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Monthly Archives: August 2012

My Friend’s Thought: One Reason Why We Need RH Bill

friend of mine (he was the mayor of his year level when I was the governor of our college back then), arrived after doing some missionary works down south of the Philippines. I could see the disappointment and frustration in his face as he related what he found out.

He came to know of a girl, she is 14 years old. Pregnant… for her 3rd child. Yes, you read that right. Pregnant for her 3rd baby at age 14. My friend thinks, it seems that in that tribe, as long as the girls reaches menarche (first menstruation), they are being taken wives by older men.

He also talked to a leader of the tribe (they’re called datu). He has vast land, around 20 hectares. He rents it out to a multinational company. The company pays him 1,000 pesos per hectare, so that would sum to 20,000 pesos… Per month? NOOOOOO… Per YEAR, yes, per year!!! In addition, my friend told me the datu has about 10 wives. And each wife has lots of kids. So it makes my friend think, how can a 20,000 sustain that big family? How cannot he be impoverished when aside from the big family he has, he is being taken advantaged of by this big multinational company?

What took me was my friend saying, this scenario should really be seen by those men in congress, especially those who oppose the passage of the reproductive health bill. They are so impossible to contend with. There is really a need for it to be enacted.

When he departed, I thanked him, for understanding how life goes on among our poor fellows, for sharing the passion about how reproductive health program will help our poor women, save lives/reduce deaths, and in the long run, help alleviate their conditions.

 
 

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Betraying Your Mother’s Trust – Early Pregnancies

Betraying Your Mother’s Trust – Early Pregnancies

It makes me wonder… how do mothers feel when they bring their daughter to the emergency room due to intense abdominal pain, anticipating that they might be confined and operated on, and then suddenly,  slapped with the findings that their daughter is due to deliver a baby at that very moment?

Shocked? Horrified? Happy? Betrayed?

This is the story of three mothers…

MOTHER ONE

She owns an apartment for rent at the metropolis but she is based at the province. She has a daughter studying also at the metropolis and was supposed to be in her 3rd year of nursing school. By the first semester however, she didn’t enroll, but kept on receiving allowance as if she were still studying. She was pregnant and never told her family about it out of fear.

One time, the mother came over to visit her and see the tenants of the apartment they are renting out. Her daughter complained of severe abdominal pain. She thought her daughter has acute appendicitis needing emergency medical attention. She rushed her daughter to the emergency room at the Surgery section. She was attended to immediately but she wondered why an OB-Gyne resident was being called. The OB-Gyne resident did her examination and told the mother, your daughter is 28-weeks pregnant, is fully dilated and needs to be wheeled to the delivery room as baby could come out in a few minutes. No prenatal check-ups done whatsoever.

MOTHER TWO

She also is based in the province and sent her daughter to a university to study. The daughter is already on her 4th year of schooling. She got pregnant by her boyfriend who is her batch mate. She never told her parents about it, didn’t go home during summer breaks and took up summer classes instead. Even before enrollment for the first semester, she didn’t go home. (Maybe her parents thought she is diligent and is eager to finish her studies on time as she was already about to be in her 4th year).

The daughter at least saw an obstetrician few days before, but still didn’t inform her parents of her condition. Then she came because she had preterm labor. She gave birth to a preterm baby who encountered all the problems a preterm would. Then the innocent mother at the province was called up, informed for the very first time that the daughter was pregnant, in the wee hours of the morning, being summoned to bring money for the hospital expenses.

MOTHER THREE

An emergency call in the wee hours of the morning woke me up telling me of a walk-in admission for pediatric care. The mother is 20 years old, first time pregnant, came if due to second stage of labor, fully dilated and is about to deliver that hour. I was also informed that the expectant mother is a student, and never had prenatal check-ups for this pregnancy.

I drove to the hospital to attend the baby’s delivery. While doing the latching on and awaiting the baby to suckle, I was asking the mother who was half-sedated. She said she never informed her family about her condition out of fear again. The school where she studies also does not know of her condition. She was supposed to have a quiz later in the day but we told her she can’t go to school yet. The OB told her that anyway she will be given a medical certificate. Then she panicked, what will be written in the certificate? I told her, the truth. Then she said the school has no knowledge of her pregnancy. So we told her, we will talk to her later when she becomes fully awake. She never had prenatal check-up thus her baby ended term, but very small for her age.

As for her mother, she went home, to get some things both for the mother and the newly born baby. They came unprepared for this unexpected delivery.

