Are Resident Doctors Really Doctors?

No, they are not.

According to a recent article that appeared in Mindanao Times, here are the new essential qualifications for a real doctor.

1. Wears a uniform. Preferably white, and in impeccable condition. One that does not get hot nor dirty even when you’re rushing and answering to all calls, especially in the Emergency Room.

2. Speaks English. It does not matter whether you’re in Manila, or Ilocos, or Cebu, or anywhere in the Philippines (or world) for that matter. It does not matter if the patient you’re attending to speaks Tagalog, or Ilocano, or Ilonggo. You must talk to them in English. That’s how you discern one from an impostor.

3. Knows the “problem” of the patient, even if the patient does not tell them anything about what ills them. They must master the art of foretelling the disease, even without taking history and doing physical exam. In other words, can read crystal balls. Nurses should possess this power too.

4. Must be courteous at all times. Never rude. Even when faced with arrogant yet idiotic patients. If you’re not courteous, that means you are a fake doctor.

5. Must see a demanding patient, right away. Now na! It does not matter if you’re attending to a sicker patient. It does not matter if you’re running a code or doing the CPR itself, or assisting in surgery, or doing a procedure. Your doctor’s license expires within an hour of not seeing the patient.

The following standard eligibility on becoming a real doctor are not needed anymore:

1. Four years of undergraduate degree. Forget it!

2. Another four years of medical (graduate) school. Forget it!

3. One year of post-graduate internship. Forget it!

4. Pass the Philippine (or other country’s) Medical Board Exam. Forget it!

5.  Lastly, no need to do three to seven years (depending on specialty) of Residency after passing the board exam. Remember when you’re a “Resident” doctor, you are a fake doctor.

*******

(This post is in response to an article with the same title, that was published 7/20/15, in the Opinion section of Mindanao Times, written by Fely V. Sicam)

Tuyo Na’ng Damdamin

Habang ako’y bumibiyahe patungo sa aming outreach clinic noong isang araw, na isa’t kalahating oras ang layo sa aming siyudad, ako nama’y nagsa-soundtrip ng mga kantang Pilipino na aking kinagisnan (OPM Classics).

Habang tumatahak ako sa kalagitnaan ng mga bukid at parang, ang aking sasakyan ay tumatakbo ng siyento-bente kilometro kada ora, ngunit ang aking isipan ay lumilipad ng dos syentos kada ora.

Sumalang naman ang kantang “Tuyo Na’ng Damdamin” na orihinal na inawit ng APO Hiking Society. Ni-remake din ito ng Silent Sanctuary at ni Noel Cabangon.

“Minsan kahit na pilitin mong uminit ang damdamin
Di siya susunod, at di maglalambing
Minsan di mo na mapigil mapansin
Na talagang wala nang naiiwan na pagmamahal.”

Habang ako’y nagmumuni-muni sa lumang awit na ito, ay nakakalungkot lamang isipin, na maaring humantong pala sa ganito ang isang relasyon. Wala ng init. Wala ng paglalambing.

“At kahit na anong gawin
Di mo na mapilit at madaya
Aminin sa sarili mo
Na wala ka nang mabubuga.”

Wala nang maibubuga? Isa lamang masakit na katotohanan ng buhay. Lahat kaya ng bagay dito sa mundo ay may hangganan? Wala ba talagang forever?

“Parang isang kandila na nagdadala
Ng ilaw at liwanag
Nauubos rin sa magdamag.”

Upos na kandila? Hindi ko alam kung ano ang dahilan kung bakit isinulat ito ni Jim Paredes, o para kanino, o anong tunay niyang tinutukoy. Pero may alam akong makabagong paraan ngayon para makaangkop sa ganitong masaklap na kalagayan. Marahil wala pa nito noon nang isulat ang awiting ito.

“Di na madaig o mabalik ang dating matamis na kahapon
Pilitin ma’y tuyo na’ng damdamin.”

Kaibigan, huwag kang nang malungkot. Mayroon ng Viagra!

