For more than two months now, I am having 5mg steroids every Monday, Wednesday, Friday and Sunday. I have not gotten back to my doctor yet to adjust the roids dosage but I now that its effect is already wearing off. Ever since I gotten this anti-inflammatory full dose, I think for more than a year already, my sniffles have vanished. There were only very rare incidents that I sneezed. While the steroids were indicated to treat my other disease, its anti-inflammatory effect has extended to suppressing my allergic reaction to certain allergents.
Last week, I noticed that once in a while, I was having spells of sneezes. Yesterday was entirely different. I got up from bed already sneezing occasionally and I had sniffles until were had our endorsement in the ward.
Right after I made my rounds, the continuous sneezing became uncontrollable. It occurred to me that my allergic rhinitis has come back. The steroids has given way. I do not know if I will feel glad that my old self is back.
I just do not know.

I was having my lunch at Pancake House at the back of the Philippine Heart Center and next to my table was a middle aged woman . Her conversation with the lawyer is within an earshot. It seemed that the lady was a taxi operator and one of her cab drivers has got into a car mishap causing serious damages to woman.
A few minutes passed and a young lady who looks to be a medical resident at St. Luke’s Medical center based on her uniform, came with her, I think boyfriend, and a female lawyer.
I cannot help it, although their discussion was not that loud, my table is just a few inches away from theirs.
I learned that the cab driver caused serious damages to the girl (with a bandage still on her forehead) that required surgery and neurological attention. Her Mac laptop has also been damaged which was not covered by the insurance. They are demanding for P150,000 to cover for all the damages that caused the lady.
The cab operator was haggling but the other party was firm on their decision telling her that it was actually reduced since the auto insurance quote covered the car repair.
It was just awful to hear stories like this.
The cab driver fled the site and remained off the hook while the operator cleans the garbage that he left.
I could also feel the trauma that the victim was experiencing.

After my long three days off, I am back on track.
I was pleasantly surprised that the young Micronesian girl has been brought back to a regular room. The girls was the one who undergone MVR, AVR left thromboeectomy and IOTEE.
She is no longer on mechanical ventilator. She is now on oxygen per nasal cannula and she has a nasogastric tube for feeding. Her Glascow coma scale (GCS) is 10. She opens her eyes spontaneously, no verbal response and only withdraws to pain.
Since she cannot move on her own, frequent turning is required. Also she needs frequent suctioning of oral and nasal secretions.
Her mom, in broken English continuously expresses her gratitude to the ward nurses as she feels our care for her daughter.
The bedside rehabilitation is ongoing and at the moment, her legs seem to be powerless.
As I browsed through her chart, I saw that she has had subdural hematoma and they also performed emergency by pass on her.
According to Medline Plus Subdural hematomas are usually the result of a serious head injury. When one occurs in this way, it is called an “acute” subdural hematoma. Acute subdural hematomas are among the deadliest of all head injuries. The bleeding fills the brain area very rapidly, compressing brain tissue. This often results in brain injury.
I remembered the neurosurgeon telling the mother before that the fluid accumulated in the brain was negligible and does not require surgery.
What puzzles me is that the girl was ambulatory before the operation and now, her GCS is only 10. I also wanted to know why there was a need for emergency by pass.
Nancy Drew investigates

I was preparing to watch Avatar on DVD on my laptop in the dorm when my co-staff nurse texted me to rush to the 8th floor for the free facial, foot and hand spa. I went immediately and to find out that I have to wait for at least thirty minutes for my turn since all the staff who will do the services are all attending to other guests.
I learned that it was a promotional service of a company making beauty products.
When I had my turn, I knew that the service will not be a pleasant one as I see the frustration on the girl’s face learning that she still have me to do service to.
When she doing my facial, she asked me if I had oily face as said I do not then she asked again why do I have I have pimples. I just smiled instead of slapping her face.
I lack sleep that is why I am having breakouts and as far as I can remember I only had only huge pimple then. I have my usually share of breakouts but it cannot be considered as adult acne.

Exactly a week ago when the medication error occurred.
I was on 7 to 3 p.m. schedule then and since I feel indifferent about the outgoing bedside nurse who will endorse the patients that I will be handling, I just did not pay attention to what he was saying.
I made my rounds and gave medications to my patients without any problems.
The nurse who will receive my endorsement was late so I decided not to read the latest orders to her.
The following day, it was night actually, the ever insistent relative of a patient of have undergone heary by pass, was questioning why we are still giving Plavix to the patient when the doctor has told that them that it will be stopped already. We just told her that if the doctor did not write any order about it, we shall still stick to the status quo.
The relative did not stop there so we brushed through the chart and BAM!
The doctor has ordered to hold giving of Plavix on June 19th and the said antiplatelet medicine with generic name of Clopidogrel Bisulfate helps prevent clot formation which is indicated to prevent heart attack or stroke.
It was already June 21st meaning the two doses of Plavix have been given to him. The doctor called in and spoke to the outgoing bedside nurse. He was mad and so frustrated about the incident. Although there was nothing serious happened to the patient, mistakes that could jeopardize the patient’s health.
The following morning, the doctor checked in. He was already calm and just asked if giving of Plavix has been stopped. No further issues to him but our headnurse did not let slide of this medication error that she demanded for an incident report.
I personally learned my lesson here and promised to be extra vigilant in carrying on my duties and responsibilities.

Instead of having her checked in a hotel, the insurance company serving the daughter who has undergone MVR, AVR, thrombieectomy and IOTEE, has decided to have the mother(a Micronesian) admitted to the hospital. She is actually occupying the room in our ward her daughter has vacated when transported to OR.
Since there was a complication, the girl was placed on heart pump and mechanical ventilation. The neuro-surgeon wanted to talk to the mother of the patient and we informed him that the mother barely understands English hence a need for an interpreter. Despite our attempt to convince him to get an interpreter, the doctor went on with his plan of talking to the mother. He just informed us that he’ll try to act and we obliged.
He let him inside the mother’s room and he introduced himself. At first the mother looked okay but when the doctor acted out as if he chopped his skull and stood still and closed her eyes, the mother began to panic. That was our queue to stop the doctor and call the interpreter in the other hospital.
The co-staff nurse and I were actually fighting hard not to laugh at the moment. Seeing a hardcore surgeon doing the “charades” is ridiculous.
We reserved our laughter until we punched out of the hospital.
Kindly check my story on The great barrier for the details about the girl’s story.

My co-staff nurse was beaming every so often and we are just puzzled by her consistent glowing aura.
She was extra cheerful and helpful that day and wondering continued until the end of our shift. As we were on our way to punch out, she whispered to me that her boyfriend has finally proposed. I looked at her finger and saw this sparkling huge rock on it. I am no gemmologist but I think that one that her boyfirned has gotten her is one of the certified diamonds. Isn’t sweet and fabulous?

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.

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.