AUGUST 27, 2012 PAIN IN THE A**

You fear you are not alone. But it is the center of divine love that is manifesting in your heart as the craving for resilience., The emotional pain you feel contains the see of all your answers you are seeking.: wisdom beyond that which logic and rational thought could produce, resources you did not know you had. As the initial impact of what has happened to you recedes, you begin to find opportunities to nurture your spirit at the deepest level. Cultivate within yourself qualities of character such as strength, faith and perseverance, and you will fortify yourself for the greater role you are being prepared to play in the world.

Thank you God for the answer to my morning prayers - PMF


ANORECTAL COMPLAINTS are frequently encountered in many doctor's office. Mine is no exception. Most of these complaints can be managed in the office. Some do need further testing, and some do require other health care providers. The most common diagnosis is hemorrhoids or anal fissures. These can occur in both men and women. Other complaints are anorectal abscesses, rectal prolapse, anal masses/rectal carcinoma and even fistulas. These must be seen by a surgeon.

A detailed history needs to be taken. There might be some questions you might not be comfortable answering, but you should answer. First of all you should feel comfortable to ask your doctor anything. If you are a gay male, you might be more comfortable with a gay male physician. You should be able to discuss your sexual practices. The physician should be comfortable in asking a heterosexual individual or couple about if anal sexual activity takes place. It is very common among heterosexuals but no one discusses this entity. I always ask these questions. I always ask about dietary habits ( ex: i ask what the patient eats for breakfast, lunch and dinner) I ask about alcohol use. I ask about intake of fiber, salads, use of enemas, and intake of nuts/seeds.

I ask about travel history as anal problems, especially itching can be the first sign of a parasite. This is especially common in pin worms and whip worms. In order to fully exam the anal area the patient should be placed in prone jackknife or left lateral knee to chest position. This is called the Simm position. This is best way for any physician to examine the anal area.

Yes inspection, palpation and examination of the anal area is neither pleasant for you or the doctor but it should be done

For the simple hemorrhoid, there are anesthetic preparations, lidocaine derivatives and even calcium channel blockers as .2% ointment or diltizem 2% gel) I often utilize sitz baths, witch hazel and a homeopathic haemorrhoid cream

For any anal rectal problems please consult your physician .

Until tomorrow...