******

(My APOlogies to APO if I totally misunderstood and misinterpret the song.)

A Stinky Cure

Several days ago, I was called to co-manage a patient that was admitted in the hospital. The patient was quadriplegic, paralyzed from the neck down, due to a neck injury he sustained several years ago.  Our service was consulted for he had a tracheostomy and has been on a home ventilator.

However, he was hospitalized not for a primary pulmonary issue. He was admitted for a scheduled transplant.

In this day and age of modern science, organ transplantation is almost an ordinary phenomenon. Kidney, liver, pancreas, heart, lung, bone marrow, cornea and skin are among others that are being transplanted. There’s even recent news reports of patients receiving total face transplant.

Not too long from now, brain transplant will be a reality. Do you need one?

But the patient that we were consulted was not scheduled for any of the organ transplant that I mentioned above. Do you care to guess what he was planned to have?

Spinal cord? Spleen? Appendix? Nah.

By the way, maybe someday we will find out what appendix are really for, and not just for the surgeons to operate on.

Back to our patient, what transplant did he need?

He underwent a fecal transplant.

Yes, you read it right. Feces, as in stool or poop. In vulgar term, sh*t.

But why you may ask, anybody needs a fecal transplant. Can’t they make their own poop?

Fecal transplant is now an available treatment for people who are suffering from severe and refractory Clostridium difficile infection. What the poop on earth is that?

Clostridium difficile is a bacteria. It’s infection can happen when a patient has been on antibiotics. The strong antibiotics that we use, kill the “bad” bacteria, but unfortunately, it can also kill the “good” bacteria we have in our colon. Yes, many of the bacteria in our body are considered “good” bacteria, especially in our gut, that keeps us healthy.

So once these good bacteria are killed, this can cause overgrowth of these super evil bugs, the Clostridium difficile, and they wage a coup d’ etat in the gut’s bacterial colony. This cause the problem. The takeover of these rogue bacteria is manifested by severe diarrhea, nausea, vomiting, abdominal bloating, fever and sometimes overwhelming sepsis, shock and even death.

Clostridium difficile can be treated with specific antibiotics, but then again, antibiotics are double edge sword as it may cause more problems. So one of the newer method to fight this is providing a new bacterial colony.

Thus the fecal transplant, or also known as fecal microbiota transplant. The good bacteria in the donated stools restores the healthy colony and community of bacteria in the colon.

Currently, there are undergoing studies evaluating this treatment for other gastrointestinal disorder besides Clostridium difficile infection.

How is it done? Do we tell them to eat sh*t? No, it’s more sophisticated than that.

The fecal material from a donor, is inoculated or sprayed directly inside the colon through a colonoscope. However, under development right now is fecal material in pill form. Poop pills! What a stinker.

Where do we get the donor feces? Good question.

The donors are healthy volunteers who out of the goodness of their hearts (or guts?) want to share their…..you know what. No kidding. My gastroenterologist friend told me that most of the donors of the fecal matter available in the US are from college students of a prestigious university in Cambridge.

Maybe you want to be a donor too. They may even pay you for your precious donation. Some people donate blood, and some donate sh*t.

poop in lab

(photo from usnews.com)

Fecal transplantation most of the time is done as an outpatient, and does not need hospitalization. However, since our patient was on a ventilator, it was felt that the rigorous colonic prep plus the conscious sedation during colonoscopy may be too taxing for him, so he was admitted for observation.

I would say he had a successful transplantation. He went home the next day, pooping happily ever after.

Weekly Photo Challenge: Symbol

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Iowa Capitol Building

This structure can be a symbol of many things. Of a State. Of a government. Of law and constitution.

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Free as a butterfly.

Or it could be a symbol of liberty. Of freedom.

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But on the day I took this photos, it took another meaning.

As a transplant, and after several years of living as an outsider, it became a personal symbol of my adopted home.

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A foreigner, no more.

(In response to WordPress The Daily Post’s weekly photo challenge: “Symbol.”)

