Yesterday marked the 45th day since I came to this nation and the 45th day since seeing their capital city. I have since lived in a different state where there are no road signs, no street signs, and where land crabs have the right of way when on the road.

In this state, there are no traffic jams, and the only buildings you’ll ever see are houses, ruins and a power plant. As such, seeing 2 or 3 cars parked along the side of the road signifies something important, like a funeral, a party, or perhaps a number of bystanders watching some men fix the telephone poles.

I realized that this is the longest I have been isolated from the busy life I know. So for me to go to the capital city for the first time in 45 days pumped up my adrenaline. I never thought seeing that all-too familiar Shell station sign at the port would bring a humongous smile to my face. Moreso, being caught in a traffic jam made me excited and had me applauding like a little girl seeing a pony for the first time.

There are two reasons why I went to the capital city on this particular day. First was to bring my friends to the airport and say goodbye to them. I felt so sad being left back in the Land of Enchantment and not being surrounded by people close to me. I felt like I had no purpose and that I would just be floating on for the next 5 days. I needed to see them off. Second, I had to bring another friend, an Art Director, to the hospital for some x-rays and to buy the appropriate medications. And after both were done, I sat with them in a park eating the best burgers in the country (it’s a small nation).

Being back in civilization was so refreshing, like a perfect consolation for being away from the life I know, or perhaps a momentary therapy for someone who feels sad with the thought of a bus load of friends leaving.

It’s been 45 days. I wondered when the next time will be till I get to the capital city.
(To be continued)

Photo borrowed here.

“If you’re driving alone and you start having severe chest pain or discomfort that starts to spread into your arm and up into your jaw (the scenario presented in the internet article), pull over and flag down another motorist for help or phone 9-1-1 on a cellular telephone.”

I have been receiving an advisory on self-CPR for a number of times and years. This email allegedly began circulating the web back in 1999. The following is the full text:

This one is serious . . . Let’s say it’s 4:17 p.m. and you’re driving home, (alone of course) after an unusually hard day on the job. Not only was the work load extraordinarily heavy, you also had a disagreement with your boss, and no matter how hard you tried he just wouldn’t see your side of the situation. You’re really upset and the more you think about it the more up tight you become.
All of a sudden you start experiencing severe pain in your chest that starts to radiate out into your arm and up into your jaw. You are only about five miles from the hospital nearest your home, unfortunately you don’t know if you’ll be able to make it that far.
What can you do? You’ve been trained in CPR but the guy that taught the course neglected to tell you how to perform it on yourself.

HOW TO SURVIVE A HEART ATTACK WHEN ALONE

Since many people are alone when they suffer a heart attack, this article seemed in order. Without help the person whose heart stops beating properly and who begins to feel Faint, has only about 10 seconds left before losing consciousness. However, these victims can help themselves by coughing repeatedly and very vigorously. A deep breath should be taken before each cough, and the cough must be deep and prolonged, as when producing sputum from deep inside the chest. A breath and a cough must be repeated about every two seconds without let up until help arrives, or until the heart is felt to be beating normally again. Deep breaths get oxygen into the lungs and coughing movements squeeze the heart and keep the blood circulating.

The squeezing pressure on the heart also helps it regain normal rhythm. In this way, heart attack victims can get to a phone and, between breaths, call for help.

Tell as many other people as possible about this, it could save their lives!

From Health Cares, Rochester General Hospital via Chapter 240′s newsletter. AND THE BEAT GOES ON… (reprint from The Mended Hearts, Inc. publication, Heart Response)

I have concluded it immediately as not true simply because we have not been taught that in med school and during our medical training. However, some people still claim that it is true. So I unleashed my geekiness to try to prove that this is a hoax.