Which brings me back to the question… how do these mother react to this news of their daughter, having known of their daughter’s pregnancy the very first time, at that very moment? Do they feel embarrassed that they never knew of it, and they have known it in a very painful manner, in front of the medical personnel? Do they feel that the medical professionals think they are negligent because how could not they find out their daughter’s condition when pregnancy is something hard to be hidden? Do they fear what their neighbors would say that instead of a college diploma, their daughters brought home a baby instead? Do they feel crashed that their dreams for their daughters may no longer come true as their daughter has to start a family of her own already? If they get angry, they should be understood. Their trust was betrayed.

These teenage moms? While they seem to be at fault, the best approach for them now is to accept their situation, avoid telling things that will aggravate their guilt feelings and help them start their new life. But this should not be tolerated. Parents should now let their daughters stand on their own. They could help but should not be the sole provider all over again. They may supervise but should not dictate how their daughters should run their lives. Parents should remember that they can only do so much, but not to the extent of tolerating everything.

(PHOTO COURTESY OF: http://philippinephotography.blogspot.com/2008/05/batang-ina-photo-documentary-on-teenage.html)

 
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Posted by on August 22, 2012 in Pregnancy, Teenage Pregnancy

 

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LUCKY: Superstitions on Baby’s Birth Date

LUCKY: Superstitions on Baby’s Birth Date.

 

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LUCKY: Superstitions on Baby’s Birth Date

Why do Filipinos still believe in superstitions, despite being a largely Catholic country? In every aspect, in every field, in every occasion, there’s always superstitious beliefs. Even if people just came from worship or Sunday mass, they still go to a Chinese person for some feng shui advice. When I was young, the first one I heard was that those “palaspas” are for driving away evil spirit. Now that I am older, there are so many silly (I consider them silly) things. During new year, people resort to silly practices just to be “lucky” for the next year. They must have 12 different round fruits on the table on new year’s eve, they must put some paper bills/coins in their wallet so that they will have money all year round, they should be wearing polka dots, again to attract money and good luck. Is that Chinese in our blood, or are we just money-driven?

In medical field, even during giving birth, again superstitions abound. Many consider giving birth at a date with the number 8 LUCKY. It’s not a strange thing anymore when parents tell you they had a cesarean delivery scheduled on the 8th, 18th or 28th of the month, at exactly 8:00am. Some even go to the extreme of informing the obstetricians that the baby should come out at exactly 8:08 or 8:18 am. If not the number 8, others want to deliver during the 9th of September, 2009; 10th of October, 2010; 11th of November, 2011; and I will not be surprised to hear someone schedule their delivery date this coming 12th of December, 2012.

Cesarean delivery has it’s own risk. As far as the baby is concerned, when the mother delivers via this method, without prior labor, the baby has not been subjected to the “stress” the mother undergoes during labor. Because of this, there is no surge in epinephrine (otherwise known as adrenaline). Low levels of circulating epinephrine in the baby’s blood leads to a low oncotic pressure (important to absorb fluids from the lung alveoli into the bloodstream; remember, the baby’s lungs are filled with fluid, NOT air, inside the uterus). After delivery, because of low oncotic pressure, there is less/slow absorption rate of the fluids from the alveoli of the infants lungs into the bloodstream. The infant then breaths fast until the fluid in his lungs is completely resorbed (condition known as transient tachypnea of the newborn), usually in 6 hours, but may last until 72 hours in some patients.

Another lifelong implication of cesarean delivery to the baby is INCREASED RISK for baby to develop allergic disorder, even if both parents deny family history of it. Vagina of adult women, just like our skin, is normally populated by bacteria; the bacterial population differs from one body part to the other. During vaginal birth, the baby tends to aspirate and swallow some of those bacteria along the maternal vaginal tract. These bacteria populate the intestines of the baby leading to, but not limited to: (1) closure of the gaps between intestinal cells, thus inhibiting proteinaceous substances to permeate the intestinal wall and incite infection or allergic reaction, (2) stimulate the intestinal immune system to secrete secretory immunoglobulin A (sIgA) that acts as a first line defense against invading pathogenic/infectious bacteria/virus/fungi in the intestines, therefore protecting baby from infection – this is how our immune system act for the first time after birth.

