I have a minor
medical issue and thought I would take this opportunity to share the scenario
with YOU. I'll type up the basics, you give
me your plan, anticipated problems, and the plan for those problems. It would be great to hear from some of the
Chemeketan WFAs!
The Scenario:
You are hiking
with a friend on the PCT. It is day 76
of your trip. You are a day and half
from your last resupply and approximately three days from your next. It is afternoon, warm and sunny. You are between Sonora Pass and Ebbetts
Pass. One of your fellow hikers, female,
thirty-four years old complains of pain behind her right knee/hamstring.
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| Here's what you see ... the mosquito bites are much smaller and fainter. And, yes, I am being bitten again! |
SAMPLE:
S/Sx: Patient complains of pain behind her right
knee/lower hamstring.
Allergies: Sulpha drugs
Medications: Multi-vitamin, Aleve, oral contraceptive
Past Pertinent
Medical History: Rolled right ankle a
couple of times during trip.
Last Oral Intake: Second breakfast of oats and coffee, lunch of
cheese and crackers, dried fruit, nuts, and Snickers. Liter of water with lunch. Water while hiking.
Event: Pt. reports being bitten by mosquitoes and
flies behind the knees the day before.
She also reports cowboy camping the previous two nights (without a tent)
and climbing over numerous trees covering the trail.
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| Trail magic from a volunteer trail crew! (And they fed us cookies!) |
OPQRST:
Onset: Noticed pain after second breakfast, approx.
9 a.m.
Provokes: Extending the right leg fully and hiking
increases pain.
Quality: Achy, feels like a pulled muscle.
Radiates: Pain extends to behind knee, part way up
hamstring.
Severity: Pain is at a 4 or 4.5 on a 1 to 10 scale with
10 being most painful.
Time: Pain has increased since 8 a.m. Seems to be getting more painful.
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| Sunrise in a cathedral of rocks. |
VITALS:
Heart Rate: 68 per minute, steady, strong
Resp. Rate: 14 per minute, regular, unlabored
BP: UTA (unable to assess)
Skin: Warm, pink, dry
Pupils: PERRL:
Pupils equal, round, reactive to light
LOR: Level of responsiveness is A+Ox4. Alert and oriented to person, place, time,
event.
Pt. denies
dizziness, nausea, difficulty breathing.
 |
| The landscape has changed ... and we love it! |
PHYSICAL EXAM:
Reveals two
markings behind right knee/lower hamstring.
Approx. 1/2 inch across each.
Raised. White in center, red
around. Swelling in areas of marks. Tenderness upon palpation approx. 2 inches in
each direction surrounding marks. Rest
of exam is unremarkable.
 |
| Fields of flowers ... reminded me of the corn fields in early July in Iowa. Sigh ... |
OTHER INFO:
The Canadians (5
males in their 20s) are behind you. The
Rolling Stones (5 males and 1 female, 20s) are ahead of you. In your first aid kit you have benadryl,
ibuprofen, cold medicine, 4x4 gauze bandages, triple antibiotic ointment,
alcohol pads, and tape. Your patient has
a cell phone and a Spot Locator GPS device.
Cell service is rare in this area.
You have backpacking ge4 Rar for this 5
day stretch.
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| A father/son out 4-wheeling stopped to give us sport drinks. Icy cold. Just when we were in desperate need! |
What is your
plan?
What are the
anticipated problems?
What is your plan
for the anticipated problems?
Have fun! And I'll let you know how it turns out...
Dang Dorothy I just caught this post. By now you have recovered from a self limiting bug bite or died a horrible death. I'll ponder this further. Did you have any lymph involvement.... Like dark lines moving away from the bite area? Do you fantasize about food and hot showers...ask yourself deep questions about your place in the universe? Perhaps there is brain involvement?
ReplyDeleteMike N
Fun, eh? I am alive. I do think it was the two bites. Pain slowly decreased to gone over the course of a week. Yes, I dream of food and hot showers. Very deep questions about my place in the universe. Wait, are thoae symptoms?! Is there a pill for that?!
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