Thursday, July 12, 2007
Post duty status
Lord, help me survive and even enjoy Pedia kahit na ganun siya ka-toxic... (Hay naku, hindi pa nga ito IM...)
Saturday, July 07, 2007
Nanay Evelyn
I was at PALCare yesterday, where I met Nanay Evelyn, 59 years old, diagnosed with Invasive Ductal Carcinoma of her left breast just last month. She just had her first chemo session about three weeks ago, and she went to PALcare to seek for financial assistance for her subsequent sessions. I was asked to interview her before they help her out, so talk with her I did. It was a good conversation in that I did not have a hard time getting to know her. Despite her rather sad countenance, she was still willing to share about herself, her family, and how—in the face of all the hardship, her family has been a source of strength and comfort. But even as she was affirming her resolve to stay strong, her glassy eyes would betray her. I felt a tug at my heart as we talked… Why did I have to forget to bring a tract that day? I wanted to reach out to her with more than just the short ‘generic’ reassurances like “Tatagan niyo lang ‘Nay…” I wanted to talk with her more, try to share the Gospel to her, but time was limited. Sometimes I wish an instance like this wasn’t the only time I would see patients like Nanay Evelyn. But soon, I realized that God will not run out of ways to reach her. I pray that He will lead her to people who will point her to Him and that she will truly surrender her life to Jesus…
Sunday, July 01, 2007
Back to PGH
Pagdating ng second week, bagong environment naman. Tuwing umaga, sa Malibay Health Center sa Pasay ang duty namin. Nakakatuwa kasi computerized ang charts nila dun. Simple lang din ang cases ng mga pasyente kaya mabilis lang sila tingnan. Libre ang konsulta, pati ang mga gamot. Nagbibigay lang sila ng donations para patuloy na makatakbo nang maayos ang center (hindi kasi lagi on time ang dating ng funding galing sa gobyerno). Na-enjoy ko rin ang pagbakuna sa mga babies; there was a morning na naka-nine babies ako. =)
Isa pang highlight ng community rotation ay ang exposure namin sa activities ng Remedios AIDS Foundation, isang NGO na tumutulong sa pag-alaga ng kalusugan ng mga taong sangkot sa prostitution. Ibang klaseng experience din yun. Hmm.. I-upload ko na lang kaya dito ang ginawa kong paper? :)
For the last two weeks of Fam Med, sa Supportive and Palliative Hospice Care unit naman ako. Ang focus naman dito ay pag-alaga sa patients na hindi na responsive sa curative treatment (i.e. cancer patients). Meron ding patients na referred galing sa ibang wards, usually for psychosocial support. I hope this last week and a half will be meaningful..
Ayun.. so far ito ang mga nangyari sakin sa pagsimula ng clerkship.
I'll just end this abruptly for now and hope for a more coherent entry next time. Hehe. =)
================================================
Sige... storytelling time... here's my paper about my Remedios experience. :)
Bitter Reality
After a while Con fetched us and walked back, and then we dropped off Suzi, Chrys and Ate Roselynn at another cruising point (a.k.a. pickup point). Before heading back to Jill, who was still with Jenny, Con introduced me to Sally and Krystal, who then consented to spend some time with me. Since Sally asked about the common symptoms of STIs, I started by explaining the topic to them. Apparently, Krystal was already familiar with these symptoms, but claimed not having experienced any yet. After my first round of educating them, I asked how they were doing that day. They said they weren’t doing very well. Again, I asked: “Bakit, kapag maganda ang araw, ano ang ibig sabihin sa inyo?” To this Krystal replied, “Huwag mo na lang alamin, tama na ang kami lang ang nagtatanong sa ‘yo.” I didn’t know how to proceed after that. I wanted to ask more questions, to scratch their surface, no matter how little, but I feared they would just build a stronger wall against me. After a few silent moments, Jill and Con arrived, somewhat to my relief. Jill helped re-emphasize why we were there that evening—that we wanted to help them to be aware of the risks of their business, and to stay protected by using condoms. The visual aids we brought came in handy during our interaction; it caught their attention and facilitated some discussion (two more girls came to listen to us at this point). I also found out that Sally used to work in one of the bars there, and used have an annual check up and “cleaning” at the Social Hygiene Clinic. I got curious about this “cleaning” procedure they referred to several times, realizing later that “cleaning” was actually having a pap smear done. I wonder if the people at the Social Hygiene Clinics ever really explain the purpose of doing a pap smear. After some more chit-chat, we gave them free condoms, thanked them for their time, and then headed back to Chrys and Suzi’s spot. While waiting for them to finish with their own audience several feet away, I got to witness more typical Makati street activity late in the evening, even if it was raining. Clusters of PIPs stayed on the sidewalk, waiting for ‘guests’ or customers. Every now and then a foreigner would walk by with a