Farm Dining

Since we moved in Iowa several years ago, we have dined in different restaurants here in metro Des Moines area. From formal to casual, from fancy to rustic, from pricey to low-cost, and from long-sit-down meal to on-the-run fast food. This also encompassed several international cuisines, like American, Chinese, Mexican, Thai, Italian, French, Vietnamese, Laotian, Korean, Japanese, Mongolian, Indian, Greek, Ecuadorian, and Lebanese.

We also enjoy Filipino cuisine here, but it is not in a restaurant. It is my wife’s home cooking.

But when you’re in Iowa, I believe there’s a restaurant that embodies this state’s culture. The restaurant is the Iowa Machine Shed.

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The ambience is farm-themed, and the dining experience is relaxed, warm and family oriented. The establishment prides itself as a restaurant that honors the American farmer.

Outside the restaurant are some old farming equipments that adds to its distinctive appeal.

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my son on the tractor

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old gasoline pump

They even have a complimentary tractor ride that takes you around the neighborhood of the restaurant, and let you catch a glimpse of the “Living History Farm*” next door, that the restaurant supports.

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tractor ride

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Since the state of Iowa is the number one producer of pork and corn in the US, and probably the whole world, so it is not surprising these are what greets you at the door.

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Inside the place, they have a small store that you can browse through while you wait to be seated.

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The dining area, the tables and chairs, gives you a feel of a farmer’s kitchen or even a barn.

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The waiters and waitresses are in their denim overalls, that I wonder if they are dressed to harvest the corn and milk the cow, as well as to serve us our food.

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Even the silverware and glassware are uniquely farm-like: sturdy and rustic. Here’s what my son did to the glass, knives and the water pitcher. Good balancing act!

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I know that the most important part of the restaurant is the menu and the food it offers. Of course this restaurant serves lots of bacon and pork chops. But I assure you, they offer more than pork chops and corn on the cob.

I don’t have any photos of the food they serve on this post, for I intentionally left them out for you to come and visit, and personally see and try them for yourselves.

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Lastly, when you dine here, appreciate all the farmers and all the people and their efforts that brought food to your table. And besides there is a sign near the counter that says, “complaining to the cook will be hazardous to your health.”

From Iowa,

Pinoytransplant.

*******

(*Living History Farm is an outdoor museum in Iowa that tells the story of how Iowans transformed the fertile prairies of the Midwest into the most productive farmland in the world.)

(**This is not a paid post. But on second thought, maybe they should give me a free meal on our next visit. Just wishful thinking.)

Blast from the Past

Change. That is the only constant thing in this ever-changing world.

Not too long ago, we cannot get by our daily lives without the typewriter, mimeograph machine, telephone booth (not just Superman), cassette tape recorder, floppy disc, and film negatives. Do you even know what they are?

When was the last time you placed a 35 mm roll of film in the film cartridge of your camera? Or when was the last time you held a real printed photograph instead of viewing it on a computer monitor or from a smart phone?

In the world of medical radiographic images, the same is true. In our practice, rarely do we see a real printed x-ray film nowadays. Instead, everything is now digital or electronic.

Gone are the days when we have to wait for several minutes for an x-ray technician to develop the film in a dark room. Then wait for it to dry. Then hand you the film. And then you have to find an x-ray view box to hang it so you can read it.

Today, we view radiographic images digitally through PACS (Picture Archiving and Communication System), which is a network of computers used by radiology department, that we can access through our desktop, laptop, tablet, or even our smart phone. And if a referred patient comes with an x-ray taken by a radiology department not in our network, he brings in his x-ray images in a CD that we can load and view.

However the other day, a new patient referred to us came in with a real copy of her chest x-ray film. A real film!

I have not held one of these for a while. I missed the feel of its smooth texture on my fingers. The crisp sound of the film as you pull it out of the envelope and wave it softly in the air. Its peculiar slight acidic scent (from the x-ray developer and fixer chemical solution). The unmistakable exotic taste of its…..ah, er……. no, I have not done that.

Who knew that a plain x-ray film will bring me such nostalgia?

