Category Archives: Uncategorized

The Bitter Gourds

Some people will remain bitter all  their lives:

> those who have wrong perceptions and always misconstrue other people’s words, so that they can feel good about themselves.

> those who have been banned by successful societies .

> those who are not successful in their career.

> those who are poor leaders, resigned fast and furious because he cannot lead, when asked to clean up the mess.

> those who were not accepted back to become admins.

> those who sided with thieves and scammers.

> those who cannot do what I do.

>those who think that they  are intelligent..but has no proof at all.

> those who have very bad attitude, they cannot see their own bad behavior.

>those who are pathological liars, they do not even know  that they are lying.

> those who have underestimated me, thinking I will never leave them. Tough luck, you are wrong?  I need a public apology.

> Those who have no integrity nor credibility as evidenced by lack of donors and sponsors. It bit you already, can’t you see.

>Good wishes to the backstabbers. My life would have been boring without your “stupid moves”, it has awakened me that some atheists can be really assholes and do not deserve a dime from me.

Ask yourself, maybe you are one of them.

I do not need donation for myself. I even retired early, I did not miss my 6-figure salary and bonuses. My society will survive even if we do not receive donations. Your guess is as good as mine. No need to display  my 1099 and W-2.

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Dentists: Are they for real?

I have been lucky, blessed with a good set of teeth since childhood. I grew up poor so,  I was not able to eat tons of candies and sweet nothings when I was younger. I always  had  ample serving of  green mangoes fresh from a tree, hard guavas, sugarcane trunks stolen from the field in my barrio, fresh vegetables from our backyard garden.  In short, by eating non-sugary foods, I am able to preserve my teeth.

Very recently, however, my teeth are giving me some trouble. Two years ago, I cracked my tooth (molar) while on a Spain trip. I suffered for a while, but since, I am a Filipino, I am stoic and can handle pain better than others. My threshold for pain is something to be desired.

As soon, as I arrived in the USA, I went straight to the dentist. He was adamant to pull the cracked tooth and wants to refer me to a dental surgeon. I practically pulled his arm to remove my tooth at that time, my rationale, why refer when he can do it himself as he is also a dentist. That is double whammy to my insurance coverage! To make the long story short, he pulled it.

Two months ago, I visited the same dentist for a tooth problem with swollen gums. The hygienist said, still looks good but will need frequent  cleaning and flossing. The dentist thought otherwise, he wants to refer me to a gum specialist for tooth removal and replacement with porcelain worth $ 3,000.00 dollars. The price brought some shock waves to my spine. I composed myself and agreed to go to the specialist, nonetheless, at the back of my mind, I was rebelling!!

So I went to the specialist who took some special Xrays with special gadgets and the like. He placed the result in front of me. I did not tell him which specific tooth was to be removed. Guess what, he went to the xray result back and forth about three times because, he could not tell which is the diseased tooth! I have to literally point out to him which one..obviously the tooth is not that bad. I just kept quiet and went along for the ride.  He said, I need to have that tooth removed so that they can replace it with an implant. A porcelain would cost total of $ 3,000.00. I mentioned, I will think about it and will call him for further orders. He said, I should not wait long because, it will  give me a lot of issues..I should go back to him in 2 months.

That was two months ago, I still have the tooth. True, it gives me minute pain once in a while especially when I do not clean it thoroughly, but on the whole the tooth is still viable. It could still last me until I am 98 years old, as long as I go to the hygienist often.

In this story, only the hygienist was telling the truth. She is only salaried and has no ulterior motive to fleece my insurance coverage, while the two dentists are in connivance to fleece my insurance.

My hubby has very bad dentition. He goes to those dentists so often that he must have already paid for their new office furniture and equipments. As for my diseased tooth, I will just continue using my electric toothbrush with religious flossing so it will last me a lifetime. I do not want to pay $3000.00 dollars for a single porcelain tooth, much less, have a new atificial tooth.

Some dentists will not tell you preventative measures to preserve your teeth. If they do, they will have no more clients.

A Filipino non-profit organization in Jacksonville, Florida

 

A small group of thoughtful people could change the world. Indeed, it’s the only thing that ever has.
Margaret Mead

I always enjoy going to nurse practitioner conference annually to quench my thirst for new knowledge, and of course, to see lovely places in America. This time, the venue was in Savannah, Georgia. Would you believe, this is the very first time I came with a buddy? She is a new Adult Nurse Practitioner, still very excited to be counted as a member and still jumping around in the NP arena like a horse newly released from its stable.                                         

It was only last week when I saw a familiar face at  GAPNA (Gerontological Advanced Practice Nurse Association)  conference in Savannah, Georgia. This must be the fourth time that we have brushed  each other’s elbows at different places of medical/nurse practitioner’s conferences. An eerie feeling in Savannah disappeared as soon as I remember her.