Now, when the baby is delivered via cesarean section, this BENEFIT of vaginal delivery is abolished. Why? The mother’s abdomen is prepared with iodine, to prevent infection of the cesarean wound. Because of this, majority if not all of the bacterial flora of the mother’s abdomen has been wiped out/eliminated. As the head of the baby is delivered, there’s nothing to aspirate/swallow that will give the above benefits of vaginal birth. Now, even if baby is latched onto the mother’s chest during that skin-to-skin contact to allow baby aspirating the chest bacterial flora, the quality of bacterial flora on the mothers’ skin is different compared to that of the vaginal flora and may act differently thus as far as infant’s immune system stimulation is concerned.

Third, just a recently published study found out that cesarean delivery led to lower expression of a protein UCP2 at the neurons found at the hippocampal region. This protein fosters short-term and long-term memories. Among mice, knocking out the UCP2 gene or chemically inhibiting this protein interfered with differentiation of the neurons and circuits at the hippocampal region and impaired adult behavior related to hippocampal functions. (See http://www.dailymail.co.uk/health/article-2185597/Babies-born-naturally-higher-IQs-delivered-caesarean-section.html?ITO=socialnet-twitter-mailonline).

A woman who had this strange belief of giving birth during a “lucky date” REQUESTED for a cesarean delivery on the 10th of October, 2010, consciously knowing that her baby is premature at 36 weeks. (Not my patient though, but I took over the case during the weekend when baby was already deteriorating). Alright, so the baby was born with a very nice birthdate of 10-10-10. Lucky, yey! NOT…

Normally babies who are 36 weeks, considered near-term, have good transition from intrauterine to extrauterine life. We USUALLY do not expect complications, breathing becomes normal in most cases. However, this particular baby developed complications, his breathing wasn’t normal as expected and eventually required mechanical ventilatory support. Still, baby deteriorated, developed persistent pulmonary hypertension of the newborn, and expired within few days. So if babies who are 36 weeks normally have good transition, how come this baby did not do any good? Honestly I don’t know what went wrong too. Or maybe nature is telling us not to interfere, let nature take its toll.

Is there really a lucky number for a birth date? Do we really have to alter the expected date of delivery just to be born at a “lucky date?” Many of you reading this may just shrug your shoulders and go on… Just consider your child’s future, consider some of the disadvantage of cesarean section, especially if it is not indicated at your birth circumstances.

 

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Personal Struggle — Lifestyle Check!

(Photo courtesy of http://www.hobotraveler.com/health/video-the-last-heart-attack-solution-with-president-clinton-and-sanjay-gupta.php)

This is the first time I am going to blog about myself, though I admit I have almost revealed my entire self through my tweets. For those of you who’ll take interest in reading this, I hope you grab some lesson/s and amend your lifestyle while it is still early…

When I was a medical student, we had this subject Clinical Pathology, where we would volunteer to be the source of blood specimen for the designated laboratory test we will perform. Whenever it was my turn to give the specimen, my blood, after centrifugation, would always show a thick layer of fats on top of the serum; it’s almost half of the entire blood specimen. When I compare it to other blood specimens, the others didn’t have that. I did not pay attention to it at first. I never thought it was abnormal. I noticed it, but I was never bothered.

Fastforward…

On November 2008, I had a swollen knee. I couldn’t determine if it was due to my cardio workouts, or it was due to some illness, probably gout. I went to the hospital laboratory and had some tests done. Since my mother is hypertensive, I included some workups pertaining to that as well. My uric acid, which could be abnormal in cases of gout was normal; so it does not explain the swelling of my knees. Guess it was just really an injury from my workout. On the other hand, my other blood tests were blood sugar-normal, total cholesterol was 423mg/dL (normal is ;200mg/dL (normal is <;200mg/dL), triglycerides was over 200 (normal is ;60mg/dL). I then took a lipid-lowering agent and was advised by a colleague to have a repeat test after 3 months. Besides medication, I started to control my diet and worked out harder than my previous. At first, my workout was just due to vanity. But this time, I had a double purpose, this time to increase my life span further.

After 3 months of religious medications, diet and workout, I had my repeat blood test. Of course I was anticipating that it would already normalize as I was already doing the 3 possible methods of lowering my lipid. Alas! My total cholesterol decreased, but it was still beyond acceptable level. It only went down to 329 mg/dL. So I had to increase the dose of the medicine I was taking while maintaining my diet and exercise.

On the average, I would visit the gym for about 2 to 3 hours, 5-6 days a week. I was that dedicated. When I was taking the medication for about a year, I thought my cholesterol already turned out normal (without documenting) so I personally stopped taking the medicine as it was also a pain in my budget. Still I went on with my diet restriction and moderate exercise.