As I hold the x-ray film in my hand, I looked around for a viewbox (negatoscope is the technical term), but can’t find one. I guess they don’t install them anymore. I was in one of our newly constructed multi-specialty satellite clinic, and they don’t have a negatoscope in the whole building. None. Zilch. Nada.

So how did I view the x-ray?

I held the film against the bright window and squint my eyes a little, just like the “old” days.

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Right after graduating from medical school, almost twenty-five years ago, I worked in a small (and I mean really small) rural hospital in Plaridel Bulacan, in the Philippines. There whenever I ordered an x-ray, I even helped with shooting and developing it. That’s why I cannot forget the aroma of the freshly developed x-ray film. And while the film was still wet, I would hold it against the light, squint my eyes, and read it.

That was just like yesterday. Yet so much have changed.

As I looked at the film of my current patient, I also peered through the window and looked outside at the present world I’m in, while I relived and reminisced the past through the window of my mind.

(*photo taken with an i-Phone; and in case you’re asking, the chest x-ray was normal)

Awit ng Isang Alibughang Anak

Ako’y nakatanggap ng sulat noong makalawang linggo. Galing ito kay Uncle Sam. Sabi rito, ako raw ay inaanyayahan sa isang opisyal na interview o panayam.

Sa wakas! Hindi na ako pamangkin lang. Maari na rin akong maging anak. Ampon nga lang.

Matagal-tagal na rin naman akong naninirahan dito sa Amerika. Sa katunayan, dalawampu’t isang taon! Dalawampu’t isang taon ng pagiging dayuhan.

Naging masalimuot ang landas na aking tinahak para maging isang mamamayan. Iba’t ibang letra ng visa ang aking pinagdaanan. Nagsimula sa letrang B (tourist), naging J (exchange visitor), tapos naging O (non-immigrant with outstanding ability), hanggang naging H (non-immigrant worker), bago nabiyayaan ng green card (permanent resident). Mapalad pa rin kaysa ibang kababayan na ang visa ay TNT (tago nang tago).

At ngayon, iniimbitahan na nila ako para maging isang naturalisadong mamamayan (naturalized citizen). Sa madaling salita – maging ampong anak ni Uncle Sam.

Ito ay kung maipapasa ko ang aking interview.

Ito na ang huling hakbang sa pagiging citizen. Tapos na ang mga background check. Tapos na rin ang finger-printing. Interview na lang.

Madali lang naman daw ang interview. Maraming mga tanong ay personal. Maaring gusto lang nilang maniguro na ikaw ay mabuting tao, at magiging kapaki-pakinabang na mamamayan, at hindi palamunin lang at uubos ng buwis ng bayan.

Kasama sa interview ay ang pagsusulit sa salitang Ingles. Kailangan makapasa sa pagsasalita, pag-unawa, pagbabasa at pagsulat sa Ingles. Walang naman akong problema dito. Kahit Grade 1 na batang Pinoy kayang-kaya ito. Kahit ba Carabao English tayo, papasa pa rin.

Ngunit kasama rin sa interview ay mga tanong sibika (civic test). Ito ay mga tanong tungkol sa mga batas, mga prinsipyo, kasaysayan, heograpiya at samo’t saring kaalaman tungkol sa bansang Amerika. Dito ko kailangang mag-review.

May reviewer naman silang binibigay. Sinasaad dito ang mga 100 na katanungan na maaring itanong sa interview.

May mga tanong na madadali:

Tanong: Ano ang pinakamataas na batas ng bansa?

Sagot: constitution

Tanong: Sino ang tinaguriang Ama ng Amerika?

Sagot: George Washington

Mayroon namang mga tanong na medyo mahirap ngunit kailangan mong malaman:

Tanong: Kailan isinulat ang constitution?

Sagot: 1787

Tanong: Ano ang 13 na orihinal na estado ng Amerika?