Her name is Lolita Massengill, ARNP, clinic Director/President of Legacy of Care Health clinic, Inc., based in Jacksonville, Florida. She is an outstanding, indefatigable profesional who has devoted her life to charity and not for profit clinics for the very poor, disadvantaged and uninsured in her local community. This clinic is run by volunteers, not compensated at all for their time and effort in serving the public. A calling deep seated in their hearts, to give and share  whatever they can to uplift the health care delivery sytem in their local society. It is like something taken out from a book of fantasy, so noble, the little hairs at the back of my neck stand up every time Lolita describes her practice.

Lolita is not just an expert in primary care but also a cheerleader in the development of her staff at Legacy Care. She has developed her staff into independent promoters and speakers, in fact, these volunteers started to be as benign and meek as can be. All of the volunteers, including Lolita are from the Philippines. I presume they have already acculturated in the western world as they have been in the USA forever. I could not remember the exact date Lolita came to the USA. I would think,  maybe in the early 1980’s, or later. I should have paid more attention as to the details of her “Coming to America.”   

                                                                                                                    The patients they serve are diversified and multi-cultural, pretty much like the volunteers themselves. Although, they are all Pinoys ( a street slang for Filipinos), they speak different dialects. They come from different parts of the Philippines, from Luzon, Visayas and Mindanao, the three regions of the Philippines.

It is interesting to note that, Pinoys speak different dialects but we can communicate and understand one dialect, which is Tagalog.  People from any part of the country could at least speak in Tagalog, making it our national language.They all have been united and had come together for a very simple and noble cause : to serve the uninsured. Nonetheless, the purpose of this group is very transparent. It was created to serve the public, the poor, the needy, the people who have nowhere to go medical-wise. For more information go to www.legacyofcare.org.

I would like to belong to a group like this, to create a change in my local society.  I would want to be counted as a change agent. Where do I start? Lolita is my model, somebody whom I look forward seeing each year, to gather more knowledge as to how to start a charity clinic. Will I be  successful like her? Time will tell. For now, I can only imagine and savor the experiences shared to me by Lolita.

The Best Defense Against Viral Infections (Common cold, H1N1, Influenza)

A virus (from the Latin virus meaning toxin or poison) is a microscopic infectious agent that can reproduce only inside a host cell. Viruses infect all types of organisms: from animals and plants, to bacteria and archaea.[1] Since the initial discovery of tobacco mosaic virus by Martinus Beijerinck in 1898,[2] more than 5,000 types of virus have been described in detail,[3] although most types of virus remain undiscovered.[4] Viruses are ubiquitous, as they are found in almost every ecosystem on Earth,[5] and are the most abundant type of biological entity on the planet.     ( from Wikipedia) 

                                                                                                                       Virus abound and are here to stay. They mutate as often as you change your shirt. They are common just like the common cold. We even have viruses in our body, without us knowing it. They are all over. No escape from them.

What is your defense against these suckers? You!

Start physical assessment of yourself. Are you healthy enough to fight the virus? What food do you eat? Or what goes into your system? Picture yourself like a brand new car- When the specification says unleaded gas, do you put crude oil? Do you wash your car at least monthly? Do you overload your car so that all tires become flat?

Just the same, take charge of your body. Eat food only that is good for you. Eat plenty of fresh vegetables and fruits. Some vegetables are better when eaten raw to get he most of its nutrition. Stay away from processed foods like bacon, ham, or anything with preservative. You do not want to preserve your intestines, right?

Fluids are necessary, because at least 2/3 of our body is made of water. Drink at least 8 glasses of water. Water is more important than food. Do you know that you can live longer without food than water? Stay away from softdrinks or any sugared drinks. You need to stay away from anything with refined sugar. Honey, mascubado sugar, maple syrup are alternative to sugar. Better still, stay away from anything sweet!

Sleep at least 7 to 8 hours a day. Give yourself enough rest and sleep. This is how your body repairs itself. While you are sleeping, your body cells rejuvenate itself. Why do you think graveyard shift is called as such? Nocturnal shifts weaken your defense mechanism. In fact, I know of some friends and acquaintances who got sick ( with cancer) because of working at night.

The sun is also important. Vit D that is free for all. There is a study that Vit D helps prevent cancers, however, do not overdo it as the sun will also accelerate aging process and can cause skin cancers. Just the same, take care of yourself. Would you want your car to get burned? No!

