Blog Archives

So I have been very poor at updating this frequently! My apologies!

I had a very busy week last week. Ended up admitting several children to the hospital, and the parent’s weren’t very happy about it. They tried convincing me that the kids were okay, and I almost relented, but my sixth sense kicked in and I admitted the children.

The first was a 1 week old baby with jaundice who was discharged home with jaundice and was supposed to follow up with me. The baby’s blood type was known, but mother’s blood type and Rh factor (rhesus factor, the + or -) were not known. So the baby was potentially set up for problems with having different blood types than mom. Mom was also breastfeeding, and the baby could have had breast feeding jaundice. The third problem was that mom told me that the baby was only breastfeeding about 4 times a day! When asked, the mom said it was because the baby was sleeping the rest of the time. After I raised a stink, the mom started to change her story saying she was feeding more than that… but I just couldn’t risk it. The child was admitted and had labs drawn… better to be cautious than cavalier about that.

The other was a 12 year old asthmatic with an exacerbation. He had several nebulized treatments in the A+E (accident and emergency, our ER) and said he was finally feeling better. However, his mother was not going to be able to fill his prescriptions until the next day, so he would be going home without any albuterol or his needed steroids. I had to draw the line and say that when mom got his meds filled, he’d be able to go home the next day, just didn’t want him getting home and the exacerbation getting worse.

I’ve seen a large portion of run-of-the-mill respiratory infections. Rotavirus has hit Port Antonio, and it looks like it’s spread to Annoto Bay and Port Maria, as I’ve seen an increasing amount of acute gastroenteritis.

Still occasionally have some problems understanding accents, but I think I am getting better.

on Friday I gave a small “lunch and learn” presentation on asthma exacerbations and management of asthma in the acute and chronic settings at Port Antonio. A lot of the doctors and nurses from the peds ward were there. They asked great questions and seemed to enjoy it. I hope it was useful. They did ask that the next group prepare some topic dealing with nephritis/nephritic/nephrotic syndrome, as they’ve seen an increase in those patient’s recently.

I would definitely recommend to future volunteers to get a presentation done before you come down!

Will try to update later this week.
No Comments
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.
No Comments