Backlog Pa Rin

(Pagod na ‘ko mag-English. Hehe)

Sumunod sa Anes ang Emergency Medicine… dito ko nakita kung gaano ka-halaga ang triage. Maraming dumarating na pasyente na nag-aakalang emergency ang kaso nila, pero kung tutuusin hindi pa. Kelangan talaga piliin kung sino lang ang i-aadmit sa ospital, kasi kung hindi, mauubusan agad ng vacancy ang wards, at matatagalan lang ang mga pasyente sa ER. Well, in the first place puno naman lagi ang PGH. ^__^; Halos nakabisado ko na nga ang mga linyang sinasabi ng mga residente sa mga kumukonsultang pasyente:

“’Tay/’Nay, ang kondisyon niyo pang OPD naman, balik na lang kayo sa OPD bukas at pumila kayo alas-singko pa lang ng umaga ok?”

“Pasensya na kayo, wala ho kaming bakante sa charity ngayon. Pag tinanggap namin kayo, maiinip lang kayo sa ER at mahahawa pa kayo sa sakit ng iba dito. Subukan niyo sa Ospital ng Maynila o kaya sa Jose Reyes, baka sakaling may bakante sila…”

Ganyan sa ER ng PGH (sayang wla ‘kong pic)… ang Acute Care Unit halos laging puno, parang extra ward. Mainit pa’t ang simoy ng hangin, kakaiba. Haha. Sa dalawang linggong tinagal namin dun, katulong kami ng mga residente sa trabaho. ‘Pag pre-duty, tumatambay sa triage, at tulad ng sabi ko, sinasala ang mga pinapapasok upang magamot. Ang duty naman, oras para ma-practice ang skills tulad ng venous at arterial blood extraction, IV line insertion, foley catheter insertion (kasi ginagawa ang mga ‘to sa halos lahat ng pasyenteng inaadmit). Pag-post duty, matapos ng mga lecture (kung meron man), uwi na! Yey. :)

Dahil frontline ang DEMS (Department of Emergency Medical Services) sa pagtanggap ng pasyente, iba’t ibang kaso at personality ang na-encounter ko dito—may mga inatake sa puso, may masakit ang tiyan, may nahihirapan huminga, may na-stroke, maraming mga naaksidente, at pati nagbibigti at umiinom ng mga kung anu-anong kemikal meron din. Kadikit na ng pag-atupag sa kanila ang samu’t saring aksyon at drama. Madalas, ang mga tumatatak sa isipan ko ay yung mga dumarating na ‘coded’ (walang heart rate at blood pressure), o di kaya, malapit nang mag-code. Isang gabi, may dumating na maliit na grupo ng mga bading, dala ang kasama nila na blue na ang mukha. Sinubukan namin sila hingan ng impormasyon tungkol sa pasyente, pero bukod sa alias na “Joan”, wala na silang alam. Kahit edad man lang, o kung san siya nanggaling. Siguro, sandali pa lang ang pinagsamahan nila (magkakasama silang nagtatrabaho sa isang beauty parlor). Nung gabing ‘yon, galing daw sila sa gimik. Nakainom daw ng marami si “Joan”, at pag-uwi ay parang nag-collapse. Akala ng mga kasama, nakatulog lang. Pero later on napansin nilang unresponsive na pala. Ayun, dinala sa ER. Sinubukan i-resuscitate ng code team (dito ko unang nasubukan gumamit ng defibrillator), kaya lang hindi naging successful. Nakakalungkot isipin na hindi pa niya kasama ang pamilya niya o kung sino mang nakakakilala sa kanya talaga nung binawian siya ng buhay.

Ibang gabi naman, nag-admit kami ng mag-asawang biktima ng vehicular crash sa may Nakpil St. Nakasakay silasa motor at bumangga sa isang taxi. Hinatid sila ng driver sa PGH, at pinasok sa ER buhat ng stretcher—parehong bali ang buto ng kanilang kanang hita. Nahirapan sila i-intubate ng residents kasi pumapalag at gusto hilahin ang tubo. Grabe rin yung time nay un, basta emergency kailangan mabilis ang kilos. Hindi ko na alam kung ano ang sunod na nangyari sa kanila pagkatapos dalhin sa X-ray kasi Surgery na ang nag-handle sa kanila.

