First duty post: OR assist. It was Monday so there was only one case at OR 8: anterior disc decompression in a 60++ y/o woman with spinal cord compression (SCC) at T9 level, to consider Pott's disease versus Metastasis. Dane scrubbed in while Crystal and I were mere spectators. Hence, I was able to capture the following photos. 

Ortho OR instruments reminds me of building construction. Not that I was into construction or something but you know, they got that nails, screws, hole-drillers, hammer-like instruments (I guess that's called mallet? I'm not so familiar with Ortho instruments.). Ortho is indeed a profession for real men.  I salute the women who opted to be in this men's field. :)

This is the black-streaked lung of the same woman with SCC, most probably due to smoking but the senior resident told us that non-smoking urban dwellers can have the same lung picture. The answer is very obvious: POLLUTION. 

Spinal radiograph of the same patient in lateral view. 

First OR assist: Ilizarov application and fibulectomy. Trivia: ilizarov is applied to the femur to compensate for leg length discrepancy. This can be applied to normal people for leg lengthening. That made me ponder... how about three inches taller? HAHAHAHA! Ta's papagawa ko sa crush kong Ortho resident. Bwahahaha!

Pedia-Ortho Conference. 

We're about to end our Orthopedics rotation but I still know so little!!

Arthroplasty and Balls

I admit to have less Orthopedics exposure during my clerkship (it was incorporated in our Surgery rotation and we have very minimal cases) so it seems as if I'm starting from scratch on this rotation. Two weeks allotted is very scarce to learn about the broad subject. To make things uncomplicated, I narrowed my goals into two:

a. learn the upper extremities' anatomy by heart
b. learn the lower extremities' anatomy by heart

So far, I had only four OR assists: ilizarov application and fibulectomy, quadriplasty (left), ulnar pinning and debridement (right) and just this morning I had partial hip arthroplasty (left). This one's interesting for I am contemplating on convincing my Dad to undergo knee arthroplasty to stop his chronic knee pain on the left. :'( I miss my Dad so much. He called me up last night to tell me that my Mom and him are coming sometime in October to pay me some visit. Yay! I can't wait for October then. By the way, I have some geeky stuff to share about arthroplasty which I stole from wikipedia. Here:

Arthroplasty (literally "surgical repair of joint") is an operative procedure of orthopedic surgery performed, in which the arthritic or dysfunctional joint surface is replaced with something better or by remodeling or realigning the joint by osteotomy or some other procedure.

Background

Previously, a popular form of arthroplasty was interpositional arthroplasty with interposition of some other tissue like skin, muscle ortendon to keep inflammatory surfaces apart or excisional arthroplasty in which the joint surface and bone was removed leaving scar tissue to fill in the gap. Other forms of arthroplasty include resection(al) arthroplasty, resurfacing arthroplasty, mold arthroplasty, cup arthroplasty, silicone replacement arthroplasty, etc. Osteotomy to restore or modify joint congruity is also an arthroplasty.

For the last 45 years the most successful and common form of arthroplasty is the surgical replacement of arthritic or destructive or necrotic joint or joint surface with prosthesis. For example a hip joint that is affected by osteoarthritis may be replaced entirely (total hip arthroplasty) with a prosthetic hip. This would involve replacing both the acetabulum (hip socket) and the head and neck of the femur. The purpose of this procedure is to relieve pain, to restore range of motion and to improve walking ability, thus leading to the improvement of muscle strength.

Indications for Arthroplasty

• osteoarthritis (OA)
• rheumatoid arthritis (RA)
• avascular necrosis (AVN) or osteonecrosis (ON)
• congenital dislocation of the hip joint (CDH) Hip dysplasia (human)
• acetabular dysplasia (shallow hip socket)
• frozen shoulder, loose shoulder
• traumatized and malaligned joint
• joint stiffness

Googled photo. 

Our patient this morning is a 70+ woman with a posterior dislocation of her left femoral head so after the surgery, hip radiography would look like the one above. :)

On the green and funny note:

We made a segue to FMAB (Faculty of Medical Arts Building) after our small group discussion with Dr. Tanbonliong, a hand surgeon, to refresh with Bubbatealicious. Crystal was sipping her Royal Milk Tea when she exclaimed: "Shit, hindi ko ma-suck ang balls!! Puro fluids lang nasa-suck ko!!!" Well, it's up to you what to think! But it made us LOL!

