Blood Extraction Blunder

He did it again.

Using his index finger, he pointed to his left cubital fossa (i.e. the front part of his elbow) while he was giving me this sly grin.

You see a few weeks ago, I extracted blood from him in that area but, lo and behold, I failed to hit his very prominent veins! (But hey, even the great Michael Jordan misses his shots!) So while swallowing my pride, I retracted my needle and transferred to the opposite site.

But my blunders don’t end there. I forgot that his laboratory request consist of Complete Blood Count (CBC), serum electrolytes, Fasting Blood Sugar (FBS), and Serum Creatinine which should be placed in 2 vials, one containing 2cc and the other 4cc. I used only a 3 cc syringe! So as soon as he went out (he was going to the Rehabilitation Medicine Department) I asked a medical technologist intern to follow him there and make another extraction (while thinking of a good alibi).

And since then, he repeated this gesture every time we cross paths (since we live in the same neighborhood). Probably it’s just a joke in his part (I know he’s a good man), but being reminded of your mistake all the time is no laughing matter.

Well, isn’t it the same with our greatest accuser—the devil? He never stops in pointing an accusing finger toward us, making us feel we’re hopeless, good for nothing and we can’t change from our past. He always tells it to our face us that we are sinners and sinners we will forever be. He presents us these lies, thus, making us forget the real value we always had.

Good thing our Father thinks otherwise.

He knows that we are sinners, and as sinners He already paid the price for our sins—both past and future. All we have to do is to accept that grace and repent. May this be the truth that will set us free from the lies of our enemy.

“Just one drop of His blood …
… washed away all of my sins.
Saved.”

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Sutures

I have a new advocacy.

But before that let me share to you an experience I could not forget.

I was having my first day of duty in my first month of surgery at a government hospital. There was this patient who was allegedly mugged by a group of people, thus, sustaining a laceration in the scalp at the right parietal area that badly needs suturing. In a government hospital setting, there are times the patient needs to provide the material, but unfortunately for this patient he had no money because he just came from the province and was trying his luck in the big city. So we just scoured for available sutures in the “pancitan” (Tagalog for “noodles.” This refers to the used sutures that are soaked in antiseptic agent for re-use). There were also some few lidocaine left from a previous patient and luckily there was a sterile glove available. So I, being inexperienced and all, sutured a wound in the scalp for the first time!

As I was doing the minor procedure with trembling hands, I cannot help but to extend my sympathy to the patient. If he just had enough money he could have been attended by a more skilled physician in a complete facility, and not by a fresh surgical clerk who’s unsure of what he was doing. I did not know if he followed-up for suture removal or if he bought the antibiotics he was prescribed, but by the look on his face, I’m sure he was hurt more emotionally than physically because of his helpless condition.

It is just one of the many encounters I had with patients who sought medical help but were unintentionally deprived of such attention because of financial constraints.

If only they had enough money.

That’s why I’m including a new dimension in my life’s mission: FINACIAL HEALING.

I’m not saying I’m rich and capable of giving money to the poor for their health needs. I also needed to be healed in that aspect, for me to be able to take part in their healing process. Financial healing is more than giving money as a dole-out. Because if you just give money as charity, it is like giving them Paracetamol for the fever but not prescribing a broad spectrum antibiotic that will heal the overwhelming bacterial infection in their system.

For people to have financial healing they should be given proper financial education.

Luckily I found a group* that dedicates their time and effort educating people regarding their finances. I, too, am in the process of acquiring financial knowledge and soon will be an instrument of healing of many people, financially.

This is my dream: a first-world Philippines where all patients could avail proper medical attention because they can afford it.

Join me in this dream. Educate yourself and become truly rich!

* They are the International Marketing Group (IMG). In Metro Manila, they are giving FREE financial literacy seminars called Wealth Academy every Wednesday and Friday (7pm-9pm), and Saturday (2pm) at 3/F King's Court Building 1, Chino Roces Ave., Makati City. For outside Metro Manila and other countries, you may inquire to them. For inquiries how they can help you just click here.

