Chestatee Emergent Medical Care

Saturday. Amberly off for her Birthday. No Vaccines available. I am hopeful we will receive another allotment this coming week. Only 27 Patients. A series of medication renewals. Weight Loss. Urinary tract infections. Sinusitis with Headache. Right lower rear molar tooth abscess. Pharyngitis. Motor Vehicle Accident with thoracic back and neck Mm. Spasms & pain r/o fx. PPD reading. Dog bite I&D R index finger. Sinusitis with bronchospasm. Post-CoVID-19 work clearance. Epistaxi...s Left nares bleed from kesselbachs plexus. CoVID-19 Rapid Swab supplies on back order, reserving tests for making treatment decisions. More tests arrive on Monday. Viral Gastroenteritis r/o CoVID-19. Two with fever, malaise, diarrhea, & cough were Swab (+) POS for CoVID-19 & treated with alternate protocol. One swab (+) POS declined treatment. One clinical (+) POS CoVID-19 treated with HCQ, symptomatic, room mate (+) POS. Bilat. SI joint instability & pain. Fever, Hypoxemia, and CoVID-19 Interstitial Pneumonia - treated /c antivirals, nebulizers and placed on Oxygen. Five (+) POS for CoVID-19 elsewhere. Presented for an anti-viral or alternative treatment protocol. All accommodated. Two currently in hospital - sent treatment records. Headed home then out for an off road bike ride at Matt Park. Afterwards a Judo Referee Zoom meeting. See more

Friday 81 patients. Busy throughout the daybrutal last few hours. Stayed until 7:40pm to get the last patient out the door. Dr. Berliner and myself on deckDr. Berliner left around 1:30pm. Around 8 called it in. The last of our COVID-19 vaccines were administered today11. Twenty-two for COVID-19 rapid nasal swabs: 6 positive half treated with antiviral regimen and the other half with alternative protocolthe rest were negative. Six for COVID-19 prophylaxis. Five tested pos...itive elsewhere and presented for treatment. Upper respiratory infections. Urinary tract infections. DOT physicals. Sport physicals. Weight loss consult and labs. PSBR. Right otitis media. Several medication refills. Diverticulosis. Right mastitis. Follow-up on right necrotic gangrene thumb, sharp debrided to bleeding tissue, then lavaged and wrapped up. Benign paroxysmal positional vertigo. PPD reading. Positive pregnancy test. STD testing. Quick drug screen. Allergy injection. Sudden extreme left leg pain sent for ultrasound. One toward the later of the day was a patient with slurred speech, distorted orientation, right arm/hand numbness and tingling, and blood pressure 220/78sent out via EMS for CT scan to rule out CVA. Called patient before leaving clinic and patient was admitted for having atrial fibrillation that threw a blood clot to their brain causing a CVA/strokethey are stable. Finally home. Will have to do charting tomorrow morning. I am off tomorrow for a good friend’s wedding, Dr. Berliner is on deck tomorrow. Be well. (Post by Amberly) See more

Thursday. Raining. 80 patients. Only one called it in. 18 CoVID-19 vaccinations. We have provided all of the initial 200 vaccines we received (the last ten are scheduled for tomorrow). I am hoping the State will provide more. Today mostly CoVID-19 testing. Also there were those testing (+) POS elsewhere, coming for treatment. More later, heading to Judo and Jiu-jitsu to relax. 24 CoVID-19 Swab tests. Seven Positive. Ten (+) Positives coming for treatment. Six CoVID-19 follow...ups. Three were placed on IV Myer's Cocktails for dehydration and fatigue. left thumb distal phalanx fracture after patient hit themselves while hammering. Recheck on dyspnea & left low back pain in L Pneumothorax. The pulmonary Gutter is still not expanded, although the remainder of the lung has filled out after the chest tube. Allergic reaction to medications. Cholecystitis with Cholelithiasis versus Pancreatitis in RUQ & supra-umbilical pain, going through to back. Started Actigall and sent for MRI Imaging. Recurrent Strep throat and tonsillitis is (+) POS for Anti-streptolysin antibody c/c Rheumatic Fever. Started on IM 1.2 Mu Bicillin L-A inj. Qmonthly for x1 year. Several cases of Gastroenteritis /c diarrhea. Med refills. Weight Loss x3. Strep throat x3. DOT physicals. Simple sinusitis. Conjunctivitis. Sinusitis with bronchospasm. Medical Leave paperwork, under FMLA. Throid management. Drug and alcohol screening. Right intercostal pain, NOT renal colic. Sent for CT scan. Drug and Alcohol screening. Urinary tract infections. Post CoVID-19 fatigue and prostration. Gangrene of R thumb RTC for x2 wick removals, sponge and sharp debridement, removed necrotic and eschared tissues, dressed with layered iodoform strips. Ensured that abx and propranolol continue. See more

