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Category Archives: Personal

When Life Ends Unexpectedly…

Yesterday, 20th of March, was the birthday of one of my god children. A few years ago, that day was very tragic because while the grandfather was grilling some hotdogs for the celebrator, he suddenly collapsed. I was four floors down in my apartment unit, just arrived from work and just took off my shoes when I heard a soft voice, almost a whimper, calling me. “Doc… Doc… nagcollapse si papa” were the words that I heard. Immediately I ran upstairs and checked his pulses. I could not say he has no pulses. That would be the last thing every family members wants to hear. I told them we need to go to the hospital. Gladly, the son-in-law was around, and he drives well, really really well.

The relatives were saying we bring uncle to this secondary hospital but I argued and told them he cannot be cared for properly there as there is no ICU set-up there. Inside the vehicle, I tried my very best still to do chest compressions but I could not do it the proper way with the correct pressure because he was on my lap while I was compressing him; we were at the back seat. Still I tried and persevered. Traffic leading to the hospital was hell, but gladly, I was with the best race driver in Baguio. And thankfully, the vehicles cooperated with the emergency signal and honking he sounded.

We rushed to my alma mater and gladly upon reaching the emergency room, every personnel needed to do cardiopulmonary resuscitation was already there, there was no need to page for a resident. Vitals were 0. After few minutes of trying to revive him, defibrillation, his vitals were back but still comatose. He was transferred to the ICU. Later on, when the other family members arrived, I learned that he already had previous heart operations and heart attacks. Sadly, after few days, when he perhaps bid goodbye to everyone in the household, he left…

 
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Posted by on May 21, 2017 in Personal

 

The Prize of My Sacrifices

My life has been an open book, especially after that dreaded meet and greet with Death and his scythe. I have allowed it to be, so people would be aware of their lifestyles; and make them learn from my example on how they are going to live their lives towards health.

Few months after that emergency bypass operation, I was never able to control the main culprit that made me this “known” to my colleagues. I was already in quadruple drug therapy for my lipids (ruosovastatin, ezetimibe, fenofibrate, EPA+DHA). I got back to working out two months after my surgery. I had been watching my food intake, avoiding red meat and only preferring vegetable and white meat. Aside from that, I also have problem with my heart beat rhythm hence I was maintained on amiodarone. Eleven months after the surgery, finally I saw light. Total cholesterol and triglycerides went to normal levels, although LDL (bad cholesterol) was still high for a patient who underwent a bypass operation. I was then advised to have another follow-up visit after the holidays to check the effect of christmas celebrations.

Not only did my laboratory result became abnormal and back to pre-operation level, I gained weight. The light I saw few months ago was just a glimmer. On investigation, my thyroid hormones suggested hypothyroidism leading to hypometabolism, which now explains my weight gain and abnormal lipid levels. These were the result of my anti-arrhythmic amiodarone. We had to drastically revise my medications. I had to take thyroid hormone supplementation, change amiodarone to beta-blocker bisoprolol, increase the dose of ruosovastatin and increased my workout. At first I was still having palpitations and skip beats with bisoprolol and thus dose was increased. I was supposed to undergo holter monitoring in case my arrhythmia would persist.

At 18 months after the surgery, getting depressed with all the elevations of my lipids, weight gain, I decided to make a drastic change in my diet. I dropped meat and went quasi-vegetarian (having chicken or fish once a week). It was a very difficult lifestyle change as I easily get hungry, forcing me to have a lot of snacks, sometimes taking pastries (which I should also be avoiding; not that I have high blood sugar, but then simple sugars have been identified as one culprit in causing chronic inflammation of the blood vessels trapping cholesterols and forming a plaque, even if your cholesterol level is not necessarily high). Being a residency training officer of the department of Pediatrics at SLU-HSH, I decided to quit the post while maintaining the post as head of breastfeeding committee and neonatal services unit of the same hospital.

