I did not notice how time flew so fast. Almost a year and seven months ago, I started as an orientee in this hospital. I was being guided by my preceptor, who actually, I did not regard as one. I remember that during that time, he just deflects or asks me back every question that I threw at him. He even sarcastically tells me to research on some questions that I ask and get back to him about it. So arrogant. He is brilliant as he was on the list of those who topped the critical care course.
I know for a fact that it is not the right way of mentoring a newbie or any person for that matter. Show them the tricks of the trade, teach him thing that he or she might not know or enhance the things that he already know.
Now that I am in line to be the next preceptor, I will assure that I will leave something for preceptee to cherish. Something good that is.
The preceptorship training will help me in becoming the best preceptor I could ever be.

I have been to Singapore once and the experience was good . I have been wanting to get another opportunity to get there and I think this time of the year is the most perfect timing as it is the grand Singapore sale. I really wanted to check out their electronics sale especially the computers. I think having this laptop around for more than two years is enough to let it go. I need to keep up with the demands of my work and with my lifestyle. Geez, I need to get a very good deal.

I finally get to hang out with my friend right after our duty. We went to the mall to register to the Milo Marathon. On the way there, we discussed how we should continue making voluntary contribution to our government-funded insurance. We understand that no matter how hard it is for us to cope with the increasing a href=”http://www.wholesaleinsurance.net/”>life insurance rate we should still be thinking that little sacrifices everyday will just be a delayed gratification. That it will benefit us in the long run.

In my quest to catch my elusive sleep last night, I chanced upon a documentary show on Bio channel titled Obsessed. It featured two individuals who are battling a mental condition called Obsessive-compulsive disorder or OCD.
The first case was a married woman in her early 30s. She has been suffering from OCD since 5 years old. The problem according to her has stemmed, when she was abused on a school bus at that age. She felt dirty in the inside and she channelled her hunger to clean her innerself by obsessing with having clean surroundings. The OCD got worse when contracted MRSA or the methicillin-resistant Staphylococcus aureus (S. aureus) bacteria putting her quest for perpetual cleanliness into a great hype.
She caves into her obsession making her compulsive and cleaning every inch of her household. She wakes up so early cleaning up everything in their home repetitively. She straightens out the fringes on her carpet rug using a fork and cleans every corner of their furniture pieces using Q-Tips. Although she feels tired and she knows that everything is already clean and in order, she just cannot fight the urge forcing her to stay up until wee hours in the morning scrubbing everything she sees and thinks dirty.
While in Florida, a 26-year old man is also suffering from OCD obsessed in checking and ensuring that every faucet, door, stove and electric appliance is properly shut down. He uses a checklist doing the routine of checking every piece of it not one, not twice but at least four times before tucking himself at night. However, the obsession does not end when he hits the bed, he still tosses and turns in bed being bugged by the thought that he might have forgotten to shut down something completely. The obsession stems from his childhood experience when he left the faucet at home open and left. He was traumatized by the thought that their house flooded. Although no one blamed him for the accident, the event kept traumatizing him until today. He has lost a good music deal while in Switzerland due to his OCD when he kept on checking the hotel door’s every so often that the band was not able to finish recording.
It was really painful watching them struggle to fight their obsessions. The woman’s relationship with her family has been greatly affected. She cannot even sit down with them at the dinner table as she tries to finish scrubbing the sink. She really felt exhausted but her obsession keeps on pulsating in her mind. She even had to ask her kids to clean objects and places again and again even if they were not dirty at all.
On the other hand, the man’s partner does not get good night sleep as she gets awakened by the man’s constant trip to the kitchen and living room to check on doors, plugs and switches.
According to medicine.net

An obsession is defined as a thought, impulse, or image that either recurs or persists and causes severe anxiety. These thoughts are irresistible to the OCD sufferer despite the person’s realizing that these thoughts are irrational. Examples of obsessions include worries about germs/cleanliness or about safety or order. A compulsion is a ritual/behavior that the individual with OCD engages in repeatedly, either because of their obsessions or according to a rigid set of rules.

Being physically exhausted thinking and doing things repeatedly, affecting their relationship with their significant others and their performance of activities of daily living, they have agreed to undergo intervention therapy that involves OCD therapists. They were asked to face their fears by exposing them to the things that increases their anxiety.
The woman was brought out to a public toilet where she was asked to touch the toilet seat for 15 seconds and she was not allowed to wash her hand for 5 minutes. Her anxiety grew as she rated upto 8 out of 10. She survived the day but she was really in tears. After 8 weeks of continuous therapy sessions, she was asked to do a, yet, major challenge. She was asked to go out in an amusement park and spend the whole day with the family. At first, she was jittery, but as she tried on conquering her obsession, it turned out well. She had a blast and she was really up on her feet to overcome the major challenges her disorders is going to put on the table.
On the other hand, the man was exposed to things that make him jitter. The OCD therapist opened the faucet and let the water fall in the sink and he opened the gas stove while they are sitting in the living room. After a few attempts the man succeeded in overcoming his obsession to come into the kitchen and switch all the things off.
The next step was keeping all the same stuff open all throughout the night as the man was trying to sleep in his room with his partner at night. The first few nights were a struggle as night vision camera placed in his room and kitchen showed that he kept tossing and turningfighting his obsession but in the end he caved in. It took him a while to control his anxiety.
After 3 weeks of intervention and close monitoring, his OCD therapist has decided to take the exposure to its highest limit. He kept the faucet in the patient’s house open and they went out with his family to see him play his music. He succeeded.
The treatment, according to the OCD therapists, is a life long process and the person affected needs a strong support system to win the battle.
I am now hooked on the show as I want to explore the different sides of OCD.

