It was our last day in Medical ICU (MICU) and in our shift, we were only 2 trainees. I was assigned to manage two patients — both were suspected to have PTB but the other one has episodes of hemoptysis (coughing out of blood).
He was actually extubated or the endotracheal tube that assisted him to breathe has been removed. He was being prepared to be transferred to the ward because he can already breathe on his own. He though has nasogastric tubing or NGT for feeding.
I started monitoring the patient hourly until 7:00 p.m. I fed him and gave him his antihemorrhagic drug via NGT with strict aspiration precaution. I was asked to have my dinner since he was stable. The patient was talking with his wife when I left. I was starting to eat my dinner when my groupmate came to the pantry and told me to rush to my patient’s room as he was having another bout of hemoptysis. I ran to his room and the resident was already trying to intubate him. The patient continuously coughs out enormous amount of blood with fragments. The attendings have been paged. Emergency drugs have been pushed — Atropine, Epinephrine, fast drip IV fluids but the patient coded. His vitals deteriorated despite efforts to revive him. The attending and the nurses took turns giving cardiac massage but the patient remained on flat line.
I wanted to tell the code team to try reviving the patient.
Time of death was called.
We have given him post mortem care in order for his relatives to see him in resting state.
It was a sad night. The patient was okay when I left. His wife was joyful talking to him. The joy was replaced with moans and outburst of emotions as she was allowed to see him.
I tried to hold back my tears and went out of the room.

… of waiting, I finally got a call from an important person.  I did not personally get the call, our helper did. The person left a message that we need to meet up somewhere in Quezon City today at 1:30 p.m.  Good thing I was free the whole day because I could not say no to that person. I have been waiting for our meet up for almost two years.

I was at the meeting place an hour before the agreed time and I was able to talk with the person at past 5: oo p.m. already.   What is more frustrating is the talk did not last for 15 minutes and we called the meeting off.

I really wanted to storm off the building and just forgot about the whole thing but my sister texted me that waiting a few more hours is nothing compared to the two years of longing  for  that call.

So when will I hear from that person again? I jokingly texted my sister, maybe after two years again.

My rotation in the ward for my BST at the LCP has started last Monday and although sleep has been elusive, I still feel the adrenalin rush through my vein.

It is like I am an energizer bunny.

My feet are still swollen and although this signals me to follow the red light, I have no intentions of taking leave of absence. Although we are allowed to have 6 absences for the entire training period, I feel that it is just proper to maximize my training fee by taking the opportunity to be in the ward and learn new things about bedside care.

Aside from the bedside care, we are expected to perform admission and discharge procedures and to carry out doctor’s orders. If you want to excel in something you must not stop at just learning the 411 but you have to progressively learn the craft.

While I feel so pumped up in my training days, there are instances that sadness sucks the joy in my highly cholesteroled heart.

After every endorsement and rounds, I usually review the patient’s chart to check on the diagnosis, doctor’s progress notes, medications and everything I could wrap my mind around.

Last night, I managed only two patients.  One has so many medications needed to be given at certain intervals. The other has just prn (pro re nata) or as needed medications.  It was for pain.

The doctors made their rounds so I was not able to scan the charts of my patients.

At past 6:00 pm, I was asked byh the charge nurse to assist the attending – a n oncologist in medicating my patient (who only has prn med).  He was given Etoposide – a chemotherapy drug.

After regulating the drug, I looked for the patient’s chart and found out that he has bronchogenic cancer with non small cancer cells.  The cancer has metastatized in his brain.

He is undergoing 6 -cycle chemotherapy.  I was really surprised because he looked healthy, not experiencing alopecia and he kept on playing tricks on me every time I entered his room.

I am imagining, If were in his bed, would I still be the same bubbly person that I used to be? Chemo is a very scary and horrible experience based on people who have undergone it.

I know that as a medical practitioner, emotion should not get in the way of my profession.  I was supposed to handle three patients that day but my third patient who has a DNR order expired. It is sad when you are in the room with the relatives to witness the doctor to pronounce the patient dead.

Every training day is a tiring and edematous day but at the end of the day, I do not feel exhausted.

This is what I wanted to do. Screw the odds, Death is not an option.

All I need now is my Trodat so that my hands will be spared from scribbling my complete name and license number on each page of the patient’s chart.

I have got my scrub suits from the LCP.  I was the last one to claim them noting that the start of immersion in the ward is today.  It is actually my off today and my duty will start tomorrow.

I was really apprehensive in continuing my training program but my strong desire to do what I want is undeniably palpable.

For now, I will take things as they are without disregard to my passion.

I can’t help but smile seeing my name embroidered on the scrub suits with R.N.  at the end of it.

I had dinner with my old friends who were my former officemates.  One has decided to take her career up a level higher and the other opted to manage his own business.

We have discussed a little bit about my health but I decided not to go into details as I am really paranoid of discussing it to anyone after learning that the rumor about the health condition has already spread in the office.  It is not that I do not trust them but I do not want to suspect anyone close to me gossiping about me.

I just kept on joking about my impending death, how I want my funeral to be held and all the death and dying stuff that creeped them out.

Anyhow, my guy friend’s wife used to be confined for a serious illness and I have learned from him that dying  was never considered by his wife as an option. She was determined to live that she fought for and cling onto her dear life. Seriously, this has brought chills to my spine.  I would not say that it served as wakeup call but I began to think of dealing with my condition in a different way.  Instead of saying that I need to do the things I love before kicking the bucket, I will just have to say that I am living my life to the fullest in preparation for the future because I am here to live as long as He allows me to and I want to do the things that I love for the rest of my life.

For every morning that I wake up, I am whispering my gratefulness for being able to rise to another day.  I am praying that he would help me carry out my duties without pain on my part and without causing pain to anyone.

So help me God.

