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Tuesday, May 15, 2007

Planet Xiphoid

Hello. This is Doctor Bean. Psychotoddler has kindly allowed me to share a guest post with you, his dear readers.

About a dozen times throughout my career patients have come to me worried about their xiphoid process. The following is a fictionalized amalgam of those encounters.

Mr. Jones: Good to see you Doctor Bean.

Me: Nice to see you too, Mr. Jones. What brings you in today?

Mr. Jones: I noticed a lump on my chest two weeks ago and it hasn’t gone away. I’m worried it’s a tumor.

Me: Oh. Well I’m glad you came in to get it checked out. Does the lump hurt?

Mr. Jones: No.

Me: And has it gotten bigger since you first noticed it?

Mr. Jones: I don’t think so, but I’m not sure.

Me: Where is it?

[Mr. Jones points to the bottom of his chest in the midline.]

Me: [Thinking: Good Lord! Not another one.] Alright. Take your shirt off and let me take a look. [Palpating with my right hand.] Is that it, right there?

Mr. Jones: Yeah! That’s it. Is it serious?

Me: No. That’s your xiphoid process. It’s a pointy tip at the end of your sternum.

Mr. Jones: Oh, no! Do I need surgery?

Me: No. It’s fine. You don’t need anything.

Mr. Jones: Is it normal?

Me: It’s not just normal. It’s universal. Everybody’s got one. It’s standard anatomy.

Mr. Jones: Weird how I just got mine two weeks ago.

Me: No. It’s always been there. It’s part of your skeleton. You’ve had it all your life.

Mr. Jones: So why did I just notice it two weeks ago?

Me: What do you mean?

Mr. Jones: I mean if it’s always been there how come I didn’t notice it all this time?

Me: Wait a second. You came here worried that you had cancer. I reassured you that you’re healthy. But now you’re saying that that’s not satisfactory and you also need me to sort out why it’s taken you 42 years to stumble across an irrelevant protuberance of your normal anatomy? I really don’t know.

Mr. Jones: So you’re saying I shouldn’t worry about it.

Me: Right!

Mr. Jones: What if it gets bigger?

Me: It’s cartilage. It can’t get bigger.

Mr. Jones: Should I keep an eye on it?

Me: You mean just in case it gets bigger?

Mr. Jones: Yeah.

Me: No.

Mr. Jones: Can I call you if it changes?

Me: Have you ever suppressed even the most fleeting desire to call me?

Mr. Jones: Tom, my buddy at work, never mentioned feeling a lump there.

Me: Hmmm. I wonder why he’s holding out on you. [Sprinting from the examination room.] Well, take care. I’ll see you soon.


PsychoToddler said...

Crap! I have one too!


Binyamin said...

I hate to admit this in public, but I am relieved to read this post. I too recently discovered my xiphoid process (except I didn't know the name until now) and I too was considering asking my doctor about it, except of course I don't have a regular doctor and haven't seen one since I left the military 2 1/2 years ago. This was going to be the one thing that caused me to get a physical but now thankfully I am spared that ordeal.
But honestly I never noticed mine before just recently and was quite concerned. Maybe there is a condition spreading across the nation of "Xiphoid Awareness Syndrome". Or maybe, just maybe, they actually are getting bigger...

Mr Bagel said...

Is it contagious? because I think I've caught it!

Shalom Aaron
Visit: Mr bagel

Doctor Bean said...

Psychotoddler: Sorry.

Binyamin: Glad to have helped. Now you can defer finding out that your cholesterol is 5 times higher than normal for a few more years.

Mr. Bagel: No. It's genetic.

Miriam L said...

I thought you were making this up, but it's on
, so it must be real! Why is a thing called a "process"? I thing it should be clearly labeled the Xiphoid Thingy. I like the word Xiphoid. I think Trillian's third cousin is named Xiphoid, or may Xiphiod. (Bonus points if you know who Trillian is.)

Miriam L said...

