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Date Posted: 21:51:25 07/25/08 Fri
Author: Docs Helper
Subject: Rectal Temperature Story - Continued
In reply to: Phillip 's message, "Clinical Perspective - Taking a Child's Temperature with a Glass Thermometer Oral or Rectal" on 02:44:12 06/25/08 Wed

A steady stream of patients flowed into the "temperature room" during the day. The attendant, known at "the Temspter" or just called "Tempster", always wearing a white lab coat, typically takes both oral and rectal temperatures concurrently throughout the day. Although taking an oral temperature is straight forward, taking a rectal temperature involves a more elaborate process. To demonstrate this point, an example of a youngster who had temperature taken rectally follows.

Kyle, a nine year old boy, arrived accompanied by his aunt, his temporary caretaker. Sally, the 34 year old blonde patient specialist, professionally dressed in a pants suit, called Kyle and his aunt to the consultation desk. She noticed that the boy walked toward her was somewhat tall for his age, but his tanned but slim features suggested that he might be physically active. Certainly he spent a lot of time outside. He was wearing jeans and a t-shirt. The patient specialist measured his weight and height and asked that he sit down while she interviewed his aunt about his medical history. As the boys turned away, Sally's eyes darted towards the boy’s bottom and focused in on it until he sat down. Her attention changed to collecting whatever medical history Kyle’s aunt could provide as he sat in the waiting room reading a comic book. With very little medical history was available about the quiet boy, and no meaningful information about his intellectual capacity, and the fact that he was reading less intellectually stimulating literature, Sally arbitrarily decided that, by default, Kyle could not be trusted hold a glass thermometer in his mouth safely and was therefore designated to have his temperature taken rectally and a red tag was permanently affixed to his chart indicating this status. His aunt, already familiar with the practice through an acquaintance seemed very content with this outcome. Sally escorted Kyle to the restroom and instructed him on using it. Being a new a patient, he was not told that the trip to the restroom was in preparation for having his temperature taken rectally by providing clear entry for the glass rectal thermometer. A few minutes later he exited the restroom. As he approached his aunt sitting in the waiting room, Sally’s eyes were again fixed on his backside. Perhaps she was imagining what his bare rear end looked like. She turned her head away and smiled as they boy sat down next to his aunt. Sally placed Kyle's chart in the Tempster's "In" box. With the examination table only a few feet from her desk, she would soon have an unobstructed view of Kyle’s bare rear end as he lay on the examination table, and really see if his rear end actually matched her expectation. She suspended patient interviews and gazed at the examination table.

With the examination table unoccupied, and fresh paper on its surface, Tempster picked up the chart with the red tag fastened to it and briefly scanned it: a boy, none years old, new patient. He took no time at all to call out Kyle's name, and just after the boy stood up, he momentarily turned with his back facing Tempster. After getting a glimpse of Kyle’s full rear end, Tempster, being passionate about taking youngsters temperatures rectally, said to himself "Nice. Very nice. This ought to be an exciting experience." Tempster called out to both Kyle and his aunt and said “Come on over here, please." They approached the stocky bald man with a goatee standing at his workstation. Just as Kyle entered the alcove, the man motioned him to get up onto the examination table as he said "How about getting up here and sit yourself down." Complying with the command, the boy stepped on a stool and pivoted himself around and sat on the examination table with his legs hanging off to the side. Tempster picked up two other charts and called out for two other boys, one age eight, Bryan, and the other one age ten, Gary, and gestured to them to sit down in chairs against the wall. Just as they both sat down, the Tempster said to them "I'll get your temperatures in after I get Kyle here started." Kyle sat still and seemed little apprehensive. Meanwhile, Kyle's aunt, standing a couple of feet off the side from the end of the table, waited in in anticipation of the events to follow. Tempster continued as though she was not there and instructed the Kyle to "unbuckle your belt and unbutton and unzip your jeans please." The boy seemed puzzled as he first unbuckled he belt and then looked down and unbuttoned his jeans and stretched a little to unzip his jeans. His jeans loose around his waist revealed his jockey underwear. No sooner than he finished unloosing his jeans, Tempster said to the boy "Now get you legs up on the table and lie down." Probably thinking that he was getting some sort of examination, Kyle lifted his legs up on the examination table and was lying on his back with his upper body propped on his elbows. However, as soon as he got into that position, Tempster said to him firmly "Now rollover on your tummy please" and proceeded to enforce the order by assisting the boy as he awkwardly shifted himself into the desired position. Tempster further refined the boy’s position by having his upper body was supported by his elbows and his legs pressed together. Tempster shifted himself so that he was directly next to the boy's back side. Without saying a word, Tempster placed a hand on each side of his jeans, and proceeded to pull down the boy’s jeans and underwear, tugging down each side one at a time, first producing a view of the boy's hips. Seconds later cleavage separating his cheeks appeared. As more of the boy’s rear end was uncovered, the cleavage transformed into a dark crevice separating the two firm cheeks. The boy’s jeans and underwear continued to be drawn down until his entire rear end became visible. Tempster continued pulling Kyle's jeans and underwear further down until they were wadded up just above his knees.