Medical Trivias 2

Some interesting facts and figures from medical and first aid websites:

- Around the world, 50 people a day are blown up by land mines.
- The mosquito is the most dangerous animal in the world. 3000 people die each day from Malaria. World wide, 515 million people are infected.
- Properly performed, CPR delivers less than 30% of the hearts normal flow of oxygenated blood to the brain.
- A red blood cell can circumnavigate your whole body in 20 seconds.
- There are 2.5 trillion red blood cells in your body, which means about two and a half million new ones need to be produced every second by your bone marrow. That's the same as reproducing the population of the city of Toronto every second. That's 100 billion every day.
- If you look at all the cells and tissues in your body, about 25 million are reproduced every second, which is like reproducing almost the entire population of Canada every second!
- Nerve impulses travel at over 400 km/h. When we touch something, we send a message to our brain at 124 mph.
- In one square inch of our hand we have nine feet of blood vessels, 600 pain sensors, 9000 nerve endings, 625 sweat glands, 36 heat sensors and 75 pressure sensors.
- A sneeze explodes out of the body at 166 km/h. A cough travels at 100 km/h.
- The average heart beats at 100,000 times a day.
- Your blood is on a 600,000 mile journey.
- Our lungs inhale over two million litres of air every day, and if they were spread out, they are large enough to cover a tennis court.
- We make 1 litre of saliva every day.
- Over your lifetime, the average person will breathe in around 40 pounds of dust.
- There are more living organisms in one average human body than there are humans in the whole world!
- From 30 years old onwards we gradually shrink.
- We have enough carbon in our bodies to make 9,000 pencils.
- When we blush, our stomach lining goes red too.
- If we put together all the time we spend blinking, we would see blackness for 1.2 years.

Source

I Love You From the Bottom of My Amygdala!

I am halfway through my rotation at the hospital laboratory and I am having a great time!

Aside from the fact that I don't have a night duty (8am-5pm only), I am appreciating better the domains of blood chemistry, histopathology and microbiology! (Am I becoming a freak now?)

And since I am at the LAB (short for laboratory) department, allow me to share with you some of my thoughts about LOVE... (lol)

> For me, love is more than an emotion. It is a decision. If you decide to love somebody, you will stick to that person even the kilig feeling (infatuation) has been long gone. It involves more then your heart (or amygdala where the source of our emotion, anatomically speaking) but your will.

> For you to share love, you must be filled with love. If not, it will drain out the life out of you. Imagine you have a cup which you fill with water. You must be filled and overflow with love, so that the overflowing love from your "cup" will be the love that the other "cups" in your life—family , friends, career—will receive. Remember, you cannot give what you don't have.

> It is romantic to hear from your special someone the phrase "you complete me," but if you are still incomplete, then, I believe what you will give is an incomplete love.

> And before you say "I love you" to someone, you should have said "I love You" first to your God.

> 1 John 4:19 (TEV) says "We love because God first loved us." You should realize how much you are loved by God, because we ought to response to that great Love. It is inevitable! If you felt that unconditional love from God, you cannot help but to love Him back.

> It is great to show your love in extraordinary ways, but don't forget to love them with the little ways (unexpected phone call to a friend, a simple back massage for your mom, a hug for your brother.)

> Be verbal with your love! It sounds very mushy but believe me you'll regret it when you are just saying those words of affection too late; when that person is already dead upon arrival at the E.R. and the doctors cannot do anything about it!

> Love your work, so that you won't have to work a day in your life.

> Love the poor. (I'm teaching myself to be generous.)

>Love the unlovable (that unreasonable resident doctor, that demanding patient, that indifferent neighbor, that person that no one wants to befriend with). It is difficult I know, and sometimes I am having a hard time to follow this. But at least, try.

My friend, live a life full of love.

"Meanwhile these three remain: faith, hope, and love; and the greatest of these is love."

1 Corinthian 13:13, TEV

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Laughter is the Best Medicine 1

Check out one of my hospital bloopers!

