In view of the rainy season, I decided to rent a space in the hospital building. I started to fill in my space with some stuff. I have not moved in yet because there are still some things lacking like the outdoor chair cushions that would fit in the tiny room. I also have no plans of staying there since there is no cable tv, internet and cooking is not allowed. I am gonna stay there if the rain is falling heavy.

Mrs. M, 86 year-pld, female, was admittted due to complaint of difficulty breathing associated with pulmonary tuberculosis. She has edema of the lower extremities and was diagnosed to have pleural effusion or accumulation fo fluid in the interstitial space sorrounding her lungs. She also had fluid in her lungs and pericardial effusion or lung accumulation in the pericardial space. She is was started on Furosemide diuretic via IV to help her evacuate excess fluid through urine. Also, her lab works show low red blood cell count that is why 2 packs of RBC was started. I was able to finish the first unit and endorsed the ongoing transfusion of the second pack.
Her attending made his rounds on her and informed her relatives that due to the patient’s age, they will do the conservative approach in draining the fluids off her lungs.
Blood pressure was stable at 150ss and she had her highest in my shft at 180.
I was able to endorse the patient in stable condition that it why I was surprised to learn that she expired early morning.
She had 80 palpatory BP and oxygen saturation was very poor that they had to conduct emergency Echocardiographically guided pericardiocentesis in the cardiac catheterization laboratory around 1:00 am. However, around 4:00 am the code was called because she was not able to recover. She expired.
According to medline plus online:

Cardiac tamponade is the compression of the heart that occurs when blood or fluid builds up in the space between the myocardium (the muscle of the heart) and the pericardium (the outer covering sac of the heart).
In this condition, blood or fluid collects within the pericardium. This prevents the ventricles from expanding fully. They cannot fill enough or pump blood.

Cardiac tamponade can occur due to:

* Dissecting aortic aneurysm (thoracic)
* End-stage lung cancer
* Heart attack (acute MI)
* Heart surgery
* Pericarditis caused by bacterial or viral infections
* Wounds to the heart

In Mrs M’s case, hers was caused by pericarditis

While getting the hang of my fat burning moves, I learned about thermogenic fat burner I think it is like locking yourself in a sauna bath as the heat let you sweat out your fats. I figured out that it is also the same with my uphill battle as I really sweat hard climbing up my ward. I always end up soaked up and panting as I reached my side of the hospital.

I try my hardest to stick to my cardio routine ever since I learned that it will be hard for me to go back to the gym. I climb up the stairs from the basement to the fourth floor of the hospital. For me it is not just a good cardio work out but it also the cheapest way of toning my glutteal muscles and the best fat burner ever.

The Federated States of Micronesia is a group of Islands in the Pacific Ocean east of the Philippines. FSM was once a part of a United Nations Trust Territory under the US administration.
As they do not have tertiary hospital to cater to their special health care needs, most of them are flown to our institutions for consult, work ups and treatments through their local insurance there.
While English of is a common language there, there still some folks there that do not speak the language, hence the barrier.
A 26-year old small built female was admitted for mitral and atrial valve repairs, left atrial thrombeectomy and intraoperative transesophageal endoscopic electrocardiogram. She was accompanied by her mother who also barely understands English. Communicating with them is like playing charades as you need to act out and exaggerate hand gestures. Good thing is that there were other Micronesians admitted making them as our interpreter.
After a few rainchecks due to down payment issues, the little girls’ operations have pushed through. A good starting point until, yet again, another problem came up. This time is it more serious. The girl’s body was not able to keep up with the operation. She was hooked to cardiac pump and ventilators in the recovery room. The mother was summoned to the recovery room to discuss with her her daughter’s present condition. The interpreter, another Micronesian had a concern about interpreting the whole thing because he said that his understanding about medical problems is limited. The man and along with another Micronesian were discharged making it for us difficult to get an interpreter.
Knowing the need for a reliable interpreter, the insurance company has provided for us an interpreter via phone. Thing is, if there are some things that the mother is concerned about, it is hard for us to attend to it immediately.
Before the shift endorsement, the mother approached our charge nurse begging for her to purchase a call card. It was almost 7:00 pm and the concierge office is already closed. She, being admitted to the hospital, (the insurance company opted to have her admitted instead of checking her in a hotel so that it would be easier for her to come to her daughter to the recovery room), is not allowed to roam around the hospital on her own. I volunteered to buy her the card.
It is really hard to look at the face of this woman who always smiles and I do not know if she really understands how critical is the condition of her daughter. She was very thankful and even held my hand. She always waves at me whenever she passes by the stations.
Around 1:00 am right after I finished eating, she approached the stations asking me to come with her in her room. She opened the fridge and took out a bucket of chicken and some cups of rice. She handed them to me, I was refusing telling her that I have eaten already but remembering a Micronesian couple saying that it is their culture to give someone something as token of appreciation, I took them in.
Around 10:00 in the morning, the liaison officer came in with an interpreter who happens to be a doctor in Micronesia. I, together with the outgoing charge nurse, volunteered to go with them to learn about the girl’s condition first hand.
We learned from the interpreter that the mother opted to take out all the life support hooked to her daughter. But after hearing the good news from the girl’s attending physician that the girl has been taken out of the cardiac pump because her heart has started to pump on her own and that her urine output is remarkable, the mother has decided to fallow her daughter to fight for her life.
I pray that the girl will continue to take her road to recovery.

I consider my blog as my alter ego in the sense that I do not post anything that would identify me as the writer. Even though I am keeping my anonymity, I am still reflecting my everyday experiences, feelings and takes on different things. This serves as my outlet. I do not expect anyone to drop by and read through it in fact I am more relaxed when I think that no one is actually reading my blog . I am just surprised when someone drops me a line.

Ever since I started to taper off my steroids intake, my voracious appetite has also been tamed. As a result, I began to lose some pounds. Some are actually asking if I have gotten into some quick weight loss program which I vehemently deny. It is just that the old me has finally found its home and I this time, am not letting go of her.

I have ran out of my ever reliable eye cream and to for the longest, it has work for me but the problem with me now is that I have this urge to search for the best eye cream for dark circles because I am getting paranoid that I am now looking like a raccoon with my erratic hospital schedule. I want the one that will work for me and at the same time will not break my bank.

I was awakened by the loud screaming of my youngest niece. She was lying on the floor face down and when I lifted her up, she was mumbling words in between sobs that her big sisters will not let her play with them on the computer. Apparently, they were bullying the little girl. Just to settle the issue, I told them that I will not allow them to sue the computer even the adipex if they will not share it with the little one.