Things I Learned From My Patients

Hello, world! I am no longer a slave! JUST KIDDING. Clerkship (4th year of medical school) has been a year full of learning and extraordinary experiences. I gained a lot of practical knowledge and I can’t wait for the next chapter of this career that I chose.

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But before I completely move forward, I want to share with you what some of my patients taught me. Akala ko drama lang yung sinasabi nila na you learn from your patients pero totoo pala. You can learn about tuberculosis more effectively by actually seeing a patient with this disease and then reading about it on your textbook or journal articles. The patients won’t tell you about the technicality of their disease, obviously, but what I learned from them are lessons that are deeper than the things you could read in a medical book.

So, these are the things I learned from my patients, in chronological order of my rotation as a clinical clerk.

Surgery

During our rotation in Amang Rodriguez Hospital (Marikina), a woman stabbed by her husband was brought to the ER. I definitely learned to stitch the scalp (yes, she was stabbed on the head!!!). But most importantly, I will always keep in mind to marry a keeper. Girls, stay away from criminals, and criminals in the making. Katakot!

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Trying to make sense of the CT scan plates…
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This was taken in UERM Hospital during a surgical procedure.
Medicine

I had a very lovable elderly patient who was obese, with heart failure and chronic obstructive pulmonary disease (COPD). Whenever I see him, I couldn’t help but associate him with Santa Claus! If only he stopped smoking a long time ago, started living a healthy lifestyle, and became proactive in taking good care of himself, he may have been living a comfortable life without fear of whether or not he would be hospitalized again in the near future.

Psychiatry

Patients in a mental ward are still human beings, with emotions and an innate kindness in them. One time, we taught them how to make pastilles during one of their occupational therapies. They were so sweet, they even gave us some of their finished products.

Ophthalmology

My mom had a cataract operation in UERM (thanks to Dr Felarca and the whole department!). I’ll never forget how happy she was to be able to see the smallest details again, for example, a tiny dirt on my dress. Let’s appreciate the small things in life. How lucky are we that we can send text messages, appreciate Instagram photos, and read wonderful novels?

Otorhinolaryngology & Head and Neck Surgery

There are bad people everywhere. Some may even break into your house at night and stab you in the face if you try to stop them. Keep your house and neighborhood safer. Again, katakot!

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Equipped to look inside your ears. There was one patient with a cockroach stuck inside his ear. I KNOW.

Pediatrics

Looking back, I actually learned the most in this rotation. The most unforgettable is the five-year old boy who had Cerebral Palsy, a neurologic disorder. While he was still in the womb, his mother was advised that it was likely for the child to have a disorder (based on the ultrasound). She still chose to continue with the pregnancy and to give birth to him even if she had the chance to terminate it (at that stage it was still an option). I would say this kind of love is definitely unconditional. The mother was doing everything she can to provide the child with a comfortable life.

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Cute babies make work so much easier! (Photo taken and posted with permission from the mother)
Obstetrics and Gynecology

For me, the most memorable part of this rotation is when I was coaching mothers during labor. I’ll never forget this line we kept on telling them — “Hingang malalim, pigil, and push!” It must be really hard and painful for mothers to give birth. Dugo, pawis, at marami pa ang pinuhunan nila. Thanks, Mami, for pushing me out of your uterus, to be a part of this amazing planet.

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Delivery room — where babies are born (East Avenue Medical Center)
Dermatology

We had the option to choose two elective programs for one week each and I chose Dermatology twice. You may think this specialty is shallow and easy but it’s the complete opposite. Skin lesions usually look the same and you have to read a lot (and see a lot of patients) to be able to distinguish one disease from another. I interviewed one patient who had Psoriasis, and his whole body was covered in thick crusts. He was a hard-working man but his condition was preventing him from going to work (kasi nakakahiya raw). Diseases affecting the skin not only affect productivity but the mental health as well. Everybody deserves to be confident in his or her own skin (I swear this is not a sponsored post, haha).

