From time to time my medical skills get called upon, generally this does not happen in my role as a VSO medical advisor but more often than not as an ad hoc GP to other expats.
Last weekend I was overcome by an overwhelming lassitude that only later I identified as a fever in the tropics. But as my medical skills are so rarely called on or respected I just thought I was a little tired so took the opportunity to sweat quietly on my sofa & watch Bridesmaids for the umpteenth time & skype my friend who is practically a neighbour now in Singapore.
I missed a call from L whilst skyping so called her back - she was ringing to tell me that her husband A had been bitten by ants. Not enormous fire ants or monster ants just little black nondescript ants, but he has had a previous reaction to them & this time it was a lot worse. He didn't have any antihistamine in the house & L was in Phnom Penh. I said I would go & check up on him with some antihistamine tablets. Being a true doctor I then rang J - a nurse - who lives just around the corner from A & has a moto, I live a 20 minute cycle ride away & do not own a moto - asking her if she could go and administer for me.
J was (like a true Cambodian nurse) having her nails done & previously had missed a call from L & had ruined her nail polish trying to find her ringing phone in her bag, so was having a touch up when I called. She agreed that once her nails were dry she would moto around with some medications.
L called me back to tell me to go quickly as A was feeling worse. I called J to tell her that her nursing skills would not be effected by tacky nail varnish and although I was now going perhaps she would be faster than me. I text K 'duty calls' and cancelled our previously arranged coke & cake date (we live it up wild here in the 'Bang).
I called A - he answered & told me he didn't feel too well. This was useful as I could ascertain that he had an airway, was breathing, had no stridor or wheeze and had enough circulation to perfuse his brain & hold a phone - my medical skills came flooding back to me.
I peddled away in haste in the hot season sun & was half way to A's house when I received a call from J to say although A was having a severe allergic reaction he was still alive & she had administered an antihistamine tablet.
I stopped off at a pharmacy to try & acquire an epipen as I was anticipating an anaphylactic reaction - can't believe I was kicked out of the girl guides - always prepared. I wrote ADRENALINE on a piece of paper. The girl typed it into her computer - it is a rather swanky pharmacy which is new & replaced a rather lovely iced coffee place opposite the hospital. Even though the computer said 'yes' - the girl said 'no' or rather gazed blankly at me with her mouth half open not comprehending. This went on for several minutes.
I cut my losses & headed on to A.
I arrived to find A looking rather flushed & covered head to toes in urticaria with a pulse that felt better when we sat him down, when he stood up he kept telling us he felt rather strange.
J looked rather flushed also & was openly relieved to see me despite me having nothing to offer - its good to know I can still generate an false atmosphere of calm reassurance.
Within 15 minutes A was back to his normal colour & felt much better, J's nails were dry & I had stopped sweating. A refused further observations & said he would call us. J went to have a khmer lesson & I went in search of adrenaline as it occurred to me this might still be a good thing to have - ants are every where here (x-ref 'resilience - study'). After several pharmacy visits by me in Battambang & L in Phnom Penh we concluded that Epipens do not exist here in Cambodia. Plan B is insulin syringes & 1:1000 Adrenaline which comes to the great sum of $2 for 10 sets.
I fear that my pre-occupation with the lack of epipens may be masking the slightly bigger problems of the Cambodian health service.
A lives on.
Last weekend I was overcome by an overwhelming lassitude that only later I identified as a fever in the tropics. But as my medical skills are so rarely called on or respected I just thought I was a little tired so took the opportunity to sweat quietly on my sofa & watch Bridesmaids for the umpteenth time & skype my friend who is practically a neighbour now in Singapore.
I missed a call from L whilst skyping so called her back - she was ringing to tell me that her husband A had been bitten by ants. Not enormous fire ants or monster ants just little black nondescript ants, but he has had a previous reaction to them & this time it was a lot worse. He didn't have any antihistamine in the house & L was in Phnom Penh. I said I would go & check up on him with some antihistamine tablets. Being a true doctor I then rang J - a nurse - who lives just around the corner from A & has a moto, I live a 20 minute cycle ride away & do not own a moto - asking her if she could go and administer for me.
J was (like a true Cambodian nurse) having her nails done & previously had missed a call from L & had ruined her nail polish trying to find her ringing phone in her bag, so was having a touch up when I called. She agreed that once her nails were dry she would moto around with some medications.
L called me back to tell me to go quickly as A was feeling worse. I called J to tell her that her nursing skills would not be effected by tacky nail varnish and although I was now going perhaps she would be faster than me. I text K 'duty calls' and cancelled our previously arranged coke & cake date (we live it up wild here in the 'Bang).
I called A - he answered & told me he didn't feel too well. This was useful as I could ascertain that he had an airway, was breathing, had no stridor or wheeze and had enough circulation to perfuse his brain & hold a phone - my medical skills came flooding back to me.
I peddled away in haste in the hot season sun & was half way to A's house when I received a call from J to say although A was having a severe allergic reaction he was still alive & she had administered an antihistamine tablet.
I stopped off at a pharmacy to try & acquire an epipen as I was anticipating an anaphylactic reaction - can't believe I was kicked out of the girl guides - always prepared. I wrote ADRENALINE on a piece of paper. The girl typed it into her computer - it is a rather swanky pharmacy which is new & replaced a rather lovely iced coffee place opposite the hospital. Even though the computer said 'yes' - the girl said 'no' or rather gazed blankly at me with her mouth half open not comprehending. This went on for several minutes.
I cut my losses & headed on to A.
I arrived to find A looking rather flushed & covered head to toes in urticaria with a pulse that felt better when we sat him down, when he stood up he kept telling us he felt rather strange.
J looked rather flushed also & was openly relieved to see me despite me having nothing to offer - its good to know I can still generate an false atmosphere of calm reassurance.
Within 15 minutes A was back to his normal colour & felt much better, J's nails were dry & I had stopped sweating. A refused further observations & said he would call us. J went to have a khmer lesson & I went in search of adrenaline as it occurred to me this might still be a good thing to have - ants are every where here (x-ref 'resilience - study'). After several pharmacy visits by me in Battambang & L in Phnom Penh we concluded that Epipens do not exist here in Cambodia. Plan B is insulin syringes & 1:1000 Adrenaline which comes to the great sum of $2 for 10 sets.
I fear that my pre-occupation with the lack of epipens may be masking the slightly bigger problems of the Cambodian health service.
A lives on.
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