TUES

Hope every one had a great v day...

I did... not cuz I was celebrating valentines or anything, but I found yesterday finally my Air Force assignment... YES... for those that dont know I am a Captain in the USAF.. I was waiting patiently for them to tell me where i would be stationed after i finish residency... SO i was extremly happy to find out i'll be at Tyndall Airforce base near Panama city FL.. SO YEA ME!!!! Best news for me since I really didnt want to get stuck anywhere cold like Alaska..

OK well enough about me.. thats not what yall come to read about..

We made it TO Port Maria hospital and I took the Health Center duty... I started seeing pts almost immediately.. today the illness de jour was URI... LOl... i'm getting good at this.... I have still not given one person antibiotics for this yet... And I have been able to hold my ground on not giving Cough syrup to babies and young kids... AND you know what.. when you explain it to the parents they really seem to understand and actually dont even get mad... LOL.. Now I dont know if they leave my room and go next door and ask the next doc for ABX/cough surup... BUT I feel good that I can ? reach them....

CAse of the day:
9 mo old with SCABIES every where, between toes, fingers, on face in neck folds.. etc... the Kicker is that she was seen by jessica last month and prescribed permethrin.. However when she went to the pharmacy she said they gave her RID ( not permethrin) and she did use it.. infact she used it three times... She was fustrated and said the "bumps" never went away and maybe even got worse.. WEll what to do..... I gave her a bit of a lecture on scabies and told her that the bumps and itching may last 2 weeks after treatment...BUT new bumps.. I decided to re treat her and gave her strict instructions to wash all clothes and bedding with HOT water...( even toys that she plays with).. TO make sure to ask the pharmacy to give PERMETHRIN, If they didnt have it to BUY it at a local pharmacy. (the hospital phamacy has a limited formulary).. The child had been scratching a lot as well so i gave Rx for a minimal dose of benadryl ... I Also told her to come back next week monday when we will be there so i can reassess her... SHe is too young for Ivermectin so I'm not sure what the next step would be... I have some reading to do.. hmmm

well tmrw we go to Annotto bay.. I will be in the wards.. looking forward to see what intersting cases await..

ttyl