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Received my Couples Resorts Calendar that I purchased today! See a picture of one of our medical teams!  Couples -On behalf of all the children touched by the Issa Trust Foundation, we send you heartfelt thanks for your generous purchase of our exclusive Couples Resorts Calendar!The Couples Resorts 2012 Calendar is now available for those who make a charitable contribution to Issa Trust Foundation.
http://www.issatrustfoundation.com/04-donate.htm
For a $30 donation to the Issa Trust Foundation we will be pleased to send you a beautiful 2012 Couples Resorts Calendar. If you would like two calendars, donate $50.

Week 3
Day 1, Port Maria
The weekend was awesome!! Scuba diving at the resort, and ziplining and bobsled riding at Mystic Mountain Rainforest were amazing!! We also had dinner with Diane Pollard, Dr. McConkey, her husband , and two Biomed volunteers. It was lovely to meet them all and learn about the many things that Issa Trust Foundation does to improve medical care in Jamaica.
Today was back to work. Super busy day today. I saw 2 children who had stepped on nails, 1 had developed an abscess which I drained. I saw a child with spina bifida who was having chronic knee pain. An overweight male with chronic knee pain who I was sure who had have a SCFE who did not. Saw multiple other lacerations which were too old to repair. I saw a little girl with a history of macrocephaly and recurrent and persistent thrush. In my time here I have become more reliant on my clinical skills and my instincts. I have also found myself treating with antibiotics more than I would at home, especially for pharyngitis symptoms after learning there is a significant amount of rheumatic fever here and there is no rapid strep or throat cultures available. Perhaps, the biggest surprise of the day was when a mother of a 3 month old boy asked me to be her child’s godmother! I felt honored, but unfortunately as I am leaving in 2 days, I could not.

Day 2, Port Maria,-My Last Day
Today I felt as if I was in an ED and not a clinic. Multiple cases of asthma exacerbations. A case of abdominal pain which is challenging to evaluate without imaging. The girl kept crying that her stomach hurt, but had only mild tenderness on exam. I did an AXR which showed lots of stool, asked for bloodwork, and kept her for several hours for observation. Had to rely on my exam and the wbc alone to r/o appendicitis. Thankfully after several hours her pain and tenderness resolved

This has been an amazing opportunity in so many ways. It is a great learning experience to evaluate and treat children without so many of the tools that you become reliant on. It is fascinating to learn about the healthcare system in Jamaica. It is interesting work in a different culture and really getting to know the people. The resort is absolutely amazing, the food was some of the best I have ever had, the staff could have not have been any nicer or more helpful, and the activities were awesome. I have definitely gotten a little spoiled at nighttime and on the weekends here!!
I would like to thank Diane Pollard and Dr. McConkey for all of their hard work in setting up this rotation. I am grateful to the medical staff and all of the different sites for helping us out with our endless questions. Thank you to all of our kind drivers!!! Thanks to The Couples Tower Isle and the amazing staff for hosting us.
A very special thank you to Dr. Chung Lee, my colleague and friend for the last 18 days!! Thanks for all of your help, and all of the fun memories!! I hope to see you again!!!

Friday, Port Antonio
Today was our first day in Port Antonio as we were unable to go last week due to lack of transportation.
Very interesting day.
In the morning , we met with the director of the hospital, Dr. Davis who gave us an overview of the hospital. It was very helpful and informative.
Then we went to the pediatric ward and rounded on the patients there with an intern. There were some sick children there. For example, there was a patient with sickle cell disease, fever, and acute chest. We suggested obtaining some bloodwork, a chest xray, giving oxygen, and maximizing pain control. There was 1 week old baby brought in for lethargy who had severe electrolyte abnormalities, metabolic acidosis and elevated direct bilirubin We asked to repeat the blood work, and if it was still abnormal recommended transfer to Annotto Bay where the pediatricians could oversee the care of this child.
In the afternoon, we went to the pediatric clinic. As pediatricians are consultants, many of these cases were not so straight-forward and required some time and thought. I saw a child with nephritic syndrome, a girl with intermittent fevers x 5 months, a girl who had a lethargic episode 2 weeks prior among other cases.
I felt very useful at Port Antonio, which was a great feeling. Kind of nice to be in a place where pediatricians are so needed. Our driver that day was amazing, so kind to us. She totally went out of her way for us (Port Antonio is almost 2h away), and ensured we met with Dr. Davis.

soo after an awesome weekend of scuba diving, snorkeling, sailing, and realxing, back to work today. Today we went back to Port Maria. Felt much more comfrortable this week as compared to last week, as we knew where to go, who to talk to. I worked in the hospital and saw ED patients and also helped out the clinic and saw some of those patients as well. Pretty busy day. Saw a range of illness from URIs to many skin infections to knee pain. Kind of challenging to figure out how to manage patients without laboratory tests. Really relying on clinic skills. The patients are so appreciative and friendly.

so yesterday we went to Annotto Bay, a level B hospital, more advanced to Porta Maira. The pediatric Ward was very interesting, It was a NICU, well baby nusrery, and pediatrics ward in one large room. The residents were very welcoming and oriented us to t he facility. We saw the aptients in the Ward and then we got to sit in on the rounds with Dr. Ramos, Dr. Ramos is an amazing teacher. The residents were a mixture of general doctors and pediatric residents.

Today we went back to Annotto Bay and worked in the clinic which was very busy. I saw a variety of cases ranging from pulmonary stenosis with CHF to worms, to lots of well baby newborn exams. Patients were very patient and appreciative. Children adorable!!

the food at the resort is absolutely phenomenal!! fell like i’m eating iron chef food every night!!