As Kyle laid on the examination table, with his full, opaque rear end contrasting with his tanned lower back and thighs, the characteristic line separating his cheeks and thighs, and the sides of his cheeks concaving inward, he easily caught the interest from casual observers, young and old alike, in the waiting room as well as the two boys staring directly at it from the side. Looking back, he could see curious onlookers whispering to each others. He also saw Sally, looking directly at him, grinning as if he was a source of amusement for her. Realizing that his bare rear end became the center of attention in the examination room, his face turned red as embarrassment overwhelmed him. His embarrassment intensified as Bryan, the eight year old boy sitting down pointing to Kyle’s bare bottom, asked Tempster "Hey mister, why does he have his pants down?" Tempster responded, "He's going to get his temperature taken in his behind real soon." The boy responded, "Oh, why don't he get it in his mouth like us?" The Tempster returned, "You know why a five year old kid gets his temperatures taken in his behind? It is because he might bite on the thermometer and break it in his mouth. That is why Kyle here gets his temperature taken in his behind just like a five year old.” The boy's face turned red, finally facing the fact that he, unlike the other kids there, will have his temperature taken in his "butt" instead of his mouth. With his jeans and underwear no longer covering his rear end, there was no protection for his cheeks from being pulled apart and a glass rectal thermometer from entering through his anal opening and lodged in his rear end for several minutes.

To be continued ...

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[> Re: Clinical Perspective - Taking a Child's Temperature with a Glass Thermometer Oral or Rectal -- Raymond, 09:45:46 12/29/08 Mon [1]

It may be said that there are many isolated areas in the country that may be thought of as if they were "third world countries." It happened to me only a couple of years ago when I forgot it on a camping trip because I forgot to bring a medication on a camping trip. There were only one two doctors in the nearby town, and only one was a general practice doctor. I called in hoping to make an appointment and was to my relief, able to get squeezed in.

When I got there I saw was a double-wide trailer that had a gravel parking lot and there was no sign. It was outside of town on a dirt road. But there were cars, I mean some beat up cars, parked outside it. When I entered, there were several kid patients and no adult patients. It turned out because so many kids are seen there that adults tended to go to the internal medicine doctor. I felt uncomfortable at first, like a fish out of water, wanting to cancel and go to the other doctor, but felt compelled to stay and just get my prescription and leave. The only adults there were parents and other caretakers.

Temperatures, weight, and height were taken in a room just off the interior main waiting room. That is, there was small waiting room, like a reception room, for the general public, and a large waiting room behind it. I figured it was set up that way to contain the germs. A female receptionist worked in the entry waiting room and a male medical assistant worked in the real waiting room. Right after I entered the main waiting room, I was asked to come into a cubby area and he took my weight and height and sit down. There was an examination table right in front of me. Next thing I knew he was shaking down a glass thermometer and told me to open up and he put it in. I was surprised that temperatures were taken with glass thermometers. You see something different every day.

Just then he called out a boy's name and asked him to come in. He got his weight and height, and he directed him to get up on an examination table directly in front of me and sit down (instead of sitting on a chair next to me). To my amazement, the boy was prodded to unloosen his trouser, jeans I think, and the next things I know he was told to lie down on the table, and after that, rollover on his tummy. He wasted no time in tugging his trousers and underwear all the way down to his knees. His bare rear end (very white compared to his darker back and thighs) was in plain view of the folks in the waiting room. It did draw attention to the other kids there, which caused the boy to look back to see who was there looking. He expressed his displeasure about it and it did not seem to change the events that followed.

I watched with excitement as the medical assistant took the thermometer out of the glass container, shook it down, applied KY jelly from tube to the thermometer, and his cheeks were spread wide open and inserted the thermometer into his rear end. His mouth went wide open as it entered and he exclaimed it was cold. Other kids watched with excitement and their remarks were not appreciated by him. He was red faced and did not like them seeing that and watching the thermometer sticking out and made it clear as he fussed at him. He continued to complain about having it taken there instead of his mouth like the other kids. His complaints were deferred and he seemed to only draw attention to himself even more. He could see grins and there was giggling as well.

Another boy, a little younger than him, came up and greeted him and asked him how he was doing but he did not take his eyes off of his behind. Uncomfortably he said the something like, how come he is having your temperature taken in his butt than in his mouth like me. The medical assistant said that his is not ready to have it taken in his mouth yet and has to have it taken in his "behind." I found out that the 10 year old was a special needs kid with some sort of learning difficulty, and that a rectal temperature was appropriate in his case.

It was only a couple of minutes when I had the thermometer removed and checked and he stuck it in my mouth again. A minute later the thermometer was out. As I was standing up he did the same thing to the boy and we saw the thermometer inserted with some amazement. He again showed his displeasure when the other boy chuckled when the the boy protested as the thermometer entered again.

It was a long wait to see the doctor and got chummy with the medical assistant and conversed with him while he was doing his work, which included taking more rectal temperatures. I found out later that girls are taken in back to have it done and hung about until he got back with those patients. I was wondering why only boys got rectal temperatures, though it seemed that boys were picked on for that more than girls.

I got my prescription and left. That experience left me with an fascination with rectal temperatures. I have come to find that nothing has changed at that place since then with regard to taking temperatures with glass thermometers. More on that later.

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