Again, I was tagged to the 32nd Manila International Book Fair last week. This was held at SMX Convention Center at Pasay City. Being surrounded by thousands of books from various genres was the perfect time to end my OB-GYN rotation!!

I COULDN'T AGREE MORE!!

Several publishers from large to minor scales were present to auction their books, some even brought authors with them for book signing. Mostly came from the Christian religious books though so I wasn't familiar with those authors who were there. The only one I recognized was...TADO JIMENEZ! The local slapstick comedian on TV!

I know he is an artist and an entrepreneur but him, publishing his own book, is far from the image that he portrays! Ok, so I bought his book out of sheer curiosity. At the back of my mind, I was expecting some Bob Ong kind of hidden wisdom but he fails me! First few pages pa lang, olats na ang libro ni Tado! I'm sorry but I didn't even continue reading through the first half of it! I suggest authors must have that get-your-money-back guarantee on the first release of their publications for I demand a refund of my P100! 

The SMX crowd on that Saturday afternoon. Every convention hall was packed with people. At the 2nd level, there was an Anime Convention and some K-Pop Convention as well. We didn't enter because Rox and I know few of the characters (aside from the fact that the entrance fee is costly), but Jeh insisted that we must take a peek. 

At the Ateneo Press booth, this old couple scanned through books by local authors while they were discussing about it. It made me go aawww...I see myself in the future with the person whom I can discuss and debate about books and authors. :D

Jeh was wearing a pretty and colorful outfit that day that didn't seem to fit our destination----MOA. And we were quite teasing her about it. Haha. 

Thank you for the company, girls! Wonder where our next date would be. :D

P.S.

This is my 111th post on the 1st year of this tiny nook of mine! :)

I feel some sort of nostalgia for my abandoned baby, my toastedpeanuts.  Mama will come home soon babe, or not. :p

This is how we ended our OB-GYN rotation: a public health lecture about nutrition among cancer patients. These are patients diagnosed to have either H-mole or gestational trophoblastic neoplasia (GTN). H-mole is not necessarily a neoplastic disease but it predisposes a patient to acquire GTN. In addition, all of them undergo methotrexate therapy, the difference is the etoposide and actinomycin-D therapy included for GTN patients. 

We have Dr. Melissa de Quiros in this photo (the one beside me), the one and only Trophoblastic Diseases Fellow at the Philippine General Hospital. 

At the back door of the interns' callroom at Ward 8 (Ortho ward), some crazy fella wrote:

And the Chief Resident said:

"Let there be a callroom" And behold! 

There was a callroom.

Then on the 6th day, he said:

" Let there be a bed!"

And they rejoiced as a 

stretcher bed appeared. 

Not all departments provide a callroom for interns, so THANK YOU Mr. Chief Resident. :D

Best Thing I Never Had,originally by Beyonce.

Dear Crush (with a bold and capital C),

We have nothing in common. Our worlds doesn't seem to meet at any angle.

There'll never be a chance for us to bump along in any road in this lifetime.

You're not a celebrity but you seem to be one.

Please know that...

You will always be the best thing I will NEVER have. 

Love,

A.

P.S.

miracles happen through prayers though. hah!

On the last week of OB-GYN internship, senior interns (us!) are supposed to bury their noses on their malignancy and trophoblastic books as they are the ones assigned to have these cases. I was supposed to do the same to avoid being grilled and ultimately humiliated during malig and/or tropho rounds, but I didn't. Last Sunday, a day before malig rounds, I prefer to be tagged by Rox and Jehan at Legazpi Village Sunday Market where there's saliva-inducing food bazaars! I had an awesome, awesome, awesome afternoon! 

We decided to have a taste of baklava (with pistachio, hazelnut and walnut), takoyaki, and go Indonesian for our major meal! We had nase goreng (Indonesian fried rice), terong belado (egg and eggplant with sambal sauce), ayam goreng (fried chicken, Indo style). 

Postprandial plate. Nothing left. :P

Interns on escapade: Rox, moi, and Jehan.

