The after-lunch crew at the health office was pretty slim. I gave out my scheduled meds and then had a look at two campers. One had a blister on his great toe and the other had a rash.

I tackled the blister dude first. Adam, a cord hut camper, had a seat in my office as he told me his story. 

“My mum got me some new gym shoes and I figured camp was a great place to break in a pair of shoes, right?”

That’s debatable. Camp for sure is a great place to bring those shoes that are close to being tossed. That way you have no regrets when you get home and don’t have the energy to chisel off the caked on mud and simply end up trashing them. 

“They don’t fit quite right and I noticed a blister on my big toe, so I used some duct tape from arts and crafts to cover it.”

That was my first inkling that it could be bad.

“But now it’s kinda hurting and it looks funny.”

Second inkling that it could be bad.

The first thing I noticed was that Adam’s shoes were wet. The other thing I noticed, as he began to pull off his right sock, was what I thought was a tanned leg, was actually dirt and dust. A little disturbing. Adam then proceeded to remove his sock and his pale white foot came into view. It reminded me a lot of the pictures of immersion foot/trench foot that I had seen in textbooks. Adam had wrapped a full width of duct tape around his big toe and folded over the extras across the top. I carefully pulled off the duct tape to reveal a very pale, wet, macerated, pruney-looking toe. The roof of the blister was stuck to the duct tape. The smell was, um…unpleasant shall we say? But it was likely more the fetid smell of wet dirty socks and not that of infection. The blistered area actually looked pretty clean and there was no redness. Not too bad at all. Definitely could have been waaaaay worse. I pulled out the foot soak bowl, added a big dollop of hand soap, put some water in and sloshed it up to create some suds.

This is the least scariest picture I could find. You’re welcome!		http://blog.workforcetraining.isu.edu

“Adam, why are your shoes so wet?” I asked as I grabbed some paper towels and sat on the footstool in front of him.

“Well two days ago at kayaking class my shoes and socks fell into the lake. Then I left them outside to dry overnight but we had a little rain through the night, so that didn’t help.”

I remembered hearing raindrops briefly that night and I had noticed all the items on the laundry line behind the kitchen dripping.

“Do you have another pair of shoes here?” I dipped the paper towel into the soapy water and gently washed the area.

“Ya. I have some sandals.”

“Perfect. I want to you lay these socks and running shoes out in your hut to dry. It will probably take a day or two. In the meantime, wear your sandals. I will give you some band aids to put over the blister if you think it will get dirty, but take the band aid off when you go to bed, so it can dry out. OK?”

“But I was wearing the socks and shoes so that it wouldn’t get infected.” Adam explained as I gently patted his foot dry.

“Well, your feet need to dry out now. Infections need warm, dark, moist places to grow. With your dirty wet shoes and socks on, you are giving germs a perfect home. So, we are gonna dry this toe out in the sunshine and keep it as clean as we can at camp. Oh and clean it three times a day with some soap and water in the bathroom. By the way, when does the cord hut get to have showers?”

“Tonight.”

“Great.” I said as I stood up and put the foot bath into the sink and gave my hands a good scrub.

“What about when I go into the water. Should I leave a band aid on it?” Adam asked.

“Nah. Leave the band aid off. You don’t want the toe all soggy again,” I grabbed four band aids and gave them to Adam. He thanked me and left with his left shoe on and the hobbling on the heel of the right foot.

Next up was the rash. Jack, a deer hut camper, stepped into my office. Just a note here. I. Hate. Rashes. A dermatologist I was not. I have found out since then that many physicians feel the same way. If it was nothing as dramatic as measles or ringworm or chicken pox or Steven Johnson syndrome, well…I was probably not gonna be of much help.

“Tell me about this rash, Jack.” I asked as I leaned up against the sink. Jack pulled up his tank top and exposed his chest. I took a step closer to have a good look. 

“I noticed it in swimming class today. Muddy didn’t know what it was so he told me to come and see you.” Jack said as he peered down at his chest.

Sure enough there were about two dozen spots across his chest. It was technically a macular rash, meaning small flat red spots. A couple of the spots looked a little raised. 

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“Does it itch or hurt?”

“Nope,” said Jack as he shook his head back and forth. 

“Is it anywhere else?” 

“Nope,” said Jack as he shook his head again and then did a turn for me so I could see that it was only on his chest.

“Are you using a new sunscreen?”

“Nope,” with his little head going again.

“Did your mum start to use a new detergent to clean your clothes at home?”

“Nope,” head shake. OMG this little guy was as cute as a bug’s ear. 

“Well Jack, what you have there is a macular rash. It doesn’t seem to be bothering you, so we are just gonna keep our eyes on it. OK?” Jack, still holding his shirt up, nodded his head. 

“Come back to me tomorrow after lunch so I can see if it is better or worse. OK?” Jack nodded again.

“But come back to me sooner if you or your counselors are worried about it, or if it gets itchy. OK?” Jack nodded as I pull down his tank top.

Jack stepped out of my office and I watched him leave. Muddy, waiting for him in the hallway, got up to accompany him back to the hut. I gave Muddy a wink and he smiled back at me.

“Thanks Anne. All ready Jack?” 

“Yup!” said Jack as he gave Muddy a high five. “I have to come back tomorrow after lunch.”

“Oh is that right. I will have to remember that. What did Anne say about your rash?” I heard Muddy asking as they started down the stairs.

“She said I have a Mackerel rash,” Jack responded matter-of-factually. I stifled a giggle.

“Oh and what is that from?”

“I dunno. From a Mackerel fish maybe?”

“That totally makes sense,” I heard Muddy say nonchalantly as they disappeared down the stairs.

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