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
Tuesday, February 15, 2011
Monday, February 14, 2011
Monday
Howdy yall, And Happy Valentines day if ur into that kind of stuff
Hope you all had a great weekend.. I Know i did... Went horse back riding on Sat.. Didn't get a chance to learn wind surfing. cuz there was nooo wind.. kinda a necessity...LOL.. got in some R&R.
Arrived at POrt Maria A&E ready for business at 830ish... But however, did not see my first pt until 10:30.. ?? Thats ok.. It seemed that they register pts and keep them up front for some time before they send them back to my lil room.. But when it rains it pours... I only saw 21 pt today... 9 0f which were URIs and then there was the abundance of tineas, Otitis, strep throat, flu like illnesses and gastroenteritis.. OH i almost forgot there were a few stable asthma pts as well... Case of the day was a 4 y/o male who was hit in the eye with a knife by a friend the day before... OK well not really the eye.. he was lucky as snot.. it hit him in the lower lid and it was thrown by a 1 yr old neighbor so it really missed all the vital stuff. However, as i was taking my history and questioning the person that brought him she tells me she has no idea about his past medical hx, allergies, ect.. that she is only the friend of the mother... SO I asked her well where is his mother.. she went to work! so why are you here with him?? Because his mother said since my child hit him, she said I had to bring him.... HHMMM.. OK.. Well good news for him was that by my preliminary exam, HIS EYEBALL was intact, vision was fine, there were no obvious corneal abrasions ( I had no access to flouricine to really check), and he was not experiencing any pain.. THE bad news was the when I pulled his eye lid down he looked like he had a pocket of pus in on the inner lower lid (which corresponded to the small lac on the outer lid) that neither I was equiped or experienced to deal with.. SO it looked like the wound was becoming infected.. I asked the DOC in the ED and she said that his best bet was to refer him to Bustamante Eye clinic in Kingston... ( really far).. SO that they could drain it.. I tried to explain this to the young girl that was there with him and for her to tell the mother.. He was sent out with antibiotics and a referral.... I hope that they take him for a complete eye exam....
I have been eating like a pig at the resort.... I will have to hit the gym hard when I get back to NOLA...
well off to bed now... ttyl
Hope you all had a great weekend.. I Know i did... Went horse back riding on Sat.. Didn't get a chance to learn wind surfing. cuz there was nooo wind.. kinda a necessity...LOL.. got in some R&R.
Arrived at POrt Maria A&E ready for business at 830ish... But however, did not see my first pt until 10:30.. ?? Thats ok.. It seemed that they register pts and keep them up front for some time before they send them back to my lil room.. But when it rains it pours... I only saw 21 pt today... 9 0f which were URIs and then there was the abundance of tineas, Otitis, strep throat, flu like illnesses and gastroenteritis.. OH i almost forgot there were a few stable asthma pts as well... Case of the day was a 4 y/o male who was hit in the eye with a knife by a friend the day before... OK well not really the eye.. he was lucky as snot.. it hit him in the lower lid and it was thrown by a 1 yr old neighbor so it really missed all the vital stuff. However, as i was taking my history and questioning the person that brought him she tells me she has no idea about his past medical hx, allergies, ect.. that she is only the friend of the mother... SO I asked her well where is his mother.. she went to work! so why are you here with him?? Because his mother said since my child hit him, she said I had to bring him.... HHMMM.. OK.. Well good news for him was that by my preliminary exam, HIS EYEBALL was intact, vision was fine, there were no obvious corneal abrasions ( I had no access to flouricine to really check), and he was not experiencing any pain.. THE bad news was the when I pulled his eye lid down he looked like he had a pocket of pus in on the inner lower lid (which corresponded to the small lac on the outer lid) that neither I was equiped or experienced to deal with.. SO it looked like the wound was becoming infected.. I asked the DOC in the ED and she said that his best bet was to refer him to Bustamante Eye clinic in Kingston... ( really far).. SO that they could drain it.. I tried to explain this to the young girl that was there with him and for her to tell the mother.. He was sent out with antibiotics and a referral.... I hope that they take him for a complete eye exam....
I have been eating like a pig at the resort.... I will have to hit the gym hard when I get back to NOLA...
well off to bed now... ttyl
Friday, February 11, 2011
Fridays finished???
Where did the week go??
