silk 2.0

(written on January 2007, lifted from my other blog.)

summer ng May 2003 nung nangyari ito.  summer ng 2nd year college.  nasa bahay ako.  wala si manang, yung aming kasambahay, day off niya.  so ako na lang ang nagluto para sa aming magkapatid.  di naman pang-professional ang level ko sa pagluluto pero nakakain naman yung mga niluluto ko, so pwede na din.  medyo may mantika na sa kamay ko nung tinangka kong kunin ang bote ng asin.  nadulas mula sa kamay ko yung bote, nabasag sa kitchen counter at nagkalat ang mga bubog.  teka, ba't may kasamang pula?  dugo pala yun, nahiwa pala ang hypothenar aspect ng kanang kamay ko.  medyo mahaba yung sugat.  dali-dali akong tumawag sa mommy ko para sabihin ang nangyari.  pumunta daw ako sa clinic.  ilang sandali pa ay may bumusina sa labas.  nandyan na ang driver ng tita, dadalhin daw ako sa clinic.

sa clinic tiningnan ng naka-duty na doktor ang sugat ko.  nilinis ang sugat, nilagyan ng betadine para ma-disinfect.  tapos bigla niyang sinabi na kelangan daw tahiin ang sugat ko.  syet.  so eto na, tinurukan ng anesthesia tapos tinahi.  masakit din pala.  all-in-all mga 7 stitches din ang inabot.  maganda naman yung pagkakatahi.  kahit parang zigzag ang korte ng sugat ko eh nagawa naman niyang mahabol ng tahi.  after 10 days, tinanggal na yung sutures ko.

bakit ko ba ito nakuwento?  ngayong nasa med school na ako eh madami na akong natahing sugat sa kamay.  at sa paa.  at sa ulo.  at sa mukha.  pero nung unang beses ko ito gagawin, syet sobrang takot ako.  junior intern (medical clerk kung sa ibang hospital) ako nun.  paano kung pangit ang pagkakagawa?  pano kung tabingi yung tahi?  naaalala ko yung unang beses na yun.  takot na takot on the inside pero calm and collected on the outside.  form before function daw.  pero halata mo pa din na may takot.  eh ang lakas ba naman manginig ng kamay ko habang nagtuturok ng anesthesia at habang nagtatahi.  pero naging maayos naman ang pagkakatahi, down to the very last suture.  naging confident na ako mgtahi pagkatapos nun, madami na akong natahi pagkatapos.  suture sa OR, suture sa clinic, pati nga pagtahi ng bagong panganak eh nagawa ko na.

ang galing din ng nakaimbento ng surgery, pati na din ang mga gamit sa pagtahi ng sugat.  kahit nasugatan ka, gaano man kalalim ang sugat eh natatahi pa din.  gumagaling ang sugat.  pero yung nga lang, nag-iiwan ng marka, ng peklat (malas kung keloid former).  alam mong may nangyari, may pinagdaanan.  parang heartache.  pag nasaktan ka, masusugatan ka, minsan madudurog pa ang puso.  pero in time, naghihilom din ang sugat.  parang tinahi ang nagpira-pirasong puso.  pero may maiiwang marka, may maiiwang peklat.  tanda na may pinagdaanan.

nasa ER ako ngayon (may internet dito hehe!).  may dumating na pasyente, nahiwa yung kamay.

"(tawag sa nurse aid) suture set nga po.  pahingi ng silk 2.0!"

connection

can you imagine how it is a few years back, when we didn't have all these technology at our disposal?  you want to research something so you open an encyclopedia.  you type your report using a typewriter.  you don't have that fancy cellphone so you make a call using the payphone.  so much advancement has been achieved in such a short time.

with all these hi-tech stuff that we have, it is so easy to get connected.  gone are the days when you'd have to call an operator so you can send a message to your friend's beeper/pager.  now all you have to do is text him or her.  you want to know what he's doing, just open facebook and see his status message.  the world has become a smaller place indeed.

however, in spite of all these why do we sometimes feel that we can't get through?  yes, we receive text messages from friends, but why does it feel like we're not really communicating with them?  we read their latest blog entries everyday, but sometimes it feels like we don't know what's happening to them.

in this modern age of technology, i feel like we've lost that something that we once had.  we've lost that personal touch.  i sometimes feel that i've lost my connection to friends and family.  i am a people-oriented person, i enjoy other people's company.  i like to talk to them, to listen to what they're saying.  but in the midst of this busy, hi-tech world that we are in right now, the personal touch has taken a back seat.i feel like i'm talking to my friend's phone instead of her.

i am going to make some changes.  instead of just texting or talking to a friend over the phone, i'd make the effort to go to his or her place.  or set up a meeting at a coffee shop.  or just hang out with them.  that way i'd really get to talk to them.  in that way, i can connect with them.