Sagot: New Hampshire, Massachussetts, Rhode Island, Connecticut, New York, New Jersey, Pennsylvania, Delaware, Maryland, Virginia, North Carolina, South Carolina, Georgia

Noong isang araw, ako ay nag-review. Habang ako’y nag-aaral at nagpapaka-dalubhasa sa kasaysayan ng Amerika, ako nama’y hinaharana ng mga kantang Pilipino na aking kinamulatan, na tumutugtog sa aking CD player.

“Noong isilang ka sa mundong ito,

Laking tuwa ng magulang mo,

At ang kamay nila ang iyong ilaw.” (Anak by Freddie Aguilar)

Ako ba’y pinaparinggan ni Ka Freddie? Ampong anak ba kamo? O baka naman alibughang anak?

Para bang nasa gitna ako ng dalawang nag-uumpugang bato. Dalawang kulturang nagbabanggaan sa aking damdamin at isipan. Dalawang lahing nagbubuno sa aking pagmamahal. Dalawang bansang nag-aagawan sa aking katapatan.

Tapos nabasa ko sa aking reviewer ang tanong na ito:

Tanong: Ano ang isang pangako na kailangan mong gawin para maging mamamayan ng Estados Unidos?

Sagot: Talikuran ang katapatan sa ibang bansa.

Biglang bumigat ang aking damdamin. Parang may kumurot sa aking puso. Hindi ko alam kung sarili ko itong konsensiya, o ako’y pinaparamdaman ng mga multo ni Rizal at ni Bonifacio.

Sabay sumalang naman si Noel Cabangon* kasama ni Gloc-9 at kumanta ng “Manila” (originally sang by Hotdog) sa aking player.

“Maraming beses na kitang nilayasan,

Iniwanan at ibang pinuntahan,

Parang babaeng ang hirap talagang malimutan….”

Hindi na ako makapag-concentrate sa aking binabasa. Ang isipan ko’y nagsimula nang magliwaliw sa isang lugar na aking minahal at patuloy na minamahal.

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“Hinahanap-hanap kita Manila

Ang ingay mong kay sarap sa tenga

Mga jeepney mong nagliliparan

Mga babaeng naggagandahan….”

Ibinaba ko na ang aking reviewer. Ipinikit ang mga mata. At marahang sumabay sa pagkanta.

“Manila, Manila,

I keep coming back to Manila,

Simply no place like Manila,

Manila I’m coming home…..”

******

(*songs from the album “Tuloy ang Biyahe” by Noel Cabangon)

(**photo above is from philippineslifestyle.com)

Kwentong Bulsa: Isang Balik Tanaw

Ano ang laman na iyong bulsa? Pitaka? Cellphone? Mga barya? Kumpol ng susi? Kalahating bubblegum? Lipstick? Rosaryo? Sigarilyo? Balisong? Ticket ng lotto? Balato ko ha!

O walang laman ang iyong bulsa? Teka, baka naman nadukutan ka na? O maaring butas lang ang iyong bulsa?

Ano man ang antas mo sa buhay, meron at meron kang bitbit, at hindi umaalis ng inyong bahay, na wala ito sa iyong bulsa.

Hindi ko sasabihin kung ano dapat ang laman ng iyong bulsa, akin lamang isasalaysay kung ano ang nasa aking bulsa sa iba’t-ibang yugto ng aking buhay.

Noong kindergarten:

1. bente-singko

2. panyolito

3. jolens (marble)

Simple lang ang buhay noon. Simple lang din ang aking pangangailan. Kaya’t bente-singko sentimos (benchingko tawag ko noon) lang, ay kasyang-kasya na. Kontento na ako dun. May hopia o kaya bazooka bubblegum na akong mabibili, at may sukli pa.

Ito ay noon, ngunit sa ngayon kahit balat yata ng bubblegum hindi kayang bilihin ng benchingko.

May panyolito rin akong baon noon. Kahit ayaw kong magdala nito, ay lagi itong nakasuksok sa aking bulsa. Dahil mabait (*ubo-ubo*) akong bata. Kasi sabi ng nanay ko kailangan ko raw ng panyo, kapag pinapawisan o kapag tumutulo ang sipon. Sa totoo lang para sa akin, pwedeng nang pamunas ang manggas ng t-shirt ko.

