Just before I capped off my night duty. I went into my patient’s room to take his capillary blood sugar (CBG). After that, I gave his pre-breakfast dose of Novomix via Flex Pen which is reusable. As I tried to recap the pen and secure the silicon cover, the needle went through the silicon cover piercing through my right finger. It bled. I was panicking I immediately rinsed my finger with alcohol.
I reported the matter to the supervisor on duty. She asked me to fill out the Needle Stick Injury form and submit it immediately and then to go to the infirmiary to see a doctor.
The doctor has requested for an HBsAb or Anti-HBs (hepatitis B surface antibody) test.
Not that I wanted but it is good to know that this kind of test is covered by the disability insurance of the hospital I work for.

We were at the grocery store yesterday. I had with me my sister and her two daughters and as expected it was a complete chaos. The little one kept on dumping anything that she had laid her little hands on into the grocery cart.
When we are already at the counter to pay for our stuff, the little one snuck some of the stuff behind the barcode scanner mixing them with the scanned ones. It took us some time before we sorted things out.
My sister and I just shrugged our shoulders.

This is the case of a 27 year-old male who was diagnosed to have thymoma. Two months prior to admission, patient experienced on and off chest pain associated with occasional cough. Pain relievers prescribed by a doctor on private consult gave temporary relief for a month. The symptoms persisted accompanied with a gradual weight loss . He was confined in a private hospital in Manila where he had CT scan that revealed mediastinal mass. Biopsy revealed thymoma and was advised to have thoracic surgery hence the admission to our institution.
The contemplated surgery was put on hold as the attending wants clearance from the oncologist. The oncologist wants the patient to undergo chemotherapy.
Thymoma is a type of cancer that begins in the thymus. The thymus is located in the upper chest just below the neck. It is a small organ that produces certain white blood cells before birth and during childhood. These white blood cells are called lymphocytes and are an important part of the body’s immune system. Once released from the thymus, lymphocytes travel to lymph nodes where they help to fight infections. The thymus gland becomes smaller in adulthood and is gradually taken over by fat tissue.
Cancer begins when normal cells begin to change and grow uncontrollably, forming a mass called a tumor. A tumor can be benign (noncancerous) or malignant (cancerous, meaning it can spread to other parts of the body).
Although rare, thymomas are the most common type of thymic tumor. The term thymoma traditionally refers to a non-invasive, localized (only in the thymus) type of thymic tumor. Thymomas arise from thymic epithelial cells, which make up the covering of the thymus. Thymomas frequently contain lymphocytes, which are non-cancerous. Thymomas are classified as either noninvasive (previously called benign) or invasive (previously called malignant). Noninvasive thymomas are those in which the tumor is encapsulated and easy to remove. Invasive thymomas have spread to nearby structures (such as the lungs) and are difficult to remove. Approximately 30% to 40% of thymomas are of the invasive type. (Healthline.com)
Thymoma is generally a slow-growing tumor that does not usually spread outside of the thymus. Occasionally, it can spread to the lining of the lung, called the pleura. Less often, it can spread to other parts of the body. (Cancer.net)
The symptoms in 60% of patients with Thymoma are caused by pressure from the enlarged thymus on the windpipe (trachea) or blood vessels which explains the difficulty breathing or pain being experienced by the patient.
Other symptoms of thymoma may include:
• shortness of breath
• swelling of the face
• coughing
• chest pain
• muscle weakness (especially in the eyes, neck, and chest, causing problems with vision, swallowing, and breathing)
• weakness
• dizziness
• shortness of breath
• fatigue
Of these, Mr. P. only manifested the chest pain and coughing.
Thymoma is categorized into four stages (I, II, III, and IV) which may be further subdivided (A and B) based on the spread of cancerous tissue. The Masaoka staging system is as follows:
• Stage I. The thymoma lies completely within the thymus.
• Stage II. The thymoma has spread out of the thymus and invaded the outer layer of the lung (pleura) or nearby fatty tissue.
• Stage III. The thymoma has spread to other neighboring tissues of the upper chest including the outer layer of the heart (pericardium), the lungs, or the heart’s main blood vessels.
• Stage IVA. The thymoma has spread throughout the pericardium and/or the pleura.
• Stage IVB. The thymoma has spread to organs in other parts of the body.
• The treatment for thymoma cancer depends on the stage of cancer and the patient’s overall health. Because thymomas are so rare, there are no defined treatment plans. Options for treatment include surgery, radiation therapy, and/or chemotherapy. Surgical removal of the tumor is the preferred treatment. Surgery is often the only treatment required for stage I tumors. Treatment of thymoma often relieves the symptoms caused by paraneoplastic syndromes.
• A treatment that is intended to aid the primary treatment is called adjuvant therapy. For instance, chemotherapy may be used along with surgery to treat thymoma. Stages II, III, and IV thymomas are often treated with surgery and some form of adjuvant therapy. However, in the case of Mr. P, the oncologist prefers chemotherapy.
Also, since the patient is already immunocomprmised or has low level of immune system, I have advised the patient and the visitors to wear mask. The patient has been place on reverse isolation or protective environment.
Source: Healthline.com