Already Friday already the weekend.... slow down time..PLS
We went to Port Antonio today ( we didn't have Gonzales TUG - thank u GOD)... it is a 2 hr drive from the hotel.... but a beautiful 2 hr ride... Plus i had my book along to occupy time.... ( BTW great book.. ).. Port Antonio Hospital sits on a hill (mountain) and has a gorgeous view of the water.. there is so much greenery here, it really is just Beautiful....
I went to the Peds ward while Michael went to clinic.. The PD ward here was bigger than the other hospitals ( or seemed to be) and was overflowing with patients... I worked with the GP there and gave advice on a few of the pts.. Interesting cases included a 7 y/o with complete white out of the right lung on Xray and a 2 week history if high fevers.. she was being transferred to Bustamante in KIngston for CT surgery for a possible drainage of her plural effusion... There was also a 16 mo old with a very croupy like cough who i suggested racemic epi and decadron...otherwise there seemed to be an out break of gastroenteritis. I was told that they try not to give AGE any antiemetic ( which we hand out like water in the ER in the US) and that they will admit for fluids...a lil 2 mo old who was only 2.7 kgs (FTT)...but had been growing appropriately since he had been hospitalized...I think mom needed some more education on feeding..
Michael had prepared a lecture on Asthma to give during lunch.. HOWEVER... no one showed up for it.. a lil disappointing. so he will try again next week...I will prepare one for fluids and dehydration for a possible presentation....
The journey home was long as well...and we have been getting rides from random people...NO biggie as long as its not Gonzales...
Was listening to the radio on our ride and they were talking about lame pick up lines.... some notable ones were
--gul u must be barbwire...cuz i just cant get over u..
--gul, u just like diarrhea, u just keep getting away ( or something like that)
LOL... I wish some one would say this silliness to me.. LOL..
Gonna go horseback riding tmrw then maybe learn how to wind surf... COOL..
tata for now
OH yeah , I found a phone book and have about 20 numbers of persons with my grandfathers last name.. I will try calling some tmrw.. feeling like Nancy Drew...
Already Friday already the weekend.... slow down time..PLS
We went to Port Antonio today ( we didn't have Gonzales TUG - thank u GOD)... it is a 2 hr drive from the hotel.... but a beautiful 2 hr ride... Plus i had my book along to occupy time.... ( BTW great book.. ).. Port Antonio Hospital sits on a hill (mountain) and has a gorgeous view of the water.. there is so much greenery here, it really is just Beautiful....
I went to the Peds ward while Michael went to clinic.. The PD ward here was bigger than the other hospitals ( or seemed to be) and was overflowing with patients... I worked with the GP there and gave advice on a few of the pts.. Interesting cases included a 7 y/o with complete white out of the right lung on Xray and a 2 week history if high fevers.. she was being transferred to Bustamante in KIngston for CT surgery for a possible drainage of her plural effusion... There was also a 16 mo old with a very croupy like cough who i suggested racemic epi and decadron...otherwise there seemed to be an out break of gastroenteritis. I was told that they try not to give AGE any antiemetic ( which we hand out like water in the ER in the US) and that they will admit for fluids...a lil 2 mo old who was only 2.7 kgs (FTT)...but had been growing appropriately since he had been hospitalized...I think mom needed some more education on feeding..
Michael had prepared a lecture on Asthma to give during lunch.. HOWEVER... no one showed up for it.. a lil disappointing. so he will try again next week...I will prepare one for fluids and dehydration for a possible presentation....
The journey home was long as well...and we have been getting rides from random people...NO biggie as long as its not Gonzales...
Was listening to the radio on our ride and they were talking about lame pick up lines.... some notable ones were
--gul u must be barbwire...cuz i just cant get over u..
--gul, u just like diarrhea, u just keep getting away ( or something like that)
LOL... I wish some one would say this silliness to me.. LOL..
Gonna go horseback riding tmrw then maybe learn how to wind surf... COOL..
tata for now
OH yeah , I found a phone book and have about 20 numbers of persons with my grandfathers last name.. I will try calling some tmrw.. feeling like Nancy Drew...
Thursday, February 10, 2011
Hey Mon!
Hello World! My name is Michael, and I am going to try to take a small foray into the blogging world. I am a third year general pediatrics resident from the University of Tennessee (Memphis) and fellow class mate of Audra from November. I have Joined Tayo down here in Jamaica for the month of February.
I've been in Jamaica a week now, and so much to say!
I don't know what I really expected this month to be like. Discussions with Audra had prepared me for some of the things I would experience, but hearing about it and experiencing it are two different things.
