A B757 CAPT; IN ZTL AIRSPACE; EXPERIENCED EXTREME ABDOMINAL PAIN; BUT DID NOT DECLARE AN EMER AND CONTINUED TO DEST; ATL.

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CREW SCHEDULER CALLED ME TO ADVISE THAT A TRIP (A TURN) TO ATL WITH DEP TIME OF 4 HRS LATER WAS POSSIBLY COMING TO ME IF MAKE-UP TURNED IT DOWN. I ARRIVED AT THE GATE AT APPROX XE00 LCL AND PROCEEDED TO BRIEF WITH THE AGENTS ON BOTH FLT AND SECURITY ISSUES. AFTER APCHING THE ACFT; I PROCEEDED TO INTRODUCE MYSELF TO THE FLT ATTENDANTS. I BRIEFED THEM ON ITEMS PERTAINING TO SAFETY OF FLT; THE FLT AND SECURITY ISSUES; PROCS; ETC. UPON ENTERING THE COCKPIT; I OBSERVED THE FO PERFORMING HIS DUTIES DILIGENTLY. HE ADVISED THAT ALL THE PROCS REQUIRED FOR THIS PHASE OF FLT HAD BEEN COMPLETED. I BRIEFED THE FO ON ALL ISSUES AND PROCS AND WE DEPARTED THE GATE AT XE19 LCL. I WAS FLYING THE ACFT TO ATL AND WE HAD A NORMAL DEP FROM MIA. ABOUT 10-15 MINS INTO THE CLB PHASE; I FELT A BRIEF PAIN AND MUSCULAR MOVEMENT AROUND MY ABDOMEN. I THOUGHT IT WAS HUNGER PAINS. AS WE PROCEEDED TO CLB TO FL410 ON COURSE; THE PAIN INTENSITY INCREASED WITH SHORTER INTERVALS. DURING CRUISE AT FL410 AND ASSUMING IT MIGHT BE HUNGER PAINS WITH POSSIBLE TRAPPED INTESTINAL GAS; I ACCEPTED THE FO'S OFFER FOR HALF OF HIS TURKEY WRAP SANDWICH. THIS WAS NOT HELPING THE MATTER ANY. I ADVISED THE #1 FLT ATTENDANT OF THE SIT AND SHE ADVISED THAT MY CREW MEAL AND A SODA MAY HELP; IF IT WERE HUNGER PAINS. I HAD 1 BITE OF THE CHICKEN FINGER SALAD AND THE PAIN BECAME SEVERE TO ACUTE. I HAVE A HIGH PAIN TOLERANCE AND I DID NOT FEEL INCAPACITATED YET. I REQUESTED DIRECT TO MCN OR DBN. ATC GRANTED DIRECT DBN FROM VQQ. WE WERE WITHIN 50-70 NM S OF VQQ. I ADVISED THE FO THAT THE PAIN WAS NOW TOO SEVERE FOR ME TO BE THE PF AND THAT HE WAS TO FLY. I WILL BE BACKING HIM UP. THE FO INFORMED ME THAT A COMPANY S80 CAPT IS DEADHEADING IN FIRST CLASS. I ADVISED THE #1 FLT ATTENDANT TO INFORM THE CAPT AND THAT I REQUEST HIM TO PLEASE ENTER THE COCKPIT. CAPT ENTERED AND I BRIEFED HIM THAT I WOULD APPRECIATE FOR HIM TO SIT ON THE JUMPSEAT AND BACK US UP IN THE EVENT THAT I AM NOT ABLE TO PERFORM MY DUTIES. AFTER EVALUATING THE SIT ON SEVERAL OCCASIONS; I STILL CONCLUDED THAT AN EMER STATUS WAS NOT NECESSARY AT THE TIME. I DO DECLARE THAT I NEVER RELINQUISHED MY AUTH; SEAT; OR RESPONSIBILITY AS CAPT/PIC. THE FLT ATTENDANTS WERE BRIEFED BY ME AND ADVISED NOT TO BE CONCERNED BECAUSE SAFETY WILL NOT BE COMPROMISED. THE PAX WERE NOT BRIEFED. DISPATCH HAD BEEN ADVISED OF THE SIT TWICE. I RECEIVED AN ANSWER WHEN I REQUESTED PARAMEDICS TO MEET ME AT THE GATE. THE FO PERFORMED A NORMAL APCH TO LNDG. I TAXIED THE ACFT TO THE GATE. THE PARAMEDICS ENTERED THE COCKPIT AND AFTER THEIR EVALUATION; THEY ADVISED THAT THEY WILL ESCORT ME TO THE HEALTH CTR AT THE ATL ARPT. THE MEDICAL DOCTOR IMMEDIATELY EXAMINED ME. DURING THAT TIME; I RECEIVED AN INJECTION. THE MEDICAL DOCTOR ADVISED THAT HIS ASSESSMENT WAS APPENDICITIS BUT THAT IT WAS NOT ACTING AS A TRADITIONAL APPENDICITIS ATTACK BECAUSE THE PAIN WAS SUBSIDING IN TIME AFTER THE INJECTION. HE AFFIRMED THAT HE WOULD LIKE TO XFER ME TO A NEARBY HOSPITAL EMER ROOM FOR FURTHER OBSERVATION. HE STATED THAT IT COULD TAKE UP TO 5 DAYS OF OBSERVATION AND TESTS TO MAKE A DEFINITE ASSESSMENT. I STRONGLY IMPARTED THAT I WOULD DESIRE TO BE OBSERVED AT HOME AND HE RELUCTANTLY RELEASED ME. IN THE MEANTIME; I HAVE SEEN MY FAMILY DOCTOR AND HE CONCURRED THAT MY ABDOMEN IS TENDER; INDICATING POSSIBLE APPENDICITIS; BUT IT IS NOT TRADITIONAL BECAUSE THE PAIN DURING APPENDICITIS DOES NOT JUST GO AWAY. MY DOCTOR STATED THAT I COULD RETURN TO WORK; BUT IF I FEEL ANY PAIN IN MY ABDOMEN TO EXPEDITE TO THE NEAREST HOSPITAL EMER ROOM. I TRUST AND AM SURE THAT MY DOCTOR DOES NOT UNDERSTAND THE COMPLEXITY OF MY PROFESSION. WITHOUT THE TEST RESULTS; ETC; OR CONCRETE INFO OF WHAT HAPPENED; I FIND IT UNSAFE TO RETURN TO WORK. HENCE; UNTIL MY NEXT APPOINTMENT WITH HIM TO DISCUSS MY RESULTS; ETC; I FIND IT THE BEST AND SAFEST COURSE OF ACTION TO STAY ON THE GND AND AWAY FROM THE COCKPIT. I WISH TO EXPLICITLY STATE THAT AT NO TIME I WAS SO IMPAIRED THAT I JEOPARDIZED THE SAFETY OF FLT. IF THE PAIN OR SIT WOULD HAVE PROGRESSED BEYOND MY TOLERANCE OR CTL; I WOULD HAVE DECLARED AN EMER AND HAVE MY FO MAKE AN IMMEDIATE LNDG AT THE NEAREST ARPT.