Song Of The Moment

Walk By Faith
Jeremy Camp

Will I believe You when you say
Your hand will guide my every way
Will I receive the words You say
Every moment of every day

Well I will walk by faith
Even when I cannot see
Well because this broken road
Prepares Your will for me

Help me to rid my endless fears
You've been so faithful for all my years
With one breath You make me new
Your grace covers all I do

Well I will walk by faith
Even when i cannot see
Well because this broken road
Prepares your will for me

Well I'm broken- but I'll still see Your face
Well You've spoken- pouring Your words of grace

Well I will walk by faith
Even when I cannot see
Well because this broken road
Prepares Your will for me

Well I will walk by faith
Even when I cannot see
Oh, well because this broken road
Prepares Your will for me

Hallelujah, hallelu
Hallelujah, hallelu...

Before Sibol...

Hindi na ako nakapag-blog simula nung birthday ko hanggang matapos ang classes… Wala namang ‘spectacular’ feeling nung birthday ko. [Although masaya kasi umaapaw ang pagkain kahit di ako nanlibre, salamat sa LRI (alam ‘to ng blockmates ko hehe), isang local pharmaceutical company kung san namin pinalipas ang araw para sa Management class.] In my email to my aunt, I told her turning a year older didn’t feel any different as usual. But I knew the reality of it would sink in as I go on… And sink in it did. A week later, my youngest brother Jeremy texted me.

Jeremy: ate are u free on wednesday?
Me: yes…why?
Jeremy: pde ka b maging chaperone namin sa EK free ang ticket mo dinner money lang prob mo ticket mo is courtesy namin
Me: ok cge. Ilan ba kayo? Ako lang ba ang adult? (huwaw, I used the word on myself…looks like I have to start getting used to this, hahaha.)
Jeremy: may dalawa pang Ate pero 16 years young lng sila, ikaw ang pinakamatanda sa amin (or something like that)

So yun, sumama ako sa aking kapatid at walo nyang mga kaklase + yung dalawang ate… and at the last minute nagdecide ang isang dad na sumama na rin (Buti na lng. Kung hindi, di ako nakasakay ng Space Shuttle twice. ^__^). Nakapag-rides naman ako, pero syempre hindi ko nasulit dahil naging tagabantay ako ng mga gamit nila (nagsimula yun sa Jungle Log Jam). And it made me wish I had friends with me too. Or at least a book to read while waiting (imagine?). Sige lang, araw naman nila yun eh. =) Magkaka-hiwa-hiwalay na rin sila dahil entering high school na sila. Akalain mo yun, high school na ang bunso kong kapatid?!

I haven’t even begun to tell of how came to I realize that nearly all my friends my age were either recently graduated or already employed. As the cliché goes, how time flies. This is change subtly unfolding before my eyes. Soon my own tide(s) of change will come. And when they do, I pray He’ll enable me to ride them prepared and with my heart trusting Him still.ü

my Sibol testimony :)

I praise and thank the Lord for the privilege of serving Him in Sibol Camp last week. It was an awesome and refreshing experience—how the camp went smoothly was all by His grace. I praise Him for the campers and for their eagerness to know God more and make good friends with each other. Praise Him for how my small group (Rio, Izra, Yas, Aljon, Jonie, K.Billy) grew in fellowshipping and worshipping together.ü Praise God for fellow Ates and Kuyas who were ready to give of themselves for the students. Praise God for the Cross most of all—the central message not just of the camp but all of His Word. I found that we can never be reminded enough about God’s holiness, our sinful nature and the saving work of Christ on the cross. The Gospel was proclaimed clearly and was planted in ready hearts. Hearing all their testimonies at the end was such a blessing. One Kuya commented that it just takes the ‘right’ (and I added ‘ripe’) campers to have a relatively trouble-free camp. But really, everything in the camp was by God’s sovereign grace and loving hand. :)

As I also pondered on this most recent experience as counselor, I couldn’t help but be amazed at how the Lord has transformed me. When I attended my first ISCF camp in high school, I never imagined that I would someday be an Ate at camp too. Would you believe I cried on the first night back then because of homesickness?ü But then here I am now. ISCF has become a significant part of my spiritual, personal and interpersonal growth, and I am glad I can give back to Him and the ministry. I am thankful for the colorful tapestry that my experiences as camper and counselor have become. Indeed it is a privilege to be used by our Almighty King to reach out to the high school students. All glory belongs to Him! :)

Dormant Muna

Haven't had time to sit down and share the last three weeks, and now I'll be off to Naic for my 3rd Sibol Camp as counselor...

