I was trying to look asleep so my son who has been drinking his milk will finally go to sleep when I heard my husband swear in anger. I thought he was angry with me...no, he was mad at his PSP. He was really so mad that when I asked him what's troubling him he said, "don't talk to me I'm mad!". Because I have a bit of sensitive personality, I asked him again, and he said, "don't talk to me, I'm losing the game!"
Kindergarten temper.. sometimes, I can't get use to it. Even i f I know how choleric a person my husband is, I still feel hurt when he doesn't seem to listen and he gets mad at the slightest of things. However, i realized, such temper can develop among children who are into computer games. The fast-paced games may enhance irritability and stubbornness which can be added to the development of obesity and metabolic syndrome because of prolonged sitting in front of the monitor. Such sedentary lifestyle may contribute to the increase in the number of adults with chronic diseases.
Friday, May 16, 2008
Thursday, May 15, 2008
The GYM Busters!!!
This morning I found myself eavesdropping in the girls locker room of the gym, to a group of ladies of about 40-50 years old. They wore their body hugging shirts and tight work-out pants as if they were the sexiest of women while I hide my bumps in loose jogging pants. I'm not fond of tight work-out clothes, although I make sure I see some curves when I exercise to either build my self confidence or push me to exercise more. Anyway, they talked about funny things like, "you think men will like this?", I looked at them out of curiosity. (By the way, I appeared busy drying my hair) and one lady was modeling a bra- a sports bra which you're supposed to wear under thin work-out shirts or as is, if you're that confident. I wanted to laugh because her tummy was not just bloated, it was literally sagging! Out of nowhere somebody handed them an oil essence which they all applied on their bellies and here comes another lady with an obviously dyed white hair saying "Ooooh! That felt so good, will this make my fat shrink?". After 20 minutes they all hurried away to the body jam class.
You see, time and again, I always see this group. I came from another gym and the same kind of group amuse me. They go to the gym early and attend the group exercises together as if there's no tomorrow. I really wonder how old their children are now or where are their husbands? On top of that, they eat the same kind of food because they order it from the same cook who prepares either South Beach or whatever-diet they like. And they're there almost everyday!!...while I have to run from my clinic just to fulfill my 3x a week exercise regimen!
Whew! There are more stories to tell but these eavesdropping experiences help me understand my own aging mechanism plus the fact that I want to become a geriatrician. Taking care of the elderly starts from taking care of those who are in the younger old population. I know there is much to learn. Next time I think I'd bring a recorder.
Wednesday, May 14, 2008
Acute Laryngitis
For the past 4 days, my voice croaked like a frog. After two hours in the gym last Saturday, I developed muscle pains and suddenly my voice became hoarse. It was another bout of laryngitis.
For a doctor to lose her voice, it really is a big problem. For the past 2 days I've been apologizing to my patients that I could not explain well their problem because of my laryngitis. They all looked at me with pity and said they understand.
Honestly, I could see in their eyes the "c'mon-doc-you-need-some-rest" look. How can I when I know people need my help? Anyway, if you ever have laryngitis, best thing to do really is to rest your voice. Allow the inflammation of the vocal cords to heal by taking anti-inflammatory drugs such as Mefenamic Acid, Paracetamol and Ibuprofen. If the cause of the laryngitis is bacterial, antibiotic regimen may be necessary. However, should the laryngitis persist, perhaps, steroids for one week will do its magic.
On top of these, drink a lot of water at least 8 glasses a day. Also, warm saline gargle 3x a day should also be done.
Tuesday, May 13, 2008
Acute Gastroenteritis (On the Beach)
A man came complaining of loose bowel movements for the past 2 days. He was in the beach with some friends where they feasted on seafood and a bottle of whiskey. The next day he became a frequent visitor of the toilet because of watery excreta and crampy abdominal pain.
What do you do when you're far from home, on a beach where a doctor is hard to reach?
I must say, before going to the beach,here are essential drugs which you may need to bring.
1. Pain relievers/antipyretics (paracetamol)
2. Antispasmodics (hyoscine n-butylbromide or domperidone)
3.anti-emetic (metoclopramide)
4. Oral rehydration salts
5. Anti-bacterial cream
6. Local wound care kit (which inludes, povidone iodine, hydrogen peroxide,cotton, alcohol, sterile strips)
7.sunblock
While enjoying the beach,make sure you're skin is protected from the harmful rays of the sun. Use sunblock with higher SPF to ensure longer protection. If you intend to go drunk, make sure that you have food in your stomach enough to protect it from hyperacidity.
