Thursday, February 08, 2007

Armpit ?

Aitelyu, when seeing patients, one of the clinical examination that I dislike is examining the armpit or axilla (mainly palpation for axillary lymph nodes). I don't mind shoving inserting my index finger into the anus (for PR or per rectal examination) or my index and middle fingers into the vagina (for VE or vaginal examination) cos at least I'm wearing gloves for the latter two procedures.

Why examining the armpit or axilla is not favourable? Imaging touching, examine and palpating the wet and sweaty hairy armpit with bare hands and fingers? It is not just a superficial touch but few several deep touches,including pushing the fingers into the axilla region for thorough examination of the armpits, especially patients with cancer or lymphoma. Summore, there are 5 main groups of axillary lymph nodes. If the armpit is dry, it is still alright.

Of course the proper way is to examine patient with clothes off which I do when examining or palpating other body parts. But when I examine armpit, I prefer to examine with clothes on, provided they wear thin clothes, so that I can have a thorough feel & palpation without "direct" touch. Kkkkkk.... The reason is very obvious right? I don't think you all want to touch other people's armpits if possible. If the patient wears sleeveless clothes, Mmmmmm... I kena many times liao examine patients with wet armpits with my bare hands. But I still have to act cool & professional like nothing had happened, and carry on with the other necessarily clinical examination :(

Side note : Pleaseeeeeeeee don't wear sleeveless clothes when u go for follow-up, (psssss...cos doctors are humans too). :P

36 comments:

Pink Cotton said...

YEARGHHHHHHHHHHHHHHHHHHHHHHHHHH

Pink Cotton said...

*jian gui le*

SO SCARY!

CAN IMAGINE LIAo!

did u try to sniff ur fingers after the test???

LOL LOL

may said...

ewwwww! AKK!! WKK!! EKK!!
*brings shaver to remove armpit hair*

a^ben said...

ai si lor....

IF SMELLY HOW?!?!??!?! gelik si`

Chen said...

pink cotton,
sniff fingers?
siao lah lu :P
The first thing I do when I have the chance is to wash my hands lah!
LOL summore
jahat lah u
Kkkkkkkkkkkk

may,
I wish I can do that !!!
Kkkkkkkk....
Abuthen, some people still sweats even without armpit hairs woh..

ben,
if smelly ah?
Still have to pretend like not sniffing anything funny...
have to pretend like not smelly lidat
must be "professional" mah...
what a life :(

Kenny Ng said...

No worry... I'll spray perfume... LOL

Cocka Doodle said...

was this post inspired by our IM conversation about that pretty Chinese girl that has hairy armpit? LOL

Simple American said...

At my doctor they alwasy make us wear those hospital gowns for exams.

Hey I dun like getting poked in my underarm either. Ticklish lah! Kkkkk

And I don't like the finger where the sun don't shine either. I always wonder how can a gay like this sort of thing everytime I get my prostrate checked. Always worried I am going to fart during the exam too. 0.0

Chen said...

kenny,
Hahaha, keep up the good work :P

cocka,
No lah.. I wanted to write these quite some time ago liao but I lazy. And I examined someone (again!) with wet armpit lately... Kkkkkkkk....
I hope I won't come across these sort of cases so frequently.. :P

SA,
Too bad no such things over here.
I dun mind doing per rectal examination cos at least I'm wearing mask & gloves :P It is painful to some especially if the finger is not lubricant adequately And geli to some, too cos most people dun like to have a finger being inserted into their backside ;) Fart during the examination? So far I never encounter patient who farts during the procedure. *touch wood* hahahha

angel said...

I dun understand the "don't wear sleeveless when going to see doc" part... why not? I thought you said u prefer to examine those with thin clothes on?

*sotongfied*

kyh said...

eeeyerrrr...... so sei guai geli geh!!!?

why dont u prepare a towel or tissue papers to absorb the patient's sweat off the armpit b4 u poke poke poke ur fingers on it? at least dun feel that geli ma... =.=

and hv u encountered patients with smelly armpits? those who exude strong odour from their armpits! very very de tortured one when ur patient is like that!

L B said...

*agrees with angel, and removes underwear....*

L B said...

*but remembers to spray cologne first...*

Chen said...

angel,
Kkkkkk.. too sotong liao :P
What I meant is I prefer them wearing thin clothes (with sleeves) so that I can still have a thorough feel & palpation without the "direct" touch or contact of the armpit.. At least there is a layer of thin clothes in between mah :P

kyh,
Hahhaa, I dun think anyone practise that lah.. And in real life, u won't really 'see' the sweat till u touch it, unless those with very hairy armpits :P

So far never encounter any strong odour yet. Hope not ;)

LB,
Wah.. siapa yang nak remove underwear ni? o.O

and I haven't mentioned the "cheese" that I have to clean up in some patients prior to inserting urinary cathether!!!

or2ng3s said...

hee, i like to read your experiences as a doctor. sometimes you never know how the doctor will feel over the patients. :D anyway this armpit thingie, is yucky! :p

zeroimpact said...