This is my first time to Jamaica and really my first time to travel internationally (alone). I lived in El Paso before and would travel across the border to Ciudad Juarez (back when it was still safe to do so), but leaving the States and entering another country for a few hours is not like leaving for a month.
On Thursday the 3rd I got to get acclimated to the weather (that didn't take long, let me tell you!) and met Tayo. We went off to Annotto Bay on Friday morning and the drive there is beautiful. Very pretty country side with amazing ocean views. This place truly is paradise.
We made it to the Annotto Bay Hospital (ABH) and found our way back to the peds ward. The hospital there is many buildings connected by covered walkways. Each building houses a different subset of patients (peds ward, Male Med/Surg, Female Med/Surg, OB). Walking into the peds ward, there are a few small rooms to the side (one a kitchen, the other a treament room and a few others) and then the ward opens up to house all the patients in a large room. Walking up to the peds ward there is a very cute little patio where alot of the patients were hanging out in the fantastic weather with their families. Very different from what I was used to, where we expect our patients to be in their room, or sign out when they disappear for a bit.
Rounds were fantastic. The attending, Dr. Ramos, is a very intelligent man and I have had great pleasure getting to partake in rounds. We would open with a patient presentation, and he would start asking questions, reviewing physiology, differential diagnoses, treatment options. It's very thorough and a fantastic learning session/review. After rounds, Tayo and I went down to A&E (accident and emergency) to help out by seeing the peds patients. One of the patients I saw was a teenage girl (16 years) who passed out (or as we call it in Memphis "Done fell out") after becoming emotional because she lost her cell phone (life's tough as a teenage girl). The only problem was that as she was passing out, she hit the back of her head on a desk and lost consciousness for more than 20 minutes. If I were back at home, she would have been run through the CT scan to look for a bleed. That wasn't an option for me down here. She ended up getting admitted to the wards, which was an ordeal for me. I was in charge of drawing her blood and starting her IV... something I've never really been responsible for back home. We have phlebotomists and an "IV team" that will handle all that. After torturing the young lady trying for an IV, one of the other doctors helped her (and me) out by showing me what I was doing wrong.
The weekend was a nice relaxing time and I felt finally rested after a very long month of January. Tayo and I started back up on Monday where we went to Port Maria. She took the clinic and I was in the A&E there. I had a steady stream of patients and saw 19(!) in a 6 hr period, which was alot more than I have been used too. Most of it was run of the mill diagnoses of colds and tinea capitis. Like my patients at home, the families request antibiotics for viral illnesses. I have been standing strong about not writing for antibiotics when they weren't needed.
Tuesday was back at Port Maria where I was over in the health clinic. More viral illnesses, fungal disease and a couple of complaints about worms. Wednesday we went back to Annotto Bay where I sat in on rounds again. We had a lengthy discussion about hypoxic-ischemic encephalopathy, the possible causes of hypoxia (broken into maternal causes, placental causes and then baby causes, then further divided into pre-natal, peri-natal and post-natal). We then went on to management once the infant was delivered. We talked about some of the differences between the management in Jamaica and the States. I got to describe the technique of head-cooling which I've seen a few times in our NICU. I'm really enjoying sitting for these rounds.
Today we ran the follow up peds clinic at Annotto Bay. I got to do several well babies which are probably my favorite visits. You get to play with the cute 2 week old babies and show off to mom all the baby reflexes.
We head off to Port Antonio tomorrow, that will be my first time there. I am currently working on a lunch and learn presentation about Asthma. Sadly, my new laptop doesn't have powerpoint on it, so I am having to adjust on the fly.
Overall impressions: I love the island. Everyone here is very friendly and the weather is perfect. The children are wonderful (as expected). I am having a hard time understanding the accents, but I'm getting better. And I am learning that I have a heavy reliance on supporting labs to make diagnoses instead of relying on my clinical skills. I am definitely doing lots of learning and reading while down here! I am excited for the potential that the rest of the month holds.
I've been in Jamaica a week now, and so much to say!
I don't know what I really expected this month to be like. Discussions with Audra had prepared me for some of the things I would experience, but hearing about it and experiencing it are two different things.
This is my first time to Jamaica and really my first time to travel internationally (alone). I lived in El Paso before and would travel across the border to Ciudad Juarez (back when it was still safe to do so), but leaving the States and entering another country for a few hours is not like leaving for a month.
