Brighter Side of Flood

The rainy season is so IN which is directly proportional to the rain boots fad! Gone were the days when rain boots are for farmers only because now, rain boots come in wide variety of fashionable prints and colors. Perfect for the typhoon-y Philippines. Just last week, typhoon Falcon hit our country causing flood all over the metro. According to a friend, almost everyone at the hospital including interns and residents were wearing colorful rain boots. At least, colors and pretty prints can still be seen submerged in the flood---not just garbage, iwas leptospirosis pa!

My housemate Emily bought a pair that came in girly color pink and it's loaded with awesome cuteness!!! I feel inggit so I'm contemplating of buying a pair for myself. I can imagine wearing this one below walking drenched in the ankle-deep flood along Taft. Hehehehehehe. 

But this one totally looks ABSURD!! Wedding rain boots? Hello!

RIP, Des. :'(

Along with the drizzly morning, my clogged nasal cavity and nonproductive cough came the news of her untimely death. The entire day was gloomy as though the world mourns her passing.

Our friendship started when we became classmates in junior high school, we weren't really that close as we had our respective barkadas but I came to know her better during senior high when we both write for our school gazette. We had our occasional trips to downtown Iligan City to "check on the progress" of the school paper and "do some editing". Those were the days when my parents' strictness was at its peak. To make things more convenient for us, Des would volunteer their house for a sleep over then we'd go back to Marawi early the following day. Just like some common all-girls sleep over, we'd watch movies and talk about stuff. I don't remember the movies anymore but I perfectly remember the arrangement of their house at Del Carmen and her hospitality (aka, she prepares no-pork food for me). Des was one of the sweetest girls in class. When we separated ways in college, she'd really make beso-beso three times just the way Muslims do whenever we saw each other at the university "canopies", she hugs so tight and will never fail to say "I miss you" wearing her sincerely sweet smile. 

It wasn't long ago, around October 2010 if I'm not mistaken when she was diagnosed to have acute myelocytic leukemia. Ironically, the most curable leukemia. The last time I checked on her was she was undergoing treatment so my jaw dropped when Jessie called me up in the morning to announce her death. :( All the while I thought she was on the road to recovery.

Desiree T. Taburada, RN. 

Des, know that I am forever grateful for being a tiny piece in your colorful life. Thank you for the wonderful friendship which will forever be cherished. Without you, Quasar 2003 will NEVER be complete. Wherever you are, may your rest in eternal peace. 

Lakbay Tayo!!!

My Lakbayan grade is C-!!! Aaaahhh!!! 

You may want to know your Lakbayan traveling grade here.


C'mon, TAKE ME AWAY RIGHT NOW!

Unusually Better... Or Is It Just LUCK?

How often do we fail our expectations? How often do we heave a that's-life sigh while accepting our fate when things turn out worse? Or, what is the probability that things will turn out BETTER?

I was having some anxiety attack prior to our 6-weeks community immersion due to the possibility of having a not-so-nice experience from my would-be partner, would-be foster family and the community itself. I was faced with many issues and what-ifs like what if my partner (a choice between Crystal, Suzie and Tina) is someone who isn't tolerable enough (okay, that is vague), what if my foster family is reluctant to have a Muslim foster child, what if we need to hike kilometers of muddy and unpaved road to be able to get to the health center, how about my safety and security in the place? A lot of questions were running through my head I almost didn't wake up on Tuesday for our early morning trip.

Our block is divided into four clusters: Bataan, Bulsa, Imelda and Laiya,  meaning two sets of girls and another two sets of boys. We draw lots with our hands in tremors. Luck was on our side that fateful afternoon when Suzie and I picked LAIYA APLAYA!!! It's the farthest yet it's the best! For one, our foster home is a public resort which only means that our room is the one rented by guests during summer vacayes. It's not the million-dollar worth kind of resort but hey, it is absolutely NOT BAD as we expect it to be! Imagine the comfort!! Suz and I decided not to brag about our place to avoid depression among our blockmates who are, well..... unfortunate. Sorry guys. :'(  The distance of 22 kilometers from the poblacion of San Juan, Batangas is all worth it.

