I have asked the hospital’s official dressmaker to sew me another set of uniforms. Unfortunately my old uniforms are close to not fitting me anymore. Even with my erratic hospital sked and the toxic shifts which do not allow me to eat on time, I still continue to put on some pounds.
I have been giving the dressmaker my detailed instruction on how I would like her to sew my uniform and she has just jokingly told me to try clinicallix. I was surprised that at her age, she knows about these stuff. She told me that her daughters abroad are so obsessed with it.

My headnurse and I sat down for the discussion of my 6th month exam. She voiced out how disappointed she were about the turnout of the said exam. I felt like I was a butter melting under the sun as she tackled each of the item in my revalida. Honestly, I was and still am ashamed that I have not grasped the concept of cardiac medicines and the procedure and diagnostics related to cardiac diseases.
I know that I still have so much to learn and I am willing to engage in a serious one-on-one lecture in order for me to learn more. I am serious about my profession and I shall do anything to keep me knowledgeable anything that has to do about the human heart.
I owe to myself and to the institution.

Speaking and in view of breakouts, I have been scouting for the best acne treatment that would instantly zap out those pesky zits. While it is true that to each his own in every aspect, it is good to hear from others what they might say about a certain product or service. Word of mouth is still the most powerful means of advertisement. I have heard of acneticin reviews and it seems that they are all coming in good.

At first I thought pimples or worse, acne are a thing for teenagers or people in their adolescent years. For some reason, it extends up to adulthood and I hate to admit it that I am among those who still suffer from occasional breakouts. I have to have an acne cream ready at bedside especially when I am lacking sleep.
Acne is a skin disease that actually cause pimples. Pimples start to form or what we call breakout when the hair follicles under our skin or pores being to get clogged. Breakouts can pop up on your face, neck, back or chest.
While stress does not cause acne, it can sure make it worse.
If you already have acne try to do these:
Clean your skin gently
Try not to touch the affected part
Avoid the sun
If you see that your pimples are getting worse, see a dermatologist before acne vulgaris happens.
(Source: Medline Plus)

Nah, this is not about the protection one wears during an intercourse. This has something to do about the recent needle stick injury I have sustained after giving an insulin dose to my patient.
Learning that things that I have to go through after reporting the incident, I begin to have regrets. I should have kept mum about it.
Hepatitis B blood panel is the type of blood test to determine hepatitis B. There are three tests that complete the panel to complete the diagnosis:

1. Hepatitis B surface antigen (HBsAg) tests for the presence of virus. A “positive” or “reactive” HBsAg test result means that the person is infected with the hepatitis B virus, which can be an “acute” or a “chronic” infection. Infected people can pass the virus on to others through their blood and infected bodily fluids.
2. Hepatitis B surface antibody (HBsAb or anti-HBs)- A “positive” or “reactive” HBsAb (or anti-HBs) test result indicates that a person has successfully responded to the hepatitis B vaccine or has recovered from an acute hepatitis B infection. This result means that you are immune to future hepatitis B infection and you are not contagious. This test is not routinely included in blood bank screenings.
3. What is the hepatitis B core antibody (HBcAb) is an antibody that is part of the virus- it does not provide protection. A “positive” or “reactive” HBcAb (or anti-HBc) test result indicates a past or present infection, but it could also be a false positive. The interpretation of this test result depends on the results of the other two tests. Its appearance with the protective surface antibody (positive HBsAb or anti-HBs) indicates prior infection and recovery. For chronically infected persons, it will usually appear with the virus (positive HBsAg)

Source hepb.org

Anyway as far as I can remember I was reactive to Anti-HBs with 56 level of titer. What worries me right now are the questioning I have to go through regarding the incident. Why do I feel that they are indifferent about me not taking extra precaution in handling needle sticks. The department head has questioned me saying that I should not be in that situation since the precaution is very basic and I am already 6 months in the ward. The supervisor on duty told me in an ironic manner to have my other nine fingers pricked also.
I have to face the wrath of my headnurse who already called in and voice out her frustration about the matter and I have to report to the Infection Control Office.
I should have kept it to myself.

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.