Neurology

During my first day in the ward, there was this one patient who was always grumpy. I’ve never seen her smile the entire day. But then, she was diagnosed with a brain tumor so I completely understood. The following day, she was visited by friends and family. She was smiling the whole time they were there, even long after they were gone. She had a brain tumor and nobody in the entire hospital (or the entire world) was sure of what would exactly happen to her after her operation; but she seemed happy and hopeful. So, what are the key ingredients for a happy life? I guess family, friends, and optimism.

Community Medicine

While teaching barangay health workers in a health center in Rizal, one of them asked if drinking pineapple juice can decrease blood pressure. You see, most people in the province believe that if one is having symptoms due to increased blood pressure, he only needs a can of Del Monte pineapple juice to alleviate the symptoms and normalize his BP. There are so many misconceptions about health and medicine that hinder us from preventing common diseases. I think kids should be taught in school about the important things they should know about healthcare. Let’s debunk the myths at their level.

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Our group with the receptive barangay health workers

This would be longer if I’ll continue to talk about the changes I would like to be implemented in our healthcare and education systems so I’ll stop right here. I’m not an expert and I know  the people in charge are doing their best (well, hopefully).

And no, drinking pineapple juice is not enough to decrease one’s blood pressure. A healthy, active lifestyle can, with the aid of medications (depending on the individual).

There you have it, a preview of 12 months worth of education. Thank you, dear patients! In a few months, I will be starting with my post-graduate internship which for sure, would be another year full of learning and meaningful stories.

Take good care of your health because I don’t want to see you in the hospital!

‚ô•

Rachelle

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THE READING LIST: On dietary supplements you actually need, the real deal about moderate drinking, and the importance of vaccination

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I am a firm believer of the internet being a great tool for health education hence the birth of this blog segment. I originally wanted to post a new list every week but let’s just say every two weeks is more feasible. Click the link (title) to be directed to the full article.

Here it is, Volume 2 of The Reading List! ūüôā

The Truth Behind the Top 10 Dietary Supplements (via WebMD)

Multivitamins and other dietary supplements are so “in” since God knows when, but should we really take them? Some people i.e. nursing mothers, pregnant women, strict vegetarians, people with allergies and food intolerance, and senior citizens definitely need specific food supplements. How about a young adult with no known illness, or those trying to lose weight and build muscles? Promise me to read this article so you wouldn’t waste your money (or your parents’) on the non-essential stuff. Also, too much of anything is bad. If you’re taking supplements, make sure you are consuming the right amount. Most are NOT¬†like Vitamin C, whose excess amount you get to easily excrete in your urine.

Is moderate drinking really good for you? Jury’s still out.¬†(via Science Daily)

Many people believe a glass of wine with dinner will help them live longer and healthier — but the scientific evidence is shaky at best, according to a new research analysis.” A glass of red wine may be good for you, but unlikely because of the alcohol content. Claims of alcohol being beneficial to our health should be taken with skepticism.

Hygiene practices affect contact lens case contamination (via Science Daily)

I’m guilty of not always observing proper hygiene habits with respect to my contact lenses. So, here’s a summary for you (and me, LOL): 1) Wash hands with soap and water before handling them; 2) Disinfecting solutions and cases should be of the same brand or manufacturer as your lenses’ and 3) Air-dry your cases face down after cleaning them. We don’t want eye infections, do we?

Five Ways to Eat Less Without Thinking About It (via Eat Clean)

We’ve surely¬†read about these tips several times before from different sources. These five tricks for eating less really work for me, especially this — drinking¬†water before each meal.¬†However,¬†¬†I sometimes forget about them. So, here’s a reminder! Let’s get that beach body ready!

The Power of Herd Immunity (via Ted)

Know that when getting vaccinated, you don’t only protect yourself, but also others. By “others,” I refer to¬†the people around you, and in turn, the people around them. The link actually directs to a video (make sure to turn the subtitle on). You may want to view the interactive script if you prefer to read.