***

not really connected to my current topic, the new fellows of ct-mri have already started their training.  they were co-residents of mine who decided to undergo further training.  it feels nice to have them back.  although i feel a bit sad that the previous fellows are not with us everyday anymore.  they're busy studying for the subspecialty exams.  i wish them all the best.

insomnia

def. repeated difficulty with the initiation, duration, maintenance, or quality of sleep that occurs despite adequate time and opportunity for sleep that results in some form of daytime impairment. (from eMedicine)

last night was one of the most toxic duties in my residency training period.

it all started out as a regular day.  i started the day at my rotation (MRI), just about our regular patient census.  as i was on duty, i assumed my duty post (CT scan) by 4pm.  when i got in, i saw their patient census and noticed that they've already had quite a number of patients already, and my co-residents were already having backlogs.  i looked at the worklist for the duty period and saw that there were a lot of patients scheduled for CT scans, even during late night.  i braced myself for a toxic duty.  guess i didn't prepare myself well enough.

call after call for patients to have their CT scans came pouring in: outpatients willing to wait, inpatients waiting for their turn, ER patients that need to be accommodated.  for every one patient that i was able to manage to type in an initial reading, 2 patients would get scanned.  benign cases, toxic cases.  in the end i had so much backlog.

eventually the toxicity died down a bit.  we were able to eat a decent dinner.  due to the sheer number of patients who had their scans, i didn't get an ounce of sleep at all.  my junior resident asked if she can lie down for a few hours and sleep off the eye fatigue and headache.  of course i said yes.  she woke up a couple of hours later and she was very apologetic when she saw the worklist.  i managed to do initial read for almost all the pending cases while she was sleeping.  i said that it was okay.  i don't feel at ease on duty nights if there are pending cases.  plus for some strange reason, sleep eluded me last night.  even if i stopped and tried to go to sleep, i never did get to.  so i just worked on.

on an unrelated note, my co-residents who recently finished their residency have all passed the diplomate exam for the Philippine Board of Radiology.  the streak continues, 100%.  i always knew they'd make it.  i've been with them for a few years now and i know their capabilities.  there was never any doubt that they'd all pass.  and now i'm officially hitting the panic button.  it'll be my batch's turn to take the exam next year.  hoping that we'll keep the streak alive.

another unrelated note, the graduation for the residents will be this thursday.  included in the program is the presentation of the incoming chief residents.  gotta have my long coat rushed, i'll be needing it for the occasion.  it'll be the first time that i'll be wearing my long coat.  after that it's official, chief resident for 2011.

and now after the adrenaline rush has died down, sleep has come to me at last.  be hibernating

looking forward

time flies when you're having fun.

or when you're not paying attention.

or both.




the year was 2007. fresh from passing the board exams (barely, if i may say so), i was pondering my career options. which specialization was i to take? there are a few number of choices.

one was surgery. i always loved surgery. back in medical clerkship and internship i always loved it when i get to scrub in. sure, back in clerkship all we ever had to do was to retract and expose the operating field (a painstaking task, especially if you had to keep the operating field exposed for 5 hours straight). but back in internship i was able to perform minor operations in the outpatient department and even had the opportunity to perform a few uncomplicated surgeries from cutting to closing. i enjoyed it. it is a very exciting field. the drawback is that it is a very stressful specialty. long hours in the operating room, on-call status, long work hours. for someone with a medical history such as myself, i don't think i would survive 5 years of surgery residency. too bad.

January 2007 during the Surgical Mission

another option was pediatrics. i loved being around children. i like playing with them, goofing around with my little patients even if it means making a fool out of myself. and kids seem to gravitate towards me, i don't know why. i guess they think i'm a kid too, although much bigger than they are. my little patients seem at ease with me. i can even make a baby stop crying when his/her mother fails to do so. it's a great joy, being around kids. i feel younger when i'm with my little patients. but sadly, when your patients are little kids and you tend to be sickly, you really can't hang with them too much. i'd make their conditions worse rather than make them better. again, too bad.

early morning at the nursery

one other option was radiology. it has always interested me, radiology. to diagnose a patient's condition using imaging techniques, that's just fascinating! a simple x-ray study can give you so much information on what you're dealing with. plus, the workload is not so much like in the other specialties. with the advancements in technology, radiology has become a very appealing field especially now that everything can be converted into a digital format and you can view the images anywhere, be it at the hospital, in the coffee shop or even at home. very, very appealing. plus, it's very challenging. so i ended up in radiology.

