Scripture for the Day

When we consider God’s greatness and love for us, everything else (the smallest problem, concerns and daily affairs) appears trivial… It’s good to reflect on this quote:

“When I consider Thy heavens, the work of Thy fingers, the moon and the stars, which Thou hast ordained, what is man, that Thou art mindful of him, and the son of man, that Thou visitest him? for Thou hast made him a little lower than the angels, and hast crowned him with glory and honor; Thou madest him to have dominion over the work of Thy hands; Thou hast put all things under his feet; all sheep and oxen, yea, and the beasts of the field, the fowl of the air, and the fish of the sea, and whatsoever passeth through the paths of the seas; O Lord, our Lord, how excellent is Thy name in all the earth!”–Psalm 8:3-9.

Psych Matter

             It had been a long time I was out of the blogging world… 4 months  I think. And for that 4 months, I can only think of one reason to justify it: I had been busy! Busy with work, that’s certainly given. Besides, I finally finished reading the book I first started when I was in second year college. I also had a marathon of a famous american tv series which I really really liked and appreciated. It presented a main character who was diagnosed with this special case that’s psychiatric in nature. I became curious about it so I did some research. I thought it was new for it was the first time I encountered such illness/state, and at the same time, interesting, because it’s said that it could be a reason for either having mental illness or remarkable creativity. It’s called low latent inhibition. Well, as for the main character in the series, it resulted in him being so talented, ingenious and undoubtedly brilliant! Which tv series am I talking about? I guess many people already know. (”,)

            The following is a feature from the Harvard Magazine. It was written by Craig Lambert. I find it informative and enlightening. Now I know that apart from the usual psychosocial factors contributing to the development of mental illness, there could also be this condition, that is, having low latent inhibition which could either lead to psychoses or genius. I haven’t heard of it during college days, back when we were having our psychiatric nursing subject.

The DaVinci Mode: Ideas Rain In

 In 1675 Isaac Newton suffered a mental breakdown—some modern psychiatrists diagnose him as a manic-depressive—and he was still recovering in 1679. But long before that, Newton had already invented calculus and formulated his law of gravitational attraction. Throughout history, genius and madness have often dwelled together: think of Vincent Van Gogh, William James, M.D. 1869, and, more recently, mathematician John Forbes Nash (portrayed in the book and film A Beautiful Mind). Delusional psychosis and inspired creativity, ostensible antipodes of human experience, ironically also seem to be next-door neighbors. Over the centuries, thinkers have wrestled with this enigma, usually on a purely speculative basis. Now, a new empirical study suggests a specific style of cognition shared by those who hear the Muse and those who merely hear voices. The research also suggests variables that distinguish the two groups.
(more…)

Seminar Day!

                   Yesterday, May 28, my co-staff nurses and I attended a seminar entitled, “The ABCD of Adult and Pediatric Resuscitation: Our Response to Save Lives”. It had been a very fruitful seminar, I was reviewed and updated on Basic Life Support. Though I haven’t attended an ACLS course yet, it sort of gave us some ideas and background of how to efficiently carry out our roles, functions and responsibilities as members of the code team. Though in my experience, I have attended several code situations already, I could say that the seminar still shed some light and gave me some insights specifically on the ideal practice/nursing interventions and areas of improvement that must be done when attending life-threatening situations. Also, most of the time we deal with adult patients in our area, we tend to forget the must-know of pediatric resuscitation. The seminar indeed became very helpful to us for that matter.

                  The said seminar was graced by 2 known consultants in PGH, Dr. Jubert Benedicto, head of CENICU  and Dr. Herbie Uy, head of PICU, who talked about Advanced Cardiac Life Support and Pediatric Advanced Life Support, respectively.The latter part of the seminar was a talk delivered by a UPCN alumna, class valedicatorian of Batch 2004, Ms. Vicky Serdan, who discussed about the Nursing Responsibilities in Pedicatric BLS/ACLS.

                  I hope to be updated again on topics like this, a year or two from now. In the meantime, my next objective is to update my IV therapy license.

Have You Had a Miracle Patient?

         I found this story at Medscape and thought it would change the perspective of health professionals, especially nurses, on dealing with critical care situations. It  gave me some insights and I also learned something new from it (the hypothermic protocol mentioned, which is not a pratice yet here in the Philippines).

Have You Had a Miracle Patient?