Then having been a Zumba enthusiast, I went on training and earned my license to be an instructor. Having kept this diet, exercise and religious medication, I had my follow-up on my 20th month after the surgery. Sacrifice and effort finally paid off. My total cholesterol was now down to 156.96mg/dL (from a previous of 423 the first time I found out I had elevated levels to 212 prior to my cardiac arrest). Low density lipoprotein (LDL) was now down to 92 mg/dL, and my triglyceride was still maintained below 200mg/dL at 105.32. My liver enzyme was very slightly elevated and thyroid hormone was within acceptable normal limits, bordering hypothyroid. I lost two kilograms, I can now wear my old pants and I feel a little more confident than the previous months. Because of these, my cardiologist decided to discontinue my thyroid hormone supplementation, decrease my dose of ezetimibe and lower my ruosovastatin from 40 mg to 20 mg.

Whether these changes were due to my more frequent exercise or diet restriction, or lesser stress from work, it doesn’t matter; it also means that I will have to maintain these statuses so as to keep my lipids in check. I thought I could already have the clearance to eat lechon, sigh… Well, better this than have another heart attack soon. The sacrifices paid off.

Next goal: a sculpted body? I dare myself.

 
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Posted by on August 17, 2014 in Personal

 

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And The Battle Continues…

Last November 2013, I thought I had one of the happiest moment of my life when after all the rigid routines I followed – food control; exercise and medication, my total cholesterol finally went down below 200 mg/dL for the very first time, however my bad cholesterol (LDL) was still high at around 140s. According to my doctors and friends who I talked to, for a person who underwent cardiac bypass, the ideal LDL level should be around 90mg/dL or less.  Nevertheless, that was a significant achievement I had so far as far as my blood picture was concerned. At that time, my medications consisted of (1) ruosovastatin at 20mg/day, (2) fenofibrate 160mg daily, (3) ezetimibe 10 mg every MWF, (4) EPA + DHA at 1 softgel daily, (5) clopidogrel 75mg daily, and (6) amiodarone 1/2 tab every M/Th. My cardiologist, Dr. Sophia Black, told me to come back on January as I might be indulging during the Christmas break, which was of course expected, especially among Filipinos who love to party. And when you say party in the Philippines, there’s a barrage of food of all sorts, making me at risk to have a rocket-high resurgence of my cholesterol levels.

During the holidays, I tried not to disappoint my doctor by trying to avoid parties as much as possible. And if ever I cannot resist the invitation, I would only opt for white meat at the most. I had lesser exercises too however, which I regretted immensely. To my memory, there were only 2 parties I went to, that of the Dept of Pediatrics at SLU, and Christmas celebration at home. January came, I started to feel tired when I climbed 4 flight of stairs that I routinely used to do with ease where I live. My doctor also noted that I started to gain weight, I was in denial though I noticed my clothes getting tight already. The laboratory results showed that my cholesterol increased all over again, and what was remarkable was I became hypothyroid, which is a possible adverse effect of my amiodarone. Hypothyroidism brings about decreased metabolism (explaining my weight gain), and a surge in cholesterol level (which should never happen anymore). We decided to discontinue amiodarone and shift my anti-arrhythmic into bisoprolol 2.5mcg/tab, 1/2 tab daily. Levo-thyroxine 25mcg/tab, 1/2 tab daily was added. Ezetimibe was increased back to daily and the rest was maintained. I will have to come back after 2 weeks. I resumed my usual exercise schedule as before. (Please note that I only took the levothyroxine UNDER prescription).

During my follow-up, 2weeks after starting with bisoprolol, my doctor noted that I had skip beats, which I barely noticed. She increased my bisoprolol now to 1/2 tab twice daily. If after 2 weeks and my skip beats will still persist, I will have to undergo holter monitoring. She then advised me to come back again after 2 weeks. On my follow-up, it was good news that no skip beats were no longer appreciated, thus the holter monitoring was no longer pursued. I had my repeat blood test, my thyroid hormones were already getting back to normal values but still I was fat (at 68 kgs from a previous of 63 last november). So I still had to continue my levo-thyroxine. I still felt this tightness/fullness in my chest after I jog for about 5 seconds. And I had this allergic rhinitis and postnasal drip cough bugging me at the same time. I was on levocetirizine and montelukast. I took antibiotics to no avail. Montelukast really knocks me off when I take them thus I can no longer stay up for a longer time to do my paper works.