Note that the published article about MMR (measles, mumps, rubella) vaccine being linked to autism in children was proven to be FRAUDULENT hence retracted by the journal responsible for the publication. Of course, vaccines have potential complications but these are mostly mild and temporary (i.e. fever) and the benefits of being vaccinated definitely outweigh the possibility of complications. Now is the time to consult your doctor about the vaccine boosters you need, fit for your age and current health condition.

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Here’s a picture of me after my second shot (out of three) of HPV vaccine. On another blog post, I’ll tell you more about why I got this vaccine, and why you should, too.

‚ô•

Rach

Informative Pages You Should Be Following On Facebook

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A lot of people would agree with the idea of Facebook and other social media apps being a waste of our precious time. Boy, I couldn’t keep track of the total hours I spent on Facebook when I should be on a “study break.” Most of the time, those study breaks were longer than the actual studying. But then, why not make Facebook a tool to learn new things, and also to share some ideas to other people?

With that, I leave you these Facebook pages that I highly suggest you follow (mostly health-related and for Filipinos). These will make the minutes spent on scrolling your newsfeed definitely worthwhile. Now you don’t only rely on your doctor, whom you only see once in a blue moon, for health tips and advice.

Research Institute for Tropical Medicine (RITM)

They usually post infographics regarding timely infectious diseases.

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Department of Health

It helps to have a daily reminder to keep a healthy lifestyle!

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World Health Organization

They share relevant tips about healthcare, of course.

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Sometimes, we forget that we are part of a bigger picture. It feels good to be a part of a greater cause i.e. caring for the environment.

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TIME

TIME usually posts articles on how one could be happier, and less stressed in work and in life. It also highlights entries on success. It’s a fact that a person’s mental and emotional health has a great impact on the physical being as well.

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Philippine Dermatological Society

Make sure to see their older posts for more tips and information about common skin diseases.

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Washing your face helps remove dirt and oil from your face, but don’t overdo it! Frequent washing can lead to dryness and irritation and can cause more breakouts. Yikes! As a general rule, it is enough to wash your face twice a day using mild soap and water. Then, gently pat your face dry once you’re done.

And last, but definitely not the least, IN FULL BLOOM! Duh! Shameless, I know. Haha!

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You have the option to make these pages a priority in your newsfeed, actually. If you click “see first,” every new post would automatically show up at the beginning of your feed once you log in. Nice, right?

What are your favorite informative Facebook pages?

THE READING LIST: On exercising when you’re such a lazy bum, the many uses of laser for the skin, and your grocery cart must-haves

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How are you, guys? I’m a bit nostalgic since clerkship year would officially end in nine days. We actually had our last practical exam yesterday. My batchmates and I would get our medical degree during our graduation ceremony next month. I COULD NOT BELIEVE IT. Four years has passed by swiftly!

Meanwhile, note that every Tuesday, the blog would be posting a list of articles from the web, all about health and beauty.¬†I was inspired by the blog Summer Tomato to do this, actually. There are just so many stories and news out there that are worth sharing. Here’s the first one!

Happy reading! Feel free to share your favorite articles this week on the comment section below.

‚ô•,

Rach

Do you breakout ’cause of make-up?

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Sometimes, I wonder if the make-up products I’m using are the ones causing¬†my acne breakout once in a while, aside from the monthly surge of hormones or stress from hospital work. My curiosity made me take a look at the products I use on my face and research¬†if these are comedogenic (read: acne-causing, scroll¬†down to learn more). I always thought that once a product is labelled as “non-comedogenic,” there is a guarantee that it¬†wouldn’t be a culprit¬†of acne eruption.

As it turns out, I was wrong.

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Here are some of the products I use whenever I need to look made up.

Disclaimer: This is not a sponsored post.

Comedones are simply known to us as whiteheads and blackheads, which are the result of clogging of pores. These are tiny “bombs” that would eventually transform into acne. Hence, once a product is labeled “non-comedogenic,” it would seem like the neatly packaged facial cream or foundation would cause no “harm” (read: pimple eruption). But then, I learned that it doesn’t always hold true, given that this label is not actually regulated. There isn’t a universal standard on how a product could pass a comedogenicity test. Also, one ingredient may cause pore clogging in one person but not in another.