i applied to different hospitals after researching which has good training programs. i was fortunate enough to have been accepted into one of the best. but once i started residency, i realized how not so benign radiology can be. sure, you interpret imaging studies. but to do that for the entire day even until the unholy hours during duty nights is very tiring. i often get migraines from staring at the bright lights of the negatoscope (view box) or from looking at images on the computer monitors. and the imaging studies just keep on coming and coming. that's the drawback of getting into one of the busiest hospitals in the metro. and when you do get some time off to catch a few z's, you'll hear a knock on the door and waiting on the other side is an intern or a fellow resident who's requesting you to do an initial read of an x-ray film (if you're lucky) or a ct scan or mri study. to miss a crucial finding is a big no-no. you wouldn't want the emergency department to send home a patient because you said the study was normal only to realize hours after that the patient has a fracture only very subtly seen in the x-ray and you missed it because you were half asleep when you were looking at his/her film hours before. and i never knew there were so many books to read. each organ system has their own reference, and each modality has their own book as well. i spent more on books now compared to med school.

although it was unexpectedly tough, it was also fun. i am very fortunate to have co-residents that are good-natured, fun to be with, and who do not care about the hierarchy of residents. and the consultants are all very nice. they even take the time to teach.

time flies fast. one minute i was just starting residency, and now i'm almost done with my 3rd year. and wouldn't you know it, i was appointed as chief resident for next year. there are two of us actually. but still, chief resident. i never wanted nor dreamed of it. if there was a way to, i wouldn't be chief next year. but i guess things happen for a reason. of course being made chief is a huge honor, but it comes with a very big responsibility. i do hope i can live up to the expectations.

so here's to 2011. it's going to be one heck of a year, that i'm sure.

amnesia

i totally forgot about this.

back in college and in the early part of med school, i often found the time to write down my thoughts using pen end paper and this medium we call blogging. i've had a few blogs here and there, some of which are still active even if i don't visit these sites anymore. such was the case in this one. i totally forgot that i had this. if not for my google account i wouldn't have stumbled upon this little space in the internet i call my other blog (yes, like i said, i have a few blog sites).

when i first created this blog, i was planning to make it into an informational blog. being in the field of medicine, i planned to make this as some sort of a resource blog for cases, different illnesses, and other medicine-related stuff. i guess i never did accomplish that. but hopefully now i'll be able to inject some cases here, interesting stuff i've encountered during my training.

so here's to re-opening this blog. i do hope i find the time to fill this up with interesting stuff.

Rebirth: Gary V. @ 25

A couple of nights back, a friend mentioned that he can include me in a list of people with reserved seats for the Gary V. Rebirth concert. At the mention of the name Gary V., I suddenly became excited. Here was a guy that who sings songs I enjoy listening to, and to see him live would just be awesome! So I said, "I'm in!"


Oh, I forgot to mention that I went there with my girlfriend. She's a fan of Gary V. as well.

So off we went to Eastwood City. Traffic was bad, but we were able to arrive with time to spare. Ate dinner at one of the fine establishments before taking our seats. The usher mistakenly brought us to the VIP section, and we were almost seated beside Mark Escueta of Rivermaya.

Before we knew it, the concert began. As soon as Gary V. stepped on that stage, it was excitement nonstop. The guy is electric! He has so much energy when performing, you can't help but move along. His charisma transcends different generations, be the young ones or the young once were having a great time. I liked it when he sang his classic hits like Sana Maulit Muli and Take Me Out of the Dark, as well remix of Shout For Joy which was emixed by his son, Gabriel. He sang a brand new song called Ohhh as well, which I'm starting to like because it's so catchy. We enjoyed the part where e performed with his son Gabriel as well. That kid is the next Mr. Pure Energy if you ask me.

Gary V. didn't just dance and sing, he also shared some inspirational thoughts. And I appreciated that. He really does want everybody to feel good during his shows.

After the concert, there was a meet and greet. People lined up to have cds signed as well as take pictures with him. The line was moving so slow, and we weren't able to wait any longer. Too bad. Maybe I'll get my chance during his concert at November.

All in all, we enjoyed the experience. Great food, great show, what more can you ask for? Eastwood City really has it all.

breathless

i can't breathe.

that was my first thought when i woke up. i was having chest discomfort. it felt like all the air was sucked out from my lungs. i was starting to feel numb. and i knew right away that i was having another asthma attack.

thank goodness my inhaler was just an arm's reach from the bed. one, two puffs. it gave little relief. i've had times wherein i had really severe exacerbations almost bordering to status asthmaticus. no one was around to drive me to the hospital. so i drove myself to the nearest emergency room. three sessions of nebulizations later, i was able to breathe easier.

in my readings when i was still in med school, i've read that asthma exacerbations are trigerred when exposed to certain triggering factors. it can be trigerred by allergens like dust, or ingesting some food items like seafoods. it can also be triggered if someone is under stress. avoidance of such triggering factors is one of the managements of asthma. a pulmonologist from my med school once jokingly said that med students who have asthma get exacerbations because of the stress that med school brings. so therefore, clerks and interns should be excused form duty so as to avoid asthma attacks. i told him i second that motion.

have to get some rest. tomorrow is going to be another long and tiring duty.