Now,if you develop diarrhea and abdominal pain, there are different pathologic reasons. One, you could have eaten an 'infected' meal, a seafood which harbors parasites endemic in the area, two you could be suffering from indigestion or three, you could have upset your stomach and suffer from mild gastritis on top of your 'gluttony'.
It is important to replace volume per volume loss when you have diarrhea. Replace the amount you lose with oral rehydration salts. ORS comes in tablet or powder forms. It should be dissolved in distilled or 'mineral' water and have to be taken in small amounts. Do not try to overhydrate yourself or you'll find yourself vomiting in a short while. Small but frequent intake is the key.
It is very important to see a doctor once you have the chance. A fecalysis or stool exam is necessary to address the etiology of diarrhea. If it's infectious an antibacterial regimen is enough to treat you. However, if a parasite is present, another drug should be added to complete the treatment. Supportive treatment to alleviate pain is also given in the form of anti-spasmodics. However, giving so is not that necessary.
Monday, May 12, 2008
Understanding the Young ONCE...
Last Saturday, I fnally decided to become a Geriatrician- one who takes care of the wiser and older people. I realized that sooner or later all of us are going there and what better way to prepare for it is to understand the physiologic changes of aging.
The first module that we took tackled Anatomy and Epidemiology of Aging. You see, there are myths related to aging and we are all guilty, in one way or another, of using aging as an excuse not to understand our parents or the older people we work with. One night, a neighbor came to the house requesting me to visit his father-in-law who has not been eating for 3 days and not wanting to leave his room.
When I reached his father-in-law's house, I was ushered to a dark second floor room, with not much ventilation, very dirty floor, and the bed mattress lying on the floor smelling stinky and 'old'. I was surprised to see that the old man have very enlarged lymph nodes which,as explained by the daughter, has been operated on five years ago, apparently became bigger than ever after the surgery. I proceeded to talk to the old man who was lying on the bed, eyes closed appearing to look asleep. After introducing myself to him in a cheerful tone, I then asked him if he has any complaints. He said " I'm okay!". He was still closing his eyes. I told him that his children are worried because he has not been eating. He said again "I'm okay!".... so I decided to do my physical examination. It really stabbed my heart that he looked neglected but the children appeared very concerned anyway. Finally I told him that if he doesn't eat we will be forced to bring him to a hospital and feed him through a tube. Then he said " There's nothing wrong with me! I can eat but many times, I wake up hungry and when I go to the kitchen, I still have to prepare the food or heat it and that tires me a lot, besides I have no one to talk to!".
So there it is! the children thought they've been doing their best to feed the father by leaving food in the refrigerator or the microwave but the poor man is too weak to do all these things on his own--- he's already 75 and his body lost it's strength because of his immunocompromised state. Anyway, I talked to the children and told them that their father needs attention and they need to schedule a time to take turns in taking care of him. After all, he has done his part in making them professionals and giving them their needs when they were helpless children. It was their turn to take care of him. I also told them to clean the house and make the room conducive to sleep.
They were so embarassed after that but hey... let us all realize that we too will become old as this man and do we want our children to leave us in a dark dirty room with food in the ref but no one to talk to?
The first module that we took tackled Anatomy and Epidemiology of Aging. You see, there are myths related to aging and we are all guilty, in one way or another, of using aging as an excuse not to understand our parents or the older people we work with. One night, a neighbor came to the house requesting me to visit his father-in-law who has not been eating for 3 days and not wanting to leave his room.
When I reached his father-in-law's house, I was ushered to a dark second floor room, with not much ventilation, very dirty floor, and the bed mattress lying on the floor smelling stinky and 'old'. I was surprised to see that the old man have very enlarged lymph nodes which,as explained by the daughter, has been operated on five years ago, apparently became bigger than ever after the surgery. I proceeded to talk to the old man who was lying on the bed, eyes closed appearing to look asleep. After introducing myself to him in a cheerful tone, I then asked him if he has any complaints. He said " I'm okay!". He was still closing his eyes. I told him that his children are worried because he has not been eating. He said again "I'm okay!".... so I decided to do my physical examination. It really stabbed my heart that he looked neglected but the children appeared very concerned anyway. Finally I told him that if he doesn't eat we will be forced to bring him to a hospital and feed him through a tube. Then he said " There's nothing wrong with me! I can eat but many times, I wake up hungry and when I go to the kitchen, I still have to prepare the food or heat it and that tires me a lot, besides I have no one to talk to!".
