Capstone Log 12

Today: 2 hours
Running Total: 23 hours

Today was sweet and short. When I got in, Dr. Kelly and I went to see a 2 year old with a rash on her nose and a diaper rash. The mom thought the rash on the nose was a rash, but it actually was just the remains of a small scratch that's healing and probably collected some bacteria. It will go away in a couple of days. The diaper rash was quite large however and covered a large portion of the bottom. Dr. Kelly renewed a pre-existing prescription and changed it to 2% Hydrocortisone. The girl also received a measles vaccine because they are moving to Germany, where there is an outbreak of measles.
We then saw a girl who was sick with a high fever, and was very miserable; coughing a lot with a sore throat and deep breathing. We know right away that it isn't strep because cough is not associated with it. So Dr. Kelly checked her up and came to the conclusion that she probably had the flu. He did a flu test which involves a nasal culture. It looked very painful and very uncomfortable because the swab had to be shoved way up into the nose. I felt really bad for the girl, but it was absolutely necessary.
Dr. Kelly then had a physical with a teenage boy and I wasn't allowed to go in, so instead I went with Dr. Pickering for a pre-operation.
A 9 year old girl explained how when she was 5, she was running on the beach and stepped on something sharp, but thought nothing of it since there was no trace of anything stabbing through the skin. 4 years later, she feels more pain and can barely walk on that side of her foot. Her mother showed us x-rays which showed she had a piece of metal in her foot and it had snapped in half. We all came to the conclusion that it could be a hypodermic nail. The surgery is a simple outpatient surgery, and they'll put the girl under anesthesia, but the real concern is the chance of getting Hepatitis B, Hepatitis C or HIV. However, if the needle had those traces, the girl would've been infected long ago. And she has already had her Hepatitis vaccinations, so she's immune. But a blood test was taken to reassure that the girl has no disease. What surprised Dr. Pickering and I however, was the fact that the needle left absolutely no trace and no presentation until 4 years later. And it was never infected or swollen when the girl first got it.
Dr. Kelly and I then talked a bit about rheumatic fever and how it can come from strep and could cause rheumatic heart disease as well as brain damage and swollen joints.
I was also able to ask Dr. Kelly about Elephant Man, since we're watching the movie in class. He said that the movie and play were very wrenching and emotional compromising, but it's actually not completely rare to get this genetic disorder where your child ends up growing up with large tumors and sever deformity. It's called neurofibromatosis and Dr. Kelly actually has a patient with this genetic disorder who is 20 years old now and very severely deformed. The worst part is that there is no cure and no treatment.
For next week I have to read about the "5th Disease", which is literally called the 5th disease. I have to read on the importance of the other 4 diseases as well and focus on Roseola.