Ang panyolito ba ay tanda ng aking pagsunod sa aking mga magulang?

Lagi rin akong may jolens sa bulsa. Dahil laro lang ang laman ng utak ko noon. Walang muwang. Walang responsibilidad. Malaya. Malayang tumalungko sa lupa at magpakadusing, sa paglalaro ng jolens.

At simple lang din ang aking pangarap – ang matalo ko sa jolens ang aking mga kalaro. Hindi naman sa pagyayabang, minsan ay naging asintado at mahusay din naman ako sa laro ng jolens.

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larong jolens

*****

Noong highschool at college:

1. suklay

2. panyo

3. wallet

Noong mga panahong iyon, meron na akong suksok na suklay sa aking bulsa. Yung natitiklop na parang balisong. Ito ay sandata ko na dala-dala araw-araw. Kailangan ayos lagi ang buhok. Kahit pa makipagsiksikan sa jeepney o sa bus, basta may suklay, guwaping pa rin.

Kusa ko na ring sukbit ang panyo. Kailangan punasan ang tagaktak ng pawis. Kailangan punasan ang sipon. Kasi nakakabawas sa pogi points kung basa ng pawis o tumutulo ang sipon. Dahil ang pangunahing pakay noon ay ang pumorma.

Dala ko rin ang aking wallet, kahit wala namang laman ito. Madalas nga kasyang pamasahe at pang soft-drink lang ang laman ng pitaka ko, pero bitbit ko pa rin ito. Bakit kamo? Kasi pampaumbok din ng puwet ito! Pati nga panyo ko (minsan dalawang panyo pa) nasa kabilang bulsa sa likod ng pantalon, para pantay ang pagkatambok.

Kung yung mga babaeng hindi nabiyayaan ng dibdib ay naglalagay ng medyas sa bra, kaming mga patpat na lalaki, ay panyo at pitaka sa puwetan ng pantalon.

Pero nagsimula na rin namang akong mangarap sa panahong iyon. Maliban sa makaporma at mapansin ng crush ko, ay may pangarap na rin, na sana makatapos ng pag-aaral, magkaroon ng matinong hanap-buhay, maging maginhawa, at magkaroon ng laman ang aking pitaka. At hindi lang hanggang porma ang suksok na pitaka.

*****

Ngayon

1. cellphone

2. wallet

3. susi

Sa paglipas ng panahon, nag-iba na ang aking pangangailangan. Wala ng suklay (wala nang susuklayin). Wala ng panyo. Hindi na mahalaga ang paporma.

Cellphone na ang laman lagi ng aking bulsa. Ito ang aking kuneksiyon sa trabaho, sa pamilya, at sa mundo. Narito ang aking mga contacts, schedule, e-mails, at notes. Gamit ko rin ito para alamin ang mga bagay na hindi ko alam – tatanungin ko lang si Mr. Google.

Ang aking cellphone ay hindi lang pang-selfie at pang-facebook. Pero siyempre gamit ko ito bilang kamera para sa aking blog, at pang-update kung may sumilip sa aking website. (Salamat sa pagtangkilik!)

Nandiyan pa rin naman ang aking wallet. Pero hindi pa rin ako nagdadala ng malaking halaga. Dahil plastik (credit cards) ang madalas kong gamit. Ibig sabihin, malakas ang loob mangutang at gumastos, dahil may trabaho na.

Iba na rin ang pangarap ko. Hindi lang para sa akin kundi para na rin sa kinabukasan ng aking pamilya. Kailangan may laman ang pitaka para may pang-baon ang aking mga anak.

Isa pang laman ng aking bulsa ngayon ay mga susi. Susi ng bahay at susi ng kotse. Mga bagong laruan kapalit ng jolen? Puwedeng sabihing medyo nakaka-angat at matagumpay na tayo dahil may pag-aari na.