I remember when I was still a medical clerk and was rotating at Fabella Medical Center (the baby factory of the Philippines!), I was assigned to monitor the vital signs of all the patients together with some colleagues. The ward was so huge it has 100-150 bed capacity.When I was in this particular row, I noticed a pregnant patient with her baby's head sticking out from her!I noticed that the baby was already cyanotic and so my instinct told me to call the attention of the resident doctors and to pull out the baby right there and then (yes, without even wearing sterile gloves)!

And so at the top of my lungs I screamed "Doc, baby out!" All of the patients, nurse and everyone in that huge ward stared at me puzzled while I panicked. Then one of the doctors approached me and told me to calm down because it's alright. What I didn't know was the patient had intrauterine fetal death (the baby was already dead inside) and they were just waiting for the mother to spontaneously deliver the baby so that they won't have to induce labor!

Yikes! I made a scene and it was very embarrassing!

Confession of an Atypical Physician

"Atypical pneumonia is a term used to describe a form of pneumonia not caused by one of the more traditional pathogens. The term 'atypical' is used because atypical bacteria commonly affect healthier people, cause generally less severe pneumonia, and respond to different antibiotics than other bacteria." Source


A few weeks ago, I met up with a new friend. After waiting for him for several minutes, and seeing me for the first time, his first words were “Uy, ‘di ka mukhang duktor…!” (You don’t look like a doctor at all…)

I want to entertain the idea that the reason why he said that was because I look like a ramp model or a matinee idol but he was quick to say “…kasi mukha kang high school!" (…because you looked like in high school!)

It was not the first time I heard that.

Nurses in the ward would ask me how old I am because to them I have the physique of a 16-year old. They will jokingly say that I resemble somebody who’s just running an errand for his mom but then ended up having 24-hours duty in the hospital!

I can’t figure it out if it is a compliment or otherwise.

But on the other hand I admit maybe I really don’t look like a doctor—not because of my appearance but because a huge chunk of my personality and everyday life is very “un-doctor-like.” Let me share these things with you:

Generally, I don’t see myself in the future as a “hardcore physician” but, instead, I envisioned myself doing other things not related to medicine. I want to have a great family, serve the poor, be an investor, etc.

I want to put up a business that will be my main source of income (I see my medical practice as a form of service and compensation will just be secondary).

There are times I hate having patients! (if I am not in the mood!)

Sometimes, I don’t dress like a doctor. I am fond of wearing denim jeans, shirts, and sandals. There was one time I saw a patient in our house wearing only sando and shorts! (hehe!)

I am a budding entrepreneur, infopreneur, and soon I will be a financial consultant and will be in the business of educating people how money works.

Everyday I walk approximately 200-300 meters from Fatima University Medcal Center on my way home as a form of exercise (also to save money).

Before I go on duty at the hospital, I drop by at the chapel and ask for His guidance. After my duty, I say my thanks to God. I tithe. I pray the rosary with my family every evening. I even say a prayer before I insert an intravenous line (so that I won’t miss—but I miss the vein anyway!)

And there are a lot more!

Yes, I am a doctor. Unconventional, sometimes even radical!

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Smoking is Bad for Your Health

This morning I was approached by a pretty, young, sexy lady—asking me if I smoke.

You see, she's a promo girl working for a popular brand of cigarette. They were showcasing a new look for that brand name and as part of promotion she told me they are giving away freebies if I buy just one pack of cigar.

Fighting the temptation to flirt (which I did with utmost will power), I politely said that I don’t because it is bad for the health. (I felt the urge to enumerate to her conditions like pulmonary carcinoma, emphysema, chronic bronchitis and halitosis but I thought it wouldn’t make sense.)

I returned the question to her. She said she does. But probably trying to connect with a potential buyer like me she said she’s trying to quit.

Our conversation ended as she approached another customer, sensing that her charms didn’t work its wonders to me.

Yes, she’s pretty but she’s a total turn-off to me.

