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Our last full week in Jamaica was fabulous.  I feel so lucky to have had this experience.  The Issa trust foundation and the Jamaican children have a huge piece of my heart!! Monday and Tuesday we were back at Port Maria with me in the A&E and D in the clinic.   We both had two of our busiest days, multi-tasking and seeing as many patients as possible.  It felt just like being at home.  D saw 20 patients in less than 6 hours and I admitted 3 children out of the A&E.  This opportunity is a wonderful learning experience.  With limited resources it sometimes feels like you our working without all of the information but you really learn to trust your gut– sick vs not sick.  Often labs can’t come back for hours and you have to really work on communicating your concerns with patients and other providers.  The same is true at home but sometimes it feels magnified here!!  On Tuesday I had to start an IV and draw labs on a dehydrated 4 year old with gastroenteritis!  I love procedures but this helped make me even more grateful for all of our nurses at home!!  I also admitted a 9 month old with a fever and very complicated rash.  The rash was diffuse, non puritic and was seen on his palms and soles.  Some of the providers in the A&E thought it was varicella but as it was non puritic my money was on coxsachie virus and a possible superimposed bacterial infection!  I admitted him for observation to ensure the rash didn’t worsen.  I am very interested to see how things progress!!

We took advantage of a free afternoon on Wednesday and went zip lining in the Chukka Rain forest!!  It was amazing and a must for anyone in Ocho Rios.  The natural beauty in the rain forest is breath taking and zip lining is one of the funnest activities I have done in Jamaica.

We were back in Annotto Bay on Thursday for well baby clinic and D and I saw many babies.  From diagnosing murmurs and learning how to obtain echos to educating families about scabies, umbilical hernias and supranumerary digits, it  was a busy day!!  I want to take a moment to think D’s sister and brother in law for their generosity.  They came to visit last week and wanted to help the Jamaican children as well so they donated 50 bulb syringes for us to give out.  All the mother’s who received them were so excited and grateful!  It’s kind of crazy to think about all the things that we take for granted at home!!! I know the last few days of this trip will continue to be eye opening!  Thank you Issa Trust for the opportunity to experience this amazingly beautiful country and take care of these adorable children in a place where the medical need is so great!!  I am so excited to go home, but I know I will feel Jamaica pulling on my heart!! S&D

Wa’gwa! (We’re working on our Patwa).

Steph and I rounded out last week at Annotto Bay hospital. On our way to the hospital we made a stop at Port Maria Hospital for a quick pit stop and I was able to run up to the pediatrics ward and check on a couple patients. There was one young girl who had right sided facial swelling in the previous post who I was worried about. Her swelling was unchanged with the antibiotics. The doctors were unable to bring in a dentist to pull the infected tooth so they were going to send her out the next day for extraction. I was just glad that the infection had not spread and become preorbital or orbital cellulitis! She was not very thrilled to see me as I had put her in the hospital, but I was just glad she didn’t get worse! The other child I checked on was an 11 year old boy who had lost his mother and the teachers brought him to the emergency department for an asthma attack. He actually likely had a panic attack at school then on the the way to the emergency department attempted to jump out of the teacher’s car. This case broke my heart! He needed to be admitted as he was not safe to be discharged and actually had no place to go. I was happy to hear that there is a special grieving team made up of social workers and counselors. He was able to work with them and was in a better place even a couple days later. Again he was hesitant to speak with me again but I was just relieved that he was in a safe place. At Annotto Bay we were able to see quite a few children in the clinic primarily for follow-up of seizures and asthma. It was nice to be the ones managing seizure medications and when to stop them as this is primarily handled by specialists at home. We saw quite a few patients. We also spent some time in the emergency department where we were quickly handed multiple charts. One young girl needed casting for a left tibia/fibula fracture and another child needed sutures for a chin laceration. I was glad to have local anesthetic even though the only sutures available were much larger than what I would normally use. Always a little creative in whatever we do!     The weekend was amazing and extra special as my sister and brother-in-law, Maria and Dan came to visit. We spent the time relaxing, playing beach volleyball, paddle boarding and reading. They were very happy to get out of the cold Chicago winter and we were more than happy to show them around our home! Steph attempted to learn wind surfing which would have worked well if there was more wind 🙂 On Saturday we climbed Dunn’s River Waterfalls which was more challenging than expected and we each have a few scrapes to prove it. Our guide at one point wanted us to climb blindly through a vertical slope of the waterfall…needless to say we did not successfully complete that challenge. Regardless it was a great time and I would recommend it! We even shared a special Valentine’s Day dinner at Eight Rivers where we were serenaded by a Jamaican acapella men’s group! Can’t beat that! 

Gearing up for our last full week here in Jamaica!

With respect and love.

– S & D