Meanwhile, there are studies that showed how certain substances caused comedone eruption on rats’ ears. Listed below (in alphabetical order) are the chemicals that tested positive for comedogenicity (from studies I had access to). You may want to check the ingredient list of the products you are using (instead of just trusting their claims of non-comedogenicity right away). Check their boxes, or the internet if you’ve already thrown them¬†out.

  • butyl stearate
  • cocoa butter
  • decyl oleate
  • isocetyl stearate
  • isopropyl isostearate
  • isopropyl myristate
  • isopropyl palmitate
  • isostearyl neopentanoate
  • lanolin*
  • myristyl myristate
  • octyl palmitate
  • octyl stearate
  • sodium lauryl sulfate
  • squalene monohydroperoxide

*This is usually found in blushers, i.e. xanthene, monoazoanilinines, fluorans, and indigoids.

**You may want to take a screencap of the list using your smartphone and use it when buying cosmetic products at the mall.

After checking the ingredients of the cosmetic products I use, I came to the conclusion that I have been using products that are likely non-comedogenic. Again, I put the blame on the monthly surge of hormones for my acne breakouts. But then, what works for me may not work for you (and vice versa),¬†so the products I’ve posted here may not be suited for everyone.

One study actually remarked that the problem of acne caused by comedogenic ingredients in cosmetics today is almost negligible. This is why I really look up to people doing research; they make the world a better place (read: pimple-free, hehe).

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I would say this sunscreen I’ve been using daily for almost a year is non-comedogenic.¬†Click¬†here¬†for the list of ingredients.

Meanwhile, the following chemicals may contribute to a decrease in acne:

  • nicotinamide
  • lactic acid
  • triethyl acetate
  • triethyl ethyllineolate
  • prebiotic plant extracts (more details here)
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I have been using this moisturizer twice daily. Despite having lanolin alcohol (on the list aof comedogenic chemicals above), it has prebiotic extracts (barley and cucumber). They may have been balancing the effects of each other since I don’t think my occasional breakout would have been caused by this. Nonetheless, I really love this moisturizer.¬†

Aside from choosing the right products, there are two more things we should do.

  1. Always remove make-up before going to sleep.
  2. Regularly clean make-up brushes and sponges to avoid growth of acne-causing bacteria that would later on invade our pores.

Here’s a confession, I can’t remember the last time I cleaned my brushes either. Ooops.¬†So, goodbye for now as I¬†have to look for hydrogen peroxide to clean my brushes.

‚ô•,
Rach

References:

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On nearing the quarter life, and the joy of doing what you love

You may not know this, but I just turned 24 a few days ago. I used to associate this age to being old but now, ironically, I feel young. Although I have to admit, I fear turning 25 next year. I think by then there would be more pressure to act like a real adult. But you know what, before I even turn 25, I think I already experienced that quarter life crisis. Or maybe there’s another inner struggle about to happen in the future? Oh, God.

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When In Saigon

Saigon (aka Ho Chi Minh City) is a place I did not expect to like, but ended up loving very much. If you were brought up in Asia just like me, the place would offer you a sense of familiarity. But then, there are certain things that make it different in a good way. Perhaps it is because of the history of the entire country, which includes being colonized by the French, and having fought the US during the Vietnam War. Nonetheless, I bet anyone would enjoy and find comfort in this beautiful city.

I went here in the month of May, which was perfect since there were no rainfalls at all. I was used to the humidity in Manila so there was no adjustment necessary. If you have two full days to spend in the city, here are some of the things that you can do. Consider this as a sample itinerary and a travel diary at the same time. Enjoy!

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Is sugar-free good for you?

Before we welcomed 2016, I bet most of us have formulated resolutions already. I even wrote them down para mas mukhang legit. Of course, one of my resolutions (more like goals) is to have a healthier lifestyle. For sure you’ve read a lot of articles¬†on how to live a healthy life or achieve one’s goal weight. We could agree that it’s best to avoid sugar (candies, syrup, etc) as much as we could, right?

