|
|
Opening Hours : Monday to Friday - 8:00 A.M. - 5:00 P.M.
Contact : +1 868 221-3983 
Opening Hours : Monday to Friday - 8:00 A.M. - 5:00 P.M.
Contact : +1 868 221-3983
|
|
Did you know that we do minor surgery?
If you have a lump or bump that you want removed, we can do a minor procedure under local anaesthetic, right here in our new treatment room.
We also remove ingrown toenails, abscesses and do cyst and comedone extractions too!
Have a pesky wart or verruca or skin tag that won’t go? We can freeze it off with Liquid Nitrogen, in a procedure called Cryosurgery that involves no cutting! If you are interested, you can watch a video of it being done by Dr Ames here: https://www.youtube.com/watch?v=VOKdjNiKOy8
So, you had a cough and cold and you were worried about COVID….but you went and got a rapid test and its negative so all is good right? Wrong!
No test is perfect and this is to help you understand some pitfalls of Covid testing.
Let’s start with the rapid “blood” test. This is looking for antibodies to the virus, and not directly for the virus itself.
When we get the virus for the first time, it may take a while for our immune system to mount a response and produce antibodies.
If the test is done too soon, for example before symptoms start, or even in the first 2 weeks after getting it when you may even have symptoms, it may read negative when you are in facet positive, a so called “False negative”! Then you might be falsely reassured and unwittingly go round infecting others.
So, an antibody test MAY be useful after your symptoms have passed, and if you never managed to get the proper “throat swab” PCR test and you are wondering if in fact it was COVID you had!
What if you wait, do the antibody test more than two weeks after your symptoms started and you have antibodies? Does that mean you are now “immune” to COVID?
Er, we are still not so sure. It seems that antibody levels wane after 3 months or so, so we are not sure how long that immunity may last…. this is also complicated by the fact that there are different strains of COVID and it may be that the virus mutates very so often, just like the Flu, so your immunity may be short lived!
On top of this, some people can fight of the virus with a different part of the immune system that doesn’t use antibodies. So you might actually have fought off the virus successfully, and may even have immunity that we can’t measure on the test, but then have no antibodies.
Confusing right?
What about the “swab” or fancy RT-PCR test?
The swab tests for actual virus particles in the nose/throat. It is not 100% either! No test is I am afraid. The swab is most accurate if done days 3-5 of symptoms. If done in asymptomatic people right after exposure, it may be too early to get a positive result. Similarly, if taken very late in the illness like day 10, the chance of picking up the virus starts to fall.
It is very specific and moderately sensitive. So, what does that mean? Well, it means that if you get a positive result it is likely to be a true positive, but a negative result is less reliable. So, we tend to believe the positive results, but if a person has a negative test, that doesn’t automatically mean they are truly negative and that they don’t have COVID 19 and are not infectious.
That’s why in very suspicious cases you will see us asking for 2 negative tests. ..That’s because if it looks like a duck, and quacks like a duck and flies like a duck it is probably a duck…especially if it comes from an area where there is known to be a flock of ducks living. (Like say, you shot it in the middle of a swamp) So, if someone plucks a feather from that duck and analyses it and tells you it is not a duck then would you believe them?
Similarly, if a person has been exposed to someone with COVID 19, and they then develop the classic fever cough, anosmia etc, OR we know that we are in the middle of a Pandemic or local spike and someone gets a cough and cold, we have a high suspicion of COVID and just one negative test is not going to reassure us.
To complicate things, we will shortly be going into the “Flu Season” and it’s hard to tell the difference clinically between the Influenza virus and COVID 19! But that’s for a whole other discussion.
In short, please don’t just take yourself off for a test without consulting a health professional who is up to date with testing and timing and symptoms. The test may not mean what you think it does, and you may even need a completely different test!
|
||
|
Good News! We can isolate at home if we have COVID -19! No need to go into hospital if we are well enough to stay home.
I know this is a huge relief to all of you right? Everyone wants to be in their own bed if they are feeling under the weather!
So what do you do if you think you have COVID 19?
First of all don’t panic! The main symptoms are:
Sometimes:
Sneezing is not normally a major feature but can be present.