So guys, welcome to our home!!

Island Sky resort is owned by Ate Edith Abanilla, our foster ate who lives with a lola (non-blood related to Ate Edith, apparently, inampon daw niya si lola kasi pinalayas ng anak!! ) and her niece whose parents are OFWs. Our room is that brown door immediately from the terrace while Ate Edith lives at the back house, that silver-colored door at the rightmost. Technically, we don't live together as a "family" in it's real sense. Well, they're not a real family in the first place. I think that defeats the purpose, but we don't care so long as we have a tiled CR with a ceramic bowl, two large beds, fridge, electric heater and an aircon!! Ok, that part we do not want to brag to our blockmates coz they might cry sands and stones!

Another good thing is that the health center where we hold clinics every Wednesdays and Thursdays is just a five-minute tricycle drive from our home. Hailing a tricycle is one of the difficult things in our place but thankfully, Kuya Raffy's just one text away! We mingled with Ma'am Ellen, the barangay midwife and some of the barangay health workers who are more than willing to accommodate us. Most of our cases were just upper respiratory tract infections and systemic viral infections, rarely do we have hypertension and others. The most toxic one was a diffuse toxic goiter which we referred to the district hospital for the work-ups. Alhamdulillah. Things went really just fine on our first week.

We had a courtesy call to the Barangay Captain on our second day. This captain is not your ordinary captain because he owns Kabayan Resort  and most business establishments at Laiya Aplaya. He welcomed us into his mansion within his resort, and he offered us their trademark kape barako. His friend, Mr. S. from the Aplaya Corporation was also there that morning. Too bad we weren't able to linger around the resort kasi nahiya kami!!! 

Kap also owns this quiet and quite high-end coffee shop located just a few meters away from the HC. We arrive here after clinics at around 3:00 pm and that's the time they turn their aircons on, which could only mean that we are probably their only customer for that day! LOL. We stay there until nearing curfew time connecting with the rest of the world through the world wide web aka Facebook and Twitter. 

Meet the lucky duo, Suzie and I! 

Hello, Laiya Aplaya!!
If you woke up everyday to this magnificent view, don't you just wanna lie down and daydream all day loooong? 

FIVE WEEKS TO GO!! :)

Currently Thinking About These....

Photo courtesy of www.stylecovered.com

Clothes.
I want some shopping spree..
But I am on my way to becoming broke due to the expenses that our community rotation demands.
I need to withhold some personal wants for a while. Chos!
I'll be off to Batangas tomorrow.

FamMed With A B-A-N-G!!!!!

It was Suzie and I's last PM duty at the Ambulatory Care and instead of the hackneyed Last Duty Syndrome, this is what we got!!!!!

Lights off. Basically, our role last night was "bantay" ng Ambu. LOL. This scene was opposite from our last PM duty na 4:30 AM, may mga pending patients pa.

 Empty Ambu!!!! Weeee!! Record breaker kami! We had only one patient at around 11:30 pm who came in due to palpitations, shivering and a feeling of choking. We thought of a medical condition like arrythmia or some endocrinologic problems, but upon probing, we found out that she's been worrying about a lawsuit against her and the future of her 8 children, 7 of which married at an early age without finishing college, unemployed and with children of their own. It's a bitter world for that old lady. Hence, our verdict was: 

I- panic disorder, without agoraphobia 

II- defer

III- hypertension, diabetes mellitus, obese 2

IV- financial and family problems

V- 71-80

Another good news, our block received a 12-hour merit "for actively participating during EBM conference". Technically, it was only DS and Irving who should receive the merit because it was they who did most of the talking but we were just so lucky to have been showered by their blessings. The two got an additional 5 points though, perhaps will be added to their shifting exam score. Speaking of shifting exam, bukas na pala yun!!!! 