On Thursday the 3rd I got to get acclimated to the weather (that didn't take long, let me tell you!) and met Tayo. We went off to Annotto Bay on Friday morning and the drive there is beautiful. Very pretty country side with amazing ocean views. This place truly is paradise.
We made it to the Annotto Bay Hospital (ABH) and found our way back to the peds ward. The hospital there is many buildings connected by covered walkways. Each building houses a different subset of patients (peds ward, Male Med/Surg, Female Med/Surg, OB). Walking into the peds ward, there are a few small rooms to the side (one a kitchen, the other a treament room and a few others) and then the ward opens up to house all the patients in a large room. Walking up to the peds ward there is a very cute little patio where alot of the patients were hanging out in the fantastic weather with their families. Very different from what I was used to, where we expect our patients to be in their room, or sign out when they disappear for a bit.
Rounds were fantastic. The attending, Dr. Ramos, is a very intelligent man and I have had great pleasure getting to partake in rounds. We would open with a patient presentation, and he would start asking questions, reviewing physiology, differential diagnoses, treatment options. It's very thorough and a fantastic learning session/review. After rounds, Tayo and I went down to A&E (accident and emergency) to help out by seeing the peds patients. One of the patients I saw was a teenage girl (16 years) who passed out (or as we call it in Memphis "Done fell out") after becoming emotional because she lost her cell phone (life's tough as a teenage girl). The only problem was that as she was passing out, she hit the back of her head on a desk and lost consciousness for more than 20 minutes. If I were back at home, she would have been run through the CT scan to look for a bleed. That wasn't an option for me down here. She ended up getting admitted to the wards, which was an ordeal for me. I was in charge of drawing her blood and starting her IV... something I've never really been responsible for back home. We have phlebotomists and an "IV team" that will handle all that. After torturing the young lady trying for an IV, one of the other doctors helped her (and me) out by showing me what I was doing wrong.
The weekend was a nice relaxing time and I felt finally rested after a very long month of January. Tayo and I started back up on Monday where we went to Port Maria. She took the clinic and I was in the A&E there. I had a steady stream of patients and saw 19(!) in a 6 hr period, which was alot more than I have been used too. Most of it was run of the mill diagnoses of colds and tinea capitis. Like my patients at home, the families request antibiotics for viral illnesses. I have been standing strong about not writing for antibiotics when they weren't needed.
Tuesday was back at Port Maria where I was over in the health clinic. More viral illnesses, fungal disease and a couple of complaints about worms. Wednesday we went back to Annotto Bay where I sat in on rounds again. We had a lengthy discussion about hypoxic-ischemic encephalopathy, the possible causes of hypoxia (broken into maternal causes, placental causes and then baby causes, then further divided into pre-natal, peri-natal and post-natal). We then went on to management once the infant was delivered. We talked about some of the differences between the management in Jamaica and the States. I got to describe the technique of head-cooling which I've seen a few times in our NICU. I'm really enjoying sitting for these rounds.
Today we ran the follow up peds clinic at Annotto Bay. I got to do several well babies which are probably my favorite visits. You get to play with the cute 2 week old babies and show off to mom all the baby reflexes.
We head off to Port Antonio tomorrow, that will be my first time there. I am currently working on a lunch and learn presentation about Asthma. Sadly, my new laptop doesn't have powerpoint on it, so I am having to adjust on the fly.
Overall impressions: I love the island. Everyone here is very friendly and the weather is perfect. The children are wonderful (as expected). I am having a hard time understanding the accents, but I'm getting better. And I am learning that I have a heavy reliance on supporting labs to make diagnoses instead of relying on my clinical skills. I am definitely doing lots of learning and reading while down here! I am excited for the potential that the rest of the month holds.
THIRSTY THURSDAY
Today was the first day at Annotto Bay Children's clinic.
We arrived a little early..well ...cause we had Gonzales get us there.. MAN I thought at any moment we would take off and orbit for a while around the moon before crashing back down to earth and end the terror. But we arrived safe and sound. LOL...
