We're Going To Open Up The Lines

When dispatch told us that we were headed out for a 20 year old with back pain we all groaned a little. 99 times out of a 100 this would be a total BS call.

We walked in to find our 20 year old patient writhing in pain. Her mom told us that she had had thyroidectomy done about a week before. She had no other medical problems other than that.

My patient mostly just cried. It brought back bad memories for me. She looked like I had felt. We got a quick set of vitals. Her BP was 151/90, pulse 150, respiratory rate about 30 and shallow but she still had a pulse ox of 99%. She was very warm to the touch and said that she had been nauseated and had been throwing up now for a couple of days. When I asked her where it hurt she said her back. I asked where on her back. She replied that it felt like someone was scratching out her entire spine from top to bottom.

My engineer was impressed that I started a line on her in one attempt since she had no veins. That's one of my mad skills as a medic is my ability to start an IV. You could see the relief ripple through her entire body as the morphine started to act on the pain receptors in her body. Unfortunately moving her brought back all of the pain. Once she was in the back of the bus I gave her some more 'candy.'

My question for all you medically trained blog readers out there is this, what was the pathophysiology behind her spinal pain. I thought meningitis but there was no head pain or stiffness in the neck. Is there some sort of infection (or was the fever unrelated) that she could have gotten (maybe in surgery) that affected her CSF but not given her headaches? I'm just curious. I don't think it would have changed my treatment at all.