Posted By: beka serdans, Critical Care/Intensive Care, 10:43PM Mar 5

” Little is Better than Nothing”

Well, this weekend seemed to be Code City in our ICU. Some died, some lived, and some were in a vegetative state surrounded by their families. I had the opportunity to admit a 64-year-old lady who had been found slumped over the steering wheel of her car in a unconscious state. When EMS arrived they found her in VT —-> Vfib —-> pulseless state. They quickly began their ACLS EMS process, intubating her right away, shocking her along the way.

She arrived in the ER where they performed a bit more CPR, got her vitals back, placed her on high dose inotropic support, and brought her up to the ICU with a systolic blood pressure near 68/?, along with a strange rhythm by EKG - undecipherable by our Fellow. Our hypothermic protocol was initiated as her pupils were fixed and dilated right away. She had been down and out for at least 20 minutes. We packed her in ice and dropped her temp below 98.6 F. None of us were quite sure if she would survive, but hoped that brain function would be preserved by the hypothermia.

Four days later she was sitting up, extubated, and smiling at her family, yapping away about the food left in the back of the car. She had survived, but could not recall all the events except slumping over her steering wheel. Now, this was a definite MIRACLE patient. A nice save. Sometimes it’s best not to give up on patients clinically when all things look dire. Seems that often we do that more than we should…

Appreciating the finer things in life

This is from a critical care nurse blog; the blogger was Ms. Cassandra Leese. Published in the Nursing times journal, it caught my attention at once. After reading, I can’t help but agree with her thoughts and feelings. Ms. Leese gave quite a vivid illustration of what nurses really experience in the hospital ward.

Critical care nurse blogger Cassandra Leese on her generous benefits package

It is widely acknowledged that you don’t go into nursing for the money. Certainly not for the wildly unsociable hours, the tyranny of night shifts or the benefits package.

Free gym membership and private healthcare? Not a chance. A friend recently expressed horror on hearing about the length of the breaks, and almost fell off his chair when I mentioned we don’t get free tea and coffee.

Despite this, there are small and seemingly inconsequential perks to the job that I imagine people working in the more sedate professions rarely relish in quite the same way. 

Yes, I’m talking about finally getting to go to the toilet after hours of putting it off to accomplish just one more task; lying down after a 13-hour shift and discovering a whole new appreciation of your bed; the taste of fresh air and the breeze on your face when you leave the hospital - particularly first thing on a frosty winter’s morning, and last thing at night when the stars are out and a glass of your favourite tipple is beckoning. 

Driving to work in the wee hours when everyone is safely tucked up and the roads are clear can be especially pleasant. As can a drink of water when you’ve been frothing at the mouth for hours.

Coming home after every single working day knowing, without doubt, that the work you do is valuable can keep you going after a particularly bad day. As can the high after a crazy shift and the utter, utter, bliss of knowing you have a few days off in a row.

R.A. 9288

I did some research on this law, also known as the Newborn Screening Act of 2004 and I got this from famli.blogspot.com

Heel Prick Method for the newborn screening 

What is Republic Act No. 9288?

It is the Philippine law promulgating a comprehensive policy and a national system for ensuring newborn screening. RA 9288 is known as the “Newborn Screening Act of 2004.” It was approved on April 07, 2004.
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Manny Means Business

Champion boxer Manny Pacquiao has always had a business plan: Fight my way out of poverty

by Jim Plouffe

The first thing you notice when entering the dressing room of Manny Pacquiao is just how crowded it is. The room, right across the hall from where the best pound-for-pound boxer in the world has just finished taping his Filipino television show ‘’Pinoy Records'’ is spartan, basically furnished with people. The next thing you notice is that the current World Boxing Council Lightweight Champion seems to get lost in this sea of people. His agents, family, handlers and just hangers-on, are all better dressed, louder and more domineering. It takes a few seconds to even pick him out.

It’s not until Manny tells one of them to ‘’take the journalist to the other room'’ and then saunters in a few minutes later, laying his hands – complete with several diamondd adorned fingers – on the grimy table that his presence is felt.Here are the knuckles that have knocked out 35 opponents, including American David Diaz last June to win the Lightweight title. Here is the fearless dynamo, the Mexicutioner, the Destroyer, Pacman, the People’s Champ, a man so wild in the ring that he’s constantly had to move up weight classes just to find boxers who can endure his lightning-fast punches. This 169-centimetre-tall man is a weapon, and the sparkle in his eye reveals that he knows it.

But it’s not until he tells one of his handlers to ‘’be quiet, I can speak for myself,'’ that it becomes truly obvious that Manny Pacquiao really means business.