Also, PT, it's just plain embarrassing that I have to always change the text size in order to read your site. You're just making fun of old people like me who can't read small fonts. Wait until you can't see either!

Eli said...

This post reminds me of a LoadingReadyRun (sketch comedy) video:

Ralphie said...

Bean? Guest post??? Why didn't you guest post back at Kerckhoff?

Oh, I guess you wanted to be sure that someone actually read it. Fair enough.

This Xiphoid fever is a sign that not enough people are schooled in basic CPR. Everyone knows that you find the xiphoid process and then move up two fingers or so to start compressions.

You could be making big money on xiphoidectomies.

And, finally, doesn't "The Xiphoid Process" sound like a good name for a jazz fusion ensemble?

Doctor Bean said...

Miriam L: You’re right. I will refer to it as the xiphoid thingy from now on, but there’s no reason to capitalize it. Xiphoid is a great word, hence the title of this post. Not know who Trillian is???!?! Come on. You know I’m a hoopy frood.

Eli: The makers of that video needed a medical consultant. The correct diagnosis of the video’s protagonist is not hypochondriasis. It’s malingering.

PsychoToddler said...

Miriam: I believe you are referring to Zaphod Beeblebrox. What do I win?

And yes, I am making fun of old people like you...with your fancy LCD monitors. Change your own font size!

Doctor Bean said...

Ralphie: Hahahahaha! I love it!

Wow, man! I heard a new band, “Ralphie and the Xiphoid Process”. They’re cool, man, real cool.

Holy Hyrax said...

Should I be concerned if I dont have one?

pobody's nerfect. said...

ok, my xiphiod process is working just fine, not growing at all.
my question for the docs (since i, too, am quite overdue for a well check...) is-- is there supposed to be a big bump on the top of my neck, right at the tip of my hairline? and could it just be sore from working out or sleeping funny?

Doctor Bean said...

Holy Hyrax: That depends. Are you human?

pobody’s nerfect: Sleeping funny? Like “ha ha” funny? Funny like a clown? I’d love to see a video of that.

wanderer said...

Thanks Bean - now my xiphoid is all sore from me rubbing on it. Will I go blind?

Got any free medical advice about that?

Holy Hyrax said...

Doesn't my photo icon answer your question?

Doctor Bean said...

Wanderer: Careful. You'll get hair on your chest.

Holy Hyrax: Mmm.

RaggedyMom said...

If this collaboration continues, you'll have to call this blog PsychoDoctor.

andrew said...

i take my kids to a waterpark for fun. In wisconsin Dells. www.dellsraintree.com

Shira Salamone said...

RaggedyMom: Oh, great--two psychos and two doctors on one blog! :) :) :) Dare I say it's just what the doctor ordered? Or maybe I should take two aspirins and call them in the morning. :) :) :)

Anonymous said...

do women have a xiphoid thingamajingy. because im worried that i cant find one on me. should i call hatzola???

Juggling Frogs said...

"Have you ever suppressed even the most fleeting desire to call me?"

This cracked me up. I love this blog.

All the best,

Jody said...

I am very CONCERNED!! I had pain there about 6 months ago and the pain went away up til about 2 weeks ago. Now you say the xiphoid process doesn't grow but I beg to differ. Mine is huge now and seems to be getting bigger and it hurts to touch it. I never had a lump there in the past but 6 months later it went from hardly noticing it to it pertruding. Are you sure it is nothing to worry about cuz I have been looking this up and can't find out anything about it. Please let me know

PsychoToddler said...

Jody: This is a humor piece and is not meant to replace advice or evaluation from your actual doctor. If it bothers you, go get it looked at!

Neil said...

I am another one who has just discovered my xiphoid process. I have been doing some reading on the internet and I read that when you are young, the xiphoid process is like soft cartilage, but as you grow older (particularly in your late twenties) it gets harder and basically turns more to bone. So I think this explains why I never noticed mine before.