Blood In The Urine

"Oh, before we finish up, I also wanted to mention... I've been having more blood in my urine recently."

"More?  What do you mean?  You had blood in your urine before?"

"Sure, always."

"What?"

"I've always had some blood in my urine.  It's just how I am."

"That's not normal."

"Well, for me it is.  Except the last few weeks there's been more of it."

"How much blood are we talking about?"

"Oh, a fair bit.  Like, it colors the whole toilet.  Funny thing is, it only happens when I urinate sitting down."

"Hold on, explain to me what you're trying to say."

"When I sit down to urinate, there's a lot of blood.  Also, it must splash back up on me, because I can usually see it when I wipe."

"I'm trying to wrap my head around what you're telling me.  Is it at all possible that what you're noticing isn't from your urine at all, but it's bleeding hemorrhoids?"

"And those would be where?"

"Your anus."

"Wait, so you think this may all be connected to the burning I feel when I move my bowels?"

"Uh, just from what you're saying, I think it might be."

"Oh, wow, doc -- you're a genius!  All this time, I thought I had blood in my urine, but I think you may be right -- I think I'm actually bleeding out of my anus.  Whodathunkit?  Wow, my wife is never going to believe this."

"Maybe we should take a look just to be sure I'm on the right track."

"No, no, what you're saying makes total sense.  I have to rush -- I have another appointment -- but this is great -- so I can just use some of that over the counter stuff -- the Head and Shoulders?"

"Uh, not Head and Shoulders.  I want you to follow up with a specialist just to be sure -- I can give you a referral."

"A neurologist, right?"

"No."