After 2 duties in Boracay, I'm back as a reliever resident in Ospital ng Muntinlupa. Scary. It's been a while since I did in-patient management. Fluids and electrolyte management seems like rigging a carburator to me. So, the first thing I did was borrowing a copy of Pocket Pedia from the post duty resident. Great book! Too bad its not available now.
Anyway, the first 8 hours of my duty was so-so: an IV line here, chart ordering there. Benign stuff. I was also the catcher in the nursery. I resuscitated 3 newborns on that half of my duty. All of them are spontaneously born so I don't need a lot of skills AND anxiety to do that. Not so toxic. Not at all.
But wait! Before I leave the next morning, everything went so fast. I had 3 admissions (all of them need a new Hx and PE) and my PICU patient is crashing while m waiting for 2 pregnant patients to give birth! To top it all, I need to do my endorsements before 9 am.
My 28-weeker PICU patient is the worst ever! He had several episodes of O2 desaturation last night. We transferred him to an O2 mask from an O2 hood to improve his O2 sats. It went up to 98-99 but he is still having chest retractions. His vitals are stable but I was wary of the chest retractions. It was way beyond normal. And I had a bad feeling about it.
And true enough, his sats dropped to 50s the next morning. I have no choice but to intubate the poor baby. In all honesty, I never intubated a preterm baby in my whole life. I was anxious but if I don't do anything, this poor baby will die before my eyes. After a few minutes, I was standing there with the 2.5 ET tube in my hand and the laryngoscope in the other. I took a long breath and inserted it between the glottis I exposed with the laryngoscope. Breath sounds were not equal so I pulled it to level 7. Both lungs expanding, equal breath sounds...whew.
But it doesn'e end there. The baby was still crashing. I gave him two doses of epinephrine and primed the parents that the prognosis is not good. His vitals were stable when I left him but all I can do is hope for the best for that baby. Poor guy.
Sunday, July 31, 2005
Thursday, July 28, 2005
Now, what do i do?
Darn!
So WHO decided to take an in-house researcher. It could've been the perfect break: a 2-month research assistant job, with pay and a letter of recommendation to help me in my residency application. Nothing could be better. It will also translate to a longer stay here in Manila before hitting the winter months in the east coast. Haaay.
Now I have to think and consider the best plan for my career.
Option 1: Go to California. Study Step 3. Apply for a volunteer research job. Take the Step 3 then proceed with the ERAS applications.
Option 2: Study here before hitting California. (I don't think this is a good idea, though.)
Option 3: Moonlight here then go back to the US next year and hope to get a post match position.
Honestly, I don't think the last two are viable option. I better stick to option 1.
Two cents, anyone?
So WHO decided to take an in-house researcher. It could've been the perfect break: a 2-month research assistant job, with pay and a letter of recommendation to help me in my residency application. Nothing could be better. It will also translate to a longer stay here in Manila before hitting the winter months in the east coast. Haaay.
Now I have to think and consider the best plan for my career.
Option 1: Go to California. Study Step 3. Apply for a volunteer research job. Take the Step 3 then proceed with the ERAS applications.
Option 2: Study here before hitting California. (I don't think this is a good idea, though.)
Option 3: Moonlight here then go back to the US next year and hope to get a post match position.
Honestly, I don't think the last two are viable option. I better stick to option 1.
Two cents, anyone?
Tuesday, July 26, 2005
Monday, July 25, 2005
Getting back to the craze
I just got back from a badminton game. A good one, that is. I've been craving for activity since I get back here in Manila. During my 2 weeks in Boracay, I hardly exercise, except for the walking during my calls. Oh, yeah, I took a swim twice in the beach but basically that's it. I need my endorphin rush.
I got hooked (understatement) with this sport after I graduated from medical school. (That was two years ago...I'm not that OLD you know). I was studying for the boards that time and I figured that I need an escape: to ease my stress and to express the aggression boiling inside me. Two years later, I'm now licensed to practice here and in the States and yes, I'm still playing the game.
