Doctor comes to Yorke.
A busy couple of days in the clinic as one of the TI doctors flew out for a chronic disease clinic for locals. Dr Alex, is a great bloke who we got to know a little over the last 2 days. Doctors come often for 1-2 day clinics. Part of the Torres Health care model facilitates frequent check ups. The folk here all “ALL” have annual health checks looking for chronic disease markers, diabetes (about 50% of the population >50 and about 30 % of the community overall.) High cholesterol , high blood pressure, and renal disease. Everyone in the community has appointments to come see the doctor who visits for 2 days every three weeks. On Wednesday mornings, we run a Blood taking clinic, where all the chronic disease patients due for their annual check up in the next 3 weeks, come for fasting blood tests. You can test how “well behaved’ a diabetic has been by a blood test called a HbA1C which put simply tests the stickiness of blood. We can measure blood fat levels for a population that lives on high cholesterol Dugong, Turtle and shell fish.
If you were born on the other side of 1976 (that is you are over 35)and you are a TS Islander, I can almost guarantee that you would be on a cholesterol lowering medication…..Now are you ready for the big observation?? These people rarely have infarcts (Heart attacks).!! Is it the medication, or is it that there is more about high cholesterol that we don’t understand?
In the last two days this place has been busy. I have had a 10 month old child who was handed to me fitting. Some fever had triggered the scariest (for parents) presentation called “febrile convulsion” , I have seen a Prawn Trawler operator with hideous oral hygiene, and infected gums that grew a culture that Yoplait would be amazed at. His breath would have stripped paint and the garden of toxic flora, resembled some level IV biocontainment lab held in a secret US military installation working on bio-warfare agents. I selected a cocktail of antibiotics from the pharmacy, based on the pretty variety of colours of the pills, and a mouthwash that was 1 part, chlorhexidine hospital strength antiseptic, and 1 part floor polish. He was so happy with the treatment that he gave me a box of prawns and Moreton Bay Bugs, freshly cooked. After shelling those for lunch today, Jo accidentally left the shells in a plastic bag in the humid Torres sun, on the back deck. Smelling the foetid stench of the prawn shells this afternoon, was no comparison to a Prawn Trawler’s mouth when gingivitis and tooth abscess, meet in a battle for bacterial turf in one mans mouth.
A bloke’s aunty phoned me today asking that I come to the house to see her nephew. “Em b cold sick, and bone sore” she said, “Can yu go come house, for look em?” she asked.
I was in the middle of seeing a sick Aka with a flu like illness, but when someone rings the clinic and wants a house call, then a red flag goes up. I drove around to the house, and this man was not looking well. He told me that he was tired, and hot n cold, and bone pain, joints aching, headache. The differential diagnosis was huge…I took his pulse and temperature, and he was on fire. With a temp of 40, my differential diagnoses narrowed.
At this point I was thinking swine flu, Dengue Fever, malaria, or meningococcal septicaemia (bacterial blood poisoning). No mosquitos or trips to PNG lately…narrowed down diagnosis to bacteria, or flu. No access to any one with known flu, no trips down south or to TI/Cairns. I was looking at something bacterial. But where. Chest was clear…not pneumonia, no photophobia or neck stiffness, no rash, so not meningococcal disease. Urine test was clear, so not a kidney infection. No abdominal pain, so not peritonitis, or pancreatitis.
I asked him, “eh Bala, yu have any infected sores?” “Waa” he said, and bulled up his tracky daks…and there it was!! Jumping off his leg like an eager primary school kid with his hand up wanting to be picked by the teacher! “Pick me, pick me!!” it was saying. An insect bite that he had scratched on his shin, just 3 days before, was now a volcanic purulent sore, about to erupt. All around the sore, was red shiny swollen, inflamed skin. This man had a condition that we call Cellulitis. And it is dangerous. I took him up to the clinic and cannulated (put in a drip), took some blood tests, and spoke to the doctor . He prescribed 2 days worth of strong antibiotics into the drip, to be given straight away (stat), some pain killers and arranged transfer to Thursday Island Hospital. This boy was not going home today. He was flying south. It was an exciting intervention filled two days in the clinic, and whilst I have not had a lot of sleep in the last 48 hours, I have been loving the clinical variety. What is so cool is that with Jo in the house attached (physically) to the clinic, it is really easy to get her to come for a spare set of hands, and to help me with women’s business, and to show her some of the interesting stuff that I thrive on.
Infected Scabies, and staph infections (boils) are rampant here right now, and the clinic has been hopping with kids and adults coming in. We are running out of antibiotics, and I can lance an abscess with my eyes closed now.
Yesterday, I had a boy with an infected foot. There must have been some foreign body in the foot, because there was a huge blister oozing fluid. Just as I prepared to cut open his foot and explore the wound, the febrile fitting kid came in and trumped my attention. To be able to call Jo to come and do my kids foot, was a real bonus. That wound stuff, is what makes her tick, and to see her in there hacking away at the foot, was very satisfying for me and her. That boy came in today for me to review his foot, and it is all clean, healing super fast, and the Mum and the boy are wrapped. I don’t know what kind of wound magic Jo does behind those closed doors, but it must be good pouri pouri.
The Barge came into day. Tonight as has been custom for us at knock off time, we went down to the wharf, to watch them loading stuff on and off. The breeze, and smell of salt spray, and the sound os water washing gently onto the coral sand, is hypnotic, and despite the chaos that was Yorke clinic over the last two days, the anxiety relieving phenomenon of seeing the sea, breathing the air, and having sand between your toes, is good medicine for my soul, and like a battery recharge for another big day tomorrow.
Living the dream could not be better than it is right now, with my girl beside me, my kids content, and a wave and a smile from locals that openly tell us that they don’t want us to leave on the weekend. Part of me really wants to stop here for a bit longer, but a new adventure awaits us on Erub, and our trust is in God for this rollercoaster ride. So we will see what comes.
Yawo!!!
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