So there it is! the children thought they've been doing their best to feed the father by leaving food in the refrigerator or the microwave but the poor man is too weak to do all these things on his own--- he's already 75 and his body lost it's strength because of his immunocompromised state. Anyway, I talked to the children and told them that their father needs attention and they need to schedule a time to take turns in taking care of him. After all, he has done his part in making them professionals and giving them their needs when they were helpless children. It was their turn to take care of him. I also told them to clean the house and make the room conducive to sleep.
They were so embarassed after that but hey... let us all realize that we too will become old as this man and do we want our children to leave us in a dark dirty room with food in the ref but no one to talk to?
Sunday, May 11, 2008
Anxiety (or Hypokalemia?)
Oftentimes, patients come in asking for a 'general check-up' and on further query all they really wanted is a request for ancillary procedures to see if they have existing diseases or if they are at risk for developing chronic illnesses.
One day, a seemingly worried lady in her late 30's came in because of weakness of her legs. She asked for a 'general check up'. She is single,never been married nor bore a child. On physical examination everything was normal except for a blood pressure of 130/90 which is pre-hypertensive. She looked so worried and tensed asking me to allow her to stay in my clinic to rest for a while. She said that the day before, she went to an emergency room because she had difficulty getting up from bed. Her electrolytes were taken and showed a slightly low potassium levels.
I started exploring where her tension is coming from. As a family physician, I make sure I was able to check on prevailing issues which could have affected her perception of the illness that she might have. She started to cry. She said that she has been worried for the past weeks. Her boyfriend left her for another woman at a time when they were already considering marriage. She claimed though that it doesn't bother her anymore and what really worried her most is the fact that an office- mate has been diagnosed to have cancer who complained of easy fatigability for just a short time. She is afraid that her weakness might be a sign of cancer.
Many times, to satisfy a patient, you need to request a battery of test which can help in explaining what she is going through. A simple routine exam appropriate for her age may be necessary like a CBC, urinalysis, Chest X-ray, and a lipid profile perhaps. In this patient, everything came out normal.
I explained to her that her blood exams were normal. I didn't stop at that. I went back to her problems and tried to address her issues. When she realized she has been feeling depressed not just because she's worried about her health but because of the break-up, she started to open up. Aside from the potassium supplement and advice to eat bananas, I made sure she updates me on her critical issues everytime she follows up.
After 4 visits, she felt better, weakness of the legs were gone and she didn't look tensed anymore as compared to the first time I saw her.
When illness is viewed just as physical illness, we miss the chance of knowing where the perceived illness really comes from. Personal anxieties exaggerate physical experience of a disease. When we're sick and we worry a lot, sometimes the disease is magnified. Therefore, when we visit our doctors, we tell them what we really feel, physically and emotionally too.
One day, a seemingly worried lady in her late 30's came in because of weakness of her legs. She asked for a 'general check up'. She is single,never been married nor bore a child. On physical examination everything was normal except for a blood pressure of 130/90 which is pre-hypertensive. She looked so worried and tensed asking me to allow her to stay in my clinic to rest for a while. She said that the day before, she went to an emergency room because she had difficulty getting up from bed. Her electrolytes were taken and showed a slightly low potassium levels.
I started exploring where her tension is coming from. As a family physician, I make sure I was able to check on prevailing issues which could have affected her perception of the illness that she might have. She started to cry. She said that she has been worried for the past weeks. Her boyfriend left her for another woman at a time when they were already considering marriage. She claimed though that it doesn't bother her anymore and what really worried her most is the fact that an office- mate has been diagnosed to have cancer who complained of easy fatigability for just a short time. She is afraid that her weakness might be a sign of cancer.
Many times, to satisfy a patient, you need to request a battery of test which can help in explaining what she is going through. A simple routine exam appropriate for her age may be necessary like a CBC, urinalysis, Chest X-ray, and a lipid profile perhaps. In this patient, everything came out normal.
I explained to her that her blood exams were normal. I didn't stop at that. I went back to her problems and tried to address her issues. When she realized she has been feeling depressed not just because she's worried about her health but because of the break-up, she started to open up. Aside from the potassium supplement and advice to eat bananas, I made sure she updates me on her critical issues everytime she follows up.
After 4 visits, she felt better, weakness of the legs were gone and she didn't look tensed anymore as compared to the first time I saw her.
When illness is viewed just as physical illness, we miss the chance of knowing where the perceived illness really comes from. Personal anxieties exaggerate physical experience of a disease. When we're sick and we worry a lot, sometimes the disease is magnified. Therefore, when we visit our doctors, we tell them what we really feel, physically and emotionally too.
Subscribe to:
Posts (Atom)