Exercise, exercise, exercise. Start by walking, then progress to running or something that can make you perspire. If running up and down the building suits you then do it without ado.

As much as possible stay away from antibiotics. They do not kill viruses. In fact, you are just training your immune system to be weak when you rely a lot on antibiotics. Doctors are not frank and honest enough to tell you that they are not good for you, but rather would prescribe it to keep you coming back or just to keep you quiet.

To summarize, your best defense against viruses is your immune system. You can choose what you want to become.

Get immunized! I get my flu shot every year. It is free of charge from my company and work place. It is a hearsay, that people get sick from the shot.  It has no evidence at all that the flu shots can cause influenza. Do not listen to what other people say about the shots. Do not listen to ordinary people about medical care.  You are better off listening to medical providers. Nurse practitioners are trained especially in disease prevention, so it is best to listen to them!

Take care of yourself just like how you take care of your car so it can serve you well. Do you want a nice car every three years?

Why I do not trust doctors anymore? My sister’s personal experience

My youngest sister who lives in New Jersey suffers from idiopathic anaphylaxis. Her last attack was 2 months ago in May when I had my jury duty. It happened in her jobsite after a meal most probably loaded with the stuff that she is allergic to. The manager at her work place called 911. They do not have epipen, or had it but did not give it correctly so that my niece was called to deliver epipen from home.  Many minutes were wasted at that time alone. Anyway, the epipen came and the EMT injected it in my sister’s thigh. She would not wake up, became very lethargic and eventually stopped breathing, so the EMT decided to intubate her but unsuccessfully because, she was fighting and resisting intubation. When they came to the hospital finally, my sis was being bagged and they tried intubation again. Instead of checking her oxygen saturation level, the ERMD decided to intubate her, of course, she was fighting again and resisting, a clue that she was still awake. The staff gave her diprivan ( MJ’s drug) over and over again until she slept, successfully intubated my poor sister who cannot fight and resist anymore as she was totally knocked out  as if she was in a coma.

She was on the ventilator / respirator for the entire night. According to my sis she was asleep from 4pm to 7am, but could not remember much except when she was fighting with the staff when she was being intubated. The following morning, she felt that both her legs were very heavy, a symptom of rhabdomyolysis (muscle breakdown due to diprivan). The staff summoned the neurologist at her bedside, even he commented, ” they should have checked your O2 sat before intubating you.”  I called that Bingo! They were too aggressive, they should have waited for the epipen to work. She did not need that  intubation!

I was confident enough to say that she did not need the intubation because, she had an episode of respiratory arrest due to anaphylaxis  in my home few years back and I gave the epipen myself, just waited and she was back breathing and conscious without any problem after a few minutes. We called 911 though, just the same, as a fall back position. She was only in the hospital for a few good hours.

Another very recent experience of my sister was in the doctor’s clinic. She was summoned by the doctor, an allergist, for some skin tests, since her blood work was normal. She was given three types of  allergens. Her arms became very red, she became ill, vomited and felt warm all over, eventually complained of shortness of breathing. The MD specialist called 911, informing my sis and her family that they do not have the equipments for emergency and resuscitation. In the meantime, he said that the skin test was negative and my sister was just upset because my niece is leaving for college the next day. The Md suggested that my sis leave thru the back door of his clinic to go with the 911 staff. Of course, that would be embarrassing for his patients to see that he was not able to successfully treat my sister and has to call 911 for emergency services. While my sis was in the ER, the allergist was calling frantically asking about how she was doing. He still insisted that the skin test was negative despite my sister’s symptomatology including laryngeal edema. The ERMD mentioned, it must be “false negative”. She was given solu-medrol (anti-inflammatory) and another epipen in the the ER.

She was home after a few hours, and called me. I advised her to take benadryl  (antihistamine) 50mg as soon as possible, and repeat it in the morning if she still does not feel right.

I am too afraid now to go to the hospital. It is either because of their aggressiveness to charge my insurance or their experience is not very good or plain incompetence. I hate emergency rooms, I know better because, I was a certified ER nurse for 6 years before I became an ANP.

How to release your frustrations

The heart is the reservoir of all emotions: Love, anger, sadness, frustration, etc. etc. You do not want to have a heart attack, so, you need to unload the burden in your heart from time to time.

Some strategies I have learned to release strong emotions from my heart especially frustrations:

1. Scream at the top of your lungs. Whenever I feel frustrated, I go to my room or the bathroom and just scream until all the  steam has been released. I feel better afterwards.

