Delayed Tuesday

Delayed Tuesday Blog. 32 patients. Last one out the door was the late arriving lactated-ringer’s yellow bag for rehydration of alcohol related gastritis, with tremor, and anorexia. Ran a bit late, dc’d the line, then took Kell to Judo. His arm is improving. The med student incised and drained and packed her first insect bite with secondary cellulitis and underlying developing abscess – did a good job. She is gaining confidence and acumen. A purported case of poison ivy (on chest, upper arm, axilla, and scapula), turned out to be vesicular lesions on an erythematous base, in serial banded patches, confined to a single dermatome (T-1), and not crossing the mid-line – “Shingles”. Another had a similar, but isolated, single patch of vesicular lesions on an erythematous base, but this was recurrent at the same site on a mucus membrane – “Herpes”. #14 in the Rocephin infusion series. Rotator Cuff Strain. Achilles tendonosis with bursitis and calcaneal pain – “booted”. Sports, College, and DOT PE’s. A few recurrent UTI’s – “Cultured”. Peri-anal Candida Intertrigo. Several more Serous Otitis with Otalgia – sweet oil works wonders. LAC repair follow-up, and partial suture removal. Tinea Dermatomycosis. Erectile dysfunction. Malignant HTN. Disability paperwork x2. Chronic Pain referral. Vulvo-Vaginal Candida. Scattered pigmented solar Keratosis, with small BCCA. Thrush. Had some omission problems with the Lab reporting of a screening result, and am tracking the reason down with the toxicologist. Had precision trouble with called-in prescriptions, and fixed them with the pharmacy and the patient. Resulted in a bit of delay tonight.