My ICeT Prince racket is a little worn and the strings remain unchanged. Miracurously. it has still power despite the fact that I never restringed it. I still like the feel of the handles and the weight of it.
My play is a little rusty also since I have lesser time to play with friends. But I do always try to play better everytime...trying hard to give them a good whack on the butt. And I do manage to give them a mean whacking a while ago.
Actually, a friend and I are planning to have tennis lessons today. But we figured that the commotion in Commonwealth Avenue will hinder us from doing anything. I ended up playing badminton the whole day while he hit the gym just a while ago. I guess I'm kissing my tennis lessons goodbye. I'll stick with this. There's a tournament on the end of the month and I would rather practice for that. Maybe I'll take the tennis lessons before I leave for the States.
Gotta go...I have another game in an hour! :-)
I got hooked (understatement) with this sport after I graduated from medical school. (That was two years ago...I'm not that OLD you know). I was studying for the boards that time and I figured that I need an escape: to ease my stress and to express the aggression boiling inside me. Two years later, I'm now licensed to practice here and in the States and yes, I'm still playing the game.
My ICeT Prince racket is a little worn and the strings remain unchanged. Miracurously. it has still power despite the fact that I never restringed it. I still like the feel of the handles and the weight of it.
My play is a little rusty also since I have lesser time to play with friends. But I do always try to play better everytime...trying hard to give them a good whack on the butt. And I do manage to give them a mean whacking a while ago.
Actually, a friend and I are planning to have tennis lessons today. But we figured that the commotion in Commonwealth Avenue will hinder us from doing anything. I ended up playing badminton the whole day while he hit the gym just a while ago. I guess I'm kissing my tennis lessons goodbye. I'll stick with this. There's a tournament on the end of the month and I would rather practice for that. Maybe I'll take the tennis lessons before I leave for the States.
Gotta go...I have another game in an hour! :-)
Thursday, July 21, 2005
Boracay again
Just got home from paradise. It was a great 8-day duty. I enjoyed my cases, I get to meet a lot of new people and I had a better salary than the previous one. The last part means I saw quite a number of cases than my previous duty. I also enjoyed the beach this time because most of the days are sunny. My eyes are locked to the turquoise waters everytime I get a chance to have a glimpse of it from the main road in boracay. I wonder how can I ever leave this place? And the Philippines for that matter?
There are some notable cases I had during my duty that I want to share:
18 year old British girl. She called me up to see her in the resort that she's staying with her boyfriend. It turns out that her tongue was "twisted" and cannot open it so much. She was crying and really anxious about her condition. When I asked her to open her mouth, her jaw was deviated to the left and her big tongue was obstructing the view. My first thought was an infectious cause. No fever. Allergic? No history. Neuro? No other deficits. I just asked her one question: "Did you hear a click when this happened?" Yes. It was a simple temporomandibular joint dislocation. I just reduced it back to its place and the girl thanked me profusely, meanwhile, I, walked out from their room in a cloud of valiant air.
I had several trauma victims. Most of them were drunk and had picked a fight with another person. No spilling of guts, though. Damn.
First time to take out a toenail from an infected ingrown nail: my patient is a native of Neuva Ejica, also visiting boracay for a conference. She came up with a swollen toe. It was almost as big as a tomato. Plump and juicy, also. (Sorry for the munching people out there.) The infection got worse because she went to dive before the day she made the consult. She was pretty much grossed out to see her nailless nailbed but happy to get all the pus out. She promised to teach me how to dive. Although I did a digital block. I bet it hurt like hell.
Dig this. I had a patient who works for Albert Einstein in Jacobi! Waaay too cool. He promised to take me around the hyperbaric facility which he operates. He's a very interesting guy, actually. He has businesses in Boracay and Cebu but he goes back to the US every other month. He lives in Westchester and he would love to entertain me whenever I visit. He told me that he will tell the people of AE how I took care of him. Swell.
I had a malingerer chest pain patient who got to my nerves. And another one who had an abortion. She was even smiling when I went to her house. Grrr. I charged them twice...no, thrice my actual PF. Serves them right.
