Hi Ho! Hi Ho! It's off to Hell I go!
Nursing will have that effect on you. Stick it out longer than 10 years ... You're toast.
'Tis the night before thanksgiving and all through the clinic... negative air fans are humming and children are screaming... the patients all gather at the door with no cares... and they greet us with nothing but evil stares...
We are having a nice evening here at the Urgent Care. Few customers but generally people aren't here. Why not type a blog?
Side note: I am going to birth a baby soon. holyshit. This kid has been making her initial decent for weeks now. It's been sketchy at times. Wayyyy so many people have told me that first time moms rarely deliver babies early or on time... well. My kid + my cervix are threatening otherwise. So, not sure when I'll be back on here... 1 week left at work and then it's baby time. Unless she makes up her mind to come before that. We shall see!
The original mission & purpose of this blog was to discuss, educate, inform, summarize, and explain medical things understandably.
The ideas I have gotten for previous blogs (and this one) usually stem from things that I repeat 2305754982 times every week.
Humans want answers.
Vague explanations, or labels that are not "exact" make for very unsatisfied customers, that then go to the internet to air grievances and write really mean things about you.
But here's the thing - sometimes (a lot of times), a diagnosis doesn't matter.
Generally - there are certain conditions that are ALL treated the same way without knowing EXACTLY what they are...
What's an example?
The common cold.
Trademark me: It should be "the common colds".
Yes, "it" (they) still exists. In fact, in my area, "Human Rhinovirus" was circulating heavily at the time I started this blog, and people just hate that.
There's no medication that makes it go faster.
It was making adults moderately sick, sometimes even with pneumonia. And we, personally, in my clinic, don't test for it. Because it doesn't matter for most people. In some groups...it matters. For fragile kids or elderly people - it is quite helpful to know what you are treating, so that you don't give unnecessary or inappropriate recommendations or drugs. But...
"Colds are minor infections of the nose and throat caused by more than 200 different viruses. Rhinovirus is the most common cause, accounting for 10 to 40 percent of colds. Other common cold viruses include coronavirus and respiratory syncytial virus (RSV)." (1)
Is that a good source for y'all? American Lung Association. Run by a volunteer board of directors... not associated with the government... been around over 100 years...
Trustworthy info. Two-Hundred different viruses cause the common cold. And guess what?
You treat almost all of them the same way. Identifying the virus doesn't matter. They all have a similar course of illness and all are "self-limiting" (they can and will go away on their own even with no treatment).
They make you "uncomfortable for a little while" (somebody out there is having visions of stabbing me) and are a general nuisance and inconvenience... but... it doesn't. matter. which. virus. you have.
To the left, you see what we call a "Respiratory PCR Panel". This test result came up on the FIRST patient's chart I opened to see tonight as I started this blog. #nocoincidence. This panel was performed on this patient when it was approximately 5 months old. So, like I said - specifying the infecting organism matters in some patients, the littlest ones, the oldest ones, and the most fragile/complicated ones. I am notttt going to break this panel down and identify what certain infections require. But for those providers out there whose skin is currently crawling... I'll inform the masses (because sooo many people read this blog LOL)... Right in the middle... "Myco pneum PCR"... This is Mycoplasma Pneumoniae... this causes what we call "walking pneumonia" in the middle age ranged people (20s-40s) and is treatable wiiiiiiiitttthhhhhhhhhhhh... bddddrdrrdrrdr... AZITHROMYCIN! A Z Pack!!!
And if I think you have this "Atypical Pneumonia" after interviewing you, I will gift you a Z Pack.... and maybe even some steroids!!
All the rest of y'all............ take a lap. Walk it off.
I get asked every single week that I work... when I tell someone they have a cold... grown adults... "well what I'm supposed to take?" "you not gonna give me nothing for it? no shot no antibiotic or nothing?" "I don't know what to take over the counter why you can't send me a prescription?"
Story Time: I have actually said these words out loud to actual people: "You will have to go to the store, CVS, Walgreens, Walmart, wherever... and you just go down the cold & flu aisle, and you read what the medicine is for on the boxes... and when you find one that matches your symptoms, like how you feel, and you buy that and take it like it says on the box."
No. This is not made up.
Every. Single. Week.
I encounter the same questions and bewilderment with Poison Ivy, Oak, and Sumac.
And I had a string of patients over 1-2 months that came in with some pretty intense cases of it. And they repeat themselves 50 times when I don't have an answer as to WHICH poison they were exposed to. But... here's the thing... again... it. doesn't. matter.
The initial treatment plan is ALL the same.
Antihistamines, steroids, and if you require them - antibiotics.
Soooooooo, let's discuss, shall we?
What are Poison Ivy, Oak and Sumac?
Poison Oak, Poison Ivy, and Poison Sumac are plants. These plants contain a sap, that contains a chemical, that causes humans to rash.
ALL 3 plants contain the same "offending chemical".
Just like whiskey, vodka, and wine all contain alcohol, doesn't matter which one you drink, have enough and you'll be drunk.
Poison ivy, oak and sumac are three plants that carry the same poison — urushiol , a colorless, odorless oil that causes an itchy, irritating rash. (3)
This blog may end abruptly... because what I'm about to write is the MAIN point! Heyyoo.
"You can develop a rash by touching poison ivy, oak or sumac — and by transfer of the oil from someone or something (such as a dog or clothes) that has come in contact with the poison. The rash is very itchy and uncomfortable, but it is not contagious. Touching the skin of an affected individual will not cause you to get the rash, as long as the oil has been washed off.
The body's allergic response to the plant toxins may not be apparent for several days and differs in severity from person to person. The skin will become red and swollen, and then blisters will appear. After a few days, the blisters will become crusty and start to flake off. Healing time is anywhere between one and two weeks." (3)
Some sources say that we should give people a 14-day supply of steroid pills to take when they have a rash bad enough!
The OIL from the plants is the ONLY way the rash can spread! A rash may appear on your hands and arms the day after you contact the plants...or 5 days later... It doesn't mean you were re-exposed or that you are contagious... it's just a delayed show. If you have the rash over many or large parts of your body - topical steroids ain't gonna cut it. You need a shot of steroids and/or pills.
The only reason you would need an antibiotic is if the rash or blisters became infected.
If you are working outside in plants and bushes and trees - wear gloves and long sleeves. A face covering, long pants. Take them off when you are done working and wash them right away, and make sure you shower thoroughly!
So to summarize, all 3 plants contain urushiol. So it doesnnnnn'ttttt matter which one you have or what your rash pattern looks like. For me, as an urgent care provider, the treatment plan does not change. You will have to do your mental gymnastics at home. Google away.
Like a class picture: Left to Right: Ivy, Oak, and Sumac. And y'all already know somebody named their babies that out there.
And with that... I'ma see myself out...
I am SO HAPPY to be back :)
(2) Images: https://www.aad.org/public/everyday-care/itchy-skin/poison-ivy/plants-that-make-you-itch