If you have any of these
1.Do not go out
2.Isolate yourself from your family and household (see our Instagram page for a leaflet on how to do this
3.Seek Medical advice via Telehealth, or a hotline rather than coming in, so you do not infected others. If you are extremely unwell with shortness of breath, for example, and you believe you need emergency help then proceed directly to your nearest public health facility. You can call me to find out where to go if you are unsure.
If I think you need testing I can either refer you privately for accredited PCR testing or send you to be tested via the Public health.
I can also arrange a sick note or quarantine note.
If you are well enough to stay home, you can stay home with Pandol, Fluids etc. People with underlying illnesses like Diabetes, Lung, Heart or Kidney disease should have individualized advice
You will need to stay at home from 14 days from the start of your symptoms.
4.Make a list of all those you have had CLOSE contact with. A CLOSE contact is defined as less than 6ft for 10 minutes or more. It is not someone you passed casually in the corridor at work.
What to do if you have been exposed to someone with known or suspected COVID 19: Remember exposure is defined as less than 6ft for 10 minutes or more, as above…
Any questions or suggestions for further leaflets let me know!
1. Be on time..to maximize the most of your appointment
2. You must have a device with internet connection, a mike and camera.
3. Have a Private space – remember this is a medical consultation. You want it to be confidential. Ideally lock the door and turn off phone ringers to minimize interruptions
4. Consider letting family/work colleagues know that you are in a virtual appointment to avoid interruptions. If you are in an open plan office consider going to your car.
5. Have your photographic ID ready so that we can identify you.
6. If you have insurance please have your Insurance Card ready if applicable.
7. Have a list of questions you want to ask and important points you wish to make
8. Have your medications or at list a list with dosages to hand
9. Have any relevant Test results to hand
10. Think about your clothing: If the lesion you wish to discuss is on your leg, consider wearing shorts…if on the arm, wear a tank top etc.
11. If you have any medical equipment like a Blood pressure machine, thermometer, blood glucose testing kit have these to hand as they can provide the doctor with additional information.
Advancement in technology has made Telehealth and medical video consultation a reality. Learn more about what is Telehealth and its benefits . Telehealth and Telemedicine services are especially useful for patients who are housebound or are unable to show up at the doctor’s clinic due to time constraints. Follow the tips above in your next virtual medical appointment to make the most of your time.
What is Telehealth?
It a way for doctors and patients to have a consultation and exchange information and advice when they are not in the same place. This can be over telephone, video, email and whats app, using a telephone, smart phone, tablet, laptop or computer.
Is it Secure?
lt is vital that confidentiality is maintained, so here at Ames Medical we use something called a HIPPA compliant system. This is not Whats app/Facetime . It is a medical grade system that is very secure. We never record you.
Isn’t this very New?
Ames Medical was as far as we know, the first video consultation service in T and T and we therefore have 3 years of experience delivering this service. We always knew that it was going to be a big part of the future, so we invested in a fantastic platform, not weeks ago or months ago, but YEARS ago.
Now, during the pandemic, many of you are also just beginning to see the usefulness of Telehealth. – No waiting rooms exposing you to other patient’s illnesses, for example.
But we think, and always did think, that Telehealth has a role to play in the future too.
What Conditions Can you deal with on Medical Video Consultation
Telehealth will never completely replace a doctor’s visit but it is a useful option for minor ailments, like red eye, UTI, sore throat, medication and results etc. Clink here for a useful video on other things it can be used for :
Conditions appropriate for Telehealth and Telemedicine – by Dr. Alexandra Ames
It is also very convenient – less time in traffic and away from work. No need to leave your comfy PJs and bed if you are feeling under the weather and don’t want to come out.
What Can you really Examine on Video?
There is a saying at Medical School: “The history (or the patient’s story) is 80% of the diagnosis.” The Examination is to confirm what we think.. So much more can be examined on video these days….human ingenuity is an amazing thing. We can barely keep up with all the technology coming out. Just look at the wearable devices you have in your own home that can provide information! Your FIT Bit, Your Blood Pressure machines, your Blood Glucose machines, Apart from that, Video gives us an awful lot of information we can’t see on the telephone. Like, how you are breathing, if you look jaundiced or anaemic; we can see rashes. The camera is so good that we can have a really good look at the back of the throat. Plus, our medical video consultations have always been backed up by the fact that if we both underestimated the situation wrong and during the video call we think we really need to see you face to face to be safe, we will convert your appointment to an in-house one at no extra cost.
