Okay, not entirely since my back still sucks, but still... I've gotten my lazy brain wrapped around hosting this shindig for a good go-'round. How are you all this week?
It's been a weird few weeks. Well, to be fair, it's been a weird few months, but for the purposes of the here and now, WEEKS. Brexit googling, Scotland succession, and the Donald re-establishing that Americans can still win the "who can look more ridiculous" contest. The best episode of anything ever in existence came on HBO last Sunday at 9 pm, and the memes that resulted were actually disappointing. (Except for one of a pile of dog poo alluding to a character returning in season 7.) I got a mosquito bite on the bottom of my foot. (Might be the worst spot ever.) What have I learned???
Well...
Boy Child got Rocky Mountain Spotted Fever (RMSF).
A pediatric hospitalist made me realize that if I ever travel outside my geographic area and provide care to patients, I should learn the epidemiological trends of that area.
Never, EVER ignore petechiae on the feet. It is relevant to the differential, especially on a child.
RMSF is reportable to the CDC, and from 2000-2010, there were 2,000 total cases reported per year.
The typical presentation of RMSF is fever, then rash, with a recent tick bite (1-2 weeks prior). The rash will be flat, pink spots, and sometimes blanchable. It will begin in limbs and move toward the trunk. Later in rash development, petechiae will appear on the hands, feet and ankles. If the petechial rash develops, it's typically several days (up to a week) after fever onset.
RMSF attacks vital organs, including the heart and brain. Boy Child's first BAM! symptom was syncope. I did't see the petechiae on his feet until we were at the hospital. There, we also noted sinus tachycardia and alterations in mental status.
Unfortunately, not everyone gets the rash.
In the 1940s, around 28% of those who contracted RMSF died. In the 2010 data, 0.5%. (Doxy is a helluva drug!)
In other news...
Post op after spinal fusion requires more patience and endurance than I think I have.
I don't know how to make my pool water clear.
The sun burns shock off a small pool way too quickly.
I miss work, but I don't know if I'm actually recovered enough to go back.
Littlefinger is still a creepy *****.
If AN ever decides to censor ***, ******, *****, or *****, I will be a sad, sad ixchel.
I added the link at the bottom of this days ago and can't remember what it is. We'll be learning this together.