2. Cursing also helps. You let out all bad emotions from your heart. Cuss to your heart content, and feel that release from your heart, but, be sure that nobody is in the room when you cuss.

3. Walk away when you know that you have been defeated. You cannot be wrong and strong.  Accept your defeat and say ” I am sorry”. Asking for an apology is also a release of emotion. You cannot be carrying a heavy heart all the time. Forgive your enemies, and move on. I forgave all my enemies but I still could not let them in  into my kingdom. I stay away from them because I do not want them to bring me down, like the crabs in a bucket!

4. Punch your pillows 100 times and act as if the pillow is your opponent. Trust me, you will feel better afterwards.

5. Divert your attention to something more productive. Go to the gym, take a walk in the park, run around your neighborhood, in short, just do something.

This will release your frustrations and the bonus is you will burn more calories so you will lose some weight without even knowing it. Now, that is the best form of releasing frustrations !

Ways to prevent medical mistakes while in the hospital

Gone are the days when the hospital is considered the best place to get treatment when you are sick. In fact, studies show that medical mistakes contribute to high mortality and morbidity every year in the USA.

There are steps to follow to avoid being a statistic or casualty of medical mistakes:

1. Educate yourself about your illness. The best consumer is the educated consumer. Read about your illness, the etiology, treatment and possible areas of consideration like surgeries, chemo and the like. Choose your doctors wisely, read their credentials carefully.                             

2. Get a second opinion, at all times. A hammer will always see everybody as a nail. So, do not get fooled by the “words of doctors”. They also make mistakes and may prescribe treatment based on their expertise. I had a lump in my left breast long time ago, the surgeon wanted to do surgery right away. I refused and seek another option/second opinion. I went to an MD of different specialization ( the breast), she just did a needle biopsy and everything went well, until now, the lump has not recurred.

3. Look up your medications in the internet and study the side-effects yourself. If the side-effect is worse than the effect, why take the drug? There are deadly side-effects that your doctor might not tell you. Some diseases do not need heavy dose drugs. Some patients die from side-effects also especially the very young and the very old. Still, it is better to know what you are taking. It is better for you in the long run, trust me.

4. Have a friend or relative by your side when you are undergoing sedation/anesthesia. Hospital staff will never accept their mistakes when worse comes to worst. They can make differential diagnosis in a rush just to cover their tracks. I used to work in the ER of a level one city hospital for six years.  Doctors and nurses are so busy that errors were always made. Needless, to say some patients became sicker or have been statistics to medical mistakes. It is very difficult to pinpoint who made the mistake in a hospital setting. When the blame game starts, the patient is always on the losing end.

5. When you are hospitalized, be sure to learn your nurse’s name or CNA’s name.  Most of the time, it helps to let the staff know your credentials, they will be more careful with their tasks with you. Let them know you are not an ordinary patient. it will make them tiptoe and watch their moves. When I was hospitalized in a very prestigious Queens hospital, I was shocked to learn some staff being disrespectful to me. The RN just asked me whether I spoke English. Well, I look and act “Asian”, so I must not speak English. When I informed her that I was an NP, she apologized right away for her behavior. From then on, I got a better treatment. The CNAs were nonchalant, they do not care who you are actually. I overheard them saying that they are just in this job for the “paycheck”.  I can interact with them, call them, let them know my needs, yet, the treatment is somewhat substandard. How much more if the patient is a lay person or in a vegetative state? Will there be somebody watching over what they do to these poor people?

6. Mark your body part to be operated on. A few instances happened when the non-diseased part have been removed. These were documented instances: wrong amputation, wrong breast removed, wrong side of the brain operated on. The outcome is devastating, especially for the wrong side of the brain, the patient came out in a vegetative state. You do not want to be in that predicament all your life: a living dead!

Aging: Very few things are beyond our control

I am not ready to look old yet. My patients told me I only look 29. To tell you the truth, I look and feel better now than when I was 35 years old. My secret: I work only one job now, plenty of sleep, stress management, maintain my weight thru wise food selection, moderate exercise ( I exercise a lot at work because I use the stairs all the time instead of using the elevator. This is my daily exercise.) Funny, but this is true. I used to belong to fancy gym memberships which i do not even use. Now, when I get the chance I go to my basement to get a real good work-out. Otherwise, stair climbing works for me.

My best secret is being happy despite any circumstances in my life. I was happy even when I was single, but happier now that I am married.  A  lot of love also helps in staying young. Studies show that married people have better longevity than single people. So, if you are married, plan to stay married all your life. It does not hurt to have a partner in your bed when you sleep. Kissing before sleeping is also very healthy. It gives you a goodnight’s dream and better REM (deep sleep). That is the time when you renew your body cells thereby, strengthening your immune system.