Ngunit bahay at kotse ba ang simbolo ng tagumpay? O ito lamang ang mga panibagong pangangailangan sa yugto ngayon ng aking buhay. Siyempre kailangan ng bahay para kanlungan ng pamilya, at kotse para makarating sa dapat patunguhan.

Pero hindi ko pa rin naman lubos na pag-aari ang bahay at kotse, at patuloy pa rin itong hinuhulog-hulugan. Kaya kailangang patuloy din ang aking pagkayod para mabayaran ang mga ito. Ang mga susi bang aking dala-dala ay nagpapalaya? O ito’y gumagapos na parang tanikala?

Pangangailangan nga ba ang laman ng ating bulsa? O tayo’y alipin ng nasa loob nito? Pero hindi ko rin naman sasabihing mabuti pang walang laman ang ating bulsa.

Tunay na mas simple ang buhay noong jolen pa lang ang nasa aking bulsa.

*****

(photo by Rodgie Cruz from pixoto.com)

Running, Asthma and Darth Vader

Do you like running? But do you run out of breath and sound like Darth Vader when you run? Maybe you have asthma.

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Recently my cousin, who is a budding journalist in the Philippines, asked me questions on the subject of asthma and running, knowing that I am a lung specialist as well as a runner. He said that he was writing it for a fitness website. I would like to share them here.

1. How does asthma affect people? What does it do to their bodies?

Asthma is a condition in which there’s two main components, (1) narrowing of bronchial airways (bronchoconstriction) and (2) swelling (inflammation) causing edema and production of extra mucus. These can cause the difficulty breathing and wheezing, making you sound like Darth Vader. These attacks can be intermittent and reversible, and triggered by exposure to certain allergens.

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2. Can everybody have asthma?

No. It is most likely genetic or familial predisposition that leads to one’s having asthma. For example, there are certain triggers that can cause an asthmatic attack, like house dust mite, but not all people will react to it. It is like an allergic reaction, where a predisposed person’s immune system overreact to the trigger.

So if you have asthma, you can partly blame your parents and the genes they passed on to you.

I’m not sure if Luke Skywalker have asthma too (“Luke, I am your father” – Darth Vader).

3. What are the common causes of asthma?

There is a wide gamut of asthma triggers and can differ from person to person:

A. Inhaled allergens – like house dust mite, pollen, cockroaches (I hate cockroaches), indoor and outdoor fungi/mold, pet dander (I feel sorry for pet-lovers if their beloved pet cause them their asthma attacks).

B. Respiratory infections – common cold and other viruses, or bacterial infections

C. Inhaled respiratory irritant – cigarette smoke, pollution and smog (like in Manila!), certain chemicals like volatile gases that can be at the work place, and even (cheap?) perfume. If you have a co-worker that has a body odor, you can tell them to take a shower for it can trigger your asthma. Just kidding.

D. Hormonal fluctuations – like in pre-menstrual and menstrual period in women; it can be part of pre-menstrual syndrome!

E. Medications – like beta blockers (metoprolol) that is use as an antihypertensive or in heart patients.

F. Physical activity – exercise

G. Emotional state – anxiety, sudden upsets. Yes being dumped by your girlfriend can cause an asthma attack!

H. Temperature and weather – cold air, hot humid air, wet conditions (which can increase respiratory allergens in the air).

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4. What are the symptoms of asthma?

Most common symptom of asthma is difficulty in breathing, with sensation of chest tightness. You feel like you have a rubber band around your chest. When more severe, wheezing ensues. If really severe, it can lead to respiratory failure. A persistent cough can be a symptom of asthma as well, which is from the constriction of the airways.

5. Can it be prevented?

Yes. Avoiding the triggers as what I mentioned above. Also by using medications such as inhalers, especially the inhaled corticosteroid that kind of stabilizes the membranes of the respiratory tract of an asthmatic, so it won’t be so reactive. This lessen the attacks.

6. What’s the cure for asthma?

No cure for asthma. If you have it, most likely you’ll have it for life. Sorry Darth Vader. But we can control or minimize the symptom or lessen the attacks through avoidance of triggers and through medications. Asthmatics can do whatever they want and can live a “normal” life if their asthma is well-controlled.