Patients rolled in, we had mostly well baby checks coming for their two week follow ups as well as F/U from hospitalizations and Asthma follow ups. Case of the day was a 5 y/o lil girl who had severe developmental delay and seizure disorder who came in with a ?2 week history of not passing stools and now presenting with occassional NB/NB vomiting none X 2 days)... easy peasy... Her vitals were stable, she was well hydrated and her physical exam was very benign... good bowel sounds and all..I was gonna give her some miralax and gave instructions to F/U in one mo. However, her parents then started asking me for information about homes that they could send her to. Her father said that they were no longer able to provide for her and wanted to put her in a place that could. From all the interaction that I observed between them, both parents seemed to really love their daughter. I was confused, Plus i needed to call in the Calvary if they were serious.. I had no Idea about how this would work in Jamaica.... I Spoke with Dr Ramos ( the pediatrician at Annotto Bay), who informed me that there were really no resources on this side of the island for this... and that the fam was well know to him and has broached this subject to him on numerous occasions but never really went through with it... He also says that they really love their daughter but need just a little help that is often needed with Special Needs kids. Even harder to do here since the resources are very scarce.. So on behalf of the family who is willing to take any donations in any form ( Formula, pedialyte, diapers, stroller for a larger special needs child, Clothes for a girl, etc).. Please contact me if you are able and willing to help out.. I know there will be two residents next mo, so if ur looking for a way to contribute this may be it..
Miss Shaneka ( permission given by parents)
We arrived a little early..well ...cause we had Gonzales get us there.. MAN I thought at any moment we would take off and orbit for a while around the moon before crashing back down to earth and end the terror. But we arrived safe and sound. LOL...
Patients rolled in, we had mostly well baby checks coming for their two week follow ups as well as F/U from hospitalizations and Asthma follow ups. Case of the day was a 5 y/o lil girl who had severe developmental delay and seizure disorder who came in with a ?2 week history of not passing stools and now presenting with occassional NB/NB vomiting none X 2 days)... easy peasy... Her vitals were stable, she was well hydrated and her physical exam was very benign... good bowel sounds and all..I was gonna give her some miralax and gave instructions to F/U in one mo. However, her parents then started asking me for information about homes that they could send her to. Her father said that they were no longer able to provide for her and wanted to put her in a place that could. From all the interaction that I observed between them, both parents seemed to really love their daughter. I was confused, Plus i needed to call in the Calvary if they were serious.. I had no Idea about how this would work in Jamaica.... I Spoke with Dr Ramos ( the pediatrician at Annotto Bay), who informed me that there were really no resources on this side of the island for this... and that the fam was well know to him and has broached this subject to him on numerous occasions but never really went through with it... He also says that they really love their daughter but need just a little help that is often needed with Special Needs kids. Even harder to do here since the resources are very scarce.. So on behalf of the family who is willing to take any donations in any form ( Formula, pedialyte, diapers, stroller for a larger special needs child, Clothes for a girl, etc).. Please contact me if you are able and willing to help out.. I know there will be two residents next mo, so if ur looking for a way to contribute this may be it..
Miss Shaneka ( permission given by parents)OK its late, I'm going to go in search of food at the buffet..
I head to Port Antonio hospital tmrw, the birth place of my grandfather...
Good NIght..
Wednesday, February 9, 2011
Time Does FLY!!
Well its wed night. and three days into week two.. I have seen a lot of pts between Port Maria ER and Health center and today made it to Annotto Bay ER... Saw the usual run of the mill URIs and fevers.. with a sprinkling of the common tinea and scabies.. But my case of the day was a 3 y/o with green penile discharge??? really. I had to call in back up.. I had never seen this before in someone so young.. with a negative urine DIP We swabbed and sent for cultures and treated him for the usual suspects...AND got social work on the case.. However i was told it takes a week for the cx to come back so we will see...
There is definitely a real need here and the all the doctors and nurses are very friendly and forthcoming and tell us they are happy that we are there to help out..
Pediatricians are in severe shortage over here therefore the kids are usually seen by the general practitioners. Even the some of the wards are covered by them. I am hoping that as the word gets out more pediatric residents interested in international medicine will want to volunteer. ON average I have been seeing between 15- 20 pts a day, some days more some days less.. But well worth the experience.. I am learning a lot about the health care system here and also getting a chance to see a lot of interesting cases. Having to treat the kids with limited resources is a bit tricky but has to be done..
NOW WE all know ......all work and no play makes TAYO a dull girl so...
Last weekend I went scuba Diving and explored a ship wreck.. I had a so much fun and if I pay thirty bucks I can get the dive on video( not sure i want to though). I was a bit apprehensive since i haven't been since 2005.. I will do it again this weekend...
Friday, February 4, 2011
FIRST FEW DAYS!
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..
TTYL
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