It seems the only time you’ve taken a real beating is when you went for public office.
It was not the right time to run for office because I was in my prime in boxing. [The Filipino people] are looking at me as a role model in boxing. The time has come now. I think they will want me because I have a big heart.
(more…)

Two Thumbs Up For Dayo!

          In celebration of this day, Christmas 2008, my family and I went to see a movie  of the MMFF. We were  actually divided on the choice of film. Only 3 of us chose Dayo against the majority, 5 of them, who went for Iskul Bukol. Still, my sisters and I made up our minds and we didn’t regret it. 

          I have my two thumbs up for Dayo. I highly recommend it especially to children who are still on the value-formation stage of their lives. It teaches a lot of values from giving due respect to the elderly to protecting nature, valuing one’s family, etc. At the same time, it is uniquely Filipino in the sense that much of the concepts in the story are based on Philippine folklore.

          It’s a great movie with great animation, sound effects, dubbing and OST.  No wonder it got an A rating from the Cinema Evaluation Board.

          Below is the movie’s trailer and another video clip shows Lea singing Lipad, the official theme song.

Cancer to be world’s top killer by 2010, WHO says

I got this article from yahoonews. It’s good to be updated…

ATLANTA – Cancer will overtake heart disease as the world’s top killer by 2010, part of a trend that should more than double global cancer cases and deaths by 2030, international health experts said in a report released Tuesday. Rising tobacco use in developing countries is believed to be a huge reason for the shift, particularly in China and India, where 40 percent of the world’s smokers now live.

So is better diagnosing of cancer, along with the downward trend in infectious diseases that used to be the world’s leading killers.

Cancer diagnoses around the world have steadily been rising and are expected to hit 12 million this year. Global cancer deaths are expected to reach 7 million, according to the new report by the World Health Organization.
(more…)

The Greatest Advice

Don’t date because you are desperate. Don’t marry because you are miserable.
Don’t have kids because you think your genes are superior.
Don’t philander because you think you are irresistible.

Don’t associate with people you can’t trust.
Don’t cheat. Don’t lie. Don’t pretend.
Don’t dictate because you are smarter.
Don’t demand because you are stronger.

Don’t sleep around because you think you are old enough and know better.
Don’t hurt your kids because loving them is harder.
Don’t sell yourself,your family, or your ideals.
Don’t stagnate.!

Don’t regress.
Don’t live in the past. Time can’t bring anything or anyone back.
Don’t put your life on hold for possibly Mr/Mrs Right.
Don’t throw your life away on absolutely Mr Wrong because your biological clock
is ticking.

Learn a new skill.
Find a new friend.
Start a new career.
Sometimes, there is no race to be won.
Only a price to be paid for some of life’s more hasty decisions.

To terminate your loneliness, reach out to the homeless.
To feed your nurturing instincts, care for the needy.
To fulfill your parenting fantasies, get a puppy.
Don’t bring another life into this world for all the wrong reasons.

To make yourself happy, pursue your passions and be the best of what you can
be.
Simplify your life. Take away the clutter.
Get rid of destructive elements: abusive friends, nasty habits, and dangerous
liaisons.
Don’t abandon your responsibilities but don’t overdose on duty.

Don’t live life recklessly without thought and feeling for your family.
Be true to yourself.
Don’t commit when you are not ready.
Don’t keep others waiting needlessly.

Go on that trip. Don’t postpone it.
Say those words. Don’t let the moment pass.
Do what you have to, even at society’s scorn.

Write poetry.
Love Deeply.
Walk barefoot.
Dance with wild abandon.
Cry at the movies.

Take care of yourself. Don’t wait for someone to take care of you.
You light up your life.
You drive yourself to your destination.
No one completes you - except YOU.

It is true that life does not get easier with age.
It only gets more challenging.
Don’t be afraid. Don’t lose your capacity to love.
Pursue your passions.

Live your dreams.
Don’t lose faith in your God.
Don’t grow old. Just grow YOU!

When you give someone your time, you are giving them a portion of your life
that you’ll never get back.
Your time is your life. That is why the greatest gift you can give someone is
your time.
Relationships take time and effort, and the best way to spell love is T-I-M-E
because the essence of love is not what we think or do or provide for others,
but how much we give of ourselves.