According to snopes.com, there is some truth to it. It has an extensive explanation on the supposed advisory’s origin and how and why cough CPR is not recommended. It also has links to Rochester General Hospital and Mended Hearts’ statements denial in endorsing cough CPR. Furthermore, official statements allegedly released by two doctors state that “the American Heart Association does not recommend that the public use this method in a situation where there is no medical supervision.” Also, “the procedure might be the right thing to attempt or it might be the very thing that would kill the afflicted depending on which sort of cardiac crisis is being experienced. Without a doctor there to judge the situation and, if cough CPR is indicated, to supervise the rhythmic coughing, the procedure is just far too risky for a layman to attempt.”

To some of you (like me), snopes.com may not be convincing enough, especially since this and this are the only (pseudo?) reliable sites I have on Darla Bonham (supposed executive director of mended hearts); and this is the only site I have on Dr. Richard Cummings (yup, I’m pretty convinced he’s real – but did they really say those?). So I went a little further:

According to The American Red Cross: “Cough CPR is a self-administered form of cardiopulmonary resuscitation described by CM Criley in 1976 ². According to Criley, self-initiated CPR is possible; however, its use is limited to clinical situations in which the patient has a cardiac monitor, the arrest is recognized before loss of consciousness, and the patient can cough forcefully. To date, there is insufficient scientific research concerning the efficacy of cough CPR. Therefore, American Red Cross cannot advocate teaching the technique until it has been thoroughly tested in national studies and found to be effective.”

Finally, The American Heart Association recommends: “The best strategy is to be aware of the early warning signs for heart attack and cardiac arrest and respond to them by calling 9-1-1. If you’re driving alone and you start having severe chest pain or discomfort that starts to spread into your arm and up into your jaw (the scenario presented in the internet article), pull over and flag down another motorist for help or phone 9-1-1 on a cellular telephone.”

I hope these links help!

I have always doubted the news reports that Jett Travolta’s death was caused by Kawasaki’s disease (KD). Since I did not have all the facts straight on this news bit, I theorized that while it may be true that Jett had KD as a young child, he may have a concomitant disease which may have caused the seizures and his demise. And then I ran into this article stating what I –& possibly thousands of other doctors – have been doubting.

According to this article,“…Jett was autistic but was not being treated for problems associated with the disorder. The Travolta family had maintained that the teen did not suffer from autism and, after the item appeared, attorney Marty Singer told the New York Post that Travolta and Preston “have [taken] and they continue to take the best possible care of their children. To suggest anything to the contrary is very hurtful to a loving family and also would be false and defamatory.”

Kawasaki’s disease is a systemic vasculitis of unknown etiology that affects the small- and medium-sized blood vessels of the body, in particular, the coronary arteries. The following are key points in KD:

• The disease is named after a Japanese physician who first reported the syndrome in 1967. Kawasaki disease occurs throughout the world, with a higher incidence in Japan and Asia than in the United States, where 10 of every 100,000 children get the disease each year. The symptoms of Kawasaki disease can go away without treatment. However it may take 6-8 weeks for the symptoms to resolve and the child’s laboratory results to return to normal. The effects on the coronary arteries can last a lifetime. Though some children recover from Kawasaki disease without treatment, 15 to 25 percent have coronary artery damage. Damage can occur to many arteries, but the coronary arteries are the most vulnerable, making Kawasaki disease a leading cause of childhood heart disease.

• Kawasaki disease is an unusual and serious illness of young children that causes high fever, rash, red eyes and lips, swollen glands, and swollen hands and feet with peeling skin. The disease also causes damage of the coronary arteries in a quarter of untreated children and may increase the risk of atherosclerosis in early adulthood.

• The coronary arteries are most often affected. Part of a coronary wall can be weakened and balloon (bulge out) in an aneurysm. A blood clot can form in this weakened area and block the artery, sometimes leading to a heart attack. The aneurysm can also burst, but this rarely happens.

• The etiology remains unclear, although epidemiological data support an infectious cause. Thus far, the unknown agent generally is believed to be ubiquitous in the environment, causing noticeable disease only in those individuals with some as yet undiscovered genetic predisposition for the illness.

