Beauty Blog 1: Daily Facial Routine

During residency, I cared less about my looks. Because of pressure, workload, doing basic tasks like washing your face, toothbrushing and even taking a bath were a luxury instead of necessity. Especially if you're a first year resident, in which you're always "first on call". As one of my colleagues said before "Sayang ang damit."

By graduation, I've begun to be more conscious of myself. Actually, I should thank my sisters and my boyfriend for this motivation. Aside from the daily facial wash, I gradually added stuff to my daily facial routine - first was a toner then I bought night cream, eye cream, a serum & the latest addition is a day cream. Yeah I used to place a moisturizer before but I was not religiously using it. But due to the growing number, my dilemma was rising. Back when things were simpler/fewer, it was cleanser-toner-moisturizer. Period! With the creams and serum at hand, now where do they come in? Is the arrangement of my application right? Is there something redundant?

My regimen became this: cleanser-toner-moisturizer-serum-eye cream-day/night cream. In denial that I was unsure of what I was doing, I did that for 2 months (I think). It was only last night I got the courage to ask a friend if what I have been doing was right. Well, almost. And my instincts were right - some areas in my regimen were redundant. Call it overkill. Haha!

In summary, here's her advice. As a bonus, she also gave me tips for the morning regimen.
AM: facial cleanser-toner-eye cream-moisturizer-sunblock
PM: facial cleanser-toner-serum-eye cream-night cream (no need for the moisturizer)

In order to make the most of what I have (para hindi sayang), I can alternate the moisturizers and the day/night creams. For example, day/night creams today, no moisturizer. Then tomorrow, moisturizer in the morning and evening, omit the day/night creams. And so on. At least, I still get to use all of them.

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Here are the brands I patronize:
Celeteque Facial Wash
Celeteque Oil-Control Toner
Pure Beauty Eye Cream (once consumed, I will be shifting to Pond's Age Miracle Dual Eye Therapy)
Celeteque Moisturizer
Cetaphil UVA/UVB Sunblock
Pond's Age Miracle Concentrated Resurfacing Serum
Pond's Age Miracle Day Cream
Pond's Age Miracle Overnight Repair Cream

Clinic Blog 1: GERD

Almost 2 years ago, we organized a post-graduate course about Respiratory Diseases. It was well attended, and a successful one following its predecessor course which was an utmost or near failure. The last topic of the said conference was about Chronic Cough. What set it apart from the other topics that day was that it was the only interactive session and we asked help from UMED. The take home message was simply for cases of chronic cough, think of three differentials - pulmonary (PTB), allergy, or gastrointestinal (GERD). Thankfully, everyone enjoyed the fruitful and productive discussions.

Yesterday, I was able to apply what I've learned from that session. I had a female patient, with 3 months history of dry cough. She already took different classes of cough medications (mucolytics, cough suppressants, etc.) in the past, but nothing seemed to work. She also underwent chest x-ray with normal result, and sputum AFB for 3 days which all yielded negative results. Last week, she sought consult and was also prescribed with a broad-spectrum antibiotic (claimed to be compliant) because of upper respiratory tract infection. There was slight relief of symptoms but the cough was still there.

I extracted that when she was still working with her previous employer, she had several episodes of skipping meals and/or not eating on-time; she drinks coffee (1 cup a day), softdrinks, and loves spicy foods. She also experiences burning abdominal pain at the epigastric area radiating to substernal chest, bloatedness, and early satiety. She doesn't smoke, doesn't drink alcohol, and doesn't take any NSAIDs. There were no BM changes, dysuria, nausea/vomiting, weight changes. I was zero-ing on GERD. My physical examination further proved my point - (+) epigastric tenderness, tympanitic abdomen.  I explained my clinical impression to the patient (& her companion). I prescribed her medications now targetting against the acid reflux which could be the source of her cough & explained my management approach (lifestyle, eating habits, etc.).

All now I could do is hope and pray for her.

Almost

Yesterday afternoon, my laptop's networking feature was corrupted - internet access was impossible, the bluetooth cannot be detected. It was like my laptop became useless. I became distracted because I needed the internet badly (nowadays, who doesn't?).

I had no choice but to go to a service center and have my laptop fixed. At the back of my mind, I anticipated that it may have to be reformatted. The last time I reformatted my laptop was way back October 2009 when the fan broke down. I brought it at Sony Service Center near my previous training hospital. I didn't pay anything because it was still covered by its 1 year warranty. Thank goodness for my already stored file at the Seagate external drive, creating back-up files were very short. I admit I never copied some files (i.e. Adobe Lightroom, new mp3 files) thus I have to painstakingly download them again. My anti-virus program (Kaspersky 2011) will also be erased. I still have the cd but I don't know if I can still install it (since it can only be installed in 1 computer). Sayang.. Hay..

