To the 4th week I was on call.Even before my first night on call it was much busier mainly because of a lot of admissions from the North West.I started Monday with 30 patients of which 14 were new.many complicated.But I had a great team.I was allocated a second registrar and intern.Even so the round finished at 1730.
What stood out about this week was seeing the effects of lock down.Of those 14 new admissions 2 were due to worsening of chronic liver disease due to increased alcohol intake.One was alcoholic hepatitis,one overdose.
And 2 sad cases.both older women.One with a history of mental illness who had a great network of friends who visited her regularly.that stopped so she was found in the street Sunday morning having gone out,didn't know where she was and nearly succumbed with hypothermia.
The second was a woman who lived alone.normally visited regularly by family and Community Nurses.Community nursing has had to reduce the frequency of visits and family didn't want to put her at risk.Unfortunately a fall soon after daughter left and 48 hours on the floor suffering rhabdomyolysis with acute kidney failure.She did survive but will have a long stay in Rehab.
And 2 older fellows with known mental illness who took to the drink and went off their meds.
We are paying a big but virtually silent price for these restrictions.
Now it wasn't all work.I was able to drop into the Pinot Shop in Paterson Street Launceston near the Penny Royal Inn.Not just pinots but a varietal I enjoy-Dornfelder.I also was able to pick up a Tassie pinot I really like-Sailor Seeks Horse.
.
.
.
.
I also dropped in to a local Deli-Alps and Amici.Picked up some nice Tassie bacon plus a tassie curry and some fresh Miso made here in Launceston.
.
.
It does add some extra to scrambled eggs.
Sunday was my first visit to an Orange Zone patient.Meant to be symptomatic and very suggestive of Covid.So my first time totally dressed up in PPE.Face shield and all.However I had read the notes and I was confident she was in the wrong zone.She was also the only patient in the ED Orange zone.Basically she had been sent in from the North West as she was not coping at home.She had told the ED staff she had a cough,sore throat and breathless.But there was no evidence of having denied any symptom she was asked about.So I demonstrated my superior history taking by asking 2 questions.
Do you have severe pain in your big toes? Yes.
Did you have a bottle of champagne for breakfast today? Yes.However she had come in late the day before.
Despite being busy I enjoyed my week.