How Can I get a Prescription?
We can email prescriptions, sick notes and helpful leaflets and advice.
How do I Pay?
You can pay online via Paypal, Wipay or by direct transfer to Ames Medical Services account. The best bit? Your Insurance company may even cover it! – Many like Sagicor Health are now seeing the benefit of Video consultations to their clients…so ask them.
Wars like this one have always bred culture change, and we think this is one of them. Don’t be afraid of it, we can still bring you down to be seen in office if we need to….and look out for the next blog Tips for a Successful Telehealth Consultation.
|
|
|
My Prescription for Sleep during the lockdown:
It can be tempting to relax our regular sleep routine while in lockdown…especially since we are not going to work, or working from home. .But this lack of, or change in routine can sometimes exacerbate insomnia. Many of us barely know what day it is far less the time! We need to try to maintain our normal sleep rhythms.
Many of us are also not able to exercise as we usually would, and our body is missing those endorphins. This coupled with increased anxiety over this crazy situation we are in, can really affect our sleep…and lets face it, when we can’t sleep…we feel even more anxious and crazy! Think about it: The Japanese used to use sleep deprivation as a form of torture!
As much as possible try to stick to a regular bed time, and still set an alarm for waking up, as well as one for going to sleep
Resist the temptation to nap during the day
Exercise in the morning at home and not after 5pm. Exercising too late in the day can make some people feel “reved up”
Watch out for “workout ” drinks and supplements. Many of them contain Caffeine or taurine or “Green tea extract” or “Coffee bean extract” These all are basically stimulants and can keep you up at night!
Avoid Cigarettes especially before bed. Nicotine is a stimulant.
Try to limit yourself to caffeinated beverages in the morning only, and certainly not after 3pm.
Avoid an alcohol night cap if you are struggling to sleep…alcohol can interrupt our normal sleep patterns
Dinner time is important. Try to eat at least 2-3 hours before bedtime. Going to be too full can increase heartburn which can wake you up at night with pain or a cough. Remember: Breakfast like a King, Lunch like a Prince, and Dinner like a Pauper.
What you eat is also important. Foods high in Tryptophans like Turkey and chicken can help promote good sleep.
Practice good sleep hygiene: Ideally the bedroom should be for sleep and sex only….but if you are forced to stay there because you are in isolation then keep a window open, and leave the curtains open during the day to let natural light in.
If you are in isolation Try to have a desk and comfortable lounge chair in the bedroom so you resist the temptation to spend all day in bed.
At night, limit noise and increase darkness by using black out curtains or an eye mask and ear plugs if you need to.
DO NOT look at any screens like TV, Computer, phone or tablet an hour before bed. The bright light breaks down our natural melatonin.
Have a wind down ritual: A warm shower, doing a crossword or planning what you are going to do/wear the next day can help your brain understand it’s time for bed.
Sometimes medical conditions like depression, anxiety, pain, hot flushes and night sweats and restless leg syndrome can interfere with our ability to fall asleep. If you think you may be experiencing any of these, talk to your Doctor. Further updates will give more information on medical conditions which can affect your sleep.
Certain medications like Steroids and Diuretics are best taken in the morning to avoid interfering with sleep. Another common problem is Migraine tablets or “Multi symptom day tablets” – These sometimes contain caffeine. If they do, try to use these only during the day or use some without caffeine if this affects you. The common decongestant “Phenylephedrine” can also make children and some adults feel “hyper”
If you are still struggling try two Camomile tea bags in hot water and allow to draw for six minutes. You can add honey to this if you are not Diabetic. Camomile actually works on the same receptors int he brain as sleeping tablets!
You can also try 5mg of Melatonin, available over the counter, an hour before bed. This has been shown to be even more effective if you are over the age of 55.
Look out for my next update which will be on how to deal with waking up at night.
Night Night and Sleep Tight!
