### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Hi I m a 28 yr old male 6,4 220 pounds i walked out of my door way and slipped feet forward on my back ontop of the wooden stairs. 2 major injury one lower left back just above hip line. serverly bruised immediate swelling . other just behind my armpit on the back rib both painful at the time of the fall my tempature increased alot and started sweating litteral buckets. for about 2 hour.imeddate pain in stomach front near belt line continued work finished went to bed both injurys turned blue by morning feeling mussel weakness and continued pain in abdominal area away from Point of impact. can walk not extermly painful to bend of lift as i was able to work with some pain but the abominal pain is concerning me. now im sure youll say just go to your local er but I m in a romote location in the actric. and flying out would be extremly costly and possibly ruin my employment here. h

### output:

Hi. Thanks for your query and an elucidated history explaining your presence in Arctic and costly affair to fly. Also noted history of your fall on a stair and pain at the right low back and behind the armpit. Your history of pain in abdomen worries me too. The possible diagnosis is a retro-peritoneal hematoma. In this condition they are on the back-wall of the stomach has bleeding from the loose tissues it supports the organs like kidneys and major blood vessels, pancreas and part of the colon. The bleeding in this area stops due to lemonade, a natural body mechanism against sudden re-bleed and death. You can do the following tests and take help of your friends with you in the arctic. I am sure your have a machine to check temperature and blood pressure in your Emergency kit. Get the blood pressure and pulse. If they are within limits nothing to worry. Watch for the color of the stool and urine, if normal nothing to worry. Put a mild pressure n the abdomen, see whether there is pain and also see if the pain is elicited on releasing the pressure, this is called rebound tenderness. If all the signs and symptoms are normal, keep yourself under observation. Report to the flight back if :The Blood Pressure falls. If the pulse rate starts rising the urine or stool or red. If there is distention of abdomen, nausea, vomiting have to fly back, life is most precious than the job. If you are alive, you get many more jobs.