And because Jehan had been pining for cupcakes for several weeks, we accompanied her to Sonja at The Fort to satisfy her to-die-for cupcake cravings. 

I actually have no sweet tooth over cupcakes and cakes, but these ones are not bad. Jeh had Red Velvet, I had Peppermint Patty (which I couldn't figure why the icing is colored pink, it should have been green for peppermint!!) and Rox had Mocha Motion. 

On Monday was our malignancy rounds, and yay for me for I wasn't called by any consultant! I was also on duty that day. Now, on Tuesday, had a Mendeleevian dinner at Don Henrico's at MOA. Mendeleev was my original highschool classmates, until I became a Quasarian.  It was supposed to be a post-oathtaking dinner in honor of our newly licensed physicians (four of them!), unfortunately, the three (Alizar, Nashima and Jogo) had to fly back to Marawi after their oath taking. However, my BFF Lily was also there so the purpose of the dinner wasn't totally defeated. It was incredible to see people I haven't seen for ages! Abeking, Shaoque and my tukayo Aisha were present! And lo! The boys seem to be growing continuously especially in the abdominal area! LOL! It was a night full of high school reminiscence. How we've become adults! Kai, Aisha and Tatah were talking about their kids. People are no longer talking about their crushes or boyfriends, but of their husbands. The stories no longer centered on school stuff but on work. Work, work, work! It's wonderful to know that most of us have already fulfilled and living their dreams while others deviated at some certain angle but now keeping up in the track and are heading towards their dreams. 

LILY.  now, Dr. Mamari.

On Wednesday night, had to meet up with my co-bookworm and little sister Tim whom I haven't seen for ages too! I miss her and her sister Jing!  She came with her friends Nawi and Dono whom I had fun meeting as well. We dined at Banana Leaf at Greenbelt, loitered around, talked about stuff (books, movies, people we commonly know, her work, what I do, etc.) and ended up The Coffee Bean drinking tea. :D Tim is a registered nurse who have a deep passion for literature and writing, and now she's planning to go higher so she wouldn't get stuck to just being a nurse. She's Jeddah-raised and flying back there pretty soon, hence the necessity to meet up! Haha!

The Coffee Bean at Greenbelt.

I was on duty on Thursday and on Friday, yesterday that is, was supposed to be our block dinner at Crystal's place at Rockwell but I passed. I had been juggling internship and jolly social life this week!!

Had some me-time yesterday, my last postduty at LR/DR and at OB-GYN which is also my first red flag day so I decided to have manicure and pedicure and painted my nails. The Caucasian girl beside me noticed we were reading the same book (One Day). I'm about to finish, by the way. 'Course I chose my Gyne book over Dexter and Emma this week. 

In case you're wondering why the sudden nice quality of photos I have above, it's because I purchased a new point-and-shoot cam that came at a cheeeeapest price for a Canon! Now I'm sitting here broke. Will have mess hall foods then for the coming weeks. :P

Eid'l Fitr

(this is an overdue post) 

Islam celebrates only two festivities: Eid'l Fitr and Eid'l Adha. Eid'l Fitr is celebrated at the end of the Holy Month of Ramadhan while Eid'l Adha, the feast of sacrifice, is celebrated during the month of Dhul Hajj. Basically, the festivities consist of prayers (salaa'tul eid) and greeting family and friends with peace. Most often than not, families spend the important occasion with each other by rising early for the congregational prayer and afterwards sharing their best culinary specialties. Eid'l Fitr celebrates not just the mere act of "being able to eat again" after one whole month of fasting, the same way that Ramadhan is not just about skipping meals/water during daytime. Eid'l Fitr entails that the discipline and the strength of faith that we have developed all throughout Ramadhan must not put to cease but must be continued all year round. The Eid is meant to bring tranquility to the Muslim Ummah as we give our salaam  to everyone. Ironically though, looking at the news, tranquility and peace is a strange word in the Arab world nowadays. 

It is my first time this year not being able to spend the holiday at home, but being with my cousins here in Manila, I don't feel any less at home. We were up very early on the morning of August 30 to catch up the salaatul eid at Quirino Grandstand. Thousands of Muslims all over the metro were there to pray together. It was wonderful, wonderful sight. How can I not believe in the miracles of Allah when the previous night it was raining cats and dogs due to the typhoon and then suddenly the sky cleared and became sunny on the Eid morning? Allah (s.w.t.) indeed gives abundance of Mercy. 