Medical Trivias

Hello everone! I just want to share this interesting trivias I got from http://www.triviacountry.com/17_Medicine_Trivia.htm.
Enjoy!

How many miles of blood vessels are there in the average human body?
A: About 62,000.

How many fat cells does the average adult have?
A: Between 40 and 50 billion.

Do identical twins have identical fingerprints?
A: No. No two sets of prints are alike, including those of identical twins.

How much saliva does the average human produce daily?
A: One quart.

How many muscles are there in the human ear?
A: Six.

How many bones are there in the human hand?
A: 27.

What physical symptom is exhibited by those who suffer from blepharospasms?
A: Uncontrollable winking.

Where on the human face is there a muscle known as the corrugator?
A: On the forehead. It's the muscle that contract the forehead into wrinkles and pulls the
eyebrows together.

What part of the human body has the thinnest skin?
A: The eyelid--it's less than 1/100 inch thick.

How many bones are there in your big toe?
A: Fourteen, the same as in your other toes.

What is the average lifespan of a human being's taste bud?
A: From 7 to 10 days.


Truly, our human body is a product of ingenuity of a remarkable Creator! Astig!

Intubated

“This is the air I breathe

This is the air I breathe

Your Holy Presence, living in me…”

- Darlene Zschech (Hillsongs)

A few days ago we admitted a 54 year old female complaining of generalized body weakness, easy fatigability, and pallor. She was conscious and coherent, responding to the queries of her attending physician. I thought nothing special about her, probably just a case of iron-deficiency anemia.

Yesterday, I even talked to her in the morning, asking how she was. She still had body weakness although she was gaining some color after several transfusions of fresh whole blood.

Suddenly, in the afternoon she had changes in sensorium, to the point that her respiratory function stopped. She was eventually intubated. Her stat cranial CT scan showed massive bleed inside her brain, causing a part of her brain which contains the respiratory center to herniate down to the foramen magnum, thus the cessation of breathing. Before she was hooked to a mechanical ventilator I was holding the ambubag—her only means of respiration. Her children cannot help but cry because of the sudden deterioration of their mom. Silently, I said a little prayer for the family, and for her.

There she was, unconscious—dependent to the machine that was mechanically infusing air to her lungs.

Anesthesia

Today marks the end of my anesthesia roatation. During the past month, I was always at the operating room helping administer Bupivacaine and Midazolam to patients who were about to undergo herniorraphy or C-section. I experienced tapping the subarachnoid space several times (although some were traummatic, hehe) and delivering the anesthetic agent. I also experienced intubating for the first time but I must admit I still lack the suave moves in doing so. I guess the past month was a productive one because I learned a lot!

Yes, during the past month I'm a full-pledged "anesth" (short for anesthesia) intern. But aside from the technical stuffs, I'm also reminded during my stay at the anesthesia department of the little things a doctor like me should learn.

I learned how to be more humane and talk nicely to a nervous patient who's about to go under the knife, especially to an elderly or a child. To try to understand their intense anxiety and make them feel comfortable as much as possible before their procedure.

I saw the value of being nice to the OR staff (or any hospital staff for that matter), because they are the ones who will make your life easy as a doctor.

And, finally, being an "anesth" intern reminded me to be an honest doctor. Being in a position of authority requires one to keep his integrity intact. It's pretty hard to do, but not impossible.

Wounded Healers

Since yesterday I was having moderately-grade fever, cough, and body malaise. Well, it's been a while since the last time I got sick. Surely, going to the hospital almost everday would expose one to a lot of illnesses.

It just shows that we, doctors, are not superhuman beings.

I know of a medical intern who has cerebral palsy since birth. He's about to take the medical board exam in the near future. (And he is even married with one kid).

I had a doctor-professor, a pediatrician hematologist-oncologist, who suffered from poliomyelitis. She has difficulty in standing for a long time that's why she lectured to us sitting down. She's always with a cane.

I met a medical internist who is one of the best in his field. He's probably between 65-70 years old and he is undergoing dialysis due to failing kidneys. He still continues to attend small lectures and conferences to impart his knowledge though he had to be brought in with a wheelchair.

