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Friday, February 4, 2011


Well the first few days are done and the weekend is here

I arrived safely on Monday and settled in to the villa. Explored the resort sipped on a light drink.. ;-)

I started out at Port Maria ER as i guess a fast track doc?? Mrs Showed me around and introduced me to everyone.. and then I was led to my "office".. Well it was actually just a small room with one chair and a hospital tray table to serve as my desk.. there was a sink so i could wash my hands and one additional chair for the Pt. I did not get to take a pic but will next time.
we also had a quite a few boxes in the corner... SO very limited space... BUT doable with a little imagination. Made my way to the Pharmacy to give my signature, but forgot to ask for a list of meds ( so i just told parents to come back to me if they didnt have the Rx and only one did).

I started seeing Pts right away, and saw almost the same thing we see in the ER in the US... URIs, rashes, muscular skeletal pain, otitis externa ect. Many of the mothers of URI wanted abx.. But i held my ground.... NO ABX FOR VIRAL STUFF.... I may have made a few enemies.... but everyone was very thankful for my seeing them.. ( BTW they all left saying that they understood why they didnt get antibiotics) I hope I did some good... I only saw 24 pts.. Which for the record is the most pts I have ever seen in a day... MY fingers hurt...( nothing a lil ibuprofen didnt help).. Yet I survived...

Port Maria was also the next day's destination, however I was stationed in the health center.. I arrived ready to see another 24 pts, but apparently that was not in the stars for me that day... I saw quite a few less and actually was able to go home an hr early. Cases included, pharyngitis, Quite a few URIs, AGE, well child check, vag discharge... the basic bread and butter of clinic... NO PROBLEM MON...

Today we ( yes my partner Dr Gleason has arrived), and we were taken to Annotto BAY PD ward. The ward actually houses both ped pts and NICU babys. there were only about 11 pts on the ward and we sat in for their rounds. Rounds ran very similar to ours back home.. and the "intern" took most of the brunt of the questions.. however there was no feeling of intimidation between attending and residents... There were a few infants with hyperbili, and twins with FTT, Congenital syphilis, asthma exacerbation, and viral gastritis. We then went to help out at the A&E ( ED) and saw a few kids there. There was a little girl with nurse maid elbow who I unsuccessfully tried to reduce. After Xrays showed no fractures, I asked Dr Gleason to give it another try and he was successful. She was so scared to move that arm (after we traumatized her) so I waited for her to stop crying and then tricked her into reaching for something and then bending her elbow.. CURED!!! even she cracked a smile when she realised what i did...

I was able to bring a RED book to Annotto Bay, they were very appreciative.. I hope it will come in handy..

Having grown up in a developing country, I am not surprised by the things i see here, but having been partially trained in the US, I have to remember to step back and use more of my physical exam to diagnose things...I am feeling quite independent in my management which is also new for me.. I have always had an attending very close by in the US, and as pediatric residents we often do not have much autonomy... SO I am liking this new found freedom.. There are docs there with us, however they let us do our thing but are available for the rare question or to once over Xrays..

well its friday night and its reggae dance at the resort. havent quited decided if i will join them or read my book.. I am reading The girl who played with fire.. and if the girl with the dragon tattoo is any indication i know its a worth while read...

well I hope i will be able to see a lil bit of Jamaica this weekend..


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