Wednesday. 73 patients. Surprisingly few called it in. Maybe that was because we were so busy in the evening. PA Shannon and I on deck. Chelsea and April on vaccine duty. Kim at triage. Hailey and Kylie reception. Just 18 CoVID-19 Vaccinations. Had a few no-shows to the appointment. More for Friday. Still no second allotment. 16 CoVID-19 Rapid Swab antigen tests. Mostly (-) Negative. A few (+) Positives. One treated /c the antiviral protocol, and the rest /c our alternative p...rotocol. A half dozen came solely for treatment of CoVID-19 diagnosed elsewhere. Most were very ill, two had been 'cooking' more than a week, and they showed early interstitial pneumonia on Chest-X-Ray. All placed on an aggressive antiviral protocol with inhalers and cough elixer. One sent home with oxygen ordered. One given added stromectal. Two mild cases placed on the HCQ protocol, while Five patients came specifically for prophylaxis. Hypothyroid management. Diabetes. Hemorrhoids. Corneal abrasion. Drug screening. DFACS Physicals /c PPD. Sports physicals. Migraine headache. Upper Respiratory tract infections. Gastritis. Med refills. DOT physicals. Gastroenteritis & obstipation. Urinary tract infections with renal colic. Three post hospital for CoVID-19 Pneumonia, came for rechecks. All steadily improving, but one still very weak. Advised activity to tolerance, not failure, stay on oxygen. Chronic pain. Two cases of red, burning tongue syndrome, overgrowth of candida following antibiotics & steroids. STD check. Simple sinusitis, and some with bronchospasm. Strep throat and tonsillitis. I&D of Right thumb splinter puncture & early gangrene, returns, removed two wicks, sharp debrided sluffing skin, necrotic tissue, eschar, and gangrenous overlay. Lightly Repacked tunneling. No purulent dc, or fetid odor. Will follow. Off to Judo and Jiu-jitsu with Iain. See more

It is really important to emphasize that what we know right now, the vaccine is effective against this strain and while it spreads faster/easier, it does not appear to cause more serious illness than the original strain, DPH spokesperson Nancy Nydam. https://www.wsbtv.com//5-conf/OVFXW6JY4JFUFB2SKF2FSH3W2Y/

Tuesday. 79 patients. Amberly and I in tandem. Chelsea working CoVID-19 Vaccines. Kim triaging. April floating. Hailey & Kylie at the reception. Just busy. Rain came in at 4:00PM and the patient flow slowed down, other wise we would have seen 90. There were 23 for the CoVID-19 Moderna vaccine. A dozen for the CoVID-19 Rapid Swab test, 5 positives, 4 requested treatment, 1 let it ride. Seven negatives, mostly for work clearance, two wanted sinusitis with bronchospasm treated. ...One Covid-19 Interstitial Pneumonia in respiratory distress, tuned up from 71% SaO2 to 95% - given several injections, sent home on oxygen, nebulizers, antiviral protocol. A second patient ill for two weeks, now /c respiratory dyspnea, SOB, was was evident for CoVID-19 pneumonia by imaging, which was then diagnostically confirmed by antibody testing, since the Nasal swab would have showed (-) Negative. Seven came from elsewhere for CoVID-19 Treatment. Some with the antiviral protocol, some with the alternate protocol. One needing insulin adjustment. Strep Throat. Bolster sutures removed from Sebaceous cyst I&D. Work clearance. Three /c post-Covid-19 fatigue. Leg infection and cellulitis. Rheumatoid Arthritis with an allergic reaction to HCQ she was placed on by Rheumatologist, trx for hives, long term, since the half life of HCQ is 22 to 52 days. Sinusitis & stridor /c Laryngitis & Bronchospasm. Obstipation, Flatus, & Gastroenteritis. Octogenarian with Presyncope & Dehydration, NO CoVID-19, given Myer's type IV rehydration. Severe Migraine given IV anti-migraine cocktail. PSA consult and BPH treatment, with lab review that discerned alcohol induced fatty liver. Drug Screening. Chronic pain management - with requisite drug screen. Muscle spasms. Thyroid management. Asthma. Diabetes management. Sports and DOT physicals. Med refills. Post abdominal surgery with acute abdominal pain and obstipation - discerned to be CoVID-19 (+) POS - parent had same symptoms w/o the surgery. Oral Herpes Simplex, severe initial infection. Common colds. Secondary MRSA Infected Subungual hematoma, (hematogenous seeding?) drilled out with 18 gauge beveled needle and drained, started dual abx. Testosterone for Hormone replacement. Splinter self-removed from Right thumb by diabetic patient 5 days ago, now grossly swollen, necrotic, draining pus, green discoloration, dermolytic, evident early wet gangrene, performed fasciiotomy, cored out pus pockets, packed with two iodoform wicks, started dual abx, perfusion and pain medication. Will see back tomorrow. May need to send to surgeon for further dispensation. Closed out books then off to teach a Judo class. I expect tomorrow will busy too. PA Shannon and I will be on deck. See more