Kaya ako nag-hehesitate mag-blog before eh. ^__^

Learning, The Hard Way part 2 [overdue]

The weight I felt that time has long been dissipated. Hey, it's been four days--I've definitely gone over it. =) But I'm thankful because I learned from the experience...

--> Some residents are not as "maalaga" when it comes to offering what you can or ought to do, with clear instructions. Expectations are not always verbalized. I guess sometimes I'd have to pester them for specific mechanics in seeing/interviewing patients to make sure I don't overlook anything.
--> All the questions in the psychiatric history are there for a purpose, so there's no reason not to ask any of them. Or else the diagnosis will be affected.
--> Don't jump to conclusions about your patient's diagnosis, especially if you did not get his/her complete history.

Getting your weaknesses exposed can be quite embarrassing and, to some extent, painful.
Yet med school is sprinkled--or showered if you will--with moments like this. That's why it's a training. It is disciplining and character building.

Learning, The Hard Way

Today I broke down in front of the Psych resident buddy assigned to me. I didn't mean to cry, but then she noticed tears were gradually welling up in my eyes and asked why I was crying. Hala, ang luha hindi na umatras. (If you want me to cry, just comment on my glassy eyes. It never fails.)

Ang dami ko kasing naging kapalpakan.Hindi ko na nga natapos kunin ang history ng follow-up patient ni Ma'am (dahil habang nagsisimula pa lang kami sa OPD pinalipat kami sa Ward 7 at dun na lang daw sya titingnan ni Ma'am, na medyo naghahabol ng oras dahil may activity pa sya with the interns), mali at unfounded pa ang diagnosis ko sa pasyente (akala ko schizophrenic, bipolar pala. hay buhay). At hindi ko na na-resume ang pag-interview sa kanya dahil pinauwi na sya ni Ma'am. With that out of the way dahil wala na rin kaming pag-uusapan, I just offered to report the information I gathered from the schizophrenic patient I interviewed yesterday. Ok na sana ang history ko, pero meron akong mga kulang na info na walang excuse para hindi ko matanong during the interview. When she quizzed me about Schizophrenia, nasagot ko naman ang ilang tanong, pero meron ding mga hindi ko maalala. Ang dating sa kanya, hindi ako nag-aral. Pero nagbasa naman ako eh... hindi ko lang maalala lahat ng diagnostic criteria.=/

So much for wanting to be excellent in this benign-looking-but-demanding rotation. [Day 1 pa lang nabura na ang aming pre-conceived notion na benign ang Psych.] I was disappointed and frustrated with myself for such a performance. I was asking the Lord to help me be excellent, but could I still have relied on my own strength and (limited) capacity that's why I ended up like this today?

(Because i'm running out of time i'll finish this entry tomorrow, with what I learned from the experience...)

Musings from Med 250

Enjoy naman ang Internal Med rotation... pero sana mas mahaba pa sa tatlong linggo ang tinagal namin sa department. Iba-ibang klaseng pasyente rin ang nakita namin at napag-aralan. Napalapit ako kay Harrison (as in the textbook), pero feeling ko kulang pa rin. At least that's what the exams did to me. I flunked my second and third exams, hay. Pero sabi ng resident monitors namin, wag mag-alala dahil mahihila naman yun ng ibang grades sa ibang activities. They kept assuring us that at least, we still learn from the feedback of the answers. Man, they sound like exams are so trivial. Di naman sa super grade conscious ako; sang-ayon naman ako na di lang exam ang batayan ng kahusayan ng isang doktor. Now that we're in the realm of clinical training, I guess I just have to get used to relegating exams to a not-so-big-deal status, even if they make you feel that they are (lalo na kung bagsak ka hehe). It's a struggle to keep an open mind for the explanations to the answers when frustration and disappointment are clouding over you.