My family in the metro. (l-r) Kuya Dabs, Ate Papay, moi, Ate Hanna, Princess, Uncle Mumar and the two adorable kiddos Sabreen and Asma. Hosni took this photo. 

It was just us here so the table was set to seven people only, unlike in inged  where we don't use the dining table. We use tens of tabaks for a buffet style meal because everyone comes around. :)

It is but tradition that Muslim women boast their culinary expertise on this holiday. My cousin Ate Hannah is an excellent cook so she did all the cooking while Princess and I played her apprentice slicing peppers and handing her the spices bottles etc. She does it perfectly without exerting too much effort and voila! here are her mouth-watering specialties for the day.

Cassava ala Hannah. You guys must have a taste of her cassava cake, it's simply the best!! It's full of texture and every ingredient slips smoothly into your tastebuds you can't get enough of it! For orders, do text me. Hehe. 

Chickne Khabsa Rice. This is an Arabian food which is my ultimate favorite! The rice is cooked using various Arabian spices which gives a strong aftertaste but something that makes you crave for more. The chicken was cooked separately using the same spices and placed on top of the rice.

Pindiyalokan a Manok. This one's a native Meranao food, chicken cooked in shredded coconut meat and our famous palapa (this one doesn't have an English translation) and kalawag (yellow-ginger powder). 

Koning Rice. Who among the Meranaos don't love kiyuning a begas? This is cooked using coconut milk instead of plain water, peppered with yellow-ginger, laurel leaves and pandan leaves. Koning is served during the best  of occasions and when you visit a Meranao household, you know you're special when this is served.

Pasta. Need I say more? Well, I guess everybody just loves pasta! Haha. Oh, we also have grilled chicken that day which I fail to take its photo! That one's better than Mang Inasal or anywhere!

Post-Eid meal. As I always say, nothing beats being with the family on special occasions.

Alhamdulillah (all praises belong to Allah) for a wonderful family I have, back home and here; for being able to survive Ramadhan alongside OB-GYN; for providing all of us good health; for the gift of friends; for being able to live everyday with peace and tranquility in our hearts.

I'm at page 157 of the 435 pages of One Day and I can't seem to put it down! I reckon I am half-Emma Mosley half-myself! That, love-wisely anhedonic, cold-hearted, robotic nun! 'Cept that, I don't have Dexter Mayhew and it's a bit too late to have him around.

Argh.
This fiction/med book juxtaposition is disturbing. Lol! Just give me thirty minutes and I'll go back to my Comprehensive Gyne book and deal with malignancies. Weee! :)

My alma mater, the great Mindanao State University,  celebrated its 50th Golden Jubilee Foundation Day!!! For the first time in my entire life, I am not physically present on the day that everyone awaited for. Plenty of alumni from all over the globe joined the celebration as they reminisce their good old MSU days. I only get to see photos of them enjoying the activities making me wish I was there too! ;'( 

On a lighter note, I noticed that big universities in the metro print their logo on the Philippine monetary bills when they celebrate a particular year that marks something for them. 

By that, I believe MSU logo should be printed on a P1000 bill too!!!

I purchased a book called "One Day" by David Nicholls, my second non-med book purchase during internship. By looking at the cover, you wouldn't mistake it for any other genre than love story. It's already on big screen, you can watch the trailer HERE by the way, starring Anne Hathaway and Jim Sturgess (hottie!), which I have missed to see with my friends who rated the movie excellently. So I thought that if the movie is great, then the book must be tenfold greater! Admittedly, I bought it out of utter desperation for love stories nowadays, may it be fiction or stories of real people. I guess it's human nature to crave for something that's lacking in you. Therefore, this book is now juxtaposed to my William's Obstetrics book. 

"You're gorgeous, you old hag, and if I could give you just one gift ever for the rest of your life it would be this. Confidence. It would be the gift of confidence. Either that or a scented candle."

We're on our week and a half in OB-GYN and I'm so excited to move on to the next rotation! Hopefully I can update this blog on the things I sorely missed for the past month!!