App To No Good

In January 2011, the American Dialect Society named “app” the word of the year for 2010. Today, that word is engrained in our daily vocabulary. App is shortened for application, something that you download in your mobile device. I think everybody knows what an app is, unless you’re living under a rock.

There are more than 2 million app available in Apple app store currently, and for Android users, there are about 3.5 million apps. If you think about something, there’s probably an app for that. This technology has been part of our day-to-day life and it’s really on the up and up, or should I say, on the app and app.

I have several apps on my smart phone that make my life “easier.” I have an app for the weather alerts, an app to know where I park my car, an app to read and check the latest medical literature and studies, an app to do my banking, an app to control the air-conditioner or heater at my home even if I’m not home, and app to listen to Filipino radio stations, even if I’m 8000 miles away from the Philippines.

You already know that for about 3 weeks now, I have been using an app to help me improve my running (see previous post, App for the Challenge and App to Speed). I started with a pace of about 11 minutes per mile but with the aid of the app I was able to decrease it to 10 minutes per mile on my last run.

After a couple of runs with a faster pace, this week it was my objective to build on that and further improve my pace. My goal is to have it under 10 minutes or even a 9-minute mile.

But I failed!

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I ran a longer distance this time though.

I can think of a hundred reasons of why I was not able to achieve that goal. First, I had only 5 hours of sleep the night before I made that morning run.

Second, it was hot outside when I ran, with the temperature near 80º Fahrenheit. I know that was not really hot, especially if I consider that I grew up in a tropical country. But for me I rather run in a 30-60º F temperature and just layer up in my running gear. If the temperature is 90º F or higher? Forget it, that can kill a runner.

Third, the app did not give me wings in my feet.

Fourth, the app failed to give me more air in my lungs.

But I think the only acceptable reason is that running a 9-minute mile is not as easy as I thought, and I am not as fast and strong as I believe I am. As in most endeavor, it takes time and perseverance to achieve what you aim for. Maybe it would take me few more weeks or even months to attain that lofty goal. Or maybe never.

For now, I’ll just blame it on the app.

(*background photo taken during my run)

 

App for the Challenge

It’s summertime here in our area. I can’t use the excuse of “it’s too cold to run” anymore. Though I can say, “it’s too hot.”

Anyway, it’s time for me to take longer and more frequent runs outside. If I plan on joining the half-marathon this autumn, I have about 4 more months to prepare. That’s plenty of time.

In the past, I just needed 10-12 weeks of rigid training schedule to be in good running form. ‘Good running form’ does not mean I can compete with the elite runners, for me it means finishing the 13.1 mile course without keeling over. But I know I’m getting older, so maybe my body needed more time to be ready.

I want a ‘smart’ runner’s watch that has GPS that can track my distance and or pace me when I’m running, which I think can help me train. Perhaps it’s another excuse to get another “toy” to get me motivated to continue running. When you’re more than 50 years old, and your joints and muscles often times protest after a run, you need all the motivation to keep going.

But when I shop around for that nifty runner’s watch, it’s kind of expensive. The ones that I like are north of $200, so I hesitated to buy. Maybe I’m too cheap.

Then it dawned on me that there are several running app that I can download on my phone that are very inexpensive or even free. Why have I not thought of that before? I used to just estimate my distance and pace before, which is not accurate nor scientific.

I always carry my phone anyway when I run. I carry it in case of emergency, like if a deer ran me over or a wild rabbit attack me. Or if I get disoriented and get lost in my own neighborhood, I can use its GPS to guide me home. Kidding aside, I carry my phone all the time to take photos when I run.

After downloading a running app, I used it for the first time this morning. I only planned on running 1-2 miles as I have to be at work early, but I suddenly got challenged when my phone started chirping my progress and telling me my time and pace every mile I covered. So I finished a standard 3.1 mile (5K) run.

Not bad for this time of year. If I can shave several more seconds on each mile and extend my distance little by little, I think I would be alright for that half-marathon. I think this running app is helpful. Or if at all, it’s more for bragging rights.

Happy running!

(*background photo taken during my run)

Long Beach, a Gala, and an Electromagnetic Lecture

Part of our big summer trip few weeks ago was going down to Long Beach, California. Long Beach is a city in Los Angeles County at the pacific coast of the US. It is 24 miles away from the city of Los Angeles, but that drive can take more than an hour due to terrible traffic.

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We went to Long Beach to attend my medical school’s sponsored event. It was the 24th University of Santo Tomas Medical Alumni Association of America (USTMAA) Grand Reunion and Medical Convention.

The Hilton Long Beach was the site of the event, and that’s where we stayed for a couple of days.

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Only a few blocks away from the hotel is the ocean and the Pine Avenue Pier. One early morning, I went out for my 2-3 miles run, and I wandered down to the pier (above and below photos were taken during my run).