Muahahahahaha
But then hor why when they examine me no ask me take off clothes one
:P
Hmmmmm

Pink Cotton said...

REMOVE 'CHEESE'!!!

*FAIN*

Pink Cotton said...

we were just talking abt making CHEESE biscuit wei!

*PUKE* *VOMIT* *UWEKKKKK*

there goes my breakfast

sengkor said...

*remember put deodorant before going to clinic everytime*

Chen said...

orange,
Haha, even though at times we might feel disgusted or uncomfortable about certain things, we won’t show on our faces.
Cos of Medical Ethics...
And summore we have to care about the patients’ feelings too ;)

But... not every medical practitioners practise that..

zeroimpact,
hehehe.. It depends on what is he or she examine also lah...
And what is the provisional diagnosis that comes to his/her mind too ;)
Normally we only do the necessarily examination, cos of time constraint..
And in private sector, time is $$$$ too ;)

Chen said...

pink cotton,
Some guys have thick layer of "frozen cheese" leh :P
really yucks...
Dunno how these people keep their personal hygienes wan...
Like never wash lidat for dunno how long xx(

U wanna make cheese biscuits ah?
Bake more for me..
I want (I like cheese biscuit leh) Bring some out next Thursday !!!
TQ TQ
Kkkkkkkkkkkkkkkkkkkk

sengkor,
Good lah u, keep up the good faith :D
Abuthen, I don’t think they will examine your armpits lah..
Kkkkkkkkk...
I don’t examine the armpits in every cases too, only when indicated ;)

Bernard said...

Wash your hands already or not after the examination ... ?

mistipurple said...

erm.. silly question.. can wear gloves or not for the armpit examination?

carcar said...

wat topic is this ah doc?

eve said...

eh wan to ask u..do u wash ur hands right after u examine or u go n write on the pt's card , do ur explaination and write ur prescription first , then oni go n wash?...i used to 'jaga' their perasaan oso, so i washed after i sent them out..but then..my pen , table n MC book..all tainted liao..so nowadays , no more..while they are wearing back their baju, i go n quickly wash liao..

_butt said...

dun think, dun think..

*shut eyes tight tight*

can wear gloves or not? then what about patients who didn't shave.. umm, their armpit? :P

papercrazy said...

hahahha...

I used to threaten somebody by calling the armpit with hair BUSH!!!

HAHAHAHAHAHAH

Chen said...

bernard,
that is a must-must-must do thing
Die-die also must wash hand :P

misti,
The standard teaching & standard practise is to examine & palpate the armpit with bare hands. Not nice mah if wearing gloves to examine. Patient might feel insulted :)

carcar,
Carcar yang disayangi, ini topic pasal armpit aka axilla or ketiak dalam bahasa Melayu.

Chen said...

eve,
Last time I was like u also..
Only washed my hands after the patient left the clinic, cos "jaga their perasaan mah". Nowadays no more liao, I washed immediately after I examine. Dowan to "contaminate" my pen or the clerking sheet or whatever things on the table lah.

Dulu lain, sekarang lain...
Hahaha...

butt,
copy & paste the answer I gave to Misti earlier on..

The standard teaching & standard practise is to examine & palpate the armpit with bare hands. Not nice mah if wearing gloves to examine. Patient might feel insulted.

Patient who didn't shave the armpit ah? This is not uncommon leh.. Those middle aged group or elderly patients mana ada shave armpits woh? Still have to continue on examine mah..

papercrazy,
*thinking who is tat someone*
Kkkkkkkkkkkkkkkk

Redsponge said...

aiyeryer...

it is not easy to be a doctor hor?

but u good loktor lor, i think those patients also very paiseh want to see a doctor for those examinations lo...

Chen said...

redsponge,
yeah loh..
not easy :(

hahhaa, some patients might not expect us to examine their armpit, or they dunno what we are looking for actually when palpating their armpits
Those with lymphoma will know lah..
Kkkkkkkkkk
cos everytime during follow up, sure the neck, armpits, abdomen & inguinal regions will be examined :)

Bernard said...

Wash immediately lah... then the patient knows that you've washed after the previous patient as well. No problems one lah.

I wash after every exam. Including abdominal exam, even if no PR was done. Habits from SCN days.

Semmelweiss will smile from his grave.

day-dreamer said...

Yucks!

This is what I called the dark side behind the so-called "glamorous" doctors' life. Who said doctors' life are all glamorous, btw? I don't think so, prefer to regard it as 伟大.

Chen said...

bernard,
yeah, nowadays I wash my hands immediately after examine :D

Semmelweiss indeed will be happy ;)

day dreamer,
Yeah loh. Doctor's life is indeed not glamour at all. The "glamour" part is only applicable to a small proportion of doctors only :P

www.yenjai.net said...

I also wash my hands immediately.
To show that my hand is clean.
Patient feels better.

Chen said...

yenjai,
Semmelweiss will be happy with u too ;)