One of the signs of nation’s development is the advancement of infrastructural projects and architectural designs. We have learned so much in Japanese architecture making metal buildings that are proven to withstand the test of time and nature such as the killer quakes. It is good the third world country like the Philippines is adapting to the demand of our era. It might require some serious amount of financial investment but for sure, it will turn out to be practical in the long run.

I have a 28-year-old friend who works in a call center. He has been in and out of the hospital due to complaints of difficulty breathing, chest pain and easy fatigability. He does not smoke and drinks occasionally. He has been re-admitted due to the same symptoms and this time he needs to be placed on oxygen to aide his breathing. Chest CT scan revealed diffused interstitial pneumocystis and they are suspecting HIV.
He has been referred to an Infectious Disease Specialist but since his mother was there all the time, the doctor cannot expound on my friend’s sexual activity. Well, we have known his sexual preference for the longest but it is really hard to break the news to his mother. Hearing his unsafe sexual activity, which according to him, is common in the call center place and the gym, it is not really impossible for him to catch the disease.
The IDS doctor requested for a sputum staining to test for Pneumocystis Carinii Pneumonia infection and unfortunately the test is not available in the hospital where he is admitted. Respitory discharge needs to be submitted and be brought to a hospital that cater the Indirect Fluorescent Antigen study or IFA which is 97% reliable in confirming PCP. PCP is common among HIV positive patients. It is a kind of pneumonia caused by bacteria called Pneumocystis jiroveci which is classified as fungal pneumonia. It is the most common opportunistic infection among HIV positive patients.
The first signs of PCP are difficulty breathing, fever, and a dry cough which are the spot on signs manifested by my poor friend.
Upon admission he has been placed on IV antibiotics such as Meropenem and Fluconazole (which is actually an antifungal medicine). He is also on antibiotic pill Cotrimoxazole Bactrim Forte. My online research agrees that Trimethoprim-sulfamethoxazole (TMP-SMX) has been shown to be as effective as intravenous pentamidine and more effective than other alternative treatment regimens
HIV can only be passed from person to person through body fluids, such as blood, semen and vaginal fluid. Children born to infected mothers can also become infected during pregnancy. HIV causes AIDS by damaging the immune system cells until the immune system can no longer fight off other infections that it would usually be able to prevent.
It takes around ten years on average for someone with HIV to develop AIDS.
The most common ways HIV is passed are:
There are various ways a person can become infected with HIV:
• Unprotected sexual intercourse with an infected person: Sexual intercourse without a condom carries the risk of HIV infection.
• Contact with an infected person’s blood: If sufficient blood from somebody who has HIV enters someone else’s body, then HIV can be passed on in the blood.
• Use of infected blood products: Many people in the past have been infected with HIV by the use of blood transfusions and blood products which were contaminated with the virus. In much of the world this is no longer a significant risk, as blood donations are routinely tested for HIV.
• Injecting drugs: HIV can be passed on when injecting equipment that has been used by an infected person is then used by someone else. In many parts of the world, often because it is illegal to possess them, injecting equipment or works are shared.
• From mother to child: HIV can be transmitted from an infected woman to her baby during pregnancy, delivery and breastfeeding.
Source: www.avert.org
I do not understand but he has not been placed on ELISA which is the definitive test for HIV infection but I have secretly discussed the matter with my friend. detects HIV antibodies in a person’s blood. It is necessary to wait at least 3 months which is called the window period after the last possible exposure before having an HIV antibody test, to be certain of an accurate result.
I just do not know how he could come out to his parent which is badly needed. He is worried about the stigma that he needs to face if his health condition also becomes known to the public.
I hope that it is not PCP.

Working in a hospital that specializes in cardiac cases, it always a learning experience for me taking on new cases. Like being assigned to a patient who broke her left should and was diagnosed close fracture humeral head, left. I learned from the ortho-surgeon that it is not being operated on. Instead, an arm-sling will just be in place at all times and the patient will be on anti inflammatory medications for a long time. It is different from the aircast-airsport-ankle-brace that is being used on some who has dislocated or snapped ankles.

It is shocking to learn about the death of the Jackass star Ryan Dunn from a car crash last Sunday in Pennsylvania. Dunn, 34, was with an unidentified passenger who also died in the fatal accident. While police are still investigating the cause of the mishap and they are suspecting intoxication as the cause of it since Dunn has posted on his twitter account a photo of him and his friends having some sort of alcoholic beverages. The car was set on fire.
While I hope that the cause was not due to DUI, we hope that he availed of a motorhome insurance to leave something for his family.

Ever since I cut my hair short, I get constant praises that my new hairdo looks good and it chopped off some 10 years of my actually age. While it is taking me some time to fix my hair everyday, I am planning to keep it this short. I am thrilled by the admiration that I get from my colleagues. It is the more natural than any anti aging products ever concocted

I have my hand-me-down BlackBerry for almost a year now. I decided to stick with it since it does not give me any problems. But I guess, like any other thing on this earth, its battery has reached its wear-and-tear condition. I cannot afford to get an original battery for a replacement so I settled for what they call “Class A”. There are mobile batteries that really work compatibly with your cell phone. Just be patient in scouting for one.