This Christmas break has highlighted to what extent some people will go to fulfill the need to travel.
Examples of note
A 60-year old man leaves home with the hint of an impending UTI. Pre-emptively he started a course of antibiotics from a repeat left over from a previous successfully treated UTI. He travels across Australia gradually getting worse such that he stops for advise at a mainland country hospital. There he is given the diagnosis of pyelonephritis treated with oral antibiotics and analgesia. I am not certain what my colleague was thinking but the man continued on his way to KI. Vomiting can be expected on the ferry but not fever and vomiting along the highway even before Cape Jervois. Shortly after arriving on KI he presented to the local hospital quite unwell, febrile, tachycardic and dehydrated with marked left abdominal pain. My working diagnosis was diverticulitis and I admitted him, hoping that he would settle with IV antibiotics and not requiring a journey with the flying doctor to Adelaide.
A 50 something year old man arrives to check his warfarin dose. Two days earlier his implanted defibrillator has fired off, not once, twice but three times. Felt like a horse kicked me in the chest her explained. Oh he went to hospital and got cleared to continue travel. He was restarted on amiodarone and ask to check his INR given the interaction. The local doctor did have a conversation with his cardiologist. Good and did he think it was a good idea to continue to travel to a remote (but stunningly beautiful :- ) part of Australia? Sure he said. The look on his wife’s face suggested maybe subtly different advise.
A family of four had booked a Christmas holiday on KI to spend time with his cousins including a new born baby. A two year who developed a red rash, fever and stopped eating was not enough to deter the holiday. Thankfully a viral exanthem rather than meningitis. A few days latter the local family brought in one of the children with something similar. Thanks for the Christmas present.
I wont tell you how many times I have had to write prescriptions for people who travel with their medication still in the bathroom cupboard back at home.
No we don’t have a CT, MRI or half reasonable ultrasound machine here.
Apart from an istat, bloods and other pathology get sent to Adelaide once day and we get the results the next day.
Oh and we drive on the left…….