Yesterday morning, I had a rheumatologic consult at St. Luke’s.

I am pretty impressed with the spa-like set up of the clinic and the consultant is the only one holding clinic there.  Usually, there are about 3-4 consultants occupying an OPD room.

When I’ve made my appointment last week, I was informed that I was fifth on the list and I should come by 11:30 a.m. so I came. Only to find out that the doctor was still seeing the first patient.

While waiting for my turn, I was interviewed by a fellow (read: a resident).

When the fourth patient has been called, the doctor went out and patted me on the back apologizing for the long wait. Pretty unusual for a consultant. How can you get upset especially when you look at his pleasant face?

I was finally seen at past 1:00 p.m.

The resident started to present my case.  I felt I was on Grey’s Anatomy playing as the patient being presented by the interns to the attending.

It was kind of interesting. On a side note, I have always wanted to be a doctor ever since I started watching Grey’s.

I was there for a consult about my joint pains so I did not bring my lab work up and the biopsy results. Too bad, the consultant asked for it. He even corrected the resident in jotting down a diagnosis telling her that you always suspect a diagnosis and it is important to check first the lab work up results.

Pretty impressive!

He asked me to being the results ASAP and just slip them into the clinic’s door and he will just contact me for anything.

The consultant was so courteous that he kept apologizing whenever he needs to talk to someone on the phone. Another praise-worthy act.

During the interview, the consultant asked me who I am seeing for a nephro consult and I do not know if it was just me but I noticed that he and the resident exchanged awkward looks when I told them who is my nephrologist.

He asked me if I was given the option to take cyclophosphamide instead of the immunosuppressant I said yes and I declined to go under chemo because I was also presented with its dangers. After learning that I have been on immunosuppressant for 4 months already he informed me that the dosage that I am taking is not the maximum yet and it can be increased upto 3000 mg per day. This I think my nephro did not discuss to me actually, he did not discussed anything to me.

Since I do not have the lab results with me then, the consultant informed me that on the interim, they need to focus on cough and the fever that I have had for this might be signs of infection and the infection might be the one that causes my throbbing joints. A good point actually because when you are feverish, you tend to manifest body aches.

He then prescribed Zithromax which is one of the most potent antibacterial. He kept on reminding me to take it in full stomach to avoid upset. He also informed me that I could temporarily stop taking the immunosuppressant while on antibiotics,

Then the physical exam part came.  This procedure was never done by my nephrologist. The two doctors perform four components of physical exam: inspection, percussion, palpation and auscultation. They both confirmed that my lung fields are clear but then the consultant has ordered a chest x-ray work up to rule out bronchitis.

I feel comfortable with the doctor. I hope that this first impression would last because I really need a doctor who really cares and who will practice not just no maleficence but more importantly benevolence.

On Monday, I shall be having my chest x-ray and dropping by his clinic to hand over the lab work up results.

While I was out of my way from my check up, I got a text from my officemate who’s from other department.  She was confirming if I really have a serious health condition.

I never felt the concern there.  Like anyone else in the office, it was just a mere gossip girl act on her part.  I felt violated.

I never really liked gossiping about other people. I believe that people who gossip to you will gossip about you.  As long as other people don’t get on my way, I let them live.  I just can’t understand why it is hard for other people to do the same.

Going back to the topic, I asked her back where she got the news from she replied after four hours telling me that she got it from our program manager.

While I know that the pm has the right to know the health condition of his subordinates but especially if it affects the subordinate’s productivity ( I was cut out of the program for the newly-built group because I was ordered to go on bed rest) but whatever he knows, he should keep it to himself and not discuss it with anyone else.  I would have appreciated the concern, if he approached me and asked me directly about what’s going on with me hut he did not. A simple “how are you doing?” or “what is wrong with you?”  might be considered a gesture of  concern but talking about my condition behind my back is something unprofessional and is a violation of someone else’s right to privacy.

That act is too low, even for him. I learned something about him that would make him the talk of the town and the question is, would I drop the bomb right under his nose?

Why can’t these people just let me live?

In the past few days, I have noticed that my morning sniffles have returned. I have been sneezing like before, sneezing like there is no tomorrow.

I’d like to think that I am back to the good ‘ol days but that would be a  pulsating  lie.

I have developed joint pains, my feet continues to swell if I stopped popping  in diuretics, I still have hematuria and my back pain begins to eat me.

Maybe morning sniffles has just been added to my list of  unending physical condition.

Here’s to life. Cheers to life!

I decided to go  back to work after four days on bed rest.  I did not rest actually because I have been to St. Luke’s for some lab work up, tests and consults.  So  basically I was just on sick leave.

Punched in at exactly 9:00 a.m. and towards the middle of the shift I felt frail.  I was able  to produce an acceptable amount of work but I felt so exhasuted.

I don’t know but I think being in the office really makes me sick.  I am sticking to my job because I need an insurance to cover my medical expenses but  if this work is causing me enough stress to hammer the final nail in my coffin, I think I should just quit.  My only fear is that if I quit, will I get better?  I am really giving it a serious thought.

I never thought that call center stress could be harmful enough to take someone’s life  progressively.  It is really catching up on me.

As I have said, if ever I will die, I wanna die  with a smile on my face because I have served my purpose and I have done the things that I really wanna do.

I want to save lives even If I can’t save mine.

Still on bed rest, I got a text from my team lead that Iam temporarily cut out of the program pending next batch of trainees for the newly formed group.

Am I  sad? No.  Actually, I am loving it. Just the thought of calling out clients to help them out with their complaints creeps me out. I’d rather be at the bedside of a dying  patient.

I hope that I will be cut out of the program forever and I hope to land a hospital job soon even if it will compromise my health.

I want to do the things that I really love to do before I die. I do not want to die unfulfilled.