–Rick Warren, The Purpose Driven Life

Stand Up To Cancer

          “If the mind keeps thinking you’ve had enough. But the heart keeps telling you don’t give up. Who are we to be questioning, wondering what is what. Don’t give up! Through it all, just stand up…”

          Check this out fellow bloggers! International singers like Mariah, Beyonce, Nicole, Rihanna and others came up with this grand song production. The collaboration was for a noble cause, that is, to spread awareness on the deadly disease, the big C and also to express sympathy to those people afflicted with it… The song’s good, I liked the message particularly.

           Enjoy watching! (”,)

10 Steps to a Healthy Heart

Simple ways to reduce your chance of a heart attack by up to 90 per cent

Dr Michael F. Roizen

Even if you follow just the first seven tips below (and don’t smoke, of course), you’ll reduce the chance of having a heart attack by as much as 90 per cent compared to a typical person your age!

Tip 1: Walk 30 minutes a day every day, no matter what – and then call someone. Walking a half hour a day decreases the risk of having a heart attack by about 30 per cent. I’ve found if you succeed at walking daily, you can also succeed at doing other things to improve your health. If you skip, you’ll start compromising your health in other ways too. Calling someone every day is crucial; that’s the real commitment. Find a person who’s supportive and will not nag but will call if you haven’t called her. And by the way, it usually is a ‘’her.'’ Men tend to be lousy at this!

Tip 2: Know your blood pressure and do whatever it takes to get it down to 115/75. Your blood pressure number may be even more important than your cholesterol. And you can lower it yourself. The best way? Getting a little exercise and losing some belly fat. The omentum is what hangs over the stomach. The fat that’s stored there feeds the kidney, liver and other vital organs. But when you gain weight, you add fat inside the relatively rigid ‘’kidney capsule.'’ This fat pushes on the kidney and more blood pressure is needed to drive blood through. So it releases hormones that cause increased blood pressure. When you lose a little of that fat, your blood pressure goes down really fast.

Cutting back on salt may help, but for some people reducing sugar and saturated fat in the diet may help even more. But if your blood pressure is over 140/90 and you’re not going to do these things reliably, then you should probably go on blood-pressure medication. New drugs can reduce blood pressure without major side effects.

Tip 3: Eat an ounce of nuts a dayNuts raise high-density lipoprotein (HDL) good cholesterol and decrease inflammation. But they have a heart benefit independent of those too. We’re not sure why. Nuts have healthy omega-3 fatty acids, healthy protein and some fibre. And this tip is easy to do! Nuts that are raw, fresh and unsalted have the most benefit. You can develop a taste for them if you give them a chance. But if you want to roast, say, (shelled) walnuts, put them in the oven at 175 degrees Celsius for about nine minutes. If you do it yourself, it won’t cause any bad fats or dangerous chemical acrylamides to form.

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Leiomyosarcoma

I became curious about this particular kind of cancer. Presently, one of my patients suffers from it and just last night, he was in severe pain that he was extremely agitated, already yelling at me. I understand his condition and I couldn’t see any reason for us nurses to be offended by such behavior. It’s just something that shouldn’t be taken personally. I pray for the healing of people afflicted with this rare, painful disease, as well as for their families and significant others. 

Leiomyosarcoma is a rare cancer.

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3rd Annual Are You Normal or Nuts?

William Speed Weed

Dear Reader,

Are you too shy? Too pushy? Do you cry too much? Do you cry too little? Do you pull your hair? Other people’s hair?Are you afraid of spiders? Or stuffed animals?

Yes, yes, and yes. You are, dear readers, all these things and more. As the hundreds of letters we got this year prove once again, we are a bunch of nutty folk. But not to worry: To be human is to be quirky. Of course, not all quirks are cute. It’s often difficult to know whether a given behaviour is harmless or hurtful. The line between silly and serious is vanishingly thin. And so we put your letters before a panel of trusted experts to demonstrate which are merely colourful and which may require professional attention –to giggle where we can and to guide where we must. (more…)

Spot Strokes Fast

Rapidly treating a mini-stroke, or transient ischaemic attack (TIA), reduces the risk of a major stroke by 80 percent according to a study by Oxford’s Radcliffe Hospital. Someone who suffers a TIA has similar symptoms to a stroke but the symptoms may only last a few minutes.

Ignoring them, however, can result in a major stroke following within three months. The Stroke Association uses the FAST test to diagnose whether someone is having a stroke or TIA:
Facial weakness – can the person smile, has the person’s mouth/eye drooped?
Arm weakness – can the person raise both arms?
Speech problems – can they speak clearly and understand what you say?
Test all three symptoms. If he or she fails any of these tests, call emergency so they can receive treatment quickly at a hospital and damage to the brain can be reduced.