Patient interactions will always be a highlight for me in any rotation, and I'm glad that we had a lot of them in IM.You'd think we had really gotten used to seeing patients at the OPD. Well, we are used to it, but I still don't think we're good enough. In this rotation I realized that even a group of 5 to a patient is a big ratio (when I used to think that it was better than having 10 people in a group). What usually happens with my group is that one or two of us carry the conversation with the patient--but the interview is not always systematic. Nakakahiya minsan pag nasasabon pa rin kami ng consultant pagdating sa history taking, samantalang 3rd year na kami. Sa tingin ko mas effective kami kung 2 students : 1 patient ang ratio. Either that, o mag-usap nang masinsinan ang group ko at mag-troubleshoot. Haay... the ideal me ranting at frustrations in life. ^__^

Tama na nga 'to. Bottomline: Med 250 was 'sweet torture' (kind of). But I wish it were a longer rotation.

Time to finish my journal report and dive into Community Medicine readings...

Taking a step closer to Him

Not that I made any big mess lately, but small messes, yes... I did have my shortcomings and inconsistencies, bouts of worry and bouts of selfishness in the past year. I pray this year I will be much more intimate with my Maker, by His grace...

Mercies New
Nicole Nordeman

Is it fair to say I was lured away?
By endless distractions and lovelier attractions then
Or fairer still, my own free will
Is the better one to blame
For this familiar mess I've made again

So I would understand, if You were out of patience
And I would understand, if I was out of chances

Your mercies are new every morning
So let me wake with the dawn
When the music is through or so it seems to be
Let me sing a new song, old things gone
Every day it's true, You make all Your mercies new

The distance left between East and West
Is how far You would go to forget the debt I owe
And thrown into the sea, the wicked ways in me
Will never have a chance to wash back on the sand

So I would understand, if you would make me pay
I would understand, lying in the bed I made again

Your mercies are new every morning
So let me wake with the dawn
When the music is through or so it seems to be
Let me sing a new song, old things gone
Every day it's true, You make all Your mercies new

Up comes the sun on every one of us
Gone, gone, gone the guilt and shame that knew your name

Your mercies are new every morning
So let me wake with the dawn
When the music is through or so it seems to be
Let me sing a new song, old things gone
Every day it's true, You make all Your mercies new

Realization for today

Mukhang hindi na ako sanay magsulat ng liham.

Mga tatlong oras na yata akong nakaharap sa PC (may kasama namang distractions hehe ^__^) para sa isang liham na ako ang naatasan ng pamilya na gumawa. May kaibigan kasi kaming taga-Germany na ni isang beses di pa namin nasulatan, samantalang taon-taon siya nagpapadala ng liham sa amin.

Mahirap naman talaga magkuwento ng mga karanasan ng bawat isa sa nakaraang taon... Sa dami nun alin ang ikukwento ko? Alin ang pwede nang hindi isama?

O marahil ay kinalawang lang talaga ako sa pagsusulat. Araykupo.

Sa kabilang banda, okey na rin 'to.. napipilitan akong balikan ang mga nangyari sa amin ngayong 2006.

Sa totoo lang kailangan ko rin ito...para masuri kung nasaan na ako sa kasaysayan ng aking buhay. Patapos na ang bakasyon, at ang taon.. di ko pa nagagawang magbulay-bulay at kausapin ang Panginoon...

Three days to go...

I am so raring to go on vacation already...

On that night when the whole UP Med community celebrates talent...

Our class won the TRP chorale competition again! I'm so proud of my class... go 2009! ^__^
Salamat sa lahat ng aming mga naging pasyente na nag-inspire ng aming kanta... :)

Happy Birthday Pa!

I'm glad I was able to spend tonight with my family to celebrate. Salamat sa mga pumayag sa 'kin wag muna mag-practice for TRP (Tao Rin Pala--I might write more on that this weekend when it's done). We ate at our (apparently) favorite pasta place, The Old Spaghetti House. Yum! We shared stories and laughed together and went camera shutter-happy..hahaha! Hanggang sa van pauwi umiral pa rin ang kakulitan naming magkakapatid.. nakakatuwa. This was definitely worth going home at the middle of the week. Buti na lang, declared walang pasok bukas! Thank you Lord! I don't have to wake up super early to get to the OR on time. ^__^

I thank God for my dad who loves the Lord so much and serves Him well; this down to earth dad who seeks to raise a Christ-centered family in spite of his imperfections... Happy Birthday Pa. :)

Surgery: Day 3

I had quite an interesting morning at the outpatient General Surgery (GS) clinic today. This was just my second clinic duty of the week, and I was expecting to see either a breast mass or a neck mass case since these were the more common conditions seen at the surgery OPD. But I forgot that this is GS after all, and what I would see could be anything.