Kindly click on the link to give you a better perspective on how to avoid the aging process or at least slow it down. I have been practicing a few of them even before I found this link. Remember, you only have one life, one body, and you need to take care of it. Good read and good luck!

http://health.msn.com/health-topics/caregiving/end-of-life/articlepage.aspx?cp-documentid=100194876&page=1

Life’s important Lessons: Simple things, the right spouse and Giving

What a person learns and leaves is as individual as his fingerprints. But I found some heartening insights into common themes in this new research from Priceless Legacy, a company that turns interviews with older adults into life stories in print or video format. An analysis of its projects shows that the top five life lessons shared by people ages 65 to 104 are:

  1. The simple things matter most.
  2. Humor and time cure most pains.
  3. There’s more satisfaction in giving than getting. Service to others is the most satisfying activity.
  4. Choose your spouse carefully. It will be your most important decision.
  5. Work hard and in a field or role that you enjoy.

I am very pleased with the above lessons. Amongst the interviewees, nobody mentioned about money and success, thus, shows that they are not that important in life. What is important are the simple things in life, ie, walks in the park, eating your favorite food no matter what it is, cuddling in the living room, hugging and smiles. A lot of smiles will win you friends, and it will ease up your day. I smile a lot, and  people really smile at me back. I am sure they did not think i am funny looking, but genuinely give back a smile or two. Smile cost nothing yet it gives you so much. Try it sometime and you will see the results!

Time heals all wounds is an adage that connotes, all things shall pass, just be patient. Laughter is the best medicine, in fact in some countries, a laughing session is being  practiced to promote health.. So let us start laughing now. HAHAAAHHA!

I started giving when I was in high school. I was poor so  the only thing I could give away were answers in our exams. Boy, I had a lot of classmates who have benefited from this. Now, that I can afford to give away some money, I see to it that I give especially to people whom I know are in dire need for food and some basic needs. I have also helped people who want to go abroad, or open some  business.  There is joy in giving. When I retire, i plan to volunteer also.

This is my favorite life lesson: choose your spouse. I have chosen the best spouse in the world. I am married to a wonderful human being, not because he is generous but because we are in love with each other. Love is very important. You should marry for love, security is only secondary. No amount of money can make you happy, but love will. However, love and happiness should come from within. You need to love and be happy with yourself. If you do not, who will ever love you? Do not expect anybody to make you happy either. You are the only one who can make yourself happy.

There was no mention about offspring or children as important in the study. It only proves that children are not important either. In fact, some people admit that their children are creating a lot of problems for them. You will never know how your kids will turn out. Lucky for some their kids are great, but could be their worst enemies, too.  So, do not brag if you have children because the study above just confirmed that they are not that important.

What is most important is that you believe in yourself. Do what you can do now for yourself and  mankind, for you will not pass this way again.

Believe in yourself. Who will ever believe you if you do not believe in yourself?

 

Why drug addiction is rampant in the USA (My personal experience)

The latest death of a movie star has stirred the medical world again. Who should be blamed for this actor’s death? The prescriber or the actor?

The medical and dental practitioners in the USA have a bad  habit of prescribing narcotics to their patients for simple pain.  When I had  pelvic fractures in 2004 due to an MVA, the medical intern was literally forcing me to take his prescription of Vicodin, I said, tylenol is fine for me. He said, “you are the only one refusing narcotics.”  I prescribe myself, so I know the dangers of  narcotics.

When my hubby had a tooth extraction last week, the dentist ordered Vicodin . He went to an MD for some rotator cuff injury in the same week and the doctor also prescribed a narcotic Tylenol # 3 (with codeine). If I did not know any better, my hubby could have ended up a drug addict because both medications are hightly addictive. If I were a layperson, my hubby could have taken both medications for different types of pain and can end up easily six feet below the ground.

When my hubby and I went for a cruise in 2006, I heard two prominent doctors talking about how difficult it is to practice in the USA.  Both are pain management specialists and they both agreed that it is like “pushing drugs” to patients who complain of pain. The patients themselves are also asking for narcotics even before trying a lesser kind of analgesics. The big problem is that, most people in the USA can not and will not tolerate pain. They would like to treat pain before it occurs. Their tolerance to pain is zero.

My 55-year old patient recently just died. I educated him about the dangers of polypharmacy. He was on methadone, Roxanol, ativan, MSContin and numerous medications for his co-morbidities. Guess how he died? Your guess is as good as mine.