Medical Information

As mentioned before, it is critical that all family members pass the Overseas Screening (OSS). Please be advised that medical care on Kauai is VERY basic! If you have any type of medical specialist- based needs, plan ahead! You will want to become VERY familiar with what Tricare covers and what they do not! Tricare will cover your medical travel expenses should you need to fly to another island for medical care (and many people do!) Doctor referals and the correct paperwork will be needed to qualify for Tricare funds. Contact PMRF ADMIN in Building 275 (behind Subway) at (808) 335-4446 for paperwork information. For more information, or to download a Tricare Prime Remote West Region application, please visit the following websites:

Tricare
http://www.tricare.mil

Military.com
http://www.military.com/benefits/tricare/tricare-prime/tricare-prime-remote-overview


Prescriptions
Also, please be advised that because there are no Military Treatment Facilities on island, you will be responsible for co-payments for your prescriptions. The following are the pharmacies located nearest to the base:

Pharmacies
Menehune Pharmacy, Waimea………………………………………(808) 338-0200
Longs Pharmacy, Eleele………………………………………………(808) 335-0700
Kalaheo Pharmacy………………………………………………………(808) 332-7660
Costco Pharmacy, Lihue………………………………………………(808)241-4000
Westside Pharmacy………………………………………………………(808)335-5342

Hospitals
Kauai Veterans Memorial Hospital, Waimea………………(808) 338-9431
Wilcox Memorial Hospital, Lihue…………………………………(808) 245-1100
West Kauai Medical Center, Waimea………………………………(808) 338-9431
Poison Control Center……………………………………………………800-222-1222






Common Hawaiian Medical Issues
The following medical issues may be encountered during your time here. These are the most common issues we PMRF spouses have had to deal with. Descriptions are retrieved from www.webmd.com.

Lice/Ukus:
What causes a lice infestation?
Lice spread easily from one person to another through close contact or through shared clothing or personal items (such as hats or hairbrushes). A louse cannot jump or fly.
What are the symptoms?
The most common symptom of lice is itching There are different symptoms, depending on which type of lice you have.
• Head lice may not cause any symptoms at first. Itching on the scalp may start weeks or even months after lice have started to spread. Scratching can make the skin raw. The raw skin may ooze clear fluid or crust over, and it may get infected.
• Pubic lice cause severe itching. Their bites may cause small marks that look like bruises on the torso, thighs, or upper arms. If pubic lice get on the eyelashes, the edges of the eyelids may be crusted. You may see lice and their eggs at the base of the eyelashes.
• Body lice cause very bad itching, especially at night. Itchy sores appear in the armpits and on the waist, torso, and other areas where the seams of clothes press against the skin. The lice and eggs may be found in the seams of the person's clothing but are generally not seen on the skin.
Frequent scratching can cause a skin infection. In the most severe cases of head lice, hair may fall out, and the skin may get darker in the areas infested with lice.
How is a lice infestation diagnosed?
A doctor can usually tell if you have lice by looking closely for live lice or eggs in your hair. He or she may look at the lice or eggs under a microscope to be sure.
Your doctor can also find pubic lice and body lice by looking closely at your body or your clothing.
How is it treated?
The most common treatment is an over-the-counter or prescription cream, lotion, or shampoo. You put it on the skin or scalp to kill the lice and eggs. In some cases, you may need treatment a second time to make sure that all the eggs are dead. If two or more treatments don't work, your doctor may prescribe a pill called ivermectin.


Molluscum:
Molluscum contagiosum is a viral skin infection that causes either single or multiple raised, pearl-like bumps (papules) on the skin.
Molluscum contagiosum is a chronic infection and lesions may persist from a few months to a few years. However, most cases resolve in six to nine months.
Causes of Molluscum Contagiosum
Molluscum contagiosum is caused by a virus (the molluscum contagiosum virus) that is part of the pox virus family. The virus is contagious through direct contact and is more common in children. However, the virus also can be spread by sexual contact and can occur in people with compromised immune systems. Molluscum contagiosum can spread on a single individual through scratching and rubbing.
What Are the Symptoms of Molluscum Contagiosum?
Common locations for the papules are on the face, trunk, and limbs of children and on the genitals, abdomens, and inner thighs of adults. The condition usually results in papules that:
• Are generally painless, but can itch
• Are small (2 to 5 millimeter diameter)
• Have a dimple in the center
• Are initially firm, dome-shaped, and flesh-colored
• Become softer with time
• May turn red and drain over time
• Have a central core of white, waxy material
Molluscum contagiosum usually disappears spontaneously over a period of months to years in people who have normal immune systems. In people who have AIDS or other conditions that affect the immune system, the lesions associated with molluscum contagiosum can be extensive.
Diagnosing Molluscum Contagiosum
Diagnosis of molluscum contagiosum is based on the distinctive appearance of the lesion. If the diagnosis is in question, a doctor can confirm the diagnosis with a skin biopsy -- the removal of a portion of skin for diagnostic examination). If there is any concern about related health problems, a doctor can check for underlying disorders.
Treatment for Molluscum Contagiosum
The condition is usually self-limited, so treatment is not always necessary. However, individual lesions may be removed by scraping or freezing. Topical medications, such as those used to remove warts, may also be helpful in lesion removal.
Note: The surgical removal of individual lesions may result in scarring.
Prevention of Molluscum Contagiosum
To prevent molluscum contagiosum, follow these tips:
• Avoid direct contact with anyone who has skin lesions.
• Treat underlying eczema in children.
*As a side note, be sure to thoroughly scrub your kids down after playing in inflatable bounce houses and waterslides, as these seem to be breeding grounds for molluscum here in Kauai.

Impetigo:
What Is Impetigo?
Impetigo is a highly contagious bacterial skin infection. It can appear anywhere on the body but usually attacks exposed areas. Children tend to get it on the face, especially around the nose and mouth, and sometimes on the arms or legs. The infected areas appear in plaques ranging from dime to quarter size, starting as tiny blisters that break and expose moist, red skin. After a few days the infected area is covered with a grainy, golden crust that gradually spreads at the edges.
In extreme cases, the infection invades a deeper layer of skin and develops into ecthyma, a deeper form of the disease. Ecthyma forms small, pus-filled bumps with a crust much darker and thicker than that of ordinary impetigo. Ecthyma can be very itchy, and scratching the irritated area spreads the infection quickly. Left untreated, the sores may cause permanent scars and pigment changes.
The gravest potential complication of impetigo is post-streptococcal glomerulonephritis, a severe kidney disease that occurs following a strep infection in less than 1% of cases, mainly in children. The most common cause of impetigo is Staphylococcus aureus. However, another bacteria source is group A streptococcus. These bacteria lurk everywhere. It is easier for a child with an open wound or fresh scratch to contract impetigo. Other skin-related problems, such as eczema, body lice, insect bites, fungal infections, and various forms of dermatitis can make a person susceptible to impetigo.
Most people get this highly infectious disease through physical contact with someone who has it, or from sharing the same clothes, bedding, towels, or other objects. The very nature of childhood, which includes lots of physical contact and large-group activities, makes children the primary victims and carriers of impetigo.

Jellyfish Stings:
Can be present at certain times of year on PMRF beaches. If you are stung, seek medical attention immediately. Meat tenderizer can be applied to aid with the pain.


Allergies: Stock up or refill your allergy prescriptions! Kauai flora and “vog” (volcanic ash and fog) make for some serious Kauai allergy seasons!