Enter patient #1: B.L., a 22-year old male from Pasig. "Magandang umaga... so anong ipapa-konsulta mo ngayon?" I asked. The patient answered,"Luslos po." At first I was a little confused because I couldn’t remember what the colloquial term meant. But as the interview went on it dawned on me. Oo nga pala, hernia... For a fleeting moment I felt awkward. Buti na lang may ka-partner akong classmate! I can't imagine encountering my first hernia patient on my own. It would probably take a bit longer for me to 'recover' and be efficient in my interview. Siyempre 'di pa naman ako sanay tumingin ng hernia patients noh.. hahaha! He first noticed the hernia when he was Grade 3 or 4... Sobrang tagal na! But he said he experienced pain only three times (first during high school and the next two in college). We managed to examine him with the guidance of the resident surgeon on duty. We actually insisted, even if he said, "Ok lang yan, kaya nyo yan." Hahaha. Then we sent the patient off with a referral to Urology for repair of his hernia.

Patient #2: N.R., 31-year old male from Bulacan. Chief complaint: "Luslos". Wahaha! Second hernia patient! This time 2 months lang ang history nya. At inoperahan na rin sya nung bata sya para sa luslos sa kanan. (Kaliwa ang nirereklamo nya ngayon.) Sabi ko 'pag yung susunod pang patient hernia pa rin, ay exagg na. Haha..

To our relief (which was kinda relative now, on retrospect), patient #3 was different. A.D., 16-year old male from Tondo, had a painful mass on his lower back, which grew from a size of 1 1/2 inches to about 4 inches wide in just one month. He also had on and off fever. He consulted a private doctor two weeks ago and was prescribed antibiotics and paracetamol for a week, but the pain still persisted. The mother also said he was prescribed cough meds (which she couldn't recall), but they were not able to buy them. We tried to further explore the cough for a moment, and we didn't get much except it was non-productive, and that the mom and a sibling had chronic cough as well (about a year's duration). I was thinking (and I'm sure my partner Jill was, too): TB kaya yun?? And when I listened to his lungs, I heard something like wheezes on all lung fields. Warning signals began to go off in our heads, but on we went... His mother also said he had similar masses in 2004--two on his back and one on his left upper thigh. One was excised in a hospital and the other two 'erupted', with pus draining out. On examination, his current mass was reddish, and on palpation it was warm and felt like it was fluid-filled, most probably due to pus also. We endorsed our case to the resident, and in just one minute, he said, "Naku, hitsura pa lang Tuberculosis na! Ipa-AFB smear na tsaka thoracolumbar x-ray… Baka Pott's disease yan..." Yikes! We just got ourselves exposed to a TB suspect… I sure hope my immune system doesn’t get weak enough that my lesion (if I already have one) gets activated…

Back to our patient—the resident asked me to aspirate some pus to submit to the laboratory, but for some reason I couldn’t get enough. So he decided to proceed with incision and drainage (I&D). Poor kid—no local anesthesia was given (even if the Pain Clinic was just next door), so he was shouting and wincing in pain while the resident stabbed his abscess with a blade and milked out pistachio-green pus (yeah I know it’s gross... hahaha). We didn’t get to see the resident finish up though because we had to leave for a small group case discussion. On our way out we saw the mother looking quite worried that we had to assure her that the I&D was done for her son’s sake (although I agree with my classmate that giving anesthesia would also be a big help… =/). Kawawa yung patient… pati yung family members nya kelangan nang matingnan, malamang may TB rin sila.

