To avoid a ticklish response in patients during abdominal examinations, I first auscultate the abdomen, wondering aloud if I can guess what my patient had for breakfast, lunch, etc. I then ask, “What did you really have?” (Sometimes I am right.) Then I say, “Now you are going to have a hand sandwich.” I place the patient’s hand between my hands and am able to complete the palpation part of the exam. It’s a brain trick that works on ticklish patients of all ages.—MARCIA HUSZAGH, ARNP, Tallahassee, Fla. (199-4)

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