I feel so sad to learn through a Twit from a friend that one of her fellow bikers was hit by an unruly car driver. The woman who hit the victim told the police that she actually saw the biker wave his hand to signal that he is going to take the shoulder lane but she did not mind to slow down. The biker was not seriously injured but suffered some bruises. Good thing that he is a member of the roadside assistance club that helped me pull through this serious accident.

I was excited to report for work after hearing that we will be given with the sports allowance. Seeing that no one is in the ATM booth, I immediately tried checking my balance only to find out that I only have P300 in it. When I reached the ward, I learned that only regular employees were given with such an allowance. So I came to thinking where did that P300 come from? I did not avail of any : rv loans. Maybe it was a mistake.

Along with the literal drum rolling, I have come to learn that the people bringing in the steel drums are also the water filter supplier water filter supplier. While on our way home, my co-staff Chris has asked me why I am not staying at the dorm. I just told him that I am not really comfortable staying there plus the fact that there is constant hammering and screw bolting here and there. Sleep is the most luxurious activity for me and I am trying to savor every minute when I have the opportunity to shut my eyes.

One of my closest friends in the ward has just got married in June. I am so happy that she has found her better half. What also made me happy was the fact the I was one of the few who she trusted and told about her wedding. It think it was in January or February that she told me, along with the other juniors in the ward, that she’d be tying the knot.
We understood that might as she wanted, she chose not to invite any of her closest friends in the hospital to avoid hurting some people’s feelings.
Although we were uninvited, we were thinking of getting her wedding gifts at redenvelopewedding gifts at redenvelope. I am sure she would love them all.

I thought it will all end in the submission of incident report regarding the medication error until I got a text from my headnurse. There was a scheduled meeting with the medication error committee. I did not know that there was such a committee and it seems that they would not let us off the hook although there was nothing serious happened to the patient.
We were from the PM shift and we were prioritized among the 9 offenders.
It was the second to be roasted. As expected, it did not go well. We were judged before we could defend ourselves. We were asked to make a correlation between the withholding of Plavix and the left side body weakness of the patient.
It is due to be submitted on Monday.
And yes, we still have to await the sanction for the error that we committed.
Although I did not take full responsibility for the offense, I did not bailout on anyone.

I am a Lysol kid. I have a Lysol in my locker, in my room and in the dorm. I cannot stand holding a door knob because I know that it is the filthiest spot on the planet most especially the faucet knob. I do not dare touching it without tissue on hand or spraying Lysol on it. I do not care if it is Grohe. I would not dare touching it if I am aware that it is contaminated.

Little by little, I am sprucing my space in the dorm. I have bought a wall hanger that will serve as space server. The problem is, the hanger just collects dust in the dorm unused because I need spring plungers to mount it on the wall. At the moment, my towel and bathrobe are hung on a hook mounted on the door of my closet.