Ask Ticklish Patients to Give You a Hand

To palpate the abdomen in a ticklishpatient, begin by placing the patient'shand on the abdomen in a pain-freearea. Place your hand (which shouldbe warm to the touch) on top of his orhers and palpate several areas. Then,place your hand on the abdomen withthe patient's hand on top of yoursand continue palpating. You can increasethe accuracy of your findingsby using your free hand to supportthe patient's lower back or to applycounterpressure.-- Arthur F. Greenwald, MD
   Palm Springs, Calif