Monday the 15th

 
Today was another clinic day in Port Maria (roughly 30 minute drive). It seemed slower but that was because there was a heart screening going on at the same time. This made the patients flow more steady instead of a huge rush.
I saw 19 patients today.
Found out that they don’t carry Claritin/Loratadine in the pharmacy (I’ve probably written 10 scripts for it and today was the first time someone came back in to tell me the pharmacy didn’t carry it).
The very last patient I saw was a bit frustrating. She had viral pharyngitis. I spent awhile explaining the difference between a virus and bacteria and how we do not treat viruses with antibiotics. Mom and 12 year old seemed ok with this but then they came out and told the lady that had asked me to see them about my diagnosis/treatment plan. I had to leave my room to walk to the pharmacy. When I came back they had taken the chart (which they call a docket) and put her in line to see the nurse practitioner!
This is a common battle we fight in the US as well. Viruses are not treated with antibiotics but families sometimes get upset when you explain this. Studies have supposedly shown that if the doctor explains the nature of the illness that they family is ok with not getting a prescription. I have not found this to be very true (here or at home). Also, we are not supposed to give cough and cold medicine to anyone under the age of 6 years. I had a mother last week tell me that she wanted a prescription for their local cold medicine for her 9 month old baby. I explained why we don’t give the medicine (risk is greater than benefit). She demanded 2 more times for me to write it and I finally had to say “you can leave now because I will not write you a prescription.”
Please don’t get me wrong. The vast majority of my patient encounters are pleasant and the families accept what I tell them. I just needed to vent about those.
Today I admitted a child to the Annotto Bay hospital. I hope he is still there on Wednesday when I do hospital rounds there. He is not growing and developing and has frequent infections (this is not a good combination).
Tip of the day: Don’t travel with black luggage.
Time for Jamaican fun:
They report time like this: 1 day= 1/7, 1 week = 1/52, 1 month = 1/12
$1 US = $84 Jamaican
Their version of Sprite is called Ting
Kids here do not think of Santa Claus like we do. He is a figure at Christmas but he doesn’t come down the chimney (they don’t have them) and bring all of the presents. He rides on a donkey that pulls a cart with some toys in it. On Christmas Eve kids dress up in their finest clothing and walk around the town with their parents. They buy toys and candy that night as their gifts.

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