too busy to pose. Thursday was another school-based clinic, so we
wound up treating many kids with so-so chief complaints, because they
all wanted a basic checkup from the American doctors. The complaints
caused a day full of wild goose chases, but did result in some really
good necessary care for a solid population.
One of those patients was seen in the women's health room of the
clinic. She was screened with a 230/110 BP, and was brought in to see
the provider. A series of confirming BPs later, the seriousness of her
complaint (headache) was confirmed. Joy, an NP, gave the lady some
hypertension meds and sat her down to be monitored. While others
unknowingly tried to shoo her out, Joy wouldn't let her ICU patient
leave the room (only to stroke out while walking home). After an hour
or so, her BP had reduced adequately for the situation, and she was
sent to the pharmacy for meds, after receiving education on her
condition and ways to treat it. To the people who question the
importance of education in a trip like this, sometimes it is all you
can provide. When we treat a grandma or a baby in the clinic, we treat
the evident, as we can with the supplies on hand. If we take the time
to provide a name and explanation of their condition, and tactics for
management, our patients will have the tools to take personal
responsibility for their own healthcare. If they know that a
particular symptom requires a certain action (meds, hospitalization,
etc.) they will be more inclined to seek appropriate care. Grandmas
all over this region now know that their grandbaby's virus may lead to
life-threatening dehydration, and that they need to treat it by mixing
a concoction of salt and sugar. They also understand why antibiotics
are not applicable, and how to prevent its spread to other kids. Our
own citizens miss these points frequently.
I spent Thursday morning wrangling patients, shuffling them between
providers, depending on their needs. In the afternoon, Kelly and I
swapped jobs, and I worked in the pharmacy. What a freaking zoo. Any
sane pharmacist to stumble in would have had a coronary in the middle
of it all. Meds are sorted and stored in suitcases, which are lifted
and opened on perimeter tables around the room. There are hundreds of
meds, and the pharmacy was commonly staffed with people inexperienced
with pharmaceuticals. One person asked me how I knew so much about
pharmacy; i couldn't imagine not considering it common sense.
Contemplating this later, I chalk it up to years of mom and dad
talking shop at home, post-it's and pen samples from drug companies
all over our house, my EMT certification, my internships and
volunteering at UCDMC and Mercy, and my Anatomy/Phys classes, where
these were expected to be known. To get into a field requires legwork,
knowing the difference between Tylenol and Atenolol is just the
beginning.
After a record number of patients (370!), I came home Thursday covered
in a rash. Aside from the ridiculous number of bug bites I've received
(will be counting them after I get home), I'd been so far lucky to not
have my skin freak out. A very mild sunburn (really, it's already tan)
is really the only other issue I've caused myself. The rash however
was more or less unavoidable. I popped to Benedryl and passed out at
the end of the night. By Friday at lunch it was gone. I should also
note that Thursday's location was meagerly shaded, and was by far the
most hot (miserably hot) location we've been in. Concrete everywhere
makes for some upward heat deflection. Ugh, it reminded me of the
basketball courts in the summer.
Thankful for temporary relief from (self-inflicted) itching, I'd gone
into our tent, only to have it rain beautiful clear cool rain into the
evening. And all I wanted to do was be in it!
After dinner we had a panel discussion Q&A with the providers. Lynne
was one of those participating, and she gained many new admiring
students after the talk.
Below is a pic of one of those wild goose chases mentioned above. I
was dipping a patient's urine in response to a chief complaint of
painful urination and blood in the urine. We never found it, but it
was a good learning opportunity for all the students in the room, as
well as the patient.
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