7. Can running trigger asthma?

Yes. As any other form of exercise can.

8. Can a person still run if he/she is an asthmatic?

Yes. Even though exercise is a potential asthma trigger, it should NOT be avoided.

9. Can running help a person fight asthma then?

Yes. Aerobic exercise strengthens the cardiovascular system and may lessen the sensitivity to asthma triggers.

However, it is important for persons with asthma who are not in a regular pattern of exercise to build-up their activity level slowly to minimize the risk of inducing asthma. Also, if exercise is your asthma trigger, use your “rescue” inhaler (like albuterol meter-dose-inhaler) 5 -10 minutes before you exercise to preempt the attack. And if you have an attack while exercising, you can use the inhaler again.

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Jackie Joyner-Kersee, an Olympic medalist, uses an inhaler after running

10. Can a person run if he/she has an asthmatic attack or episode?

Yes and no. If the asthma attack is pretty mild, you may be able to endure it. However if the attack is significant that you’re wheezing, I would recommend to take it easy for that day.

11. How long should a person run after he recovered from an asthmatic attack?

No fast rules. You can sense when you’re ready. Listen to your body.

12. What’s your advice to people with asthma who wants to enjoy running?

Continue running. But you may want to run when it is not so hot and humid, (or too cold if you’re not in the Philippines). Or run in areas not so polluted or smoggy. That is maybe doing it early in the morning.

Also avoid stray dogs. Not because it can trigger your asthma, but it can chase you!

13. What should runners with asthma remember during their runs?

Have your rescue inhaler handy during your runs. It easily fits in even the smallest pocket of a running shorts anyway.

If there’s a lot of dogs in your area, you can carry a pepper spray too to ward them off. Just don’t mistake it for your inhaler!

And most importantly, have fun!

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This is how to defeat asthma and Darth Vader.

(*photos from the net)

Bite Me

Summer breeze is now blowing here in the northern hemisphere. Yesterday, we had our first 90-degree-Fahrenheit day for the season, and it is predicted that it will be the same today. Summer has arrived in our neck of the woods.

I went out for a run in our neighborhood this morning. Just my usual 2-3 miler run. Nothing extraordinary.

With the warmer air, I felt it was harder to run. Though I am not fond of the cold, I will admit, that running in the colder weather can be better. Personally, I feel that 40 to 60 degrees Fahrenheit is the best temperature to run, especially when doing longer distances.

As I was struggling this morning on a steep uphill climb, but was nearing the top, suddenly a fierce-looking black bulldog came out from a neighbor’s yard.

The dog was not barking. It was just charging towards me!

They say that there are two ways to react when faced with danger. The first response is flight.  But as I said, it was uphill, and it would be very difficult to sprint ala-Usain Bolt. Plus I am not sure I can outrun a charging bulldog.

The second response is to fight. Me fighting a menacing-looking bulldog? But I don’t have my Black Ninja sword with me. Would my Kung-Fu deter this attack dog?

Confronted with danger or in an excited state, the flight or fight hormones (adrenalin and the like) will be secreted by our body. With these body juices rushing, individuals can do extreme feats, like carrying a refrigerator all alone during a fire evacuation, or clearing a high fence on a single bound when being chased by a vengeful lover.

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Fight or Flight (as in flying!) response

Well, some people say that there’s another response in facing danger. That is to freeze. Like a deer caught in a bright headlight.

Scientists say that standing still or playing dead is a real mode of defense mechanism. It is employed by many creatures in the animal kingdom. Best known is the opossum. They freeze not just because they are gripped with fear, but rather they are using nature’s way of self-preservation.

And that’s what I did. I stopped running and stood still.

But the bulldog did not stop on his charge. It was rampaging straight for my legs! I saw it open its mean snout……

And then it licked my leg! No bite. Just a friendly lick.

I must be like Kentucky Fried Chicken to that bulldog. Finger-licking, ah, er, leg-licking good!

(*photo from the internet)