I had monthly follow-up afterwards. On the month of May, we repeated all my lab works. Thyroid hormones were still on the above normal values. Cholesterol was still high. So my doctor decided to maximize my dose of ruosovastatin from 20 to 40 mg daily, with an advise to have a liver function test one month after to check on the effect of the statin to my liver. I also saw my pulmonologist, Dr. Kareem Eustaquio, who also gave me fluticasone nasal spray on top of my anti-colds medications. Still not completely ruling out GERD, I took pantoprazole as it is the only potassium-pump-inhibitor that will not interact with my other lifetime medications (again, UNDER prescription). They say that statins usually makes muscles sore when taking it. When I had it at 10, 20 mg daily, I never felt such even after intense workout. What I noted though is that after taking it at 40 mg daily (even if my workout is just plain cardio), I would feel very tired and doze off easily, even if I haven’t taken yet my montelukast. And of course I have still to take my montelukast for my rhinitis. With that effects of statin and montelukast combined, they knock me off immediately, impeding my planned paper works to accomplish before I call it a night. From this time on as well, I have decided to have my food devoid of meat – both white and red, as much as I can. But there were occasions where I could not completely avoid eating meat (chicken and fish) and that happened less than 5 meals in a month.

One month after, at the first week of June, I did my liver function test. It was a good news after all, my liver was not adversely affected by my high dose of statin. I mentioned to my doctor the chest tightness I feel initially when I do my exercises, and she told me that it could be an effect of my bisoprolol. So since my blood pressure is still maintained (last check up it was 90/70), and I don’t have irregularities of my heart beat, she reduced my bisoprolol to 1/2 tab daily already. All the other medications were maintained… I now weighed 67 kgs. (Just 1 kg shed off, it’s too slow!)

This made me realize how hard it must be for patients with hypothyroidism to lose weight. Mine was an acquired type, and yet it is taking me a difficult time to shed weight. I thought that since we already discontinued the culprit and I was on thyroxine supplementation, I would be able to lose weight fast. It is not that easy. So you can’t blame those overweight people with the same problems, especially if it is congenital, or if the factor causing it remains, to remain obese no matter how hard they try to lose weight. It’s not that simple.

Meanwhile, I am still strictly watching my intake. I still do my exercises, at least 4x a week, where I would spend about 1-2 hours in the gym dancing zumba with spinning, or some resistance training… My next visit will be 2 months after (August), with repeat lab works. So, here’s to wishing myself a normal cholesterol, after depriving myself of all the food I wished to have eaten.

To the enlightenment of everyone, if I avoid going to scientific fora or a party where food is involved,  it’s not because I dislike the company that sponsored it, it is because I don’t want to insult the host by not eating the food offered; I only have a few food I can take. That is also the only time I could go to the gym and workout. And, take note that exercise is my lifetime prescription. I can’t go with the excuse of “minsan lang naman…” No. That missed one chance to exercise may be detrimental to me, which may not be applicable to your scenario. I am not the same as you all are. Remember that I am not diabetic nor hypertensive, I was watching my food, I exercised, I took medications and yet I had my cardiac arrest, compared to you have none of these that I have…

 
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Posted by on June 12, 2014 in Personal

 

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Bits and Pieces

ON FAT JOKES

While it is true that fat jokes are at the most offensive, this is what I think about it.

IF a person is fat because he/she suffers from medical conditions (endocrine-metabolic problems), or is taking medication/s that makes him/her fat as a consequence, psychological causes like depression, then making a joke out of his/her fatness would be outright offensive; he/she did not acquire his/her fatness INTENTIONALLY

However, if the person became fat because of his/her lack of discipline and irresponsibility towards his/her own body, and his/her attention was called to it, and still intentionally keep on doing things that brought about his/her, or aggravate his/her dysmorphology, then he/she has no right to be offended if ever generic fat jokes are cracked. Fat jokes at the expense of one person though, remains offensive.

