#55- when is an STI and STI?

#55 – When is an STI an STI?

It intrigues me when a person comes in with one problem but leaves with another.  Some years ago a former mentor of mine suggested that when a young bloke presents to a clinic with an insignificant ailment, start digging and you will find the real reason for his presentation.  Well I have spent too many years as a jaded, and at times burnt out ED nurse to really have time to bother with halfwits that want to waste my time by not getting to the point of their consult; that is , until I started to work in remote practice.

The pace is slower.  The world up here is not ruled by the clock like it is down south.  So One of the good things is that as a clinician I can take my time developing a rapport, and getting to thoroughly assess someone before rushing them out the door.  Today a prefect example took place.  A young man in his early 20s presented with an “old football injury”.  I asked all the relevant questions, and assessed what was just a mildly painful soft tissue injury, what we call an STI.  I suggested he could take some panadol or nurofen for his pain, but he declined.  I was puzzled.  First he comes to me for help.  Next he is refusing to take the advice I give.  Then it dawns on me that there was something not right with this picture.  Young fit healthy men don’t take themselves to the doctor until there is something seriously wrong!!

I shut the door to the consult room, and leaned in close and asked him. “is everything ok with your privates mate?”  The look of relief on his face was all the answer I needed.

He started with a story about not being able to pee well.  “No Uncle, it prapa hurts wen I go pisspiss”.  “Ah ha! “…like pissing razor blades”? I asked, and he raised his eyebrows which is Torres gesture for “Yes!”

“Any thing else  Bala” I enquired, and he raised his eyebrows again.  “Waa Uncle, I gad dis sores, and some pus, on there.”  I told him that I needed to have a look at his “there”.  The sight that awaited me was enough to make me wince.  The poor bugger!

This young bull, had sores , and discharge and a whole farm of sexually transmissible infections (what we call STI), and he told me that he had been having symptoms for over a month.  The good news that I gave him was that most of the treatment for STIs are a single oral dose of strong antibiotics, and in some cases a needle.  That is it.  Done.

I ran some pathology samples (urine test, blood test) and swabs, and he was on his way, brown paper bag full of condoms and lube tucked under his arm, with out the limp that he came in with.  So was his presentation an STI, or an STI??  Ill let you be the judge of that.

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Blister packs are packets of pills.  Usually packed for ease and convenience by the pharmacist, a blister pack has the week divided into Monday – Sunday rows of medications separated by ‘breakfast-lunch-dinner-bedtime’ columns.  Many of our elders in the community are on Blister pack, which change from time to time.  We supply them through our clinic, in batches of 2 weeks lots, and use the consult as an opportunity to catch the person for a Blood pressure check, or blood sugar level check when they come up for a refill.  Occasionally after doctors clinic, the meds are changed, and new blister packs need to be issued, dispensed via TI pharmacy, and then supplied to the patient.   Today I did 8 home visits to distribute blister packs.  Going into the homes of the community members really gives me an insight of how these folk live.  In the yards of two people I visited today, the family was butchering freshly killed Turtle.  These magnificent animals are part of the traditional diet of Torres Strait islanders, and to see them out in the open air, with dogs and flies hanging around, and sunlight bearing down, was a little stomach churning.  One home had a huge open wood fire boiling chunks of turtle meat in a concoction of onions, celery, and herbs.  The meat is red like venison or beef, and the fat is green like the colour of a lime.  I casually asked some questions and handed over the medications, and was on my way. 

Later this afternoon, while fishing on the jetty, my oncall phone rang, and it was a mn from one of the families, asking if I could stop at their house on the way home to the clinic.  Curious I finished my bait, and wandered home via the main road.  As I approached the house, I could hear laughter, and music.  I could smell an unusual aroma coming from the fire pit.  One of the young blokes came over to see me with a plastic bag in hand.  He held out the bag, and says, “ good afternoon Uncle, we have some Totol (turtle) meat for you”.  I was honoured, and a little repulsed, but very touched.  I asked how to cook it and was amused to hear that they often cook it with flour, curry powder and soy sauce.  It amused me that such a traditional meat is cooked with flavours that are more at home in a Caucasian kitchen.

Following his advice, I came home and cooked my totol, and am thrilled to say that once I got my head around eating something that was not normally something that I would have associated as food, it was delicious.  I have enough for another meal, so am looking forward to having a crack at using it in one of my own curry recipes.

Well that is it for this post.  Two more days on Yam, and I will be home with my mob, packing for their adventure of a lifetime.  I cant wait.

If you are a bloke reading this.  Do your lady (or man) a favour. Go get a confidential check up with your health clinic or GP.  You don’t need to know why you are there.  Just tell the doc, you haven’t had a Grease and Oil change, or pressures checked for a while…and your health care professional will know what to do from there.

Don’t leave it until your exhaust pipe has almost fallen off!!!