Soon, it was past 10 pm. By this time on a normal Saturday night, I would be at home sitting in front of the TV set, watching a rerun of Lost. But for countless girls in entertainment districts all over Metro Manila, a normal Saturday night would mean getting dolled up and enticing guests to sleep with them just so they could pay for bills, or tuition, or medicines, or simply be assured of a full stomach next mealtime—and the more guests, the better. We did not stay until midnight, yet even for a few hours that night I got a closer glimpse of a world that I deliberately kept to the margins of my consciousness. Quite naturally, the girls did not easily open their lives up to me, an outsider. I could only surmise how desperate they are to be going out and offering sex for money so they could get by. Sally and Krystal appeared all perky when I talked with them. But when the gaiety and nonchalance wear out, how often are they haunted by the shame of what they do?
That night showed me how valuable the painstaking work of the CHOWs was. These PIPs would not readily come to PGH or to the local health center, and many apparently still have misconceptions about reproductive health and hygiene. Thus it is really better to go and reach them where they can be found. I hope that with persistent information and education campaigns, they would be stirred to act positively about taking care of their bodies. I hope more organizations will pay attention not just to their health needs, but to their emotional and spiritual needs as well. Frustrating as it is, I wish the government would do something substantial to alleviate their condition. While it seems that this Prevention Project is all we could do for them in the meantime, I hope we don’t resign ourselves to thinking that when it comes to radically changing the system, there is nothing much we can do. This bitter reality will go on if we do nothing else.
Sunday, June 03, 2007
An Adventure of Faith
(Warning: Detailed kwento up ahead. ^__^ )
I just had a trip to
Our core team of 10 (including K. Dave) was divided into two groups for the two “M” communities we were going to visit. Faye, Ron, Alvin, Jaylord, Paul, Jana and K. Dave went to
Monday and Tuesday afternoon, we went in pairs downtown to share the Gospel using tracts and Gospel bracelets. We tried SM on the first day (we didn’t really have much choice since it was raining hard). It was difficult—our first time to be deployed for ‘stranger evangelism’—and we all had to overcome our timidity. With much prayer and asking from the Holy Spirit, He led us and enabled us to share the Gospel to several people, but not without a few blunders, though (like not being able to follow up the bracelet with a tract). But we still learned a lot, especially about the importance of prayer and practice. The next day, God continued to reveal Himself, His goodness and grace. He held back the rain, to our amazement! Two teams, mine included, were able to go around and witness to people in
The third full day was another faith-stretching experience for me. We did an evangelistic gathering for the “M” teenagers who came over to
Thursday, May 24, 2007
We Have A Long Way To Go
Hearing how the recent election was labeled ‘peaceful’ (relatively) gave me but little comfort about the condition of our nation. They say technology and more vigilance from the people have made it more difficult for fraudulent schemes to succeed. But then I watch the news, I read the news paper, and I hear of controversial ballots, flooding of counterfeit money in the provinces, bombs going off, a school getting burned, teachers, watchers, and even some officials getting killed, ballot-counting by candlelight, the never-ending count update of our utterly slow canvassing system (when, oh when will we be automated?), and how the partial senatorial tallies reflect what the people think of the administration.
Let me share this vision for the nation that I am holding on to. Our church pastor was the one who wrote it, and he shared it with us a year ago (I can’t remember if it was during a worship service or a teaching session). The piece of paper got buried in the clutter on my desk, and I got reminded of it when I went on a mission to clear up that clutter. =) I hope this becomes your vision too.