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The Pier was lined with prime restaurants, so I guess you won’t get hungry if you stroll there.

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Here’s the marina with some of the boats docked there.

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There’s even a lighthouse at that Pier.

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Back to the USTMAAA event, since the event is billed as a Grand Reunion, many medical alumni from different batches attended. The oldest batch represented in the gala night was from medical class of 1951, though he was a lone attendee of his class. He was probably in his 90’s or nearing 90, yet he still looked strong and springy.

One of the biggest contingent was from the class of 1966, who were celebrating their 50th (Golden) anniversary. I tell you, those “old” folks can still dance the night away.

The “youngest” (the term ‘young’ is really relative) batch in that reunion was our class – from year 1991, which in my estimation was the biggest group represented. We were celebrating our 25th (Silver) anniversary.

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Above is a photo I grabbed from USTMAAA website, showing our batch during the parade of the different classes at the gala dinner. Though many of my other classmates who went to Long Beach did not attend the gala, but came for the other festivities and the medical conference.

To be honest, I am not really a fan of galas and pageantries, so that was not the main reason I attended. Sad to admit, I can’t even dance. Of course seeing my old friends and classmates was enough motivation to attend.

But the biggest reason I came was, I was invited to give one of the lectures during the medical convention, which I considered an honor and a privilege. Many of the lecturers, including the keynote speaker, was from my batch.

The theme of the conference was “Current and Interesting Topics in Medicine and Surgery.” Below is an ‘official’ photo (grabbed from USTMAAA website) of me giving the talk.

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The title of the lecture I gave was: The Lung and Winding Road (my apologies to the Beatles): Current Trends in Lung Cancer Screening and Diagnosis.

A portion of my talk was about Electromagnetic Navigational Bronchoscopy, a relatively new technology using GPS-like guidance with videogame-like images, when doing bronchoscopy and lung biopsy (see previous post about this topic).

Are you wondering what was the slide projected on the screen on the photo above?

Here is that specific slide on my presentation:

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For readers who are not familiar with the above character, this is Voltes V. He is an anime super robot, aired as a TV series in the Philippines in the 1970’s. One of his weapon was the “electromagnetic top.” We definitely are not the first ones to use the “electromagnetic” technology.

After the lecture, many attendees approached me and told me that they enjoyed my presentation very much. Maybe they were all Voltes V fans.

I had a fun time in Long Beach. I hope to be reunited with my classmates and other alumni in the next UST event. Borrowing the battle cry from the Voltes V team, “Let’s volt in!”

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P.S. Voltes V is now forever profiled in the USTMAAA website.

 

 

Frankenstein Medicine

For this week, I have been spending 8-9 hours a day inside the classroom and in the simulation laboratory trying to learn something new. Never too late to learn a new trick, even for an old dog. Though I admit I was almost half asleep in some of the lectures.

The hospital where I have affiliation with, will have a “new” intervention available as soon as next month. This treatment is called Extracorporeal Life Support (ECLS) or also known as Extracorporeal Membrane Oxygenation (ECMO). So they are training us doctors (critical care specialists, cardiologists and thoracic surgeons), as well as nurses, respiratory therapists and perfusionists, so we can have this life support system off and running.

In a simplistic way, ECLS entails placing large tubes to suck out the blood from the patient. Then having the blood run into a machine where it will be bathed with oxygen and then pumped back into the body. ‘Extra’ means outside, and ‘corporeal’ means relating to body, thus out-of-body life support.

Does this mean the patient will have out-of-body experience?

For patients, whether kids or adults, whose organs have failed for one reason or another, especially the heart or the lungs, can be placed on this life support system to sustain them and keep them alive and buy some time. The use of this intervention is not by all means the first line of treatment but rather of a last-ditch salvo. But it definitely has saved lives, and more and more advanced centers are offering it. Our hospital will be one of the first to provide it in our state.

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baby on ECLS (photo from the net)

ECLS is not really a new procedure. This has been done for several decades now. Except before, the intervention is only limited to short period of time, like several hours only. The main use of this before was in the operating room during cardiac surgery. They run the blood out of the patient’s body and through this machine, while the surgeon stop the beating heart and tinker on it. I can imagine the heart surgeon singing Sting’s “Be still my beating heart” while he operates. Then the machine is shut off once the heart is beating again.

Now ECLS is also being used outside the operating room, and people are placed on this life support while in the Intensive Care Unit. They can be on this for a few days, a few weeks, or sometimes even months – while their own body and organs recover, or while they wait for a new heart or a new lung, or both, or until “kingdom come.”

Of course the complexity of this intervention is beyond what I can explain here, not to mention the immense cost to the already burdened health care system and the sensitive ethical questions involve, like who to place or who not to place, or when to continue and when to stop. Are we playing God?

