Family Medicine Clerkship

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Family Medicine Clerkship

• Brush Family Medicine
• Andrea M. Vitello, MSIII

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• History
• Brush!
• Where I lived
• Medical facility
• Community resources
• Family medicine practice
• Patient presentation
• Questions

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History of Brush!

• Named in honor of Jared L. Brush
• He later served as Lieutenant Governor of
  Colorado
• This area used to be a shipping point on the
  Texas-Montana cattle trail
• 1900 city of Brush! was established
• 1952 town started to grow with the exploration of
  oil and gas south of Brush!
• Agriculture, cattle raising, transportation,
  energy

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Brush!

• Farming community corn, sugar beets, hay,
  wheat, potatoes, onions, pinto beans, alfalfa,
  barley, nursery and greenhouse crops, field
  seeds, grass seeds, turf, and sunflowers

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Where I Lived
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East Morgan County Hospital

• Opened in 1910
• Level IV trauma center
• 25 bed hospital
• Specialty clinic
• Family practice office with 6 practitioners

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Specialty Clinics

• Anti-coagulation (Tele-health)
• Asthma, Allergy Dermatology
• Audiologist
• Cardiology
• ENT
• Neurology
• OB/GYN

• Oncology Hemotology
• Orthopedics
• Podiatry
• Prosthetics Orthotics
• Psychiatry (Tele-health)
• Rheumatology
• Urology
• Wound Clinic (Tele-health)

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Community Resources

• Assisted living facilities/ nursing homes
• Ladies auxiliary for hospital
• Alcoholics Anonymous, Narcotics Anonymous
• Northeast Colorado Diabetes Health Fair
• Diabetes Education Clinic
• Centennial mental health

• SHARE program
• Human services
• Baby Bear Hugs
• Friends of Man
• Family planning
• Volunteer groups
• Independent fitness program
• 9 News Health Fair
• Support groups
• Home health care

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Brush Family Medicine

• Dr. Marc Ringel
• Other healthcare professionals
• Typical patients
• Hypertension
• Dyslipidemia
• Type 2 Diabetes Mellitus
• Workmans compensation
• Geriatrics - Alzheimers
• Depression

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Patient Presentation - B.W.

• HPI 37 yo male with decubites ulcers that are
  currently being cared for in the Tele-Health
  Wound clinic. Pt presented for routine wound
  care but was found to be shaking rigorously and
  had a low blood pressure. He was subsequently
  admitted to East Morgan County Hospital for
  possible sepsis.

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Patient presentation - B.W.

• PMH Paraplegia
• Recurrent UTIs
• Alcoholism
• Generalized seizure disorder
• PSH Multiple decubites ulcers
• Harrington rod placement
• FHx Alcoholism
• Narcolepsy
• Schizophrenia
• MI
• SHx Diet eats intermittently due to poor
  appetite
• Exercise getting around in wheelchair
• Living on disability
• No relatives in town, only friends
• Tobacco, Alcohol, Drug use
• Medications Baclofen, ibuprofen, dilantin,
  oxybutinin

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Patient Presentation - B.W.

• Why I chose this patient
• Chronic disability
• Rarely seeks healthcare
• Poor social support
• No marital support
• Chronic physical illness
• Alcohol and substance abuse
• Family history of psychiatric disorders
• Physical barrier to health care
• Financial difficulty

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Patient Presentation - B.W.

• Community resources
• Alcoholics Anonymous
• Home healthcare services
• Mental health resources
• Tele-health Wound Care Clinic
• 9 Health Fair

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Rural Medicine in Brush!

• Large geriatric community
• Complicated medical problems referred to Greeley
  or Denver
• New Internal Medicine/ Pediatrics physician
• Actively recruiting healthcare professionals

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