And there are many others who may not be suffering from physical ailments but is battling emotional, financial, spiritual sickness.

Again, we are not superhuman beings. We are very much susceptible to the many adversities of life, just like any other people.

But we continue to take part in the healing process. This is our commitment, no matter what.

Toxic

Toxic!

My favorite word for the day!

Translation: lots of work to do, less time to play!

Sometimes I wonder why I am in this career? Why become a doctor when doctors train to become nurses?

This is insane, to punish yourself with several hours of duty. To burden yourself with responsibilities. To eat your lunch at 3 p.m. and have little sleep, if any.

But then suddenly I envision my future patients. This is my calling. I owe it to them.

Cataract

A cataract is a condition of the eye wherein there is opacity of the lens which causes blurring of vision. Cataracts may be congenital, metabolic (e.g. secondary to diabetes melitus), injury to the lens (either direct or indirect), prolonged exposure to ionizing radiation or infrared rays, or may be due to old age (i.e. senile cataract) which is the most common. It has different types such as nuclear sclerotic cataract, posterior subcapsular cataract, Brunescent cataract, and cortical cataract. Treatment is surgical, which is done either by phacoemulsification (using an ultrasound probe in breaking up the cataract) or extracapsular cataract extraction (ECCE).


There were times I get annoyed by difficult people in my workplace - unreasonable resident doctors, demanding nurses, inneficient co-interns. When I encounter such persons I tend to harness some sort of hostility towards them.

But little did I know that, sometimes, other people also felt the same way towards me.

There were times I'm the one being unreasonable.

There were occasions I demanded a lot from other people.

There were a lot of times I'm guilty of being inneficient.

I easily see the fault in other people but I don't recognize my own shortcomings. Now I realize before I try to correct other people, I have to address my own mistakes first.



"Why do you look at the speck in your brother's eye, but pay no attention to the log in your own eye."
Luke 6:41, TEV

Lesson from the E.R.

I remember an incident when I was having a duty in the Emergency Room of Fatima Medical Center. There were no single patient during that time which was around 4 o' clock in the morning. Some of my colleagues were just hanging around while some were trying to get some sleep.

Suddenly a patient was brought in, unconscious. He was a male patient, probably on his early 60's, accompanied by his daughter who was crying hard. The whole E.R. rushed to the patient and we tried to resuscitate him. As we were attending to the patient, the daughter was really crying aloud, talking to her father and telling him how much she loves him. She kept on crying and talking, asking her father to wake up. She told him that she loves him very much, but to no avail, since her father was already dead upon arrival at the hospital.

Even after doing post-mortem care, the woman just keep on saying how much she loves her dad and was even praying at the side of his cadaver.

It just struck me at that instant, why just now say those words of affection when the person cannot hear you anymore. Since then, I tried to kiss my mom every morning. I tried to hug my dad every now and then. I use "sorry" and "thank you" as often as I could because I don't want to come to a point when it will be all too late because those words are being addressed to a lifeless person.

iSTETHOSCOPE

"Sumus nihil nisi instrumenti salubres*."

Hello!My Name is Jan Edward Sayco, M.D. I recently graduated from the college of medicine of Our Lady of Fatima University, a medical school in the Philippines, and currently undergoing a 1-year training as a post-graduate intern at Fatima University Medical Center before I can take my licensure exam.

I'm glad you (somehow) stumbled upon my blog. Join me here as I share to you my different adventures (and misadventures) while living the life of an up-and-coming physician.

I will share to you my triumphs and victories.

I will bare to you my down-moments and defeats.

I will relay significant milestones and mundane moments of my everyday life.

All of these in my hope that, in one way or another, I'll share to you something that you can treasure and so fulfill my life's greatest dream - to be an instrument of healing.

P.S. I'll also share some significant, exciting, interesting facts about health, medicine and other related topics so please watch out for that.

* "I am nothing but an instrument of healing."