• Epidemiological studies suggest a controversial association of Kawasaki disease with recent carpet shampooing, flooding, and locations near bodies of water. These data have produced a water-borne vector hypothesis.

• No laboratory test can diagnose Kawasaki disease with 100 percent certainty. Instead, a set of criteria described by the Centers for Disease Control are used.

• Treatment for Kawasaki Disease is most effective if given in the first 10 days of the illness. There are two principal treatments. Intravenous gamma globulin (IVIG) is used to shorten the acute phase of Kawasaki disease and prevent some coronary damage. Aspirin is used to decrease inflammation and lower fever, as well as prevent blood clots.

It’s clear from this info that KD affects the coronary arteries and the heart.

In other words, it is likely that there is a concomitant problem and it’s quite possible that it wasn’t KD that caused Jett’s demise.

That, or there are some info that the Travolta family has kept to themselves (which we will, of course, respect); for instance: maybe it really wasn’t an episode of seizure that caused this, or that the family was better off saying that he has KD as opposed to autism.

Whatever the case may be, it doesn’t really matter. Personally, it would only matter if the kid we’re talking about is a patient and learning more from his case may be contributory to our knowledge of KD.

(So why am I even discussing this? It tickled my logical side for a few seconds, so I found it blog-worthy).

To learn more about what Sci Am found out about KD from Dr. Walter Mofolsky, Chief of Pediatric Neurology at Beth Israel Medical Center in New York, click here.

To learn more about Kawasaki’s Disease – it’s causes, treatment and medication, click on these sites from The American Heart Association, Mayo Clinic and e-medicine.

Good thing I was suspicious on why she “needed” my autograph as opposed to “wanting” it, but I never considered voodoo as a reason. I just diverted the conversation to something else so she quit insisting.

Just when I thought my life exists in hard core science, something comes up and shakes it. Weird, weird place.

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There is an existing rule of thumb among the simple folks in rural Cavite: THE MORE OBNOXIOUS THE PATIENT IS, THE PRETTIER THE UNDERPANTS HE HAS ON. This has been proven time and time again. We have a variety – the pink cotton panties (Oooh! Floral!), the lavender laced panties, the printed panties with the teddy bears or hearts, down to bikini cuts. Supposed reason being: panties are cheaper than men’s underpants. And they’re more comfy, too.

So to that drunken buttwipe who came in last weekend – I know why you didn’t want us to take your pants off!!!

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It is in Medical ethics that a doctor should not charge a fellow doctor with their PF. This extends to the immediate family of the doctor who is dependent on him/her. However, in this country, a lot of patients suffer from what some of us in the medical field would like to call “extentionitis.” This means someone who would want to benefit from this special agreement even though he is not an “extension” or a dependent of a doctor. This condition is so bad that sometimes, a patient will go as far as being not even being related to a doctor.

For instance, I had 2 cases over the weekend: an old lady claiming to be the very very close friend of Beth who has a daughter that works in the hospital. Asked who the daughter is, she hasn’t a clue. Asked if the daughter is a doctor, a nurse, or any other member of the staff, I only got a blank stare. And two blinks. Anyway, she still will have to be charged with my PF because she is obviously suffering from extensionitis. The 2nd is a drunken guy whose son I attended to after being mauled during a drinking spree. Not only were drunks difficult to deal with, his son was not an easy case. And in both cases, they were demanding that I shouldn’t charge them… heck, drunk guy allegedly even threw a fit in the E.R.

What were thinking??? Were they even thinking at all? I had to ask my colleague if my price was reasonable. He said it was. I had considered giving him a discount so he’d give it up and go home. Still, drunk guy was persistent on not being charged with my PF. I thought I was close to not being able to receive any professional fee for what I’ve done for his difficult son and his unruly drunk posse (who was making my management even more difficult for the singular patient), if not for some very enterprising nurses and staff.

And this is the reason why not all doctors are wealthy.

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