Pig in a Blanket--hold the strawberry jam please! (note this is a graphic short story)

Just the other night, I had a man sign in with what looked like another crazy complaint.  I will simply let you look at the chief complaint below.  Then, I want you to sit back, close your eyes and try to visualize being the doctor going in the room.  What the hell do you say?  How do you break the ice on this one?





As for me, I have a limited filter for speaking my mind so we just cut to the chase.

Me: "Hi, I am Dr. J  you are so and so?"

Him: "yep"

Me: "well, it says here that you were masturbating and now your penis is bleeding?"

Him: "well, not exactly"...pause, i was hoping that he'd just keep on rolling but no.

Me: "alright then, why don't you just tell me why your penis bleeding"

Him: "well it was my girlfriend."...pause....

Me: " your girlfriend?"

Him: "Yeah she was...um....it started bleeding"

Me: now, I have two general thought processes crowding my brain: first this is a younger guy and his lady friend didn't tell him that she invited her little friend flo to the sleepover (euphemism for she started her period during their mambo session).  OR she bit him, or bobbited him or something along these lines.  He sure as hell wasn't going to spit it out so I launch into...."how bout you try to tell me what DID happen since you're having a hard time telling me HOW it happened...."

Him: "uh, she was, you know, using her hand and stuff..."

Me: (my brain is thinking this, i did not say this to him)  WTF, I know you look like a 22 yo virgin and probably aren't used to bragging your sexcapades to your larping buddies or dungeons and dragons "friends" or magic the gathering goons (fill in whatever the socially challenged males of today do with their same sex buddies in lieu of sex), but i need to know WTF happened....   So, I say:  "why don't we just take a look at what happenend..."

Him: "ok"

Fastforward a two minute slow undress of the jorts (jean shorts) and boxers and I am now looking at the scene of a hog slaughter.

Me: "Jesus, that's a lot of blood"  I am thinking, man the bleeding is disproportianate to the size of the appendage damaged.  The kid has blood on his low abdomen and his thighs and his crotch.  Nothing is spurting out anywhere so I am starting to assume his girlfriend bled all over him. 

Me: "ok then, how bout we give you a washcloth so you can get all cleaned up."

Him: "ok"

Fast forward an awkward two minutes of him by the sink trying to wash his junk off so we can have another look-see.  Exam part two:

Me: "can you pull back the foreskin?"

Him: "yah, ok."

Me: "aha, she almost circumsized you."  the young man has the bottom of his glans (head of the penis) separated from its natural tethering to the foreskin essentially tearing the frenulum. 






Me: "ok, now you are cut here where the foreskin attaches to the head of the penis." "how'd this happen?"

Him: "well she was using her hand on me."

Me: "any lubricant?"

Him: "no"

Me: "nothing, like no spit or any moisture?"

Him: "nope."

Me: "well, I guess there's a few things you can learn from this...."  "first, always use some type of lube, she almost took your penis' topcoat off."  "second: your girflriend is a real go-getter, not a quitter...she probably is a keeper" 


Medical part of the post: deep penile abrasions/superficial lacerations CAN be caused from overuse (pubertal disorder).  Further, you want to make sure that if you (man) have any bleeding this is likely a good reason to stop your coital encounter.  Also, open sores increase STD transmission.  If the bleeding is minimal and all function intact, soap and water and topical antibiotics are likely all that is needed.  In this case, I don't fault the dude for seeking some help.  From the onset, it looked like someone sprayed ketchup all over his pig in a blanket.  Finally, if the cut is caused by the mouth or anus, you may be in for a significant infection.  You probably should be put on some antibiotics by mouth along with the topicals.  Finally, as with this guy, you want to avoid the foreskin scarrinng down where the skin remains rolled down on the shaft of the penis.  This condition know as paraphimosis and can kill little johnny:
what happens is the band of foreskin rolled back on the penis may strangulate the head if an erection ensues.  It forms a tourniquet and chokes off blood supply to the tip. 

So, with this gentleman I recommended no frisky business until all cuts healed.  Further, I instructed him to wash with soap and water three time daily, pat dry, put on topical antibiotics and extend foreskin back down the shaft to re-cover the head.  Anytime he entertained an erection, he was to inspect the hog to make sure the skin remained unrolled and extended as much as possible.

Penile Abrasion

 

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  • 7/26/2012 12:56 AM lorraine wrote:
    Hi. I followed you from your comment on "15 Minute Lunch". Your blog is entertaining reading. I am a RN with a wound specialty so find myself looking at stuff like this a lot. You are very funny in the way you put things. It would be a gas to work around you. On a personal note, my son had been circumcised by a goy doctor and he didn't take off enough foreskin. The kid still had to pull back the remaining foreskin and wash. On vacation one year when he was 9, the foreskin got stuck retracted. We couldn't reduce it so he ended up in the ER. Even after versed, everything they tried was ineffective. They finally called in a pediatric urologist (a Jewish guy btw) who performed a circumcision at 2100. My poor kid - I wasn't a nurse then so had been doing the best I could with everything. Dealing with male junk is truly a delicate situation. I love that the gf is a keeper. Great take away of the scenario.
    Reply to this
    1. 7/30/2012 10:27 AM DoctorJ1 wrote:
      Thanks for the follow.  I enjoy writing and sharing, even if it is the uneasy side of medicine.  As an RN you know how that goes.  There is a lot of unsaid, that we have all shared in from time to time.  Yes, there are a lot of "interesting" things to see in our jobs.  I am sorry to hear about your son's botched circ.  I hope all is healed and perfectly functioning.  Thanks again for your readership.  Feel free to forward your friends to my site.  I am sorry for the late reply, as work has really been busy lately.  Usually, that is good for the storytelling though.  Take care...
      Reply to this
  • 8/3/2012 9:54 PM Glesda wrote:
    WOW now that was an education... 45yrs married to an ala natural man... Didn't know all this stuff. I guess all that extra rain coat has a purpose! Boy you have a interesting career. Hmmm makes for interesting dinner talk.
    Reply to this
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