Post-shift topic: Biggest Pet-Peeve
General Notes/Announcements
We need a CSC replacement.
Scott is looking for someone to work in Belize as an interviewer (contact him if interested)
Discussion concerning turning the phones on. Much of the
Everything needs to be in the blue binder after shift, otherwise it will remain in the clinic.
Hep-TEV has access to the medical section database in case we need information from the database.
In a couple weeks, we will be short on support staff, recruit your friends.
Steve
28yo MSW
Man came in CC scabies. Itching in armpits and groin but nothing in webbing. Sx tend to get worse at night. Lives with others in a car, but no other people have scabies. Did not give them medication because it is an insecticide and cost component. Hydrocortisone cream given after Dr. Fred saw the client and it was less likely that the cause was scabies.
50yo MSM
Syphilis follow-up
25yo MSW
Penile warts. He did not want syphilis drawn. The problem was that our protocol is that when we Dx warts, we need to draw blood for syphilis. He came in to see Med Sx in Sept and RPR was non-reactive.
44yo MSM
Here for wart treatment from Denmark. He had been treated years ago with histofreeze and while shaving, he noticed a couple bumps. Looking closer, it seemed like folliculitis and scar tissue. Dr. Fred took a look and said that because of his Hx of warts, we should treat them. During treatment, noticed that 2 of them had hair follicles.
Evan
22 MSW
Seen last March. Dx then with normal anomaly. Did not seem like warts but larger than zits. Dr. Fred said that it was molluscum. Dimple became apparent during TCA treatment. Felt bad with previous incorrect Dx as a non-contagious.
24 MSW
Previous had warts. Tx Liquid N2. Had warts since last May. Had long pubic hair. Normally tell them do not shave to show us. He was glad we told him not to see.
Sam
31 MSW
Came in saying exposed to CT 2 months ago (untreated) as well as Trich (treated). Many F partners, no condom use. Throbbing pain in testicles (may be a result of untreated CT). Lab results +, Dx with NSU.
33 MSW
Came in thinking he had herpes. Itchy and burning. Tiny bumps everywhere under foreskin. Skin shiny and reddish, more like a fungal infection. Given clotrimazole. Reminded him not to wash too often.
Anton
23 MSW
First seen at clinic 5/2011 for genital warts. This would have been his 10th visit. He was told by medic on his 9th visit that he could no longer seen at the clinic. Given TCA. Took syphilis draw.
Discussion
Jason: I thought our policy was that we didn't see people any longer after their 10th visit because treatment has been ineffective. Steve: No, after the 10th visit, we should reevaluate them after the 10th visit, but they should still be able to be seen.
22 MSW
Discharge had WBC and no GNIDS. Dr. Fred said we should treat for NSU (should be NGU). He has unprotected sex with women. Last time he took an antibiotic, he got a rash. Consulted with Barry and he said that doxy is unlikely to cause a rash but if it does, benedryl should take care of it.
Jason
45yo MSW
Went to Lifelong 1 year ago for derm issue and they told him it was molluscum. He later came here because the issue did not resolve and we told him it was a fungal infection. We told him to use a mixture of vinegar and corn starch (?).
27yo MSM
Condom broke during sex and used another ribbed condom. There was an uneasiness including pain during showers. He used neosporin and antii-hemorrhoidal cream. We could not find anything and Dr. Fred said it could have been a resolved external thromboidal hemorrhoid cream.
50yo MSW
IVDU during 20s and 30s. Consulted with Hep-TEV who he had seen before and they gave him his results.
Total # Seen: 36 clients (including steamworks and 1 left without being seen)