The problem with¬†avoiding sugar is that it’s so hard, mas mahirap pa ata kesa sa pagmu-move on mo mula sa gago*¬†mong ex. Dessert after a meal? Yes, please! Ice cream to cure your PMS? Yes, please! Chocolate para makalimutan ang masalimuot mong lovelife? YES, PLEASE! Wait lang, hindi pa Valentine’s Day! Bakit ang-bitter? Haha

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Tips for your future hike to Hulugan Falls

I have been seeing a lot of photos taken at various mountain peaks and waterfalls on Facebook and Instagram. One time, there was a friend who posted a photo of Hulugan Falls in Luisiana, Laguna. Since it was close to our hometown, my high school friends and I went on a day trip to see the beauty about two weeks ago. IT WAS AWESOME.

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What a beautiful sight! #nofilter

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Laguna Road Trip

If you have a day off, and happen to be just living in Metro Manila or Region IV-A (Cavite, Laguna, Batangas, and Quezon), you may want to have a little adventure in an inner area in Laguna.

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Life in the Time of Diarrhea: Why I Got a Health Insurance

Hello, guys! Are you still there? Well, I’m still here, back from an unexpected hiatus from blogging. I became suddenly drawn to hospital work and group exercises at Gold’s gym, and realized how medical clerkship (4th year in med school) can be actually fun and enjoyable. Why am I suddenly going to talk about health insurance, you may ask? I have “diarrhea” to thank for this blog entry, actually!

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Las Casas Filipinas de Acuzar: A Reason to Go All the Way to Bataan

I have been contemplating if I would share travel posts with you, guys. My original plan was to share only skin care and wellness tips to readers. However, I realized that keeping a healthy body also involves having a sound and happy mind, and what better way to keep one’s spirits up than to experience what life has to offer (aka travelling)! Also, the truth is, I miss the adventures now that I’ve been working as an intern in the hospital for five months now. In a way, sharing tips and photos from other places would be an escape for me. So now, I would like to share with you why Bataan (a province in Luzon, Philippines) should be marked on your maps.

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Getting Your Dream Body: Expectations vs Reality

They say that in order to win, you should know how to deal with your enemy. But what would you do when your enemy is yourself? Like when you’re trying to achieve that dream body of yours, nobody actually tells you that you should not do it. I consider myself a victor after leaving my obese self behind¬†a few years back. However, I find it hard to get my dream body (read: fit and toned, thigh gap unnecessary). But why is it so hard? I’ve always tried but then I can’t seem to finish what I have started every single f**king time! Continue reading

MUST KNOW: Non-Laser Hair Removal

I am not sure at which point in the history of women’s vanity did girls start caring about their underarm hair (and hair elsewhere). But when I hit adolescence, I automatically had the notion, as I have observed my mom over the years, that I had to keep my underarms hair-free. Well, it is the norm until now, although I am aware that there has been a number of movements for girls to embrace their armpit hair. There are so many revolutions at this time that it gets hard to keep myself updated. Now, look at what I just found… Continue reading

Healthy Eating Made Easy (Part 2)

Hi, guys! I just finished my two-month Internal Medicine rotation; I didn’t realize eight weeks could fly so fast! I definitely acquired a lot of wisdom¬†but still, there are so much more to learn. I’ve come to know how true what our mentors always tell us, that the art and science of medicine requires continuous reading and education. There’s no escaping the big books and journal articles!

Most of the patients I have seen, out-patient basis or admitted, have either hypertension (high blood pressure), diabetes, hypercholesterolemia (having too much cholesterol in the blood) or were obese. For sure, you already know how having a balanced diet could prevent the complications of these conditions, if not totally prevent their occurrence. It is never too late to change what and how you eat!

This is the second part of the ultimate guide to healthy eating that I’ve been working on. Read the first part here. Enjoy! ūüôā

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