A Pain in the Real Rear

Wednesday Wellness:

"Off the Record Q & A with a Local A.M.E."

DR. Larry

Part of my job is keeping pilots healthy, or so I believe. It’s not a requirement of being an FAA medical examiner, but to keep my practice healthy it behooves me to provide answers to pilot’s medical questions. Therefore are I ask, “Any medical questions today?” Answers that are simple, I share for the good of the order. For complex problems, I suggest they take my thoughts to their primary care doc for further discussion.

However, when it comes to medical exams and the FAA, pilots are a distrusting group and sometimes for good reason. Their joy and/or livelihood depend on a valid medical license and who wants to put themselves in jeopardy with someone working for the “other - a.k.a. dark - side?

After a few visits and trust is established, the door opens up and all kinds of discussions start to happen, including very personal ones. Maybe it's because when you are in for a penny you're in for a pound or it's because there's no extra charge for the medical advice so it feels like a great deal. Either way, we all win.

So the question I was asked this week and I hear surprisingly often is:

Pilot: " Hey Doc, I have pain in my bum (arse, tush, etc.) and it usually happens at night."

Doc: " How long does it last?" Pilot: " Until I get up and move around or take something for it. It can be minutes or an hour."

Doc: " Does it feel like a spasm or a cramp and comes on out of the blue?"

Pilot: "Sure does. Feels like a good stretch would be helpful."

Doc: “Would that be the sphincter we are talking about or the butt muscle?”

Pilot: “The first one, Doc.”

I love this question because it has a simple answer and a relatively simple solution, and much like removing the proverbial splinter from the lion's paw, people are grateful to know it's nothing serious.

So what is it? It's called Proctalgia Fugax, or fleeting rectal pain, and it's caused by spasms of the muscles surrounding the rectal sphincter. (I can hear the one-liners flying by now.)

We don't know what sets this off although many things have been implicated including stress and fatigue, constipation and other G.I. problems, and orgasms. Research says men and women are afflicted equally. (Who does this kind of research anyway?)

Ibuprofen or acetaminophen will settle down the intense spasms within a short period of time. Warm baths can also be of value as can direct pressure. Certain muscle relaxants can even be of help if one is not flying the next day. If the simple tricks don't work, talk to your doctor about other options.

For further information, check out Wikipedia by Clicking HERE
or for a more entertaining read, Click HERE

Did I mention laughter helps this problem just like it helps many other pain in the rear situations?

To your good health,

Dr. Larry.

Please send me your questions for Dr. Larry.

Enjoy the Journey!

XOX Karlene

P.S. Read on and meet the winner of Wings!