right. I'll... try. I guess. Starting tomorrow. Do you have Nicorette, or one of those patches, or something here?"

Parker crossed her arms and pouted. "I want a lollipop. One of Dr. House's red ones, damnit."

Okay, that display caused sensual lips to twitch, though Wilson fought to keep the grin off his face. His dark eyes danced however and he pulled the script pad free and scribbled out another perscription.

"Here is a script for a nicotine patch, if nothing else you might be able to submit it back to an insurance company for compensation. I'll dispense some Nicorette, just give me a moment."

Walking out of the room, he was gone for about ten minutes before returning with a package of the gum and...a red lollipop.

"Here." He set the packet down but held the lollipop back as he looked her straight in the eye.

"Give it an honest effort, I'll do whatever I can to help. That includes red lollipops. You can even come and watch House ream me out for handing out his darlings. Deal?"

Parker seemed thoughtful. Clutching the script for the nicotine patch, she looked from him to the lollipop, then at the Nicorette.

Then she smiled. "Deal. I'm smoking my last cigarette tonight, Doc. I can't pass up the free chance to see Dr. House ranting, can I?"

Wilson chuckled softly. He knew he was battling against the odds and it was all together possible that he'd just end up looking like an idealistic fool but that was nothing new with him.

"I usually like to sell tickets, consider this your backstage pass."

Idealistic fool or not, everyone got the same genuine offer of help and the same investment of hope that this time...it might just work out.

Parker took the lollipop and ripped off the wrapper. "Thanks, Doc. And thanks for the diagnosis. I guess." She looked disgusted, and licked the candy with a disgruntled expression. "Stupid campaign. Maybe I can sue *them* for support of Raindrop."

"I'll come back if it gets worse." She smiled. "You're a lot nicer than Dr. House. Who's a stand-up guy, but...."

Moving to hold the door open for her, Wilson chuckled.

"But...who can be an unmitigated ass? Yeah, I know...but he's lovable in a...prickly hedge hog sorta way."

Despite the snark there was obvious affection in his tone as he talk about his best friend.

"He didn't inject me with gremlin spit, which is always the first thing I look for in a doctor. Even if he *didn't* try to bust me for excessive Nice at Homecoming." Parker jumps off the examing table, and said, "And yeah, ass covers it. But hey, great lollipops. And not stupid."

She cocks her head at Wilson as she walks through the door. "You guys are cute together." She grins around the lollipop. "See you later, Doc."

Parker sashays away.

But she's still upset about the smoking. Oh yes.

_{[ooc: *loves on your Wilson* Gracias, and should she come back next week, even sicker, you think?]}

(ooc- *Shy blush!* Thank you!! I'm glad you enjoyed him, I had a blast coming in to this!! Thank you so much for drawing him in. I would say it would be up to how her week goes? I dragged the actual diagnosis and treatment out of WebMD. If she doesn't adjust her life style even a bit...yeah she'd probably get sicker.)</small)

*Parker waves good-bye*

_[[Thanks!]]

_{[ooc: Don't know about Lily, but Parker's thing is all good. Heh. *snerks madly at the MFCD boys*]}

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