– Reader’s Digest (October, 2008)

Guide in IV Therapy

Choosing a Compatible Diluent

          *D5W is a must:

                      Epinephrine                              Levophed

                      Dopamine                                 Metapropanolol

                      Ephedrine                                 Nitroprusside

          *NSS only:

                     Phenytoin                                 Vitamin K

                     Hydralaxine                             Vitamin B6

                     Furosemide                              Vitamin C

          *Not in LR:

                    Pen G                                        Cephalosphorin

                    Ampicillin                                 NaHCO3

Cold-Sensitive:

                   Phenobarbital Na

                   Metoclopromide

Photosensitive Drugs:

                  Diazepam

                  Epinephrine

                  Furosemide

If I Fell…

          Fall in love with this song! And to ladies out there, be serenaded by Jason (wishful thinking! haha!)… Great and unique version here by Jason Castro. Originally by Beatles but I think Jason did a very good job… I agree with Paula with the “emotional connection” she’s talking about. Bitter comments by Simon and Randy, they simply can’t relate. Hahaha! I told my brother to study the chords and the song so we can jam with his guitar.  

A Young Athlete in Cardiac Arrest

BACKGROUND

A 17-year-old male was found in cardiac arrest following a blow to the chest. The patient immediately dropped to the ground and was unresponsive after being elbowed by a teammate who ran into him. Cardiopulmonary resuscitation (CPR) was initiated by his coach after no pulses were palpated, and the patient was taken to the ED.

What is the likely pathophysiology that led to the cardiac arrest?

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Diabesity: A Massive Epidemic

‘Shortening the life span by 10-15 years, diabetes is now the 6th leading cause of death.’

– Philip S. Chua, MD

          Last week, I checked my blood sugar and was quite shocked with the result. It was 177 mg/dl! Knowing it’s above normal level (normal values: 80-120 mg/dl, while in our glucometer it’s 70-110), I tried at first to rationalize I was only 6 hours NPO. FBS must be 8 hours NPO I said to myself. I was in between denial and acceptance. I thought maybe that our glucometer is not accurate anymore and needs quality control testing. I bought it last year (November 24, 2007) as a gift for my mother, who is a diagnosed diabetic and unfortunately, I lost the Contrex fluid that is used for quality control testing. My sister also checked her sugar it was way greater than mine! Giving it the benefit of the doubt, she and my mother went to a local clinic where they had their blood extracted for diagnostics (which included FBS, creatinine and uric acid). My sister’s results were normal while we’re still awaiting my mother’s because she had one more test (for thyroid function) that needs more time to be determined. I hope that the results would be insignificant.

          So how do I solve the problem? Actually I haven’t had my CBG checked again yet because I’m not sure of our meter. And one thing, we don’t have strips anymore and we need to buy a box again. I’m thinking that I need to bring our meter at the store where I bought it and maybe they could lend the Contrex fluid for control testing. Anyway, I’d buy a box of strips I’ll tell the owner. If s/he wouldn’t agree, I’d have to buy another meter again. One created by Abbott so that the strips could be bought in Watson’s or Mercury Drug. 

          Though I know that I have a strong genetic predisposition to diaebetes, I still couldn’t deny the fact that I’m fond of sweets. But somehow, I'’m now trying to cut on it, which is kind of a hard thing to do. Behavior modification is not easy indeed!

         It seems that the problem on diabetes is getting more serious, warning us to be more proactive and responsible with regards to our lifestyle. Recently, as we were watching the night news in tv, the diabetes issue came up again. What caught my attention most was the statistics of diabetics in the Philippines. To date, there are 4 M Filipino diabetics and it was also said that the population of Filipino diabetics will balloon in 2010, something like that if I’m not mistaken. And 1 out of 25 Filipinos has diabetes. Really alarming! 

          I got this opinion article from Malaya and I thought of having it as a new post. Even though it was written last year, it’s still informative and the points being raised are still true.
(more…)

Two Words: "I Do…"

          “And if life should come to just one question: Do I hold each moment true? No trace of sadness; always with gladness… I do!”

          Below is the most beautiful, romantic wedding song ever composed! I so love this song. The music was by Louie Ocampo and lyrics by Freddie Santos. And of course, as expected, Lea Salonga did justice to it, great voice, wonderfully sung!!! Robert Chien must really be grateful to have Lea for a wife. Obviously, he was so touched and mesmerized with his wife’s dedication. One comment in youtube was this: a true man cries…that’s a one heck of a man right there (”,)

Two Words