What kind of
A land that is PEACEFUL. Where Muslims and Christians and animists and those with no religion at all can live together as friendly rivals but not as enemies. Where disputes are resolved by discussion and debate and not with the barrel of the gun. Where one may walk the streets at night unarmed and remain unharmed.
A people who are FREE. Free to think even the unthinkable, free to worship God according to one’s best light, free to elect rulers and to replace them, free to argue one’s case in the media, free to travel wherever one pleases, free to live and work anywhere in the islands.
A territory that is SOVEREIGN. Friendly with all her neighbors, and working in solidarity with them in promoting regional interests. Cordial with all nations in the East and the West, the North and the South, but sovereign in her foreign policy. Free to chart her own destiny for Filipinos have the special duty to promote the welfare of their nation.
A nation that is JUST. Every man and woman and child receives his/her due. The poor are not discriminated against because of ignorance or lack of access to legal services. Judges and justices cannot be bought but dispense and apply the law with impartiality. Equal pay is given for equal work. Everyone has equal opportunity for education, housing, employment, medical care, and other social services.
A community that is PARTICIPATORY. People taking responsibility for their lives, and increasingly empowered to do so. Making decisions that affect their families and neighborhoods, their towns and cities, and the entire country. Being responsible for one another for “each man is his brother’s keeper.” Political in the broadest and best sense. Our stewardship includes the care of the planet Earth, God’s appointed habitat for mankind.
A country that is PROSPEROUS. Not prosperity at the expense of freedom, but a progressive economy that grows from wise policies, efficient, government, and honest business practices. Prosperity that does not merely make the rich even richer, but one that benefits all the people, reaching to all parts of the countryside, finally breaking the back of centuries of feudalism.
A society that is RIGHTEOUS. Only through the Christian gospel are people “put right with God,” so we evangelize as vigorously as we can. However, there is a public righteousness that Christians can promote as salt of the earth and light of the world. As an “overwhelming minority,” we can influence the rest of society to minimize graft, tax evasion, violence, prostitution, and other expressions of a corrupt society. “Righteousness exalts a nation, but sin is a disgrace to any people” (Proverbs 14:34).
Date: June 25, 2006
Thursday, May 10, 2007
IBOTO ANG KAPATIRAN
We need people like them in our Senate.
http://www.angkapatiran.org
http://www.kpkcommongood.blogspot.com
Make a difference.
Spread the word. And vote for them.
THERE’S THE RUB
Again, the ‘wasted vote’
By Conrado de Quiros
Philippine Daily Inquirer
Last updated 01:14am (Mla time) 04/18/2007
MANILA, Philippines -- The last time I spoke with Ang Kapatiran [The Brotherhood] party candidates, they were saying that having gotten this far was already a victory in itself, independently of whether they actually barge into the Senate or not. It’s true. As I’ve written on several occasions, no good thing really goes to waste. Small things are stepping stones to great things. Their accumulation is what makes historic things happen.
But I’m still hoping for a miracle to happen: for the voters of this country to be stricken by light like Paul of Tarsus and convert to wisdom. The only resistance against them comes from a couple of arguments I myself have heard from friends over the past month or so. One, let’s face it, the political realities in this country are such that the voters will vote for the strong candidate -- and the Kapatiran candidates are far behind in the surveys. And, two, the votes for them are therefore likely to be wasted, might as well lend them to those who stand a better chance.
I’ve heard the exact same arguments raised before against candidates who were completely meritorious but who were not as popular as their benighted rivals. And I’ve written many columns to answer those objections. Two of them in particular, “The heroic vote,” and “The wasted vote,” I’m reproducing here in cut-and-paste form (some things can never be sufficiently belabored):
Yes, we do need to see political realities. But doing so does not mean we should resign ourselves to them, or worse perpetuate them. We have in fact two options when faced with a harsh reality, such as this country’s lack of political maturity. We can resign ourselves to it, or we can try to change it. We can perpetuate it or we can try to stop it. We can make it worse or we can make it better.
