Quimper Family Telemedicine

Quimper Family Medicine is open and half or more visits have gone to telemedicine.

People are staying home, and hooray for that, many thanks to everyone who is trying to protect themselves and others. We have seen our patient numbers drop by more than half. We have intensified cleaning and discuss whether a clinic visit needs to be in person or can be via telemedicine. I am using VSee, Zoom and in a pinch, Messenger. At the same time I am still seeing some patients in person. We are extending refills, putting off labs, trying to walk the tricky balance of sharing decisions for each particular person.

Many thanks to everyone who is working with us. I am deeply thankful for all the people who are staying home and also for the people working in the grocery stores, supplies, garbage, electricity and medicine. Thanks to the Health Department and to the University of Washington lab and to Jefferson Healthcare’s Covid-19 testing. Thanks for the stimulus package that just passed and I hope will help everyone.

The photograph is Mount Baker on a hike with my daughter. It’s not in sharp focus, just like what will happen in the next week or two is not in focus.

Be careful out there.

blue gate in sun

For Norm2.0’s Thursday doors.

We are having a week of gorgeous sunny weather, where the waiting plants explode into bud and bloom. The sun and shadows are amazing after lowered clouds and soft coolness right above us. Bright contrast with the color and shadows on this gate and everything else!

I took this last weekend. This time I am shaking influenza quickly, hooray.

Influenza: check your pulse!

This year influenza is bad. My key test in influenza is not a chest x-ray. It is taking a resting pulse and a walking pulse.

Why? Influenza can cause a walking pneumonia. Walking pneumonia is where the lungs are infected throughout and there is tissue swelling. It is different from a lobar pneumonia. In lobar pneumonia people run a higher fever, look sicker, and on the chest x-ray, that part of the lung is white: infection, not air.

In walking pneumonia, the chest x-ray may be read as normal. This is because all the lung tissue is equally swollen. The swelling means that there is less air space. The person may feel ok at rest. They feel exhausted when they walk because the heart must take up the slack for the missing air space, the swollen lungs. At rest this week one person’s heart rate is 84. After walking it is 124. Normal is 60-100, so 124 is like running a marathon: exhausting and hard on your heart and body.

I have patients saying “I was sick two weeks ago and I am still exhausted.” If their pulse is much over 100 after they walk, they cannot work until it comes down. If they work and wear themselves out, the lungs can’t heal. The treatment is rest. If they are at work with a pulse of 114 or 124, then they risk getting a secondary infection in already damaged lungs. They could die.

Check your pulse at home. Count the number of heartbeats in 60 seconds. That is your pulse. Walk around, sit down, and check again. That is the walking pulse. Over 100 is not normal.

This is a bad influenza. The tamiflu (oseltamivir) helps but works best in the first three days of flu. Check your pulse, be seen, rest and get well.

http://www.peninsuladailynews.com/news/three-die-of-flu-on-peninsula-public-helath-officals-say-a-fourth-death-said-to-have-been-in-seattle/

many flags

For the Ragtag Daily Prompt: language.

I spent three days with the Rotary President Elect Training this past weekend. I am part of District 5020, which stretches from the end of Vancouver Island, BC, Canada down the Olympic Peninsula, WA, United States. There were people from ten districts.

The Rotary’s Polio Plus program is working hard to eradicate polio. This year the match from the Gates Foundation will be 2 dollars for every dollar the Rotary brings to end polio.

The flags from all the different countries and people working together: that speaks the language of peace and hope to me.

cracks

For the Ragtag Daily Prompt: fault.

I realized last night that I had not put up the prompt, and got back up to do it. My daughter called while I was thinking and told me about segmentation faults. I wrote the poem this morning.

cracks

people talk about me

whisper gossip
social skills aren’t right

they only see now

I had to grow in cracks
hold on tightly
find nourishment where I could
not fall
survive

if they could see my roots
if they could see
where I had to grow
no choice

maybe they would be kinder

needle and thread

For the Ragtag Daily Prompt: needle.

The Great Port Townsend Kinetic Sculpture Race takes place every fall. The costumes and the sculptures, human powered, on land, in the water, through mud, are amazing and fabulous. I think the racers are mechanics, seamstresses, engineers, divinely silly, skilled in wheels, gears, needle and thread, glitter glue, duct tape and teddy bear placement. The costumes are amazing and the mobile sculpture transports are even more amazing.

PETS

Not pets, right? PETS here stands for President Elect Training Seminar. We are gathered to meet each other, exchange ideas and prepare for a year as president of our local club. Yesterday the president elect for Rotary International spoke to us, amazing. We also had a flag ceremony with the flags you see, from nearly 200 countries. How amazing!

new again

I get to start again

I have always seen the monsters under the bed
I have to
to survive

you don’t tell people about their monsters

I learn that early

they get angry hit punish send away
and anyhow they leave you even if they love you

when I am alone
we play
the monsters and I

they are so happy to be seen

they cry often
why doesn’t he love me?
why won’t she hold me?
why does he throw me out?
why?

I hold them
dry their tears
cuddle them
wrap them warmly

they cheer up
and play

they never forget
they alert
their person is near
they rush back

sometimes one rejected
returns with seven friends
hoping to storm the person

that doesn’t work

the monsters never lose hope
never

sometimes I see
a person see their monster
let it be conscious
the person is grown enough
to love

I am so used to the monsters
I work with them in clinic
visit after visit
the monsters weeping on my lap
while the person refuses refuses refuses
and sometimes a crack opens
like a portal light blinding
and the monster
is loved

that’s why I am here
what makes it worth staying
Beloved

now I think
I am new again
it’s hard to date
when the monsters are yanking at my skirt
crying howling distracting
and I am hopeful
but it is not my role
it’s not ok
it’s antisocial
to ask about the monsters

I am new again
I won’t date anyone with monsters
that I can see

they must love them first