CHARICE

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Finally, Charice Pempengco, the diminutive singer with a big and magnificent voice, publicly admitted her real sexual preference on television yesterday. However, what was sad with her announcement was that, she had to APOLOGIZE! People lauded her, while others remained critical. She is proud of her being, she said. She is unsure how people will accept her, but has foreseen that some of her fans may leave her camp after this public admittance. There was nothing wrong about her being a lesbian, and she should not apologize for being one, not even to her mother or brother. It was not a choice for her to make, it was her being.

What statement I liked that supporters were saying was that “talent has no gender.”

I echo the sentiments of others who said they look forward to the day when living who you are should not require public announcement; people who are gay should not feel obliged to divulge about themselves publicly and that they be accepted without hostility.

MICHAEL DOUGLAS AND ORAL CANCER

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Michael Douglas has admitted that it was oral sex that brought about his oral cancer, and not anything else. It was caused by human papilloma virus. This virus is acquired through direct skin-to-skin contact – whether sexually or otherwise. This virus as well causes ano-rectal cancer for those who practice unprotected anal sex.

This again highlights the importance of men and women having the human papilloma virus vaccine as the virus do not only cause oral, anal and genital warts; and oro-pharyngeal, rectal and cervical among women. It also causes the same in men, gay or not.

 
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Posted by on June 3, 2013 in Personal

 

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My Journey To A Healthy Heart

It’s almost 6 months after my arrest and revival (December 8 2012)… (for more details on this, read my other blog “Flat Line… My Personal Account”)

November 2012

One month before the arrest, my blood test showed my total cholesterol was up at 222 and triglycerides at 350.

Jan 3, 2013

One month after I was revived, when I was only on fruits, vegetables and fish diet, my repeat blood test showed my total cholesterol was still high at 211, and my triglycerides went up to 352. It was at this point when my cardiologist asked me to resume taking my cholesterol-lowering medication. I started on atrovastatin and fenofibrate.

Jan 22, 2013

I took my post-arrest stress test. I was found out to have premature ventricular contractions (PVCs) not just in singles, but in quadruplets in a row. We surmised that this must have been the factor that lead to my arrest before. I was started on anti-arrhythmic amiodarone.

Feb 5, 2013

We checked on my liver enzymes and they were elevated as a possible side effect of the statins. My liver-protecting medications were increased and fish oil (eicosahexanoic acid and docosahexanoic acid, EPA + DHA) was added. My colleague cum friend cum cardiologist also added ezetimibe which works synergistically with both statins and fibrates in lowering the serum values. My thyroid function was also evaluated as an effect of the anti-arrhythmic. It was alright. My ECG showed widening of the QT interval thus my amiodarone was decreased.

I continued to restrict my food to merely fish, and sometimes chicken. I kept on working out. I have started this hobby of running on the treadmill.

March 12, 2013

One month again after the start of medications, my liver enzymes were still elevated. We shifted the atorvastatin now to ruosovastatin while my other medications were continued. My ECG tracing was already normal hence the amiodarone was already decreased to every other day.

May 23, 2013

I had my repeat labs done. Thyroid function and liver enzymes were A-OK, very excellent. Total cholesterol, for the very first time in my life, became normal at 185. High-density lipoprotein (HDL, good cholesterol) went up from 28 to 58. Low-density lipoprotein (LDL, bad cholesterol) decreased too from 183 to 111 (but still abnormally high). Triglycerides went down from 352 to 75.

I am just so happy and elated. I thought I will never see this day that my lipid profile will border if not fall to normal.

Previously, I made a bargain with myself. If despite all the measures I am taking and still my lipid profile will not go normal, I might as well eating foods I personally restricted myself from eating. What’s the use anyway of restricting. If my lipids will not improve, why should I deprive myself of these food. Better die soon but satiated instead of starving and yet dying soon just the same. The other compromise was, if my lipid profile will decrease to normal, then I will go on with my food restriction, medication and vigorous exercise, for life.

Now, since my values have already gone down to normal, I am now committed to living healthy – diet, exercise, and medication. For life. Here’s to celebrating the chance of having a longer life more…

 
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Posted by on May 24, 2013 in Personal

 

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Election 2013: My Personal Experience

It has take me a long time to come back to this website to write. Problem is I don’t know what to write next. After all that election fever.