This day at the OPD was a lesson for me to be observant and alert, especially when an obvious case is already staring me in the face. Looks like Surg will be another fun rotation… =)

Last week na namin sa Pedia...yey..hehe.. pero hay--may maaalala kaya ako by the time we take the exam at the end of the year? I think I may have to do extra studying during the few weeks before that.. buti na lang benign rotations na kami nun.. ^__^

Yup, that's how Pedia was for me... parang di ako sigurado kung may nareretain akong information... Na-realize ko challenge talaga ang iniiwanan ka lang na magbasa on your own (na minsan di ko nagagawa hehe). Pero marami naman kaming nakitang cases sa OPD. Natututo pa rin naman ako. =)

Iba-ibang disposition din ng patients ang na-encounter ko... mula sa mga baby na walang ka-imik-imik, hanggang sa sobrang likot na batang developmentally delayed at may cleft palate, hanggang sa batang grabe magwala makakita lang ng karayom... Whew!

Sabi ng blockmate ko sa simula ng rotation mukhang bagay daw ako mag-Pedia... Kung may heart man ako para dito, di ko pa yata natutuklasan... At muli ako'y nagtatanong: Lord, ano bang kalalagyan ko 'pag naging ganap na 'kong doktor?

I survived OB!

And who would’ve thought I’d miss it after all?

It was our first major 4-week rotation, one that my block mates and I initially approached with dread. We didn’t know if we could keep up with the daily 7am schedule and having to face the strong personalities of some residents (we did get warned by the previous blocks). But stressful as it was, OB-Gyn 250 grew on us. In those four weeks I saw patients one on one and encountered some interesting cases, did internal examinations and pap smears for real, got the hang of doing Leopold’s maneuvers and listening to fetal heart tones, and even did my first successful IV line insertion (with the guidance of an intern that we had to call from another ward). :)

And then there’s the 24-hr duty at the labor room and delivery room. Never mind that my body clock got whacked; I had a lot of firsts during that post too:

◊ I assisted an outlet forceps delivery, where I helped get the baby out (he was slippery and I feared I might drop him!), and delivered the placenta…
◊ I also got to assist a cesarean section delivery. My main role was to retract skin and muscles and suction amniotic fluid from the baby’s mouth, and later on suction blood as the surgeon repaired the incisions…
◊ I inserted a foley catheter into a patient in the recovery room. It wasn’t as hard as I thought it would be…
◊ One resident let me try a bit of suturing an episiotomy, albeit with somewhat fumbling hands. :) Thank you for the patience ma’am!

After that weekend I never looked at OBAS (the OB Admitting Section) the same way again.
It used to be just a ‘fixture’ in my everyday route to the college, but after experiencing what it was like inside the LR/DR, I know I’ll be reminded of those firsts every time I pass by. :)

Ironically, I still don’t see myself as an Obstetrician / Gynecologist in the future (haha). But there’s just a sense of fulfillment with all these learning experiences, and I didn’t realize I’d miss the department until I went to the hospital yesterday morning for the orientation to Pedia 250.
Tapos na pala ang OB. Next year ulit… di bale nang mas toxic na sa susunod, ganun naman talaga eh. :)

old unpublished entry: 08-25-06

I just finished my Cardio elective and once again I was inspired to consider it as an option for my medical career. =) I’ve re-learned and learned a lot of stuff… Of course a week in CVS is not enough, but I could say it was really a fruitful elective. We saw patients and heard their murmurs (one was PDA; another was VSD [classic!], and another was ASD). We were exposed to a little of 2D Echo. We got to hear of pre-op cases being discussed by fellows and consultants. My ECG reading skills improved and I don’t think I’ll forget them again. I got a little more used to doing the PE of the heart. S l o w l y I’m becoming more confident in examining patients… and I know I’ll experience a lot more of history taking and PE in the months to come. Thank you Lord for this privilege to be trained in PGH! =)

First post :)

I remember comparing high school life to a marine voyage in our yearbook—and graduation was reaching our destination on shore. And then college life I likened to a trek up the mountains. If it were so, then med school was definitely a tough height to scale. Well, it still is. But what I used to consider too far off doesn’t seem as far now. I thought graduation is still a long way ahead, until one day it sank in that two and a half years have already whizzed by. I’m actually halfway there! It’s exciting and scary at the same time. Each day is one step closer to my becoming a real physician; each patient encounter an opportunity to hone that so-called clinical eye. May each step, then, not be in vain… Oh Lord please help me to make the most out of these years of training and be the kind of doctor that you want me to be.