While we are doing the training, one of the trainee commented with a sinister smile, “we are Dr. Frankenstein.”

Is this as close as we get to Frankenstein medicine? I don’t think so. We have not created a monster. Yet.

 

iMock

MacBook, iMac, iPod, iPhone, iPad, and now iPad mini. How much gadgets do we really need? The cynic in me, sometimes wishes for the good ole simple days, when apple and blackberry are just something we eat and not something we tinker around. A tablet is something we swallow when we’re sick, and not something we play with. A notebook and a pad are something that has lined papers that we write on, not that one we can google something in the internet with. Well you can also say that google and internet are words that don’t exist yet.

However, I will say that not acknowledging these new technologies and gadgets, that really changed the way we live, is like burying your head on the ground. In truth, we have some of these “toys” lying around in our house. My children are well adept to these devices, and use them to do their homework, or “homeplay”  if we’re not attentive. My wife likes reading books on her gizmo, as well as playing Fruit Ninja. Even toddlers today know how to operate an iPad. My son who is nine, is now asking me when can he have his own phone, just like her teenage sister do. I told him he can use his toy walkie-talkie to call, and can even do morse code when he wants to text, thus he does not need a phone.

I let my kids know that I was 33 years old when I had my first laptop and was 34 years old when I had my first cellphone. I did not have my first “smart” phone (were the old phones “dumb”?) until last year. To this they will reason that when I was in their age, the computers that were as powerful as the current laptop, were contained in a room as big as our house, and mobile phones were carried in a large backpack. Though texting already exist when I was young – it was called a telegram. Yes, our kids live in a different era of technology.

Last week, when the new iPad mini came out, my daughter stated that she would like go to the Apple store and see them. (Note to myself, is “seeing” means her subtle way of saying “having” it?) Upon hearing this, my son ran upstairs to the bathroom and got something. He came back with a wide mischievous grin and handed something (see photo) to her sister and mockingly said: “here’s your iPad mini!”

(sanitary) I-pad mini?

We all can’t help but laugh, including my daughter, upon seeing what my son did. I wonder where this little rascal got this ridiculous idea. I guess, the “apple” did not fall far from the tree. And I am not talking about computers.

Technology, We Have a Problem

For a few years now our outpatient clinic had completely adapted electronic medical records. No more paper charts, no more big bulky x-ray films, and no more illegible written prescriptions handed to the patients.

Aside from the stethoscope that hangs around my neck, I lug with me a small computer tablet when I go in to see patients in every examining room. Their records from my office, from other doctors’ office, from the hospital, their laboratory works, and their imaging studies (chest x-ray, CT scans, PET scans images) are accessed at the tip of my stylus pen. The prescriptions are directly sent electronically from my tablet to the pharmacy’s fax.

Last month, one outlying hospital outside of the city I worked in, have invited me for a demonstration, as they are about to launch their project in telemedicine. What telemedicine is, is seeing patients from distance away through video-conferencing.

The patient sits in an examining room in front of a large TV monitor and a camera, in a hospital or a clinic miles away, while I sit in my clinic here in town in front of my computer screen. I control the camera which can zoom with such high-resolution to see clearly even the pupils(eye) of the patient. A nurse at the patient’s room can place the special stethoscope on the patient and I can hear the heart and lung sounds in such high-definition through my headphone set. There are even special scopes that I can look into the patient’s ears, nose and mouth (without smelling their breath!) all through my computer monitor.

 

The telemedicine project’s goal is to bring the services of physicians of different specialties in areas that don’t have them, without having the patient or the doctor leave their locale. The future implications are limitless. Maybe someday I will be in my home pad in Manila or better yet in one of the beautiful beaches in the Philippines (as long as there is satellite signal), while I see patients somewhere half a world away. I know robotic surgery (surgical robots controlled by humans) is still in its infancy. But who knows, someday surgery will be done while the surgeon is not even in the operating room!

Technology is good…… that is, if they are working properly.

Last week, while I was seeing patients, my computer screen keeps on freezing and crashing. I had to reboot it several times, delaying me for many minutes, that it made my patience run thin. Finally I called our clinic manager to give me another computer and have mine fix by IT, before it literally crashes to the floor (deliberately!) and before I give it the real boot (kick it with the heel of my shoes!).

In the future, what if a doctor is performing a delicate procedure or a life-saving intervention through telemedicine technology, and all of a sudden the connection is lost or the computer crashes? Scary thought huh?

"Houston, we have a problem."

This reminds me of Apollo 13 and the famous words: “Houston (or insert name of place here), we have a problem.” With all the advancement of technology, sadly to say, Murphy’s law still applies — If anything can go wrong, it will.