Hindi ko rin malilimutan ang pasyenteng sumubok sa pasensya ko dahil ayaw niya magpalagay ng NGT. Alam kong masakit ang malagyan ng NGT, pero grabe, walang kasing likot si Tatay to the point na kinailangan siya itali. Kailangan niya yun kasi nagdudugo na ang tiyan niya. Kaya na lang ganun din siya ka-resistant kasi wala na siya sa tamang pag-iisip dahil naapektuhan na ng Hepatitis niya ang utak niya. Sa sobrang frustration ko nataasan ko ng boses pati yung bantay na gusto nang mag-walk out. Hay, ang pasyente hindi dapat iniiwan ng bantay. Na-guilty rin ako pagkatapos nun… proof na kailangan ko pa rin ng extra helping of Grace. :)

Ilan lang ang mga ito sa mga naging karanasan ko sa ER. Ok ang EM rotation… may times na toxic—pero pag benign, benign talaga. :) Isa pang maganda dito, kailangan mo lang i-stabilize ang pasyente at pagkatapos, pwede na i-refer sa magiging primary service (kung for hospital admission), o kaya, pwede na pauwiin. Sobrang bait at fun pa ng mga residents na nakasama namin. At siyempre, masaya kasi I went through it with my all-time favorite blockmates. :)

Last day ng DEMS. Bojit’s ice cream treat. Kumpleto kami d2! Jill, Dezi, Ida, Bojit, Trine, Q, Suzi, Cesca

season's greetings + a rewind...

Merry Christmas everyone! I hope we are all having a wonderful time with family and friends this season, not forgetting the very Reason why we celebrate this time of year... :)

I've never been happier that finally I get to stay home after months of being practically stuck in Manila. Oh, I've had opportunities to go home but to be able to spend even a day here seemed impossible when I'm caught up in the middle of a rotation. Anyway, here I am, getting my much needed rest. :)

Here's a rehash of the past months in my world--part one, at least. I planned to write and publish just one article reaching up to my IM experiences, but realized I couldn't do it in one sitting. Sorry na rin kung di masyado coherent. ^__^ I'm conceding to my sister's suggestion of uploading one section at a time...

Major Backlog: Bits and Pieces

As you can see, the last time I shared anything about my med life I was having my Neuro elective. Maybe I’ll just skip the tiny details for this part. Suffice it to say that though I began the elective with apprehension, I left the department all smiles. The residents were even asking if they should prepare a spot for me in their call room after two years. To that I said, “We’ll see…” :)

<-- souvenir photo from inside the Neuro residents' call room

After Neuro came Ob-Gyne. I liked it less than I did last year, probably because the excitement of learning skills for the first time has already come and gone. We were not ‘beginners’ anymore; we have already become part of the workforce. We fell into a routine of staying in the wards during pre-duty, hustling and bustling at the admitting section or in the LR/DR during duty, then hitting the sack dead-tired on our post-duty day. Too bad I didn’t get the hang of delivering babies myself. The downside was that there were pre-residents with us—which meant added competition for deliveries and episiorraphies (a.k.a. repair of episiotomies). I should remember to make up for this loss next year. Anyway, I still got my share of OR assists for Caesarian deliveries and THBSO’s. I encountered some interesting patients as well, such as a deaf-mute victim of sexual abuse, and a patient also named Ingrid. :)

Oh well, thankfully the Lord has enabled me to endure the uniquely stressful environment of this department for a month. Witnessing the miracle of life in all those newborns also helped. :) Thank God for fun blockmates and kind interns and residents too. :)

<-- Ito ang pastime ko sa LR/DR--magbuhat ng baby ^__^

The next two weeks were spent with the Department of Anesthesia, and life took a benign turn once again. Benign, because we get to go home early (the residents would usually “shoo” us away once we’re done with procedures, haha), and if we’re not on duty on weekends, we’re free.:) I learned how to administer spinal anesthesia and intubate a patient— though the latter still needs practice. I got familiar with what was taking place on the so-called “other side of the drape” on the operating table—where we periodically check the anesthesia machine and the patient for any changes in his vital signs while the surgery is ongoing. I used to think that Anesthesiology was only about administering analgesic drugs prior to an operation, but I have come to realize that it starts with seeing the patient even before he is brought to the operating room and lasts until his post-operative pain is adequately relieved.

Cesca's Iceberg treat during Anes. L-R: Jill, Bojit,
Ida, Suzi, Cesca, Trine

***Okay, to be continued. haha. next part to follow--soon, I hope ^__^; ***