Alhamdulillah. Allah's the best! :)

FamMed Week 2

Ang sarap mag-duty sa Ambu kung ganito ang eksena. Walang tao. :)

Lalo na pag ang nasa katapat na Pedia Triage ay ang crush na benign din. Kung close lang kami, a wave would suffice to make my day. <3

At the FamMed-OPD, this sight greets us everyday. Kulang pa nga 'to eh. 50% lang 'to ng total OPD consults, our quota is at least 70 patients everyday. It doesn't seem toxic at all because there are at least 6 interns and around 5-7 residents catering to patients. So around at most 7 patients everyday for each. Plus, our cases are the super benign ones like dyspesia, UTIs, BPHs, acute gastritis, hypertension and etcetera.

 What I appreciated most about this rotation is we get to make our own assessment and plan for every patient we handle. The resident would check what's unnecessary or lacking in our management so we are being corrected. The most rewarding feeling is when the resident agrees with my management and is being carried out. I know I did the right thing. Love it! 

The one with the arrow below is the genogram I did for a patient, yan ang toxic! Mahaba-habang chikahan yan with the patient. 

We're about to end in few days time and we're off to the Community. I'm so not looking forward to it. But let's see. Baka mag-enjoy din ako. 

EBM Dilemma

I'm on my 2nd week at Family Medicine which is our last week in the department. I'm enjoying every single moment of my OPD duty especially when the resident agrees with my diagnosis and my management. There are always glitches but it feels good when the resident gently discusses the case with me and tells me what should have been done. I'm enjoying my learning experience EXCEPT for this Evidence-Based Medicine shit that I have no knowledge about. I wonder why our school didn't teach us such! Thanks to my blockmate who sent a copy of an EBM self-instruction manual to our yahoogroup. The introduction goes:

Medicine is a dynamic endeavor. Everyday challenging problems

arise, new modalities of treatment are promoted, disease 

management done under minimal or far from ideal conditions etc. 

Because of these challenges the quality of care also changes.  

Suppose a patient who consulted in your clinic with a diagnosis of

dyspepsia is asking for another prescription because the antacid

you previously prescribed was not effective. What will you give H2-

blocker or proton pump inhibitor? Or you may see another patient 

consulting for cough productive of yellowish phlegm who asked for 

a prescription of an antibiotic. Will you prescribe an antibiotic or 

not? These are common problems that may escape our attention 

and diminish the quality of care we give if we make inappropriate 

decisions. 

In the old practice faced with this question, a physician will just ask 

a colleague or an expert for the answer or rely on his/her prior 

knowledge of the disease. He may also prescribe a drug because 

of the promotional lecture he attended previously about the 

product.  

In evidence-based medicine a new paradigm is introduced. Before

he makes a decision, the physician will first try to retrieve his latest 

article about the topic that he kept from his file, appraise the article

then makes a decision. Later, he evaluates the effectiveness of his 

decision. This loop ensures improvement in the quality of care.  

The purpose of this self-instructional manual is to introduce to 

family physicians the concept of evidence based medicine and the 

use of these concepts to improve the quality of his/her own 

practice. 

EBM is real complicated for someone like me who will start from scratch. Formulating a clinical dilemma is non-tedious, clinical appraisal is. 

I'm contented with the pacing of our duty hours: 12 hours at Ambulatory Care, we receive patients from the triage who are not suited for admission. Not toxic in terms of the work load, toxic lang ang history taking and PE! Like you need to include a genogram and you're not supposed to abbreviations! Ayos lang, ganun naman talaga ideally but my hands hurt a lot! Tsaka, ubos na ink ng ballpens ko! 

When we're not on duty, we do OPD works at FamMed OPD, which means we're free on weekends like this. I want to watch a movie tomorrow but I don't know who's available to accompany me. 

We're off to the community in one-week time and I'm cringing at the idea. I just don't like going off. Hmp. 

My mind's clouded. I'm going senti. Need some shut eye.