On March 2010, while preparing for a latin dance sport competition, I noticed that without a long warm-up, I easily tire out in less than 5 minutes of choreography. When it was jive time, I couldn’t finish the 1minute 30 seconds routine without stopping in the middle, feeling a sharp pain in the chest, especially when my heart rate accelerated. I thought it was asthma as I was also coughing that time. I took medications but it didn’t improve my symptoms. I had an ECG done to check if maybe I was having myocardial ischemia but still it was normal. My blood pressure too was normal. After 21 days of preparation I was able to go through the entire competition, and won the title. Still I was experiencing that sharp pain on my chest every time I exerted effort afterwards. Admittedly though, I lost a lot of weight due to ballroom dancing! My diet and exercise was geared now merely towards vanity, as I was only focused to losing weight and possibly a ripped abs (which was a joke up to this date of course). I pushed my cholesterol levels on the side already as I thought it was already controlled.

I began to love indoor cycling (spin classes) and was one of the hardcore attendees of each class. There were even times I attended them 7 days a week. I kept my weight in check but with occasional gains when I go lazy working out or sick. Suddenly, I didn’t feel that sharp chest pain during my exercises, even when my heart beat would go suddenly fast.

Last year, 2011, the sharp chest pain recurred. This time I thought it was from gastro-esophageal reflux. I took some antacids and even proton-pump inhibitors to no avail. I don’t know why, but I resumed taking my lipid lowering agent especially after my dad had a mild stroke, also diagnosed to have abnormal lipid profile and chronic bronchitis (as a result of his smoking for years). This time I was religious with my medications and would only miss when I forgot to refill my prescription. Later in the year, sometime October, I was again do that hardcore spin class, so I thought I was getting better again.

Last March 2012, while I was again preparing for another latin dance sport competition, I again experienced that sharp chest pain. I again checked my ECG, still normal. This time though, I started already eating some fatty foods as many articles I have read said we should not remove fat completely from our diets, even if our aim was to lose weight; it is the carbohydrates that we should watch out for.

Few days ago, I wanted to check how good was I doing as far as my lifestyle was concerned. And to my surprise, my lipid tests were as follows: total cholesterol – 299mg/dL, LDL 260 mg/dL, HDL – 41mg/dL, Triglycerides >; 200mg/dL (forgot the exact value), ALL ABNORMAL. Upon seeing it, I felt the heavens crashed my heart. I thought I was already living healthily and still I got this result. I felt I was sentenced to a shorter life span. My efforts didn’t work.

Guess, I’ll get back to eating only fish/chicken, fruits and vegetable salads. The passion to workout should never wane thus. So if I get frustrated when my workout gets disrupted, please understand. I am fighting for my life, not for vanity anymore. As of writing, I am 37 years old…

 
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Posted by on August 5, 2012 in Personal

 

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GMA, CBCP, RH BILL – The Entanglement?

During the 2004 Presidential elections, which GMA “won” against Fernando Poe Jr, the former was accused of massive cheating thus her victory. Many were protesting against her. In fact, then former President Cory Aquino, together with some CBCP members were calling for GMA to step down and honor the people’s clamor. Yes, CBCP with former President Aquino were together and bidding GMA’s step down.

Then GMA staged a checkmate with the priests. She bargained NOT to touch, and possibly kill any moves on POPULATION CONTROL (RH Bill) as well as Mining (where many diocese are major stockholders). Vatican then called the Filipino priests to remain neutral, and insisted that bishops distinguish between pastoral care and political involvement.

So the bishops no longer pursued the call for GMA’s resignation from office. Then what happened next? Bishops already started to ask favors from her. Of course, you now remember the scandal involving some bishops directly asking the president for vehicles as birthday gift. That PCSO intelligence fund being siphoned for purposes other than charity that eventually led to plunder case.

Now that GMA is out on bail, she vowed to vote against the reproductive health bill. Recently, she got readmitted due to some choking incident. She was advised complete bed rest. But come Tuesday when the RHBill will be voted upon, I will not be surprised if she will again insist to be discharged against medical advise and report to congress, earn media mileage and champion all those who are rallying against the bill’s passage. Voila, those of you who were calling for her resignation before, will now be swayed to shift side with her. 

Wait… can someone find out had there been negotiations between the camps of GMA and the bishops before this rally?

Reference:

1. http://raissarobles.com/2011/09/07/rh-bill-was-killed-by-pres-gloria-arroyo-in-exchange-for-church-political-support/

 
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Posted by on August 4, 2012 in Uncategorized

 

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