I must confess that this is the first time I have experienced an automated polling. I think the last election I voted before this was 2001. During the 2004 election, I was in Manila for my training in Neonatology. Thus I was not able to vote.

As I was not able to vote during the 2004 election, I was disqualified to vote again on 2007. So I planned to register then for the 2010 election. Unfortunately, it was not clear to me then when the registration is. By the time I have known the last few days of registration, that was the time when there were too many eager first-time voters who were registering. In Baguio City, there was only a limit of 150 voters per day. But the problem was that as early as 2 am, people already queue just to register at 8 am. I was suggesting a system to the local COMELEC then for them to issue numbers for the next day registrants so people don’t have to queue uselessly every wee hours in the morning. But it just fell on deaf ears. It was at that time when I get crazy referrals in the night or early hours of the morning so I can’t risk queuing up as early as 2 am just to be able to register. I rather sleep. In short, I failed to register. Thus I was not a part of the revolutionary election of 2010.

This time, before the registration ended on October 31, 2012, I made sure to register by September. It took me only a few minutes, with my Biometrics entered. What was even helpful this election year was the “Comelec” app for IOS that I was able to download. I was able to check my registration status. It gave me my precinct number. Unlike in the previous elections, you only get to know your precinct number on the day of election via checking of the roster posted outside the different polling centers. Only few others may have received a note from COMELEC then.

I went to the polling center. What was limiting was that for my baranggay with 8 precinct, there was only 1 PCOS machine. The polling center only had 10 desks so there were only 10 voters casting vote at a time. Thus, I had to line up for 1 and 1/2 hours outside. But filling out the ballot and casting entering it into the PCOS machine was a short time, it took me less than 5 minutes for the entire process. Perhaps because I only voted for a few candidates. Luckily, my ballot was not ejected out. I only had one attempt to enter it into the machine.

I was at the gym finishing my workout when the polling officially closed and canvassing began. The local poll (Baguio City) was not really that exciting except for the congressional post. It was a neck-to-neck battle between Aliping (independent) and Go (LP), with only about 2000 plus difference at the end of canvassing. I failed to get a COMELEC approved ID so I was not allowed to witness the official canvassing. It was already 2:30 am, I was waiting outside the canvassing center, waiting for one of the media personnel who gave us updates on the official canvassing. But with the latest update given 12:30 am with 86% votes canvassed already, I didn’t think the partial result would change already even after all votes have been canvassed. Thus, I decided to go home.

The mayoral post was won by the reelectionist Domogan, who I did not vote as I was totally disappointed with his latest political moves… The glitches I heard so far locally: the ballots for Lualhati Baranggay (4 precincts) were interchanged with those ballots for Compostella Valley. Otherwise, there were no major problems encountered locally.

(Oh, I thought there was nothing for me to write about…)

 
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Posted by on May 19, 2013 in Personal

 

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I just woke up from a dream and I badly need someone to help me interpret it.

There was a gate I was familiar with in my dream. I had passed through it before. It was a darkly painted gate, nothing fancy. It was open then not closed.

Then one day, someone supernatural (as I havent seen his face or perhaps cannot recall how he looked like) told me my life here on earth is over, at my current age. It was time for me to enter that gate again. I obeyed, without hesitations. So i brought with me a trusted friend to accompany me till the gate so I could pass on to her my belongings right that very moment. Funny, I cannot recall who she was nor how she looked like.

We were talking while walking side by side and after we walkmed some distance, she suddenly stopped. She saw the gate and hesitated to move forward. When I saw the gate, it was shut, closed. But there was a small whitish slot for me perhaps to enter.

I then took of my clothes, and gave it to her including some cash I had in my pocket. Then walked thorough that small opening. She wasn’t crying while I was handing to her one at a time all my belongings… I didn’t die like during the first time I did. i never closed my eyes. It seems I just continued on with my life after passing through that gate… Then I remember I was riding a white car, like a taxi, with two other passengers who were wearing suits… Then I woke up.

 
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Posted by on May 13, 2013 in Personal

 

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