The technician told me he'll try to solve the problem by reformatting the entire system, the problem could be the software. Otherwise, the problem lies with the hardware and changing the hardware is expensive. I had to wait patiently for 3 hours while it is being fixed (hopefully). I started to windowshop for a new laptop since I thought the possibility of buying a new one is inevitable (ouch!). I had a target - Toshiba Notebook NB--- worth almost Php25K. I was keeping my fingers crossed that the problem is just with the software. Sana.. Sana..

When I got back at the center, I was happy to learn that it was just a software problem. He was also generous to (secretly) install a new anti-virus for my laptop. To test if the network connection is restored, he installed Yahoo Messenger and Google chrome. The system runs faster compared than before. My laptop seems very new. At least, I only paid for the service fee, a smaller amount compared to a new notebook. It was a close call in spending something that I don't need at this time. Almost..

Travel Blog 2: Pagsanjan falls, Laguna

Last week when I fetched my sister from her last hospital duty as an intern, her first words to me were "Ate, labas tayo!" I thought it was a simple gimmick or malling, but she meant it as an "out of town" trip somewhere we'd never been to before. And she wanted it within that week or the following week. I immediately thought that the timing of the trip could be a hindrance because it was short notice and plane tickets could be expensive then.

2 days after, a trip was set for Puerto Princesa, Palawan. Yehey! Underground river here I come. But it was also cancelled because my sister chose to prioritise her clearance from the hospital where she had her internship. I had mixed reactions about it. Instead, my parents planned to go to Pagsanjan Falls & Kamay ni Hesus as Mother's Day celebration. Never mind it was also the fight of Manny Pacquiao but it was the opportunity and the only time we could all go out.

It was cloudy when we left home at past 6am. While cruising along South Luzon Expressway, that was when it started to rain. We first arrived at Kamay Ni Hesus at Lucban, Quezon at past 9am. It was raining and windy. The uphill garden was closed to the public because the steps were so slippery. I just took shots of the statues from our spot below outside of the church. Parts of the Garden of Eden were open but it was small compared to what could be seen in the garden. We also didn't get to see the interior of Noah's Ark because a retreat was being conducted. Because of the unfriendly weather, we all decided to skip and re-schedule the Pagsanjan Falls trip at a later date. In exchange, we all craved for a hot delicious bulalo as lunch. By 11:30, we were on the road back north and listened to a live broadcast of the Pacquiao-Mosley bout.

Pagsanjan Falls

We had lunch at Pagsanjan, Laguna by past 12. Surprisingly, it stopped raining, the sky became clear and the sun seemed to shine. The river became busy with swarms of korean tourists riding small boats heading upstream towards the falls. Since we were already there, we decided to go for it. After inquiring around, we settled to get two boats (max of 3 persons per boat + 2 boatmen each) to take us to the falls. The trip upstream was longer because we were riding against the current and the boatmen had to literally push the boat against the rocks. We passed by 3 smaller falls before we saw the main attraction. We left all of our things (bags, watches, glasses, cameras & even my slippers) at the rocks with 1 of the boatmen as the "watcher" before we rode a bamboo raft & went underneath the falls. The bamboo raft was strongly & tightly secured to big ropes & was navigated by a very muscled native. I had the coldest, hardest, & most unique shower of my life & definitely got drenched from head to toe! After 5 minutes, we were heading back to the rocks. It was so "bitin". I really wished to go back for round two. Haha! Unfortunately, the muscled man said one round lang. Awww.. After staying at the rocks for another 5 minutes, we decided to go back. It was faster going downstream, less effort for our boatmen because we were going with the flow. It also poured hard on our way back. I was careful with my DSLR because I don't want it to get wet. We got back at the river banks past 4 pm and hurriedly changed out of our wet clothes. We were all happy and we enjoyed the trip. It was worth it!        

E-Records

Yesterday, I had the privilege to be a reliever in Health First Clinic in Shaw Blvd, Pasig for the first time. Just like in any typical clinic, there were consultations and pre-employment medical examinations to be conducted. I was surprised to learn that they strictly use electronic medical records (or E-Records for short) from queueing of patients to charting/documentation to laboratory/ancillary procedure requests to dispensing medications and billing of consultation charges. Thank goodness, I don't have to call out the patient's name because all I had to do was call the operator and page for the patient. Since the clinic has its own pharmacy, I had to enter electronically the medicines I will prescribe then the pharmacists will hand it to the patient. Unless the medication is not available, that's when I do it manually and the old-fashioned way. The same goes for laboratory requests - just type it in the computer, instruct the patient to go to the laboratory. Of course, laboratory results can be viewed in their intranet as well. Not surprising, the x-ray plates can also be visualised in the computer without going out of the room. Previous consultations are also stored in the database as well. Convenient isn't it?

How I wish all clinics have this kind of system in order to avoid clutter, piles of papers/charts in one side of the room, occupying a big space. Imagine the trouble of pulling out 1 chart when you have so many stacked up, piled up.

On the downside, hopefully they have a generator if in case there's power failure. And a back-up system if the system hangs or the computer has been infiltrated by a virus. For our mentors who are not used to paper-less system, this could pose as a challenge for them.