During my stay I read a couple of books too:
1. Devil in the White City: Murder, Lies in the Fair That Changed America. I think every Chicagoan (?) should read this book. Its about the World Columbian Exposition of 1984. The biggest fair at the end of the century which rivalled the Paris exposition. Many American firsts came from the fair: Aunt Jemima, hamburger, Juicy Fruit, Cracker Jack and the Ferris Wheel. And a nice gory serial killer hunt interspersed between the pages. Very entertaining, well-researched work.
2. Opal Deception. The latest installation of the Artemis Fowl Series. Best of the four Artemis Fowl series. Took me just 6 hours to read it. Hard-to-put-down book.
3. Chronicles of Narnia. Got through the first, second and half of the third book. I'm excited to see the movie!
I was planning to have an intro dive before I leave but I felt guilty spending that much money. It was P2T bucks for a dive. My patient is willing to give me a free lesson in Palawan, so why bother if I can get it for free. I just hope it will push through.
And now m back in my room. Back to my backlog books, to my Step 3 reviewers waiting to be opened and to my dial-up internet connection that I'm trying to upgrade to a DSL connection. I'm trying to figure out where to get the funds for that. Ugh.
There are some notable cases I had during my duty that I want to share:
18 year old British girl. She called me up to see her in the resort that she's staying with her boyfriend. It turns out that her tongue was "twisted" and cannot open it so much. She was crying and really anxious about her condition. When I asked her to open her mouth, her jaw was deviated to the left and her big tongue was obstructing the view. My first thought was an infectious cause. No fever. Allergic? No history. Neuro? No other deficits. I just asked her one question: "Did you hear a click when this happened?" Yes. It was a simple temporomandibular joint dislocation. I just reduced it back to its place and the girl thanked me profusely, meanwhile, I, walked out from their room in a cloud of valiant air.
I had several trauma victims. Most of them were drunk and had picked a fight with another person. No spilling of guts, though. Damn.
First time to take out a toenail from an infected ingrown nail: my patient is a native of Neuva Ejica, also visiting boracay for a conference. She came up with a swollen toe. It was almost as big as a tomato. Plump and juicy, also. (Sorry for the munching people out there.) The infection got worse because she went to dive before the day she made the consult. She was pretty much grossed out to see her nailless nailbed but happy to get all the pus out. She promised to teach me how to dive. Although I did a digital block. I bet it hurt like hell.
Dig this. I had a patient who works for Albert Einstein in Jacobi! Waaay too cool. He promised to take me around the hyperbaric facility which he operates. He's a very interesting guy, actually. He has businesses in Boracay and Cebu but he goes back to the US every other month. He lives in Westchester and he would love to entertain me whenever I visit. He told me that he will tell the people of AE how I took care of him. Swell.
I had a malingerer chest pain patient who got to my nerves. And another one who had an abortion. She was even smiling when I went to her house. Grrr. I charged them twice...no, thrice my actual PF. Serves them right.
During my stay I read a couple of books too:
1. Devil in the White City: Murder, Lies in the Fair That Changed America. I think every Chicagoan (?) should read this book. Its about the World Columbian Exposition of 1984. The biggest fair at the end of the century which rivalled the Paris exposition. Many American firsts came from the fair: Aunt Jemima, hamburger, Juicy Fruit, Cracker Jack and the Ferris Wheel. And a nice gory serial killer hunt interspersed between the pages. Very entertaining, well-researched work.
2. Opal Deception. The latest installation of the Artemis Fowl Series. Best of the four Artemis Fowl series. Took me just 6 hours to read it. Hard-to-put-down book.
3. Chronicles of Narnia. Got through the first, second and half of the third book. I'm excited to see the movie!
I was planning to have an intro dive before I leave but I felt guilty spending that much money. It was P2T bucks for a dive. My patient is willing to give me a free lesson in Palawan, so why bother if I can get it for free. I just hope it will push through.
And now m back in my room. Back to my backlog books, to my Step 3 reviewers waiting to be opened and to my dial-up internet connection that I'm trying to upgrade to a DSL connection. I'm trying to figure out where to get the funds for that. Ugh.
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