We can say, “Well, there’s nothing I can do about it, I might as well do as everybody does.” Or we can say, “This is unacceptable, I must do something about it. Maybe my one voice is not loud enough, but it will be so if it finds an echo in the voices of others. Maybe my one vote is not dazzling enough, but it will be so if it lights the fires of others. But I do not raise my voice now, and I will perpetuate the silence. I do not light the fire now, and I will deepen the darkness. I do not try to make things better, and I will make things worse.”
Heroes do not become heroes by thinking, “I will do the heroic thing.” Heroes become heroes by saying, “I will do the right thing.” Which became heroic because doing the right thing is the hardest thing of all. You don’t always have to die for your principles, you can always live for them. The second is often more heroic than the first -- in this country more than others. We’ve always been willing to die for democracy, it’s time we started being willing to live for it.
I do not buy the notion of the “wasted vote.” The only wasted vote I can see is the one you give to a candidate you do not believe in simply because you think he or she has a chance to win. That is boundless waste, not least because it stands to waste the country. To this day, I do not regret not voting for Joseph Estrada in 1998. To this day, I do not see that I wasted my vote voting for somebody else. If there was any “wasted vote,” it was the one that went to Estrada. That is so not just because he never got to finish his term but because people voted for him simply because “he was going to win anyway” whatever they did. People who do not want to appear like fools by voting for a “weak candidate” are on a straight path to it.
Correspondingly, the wasted vote is the one you withhold from the candidate you deem deserving because “he is not going to win anyway.” That is a self-fulfilling prophecy, guaranteeing doom -- and not just for your candidate. The only thing worse than being disempowered is having the power and not knowing you do. Or worse, knowing you do and abdicating it. The vote is a great power, and it is something we hold in our hands. The victory of candidates is not written in the stars, it is written in our hearts. The victory of candidates is not foreordained, it is decided by us. We do not vote for candidates, they do not win. We vote for candidates, they win.
Even if the candidate you believe in is not a popular one, what of it? Voting is not just something you do for a candidate, it is something you do for yourself. Or to yourself. Elections are a test of character, but it is not just a test of character for the candidate, it is a test of character for the voter, too. It’s not just the candidate who’s on trial in elections, it is you, too. When you vote, you do not just decide the kind of life you want for the nation, you decide what kind of life you want for yourself. You can choose either the life of a lemming and throw yourself off a cliff because everybody is doing so or the life of a human being and act as reason and conviction tell you to.
At the end of the day, you do not just have to live with the candidate you have inflicted on the nation, you have to live with yourself and the wound you have inflicted on yourself. You can’t be true to yourself, you can’t be true to the nation. Stop complaining about this country going nowhere. There is no vote that is wasted on a candidate you believe is fit to run this country, whether he wins or not. You do not win when you vote a fool or a tyrant to office because he or she is the “strong candidate,” you lose -- even if he or she wins. Above all when he or she wins. And you do not lose when you vote for a candidate as your conscience bids, you win -- even if he or she loses. Above all if he or she loses: It is but the beginning of struggle.
The “wasted vote” is a stupid concept. You keep worrying about it, you’re wasting your time, your energy and your life.
Balik Tanaw
Nung huling araw ng camp, pakiramdam ko dinaanan lang ako nang mabilis ng isang linggo na
Salamat, Panginoon, sa LCDC 2k7. :)
Tuesday, April 24, 2007
Song Of The Moment
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...
Tuesday, April 17, 2007
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)
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 (
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! :)
Sunday, April 08, 2007
Dormant Muna
Kaya ako nag-hehesitate mag-blog before eh. ^__^
Sunday, March 11, 2007
Learning, The Hard Way part 2 [overdue]
--> 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.
Wednesday, March 07, 2007
Learning, The Hard Way
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...)
Tuesday, January 23, 2007
Musings from Med 250
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...
Saturday, January 13, 2007
Taking a step closer to Him
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
Thursday, December 28, 2006
Realization for today
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...
Tuesday, December 12, 2006
Wednesday, December 06, 2006
On that night when the whole UP Med community celebrates talent...
Salamat sa lahat ng aming mga naging pasyente na nag-inspire ng aming kanta... :)
Wednesday, November 29, 2006
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
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… =)