Pasasalamat

Naka-isang taon at kalahati din ako. Hindi gaano katagal. Pero busog naman sa karunungan, sa kaibigan at syempre kasiyahan. Pag nagsimula ka sa kahit anong trabaho, pakitang mahiyain muna. Conservative ang kilos, nakikiramdam sa mga tao sa paligid. Mahirap humirit agad, baka masabihan ng feeling close agad. Nung unang mga lingo ko, talagang animo'y mahiyain ako. Konti lang ang salita, hindi masyado umiimik. Isang tanong, isang sagot. Sa mismong trabaho naman sa loob ng laboratoryo, todo ang pagiging seryoso. Syempre kelangan magpa-impress. Maliban sa sobrang aga pumasok, dapat mabilis ang pag-iisip. Dapat matalino. Bago e, dapat impressive! Napapa-aral talaga ako pag uwi ko. Hindi naman sa pagmamayabang pero reference lab nga kasi. Mataas ang standard. Kaya kahit ilang buwan na akong nagtra-trabaho e parang first day ko pa din. Mahirap ang naging transition ko. Mula histopath tapos mircobiology. Tsk tsk... Sa staining lang ako nakaka-relate ng konti. Haha!

Sa mga katrabaho naman, nag-adjust din. Iba-ibang tao, iba-ibang personalidad. Merong malakas tumawa. Merong mahina lang. Merong makulit, meron din sakto lang. May maingay, at may... mas maingay. Madali lang naman silang pakisamahan. Iba-ibang tao na merong iba't ibang personalidad pero may dalawang hilig lang naman kasi. Pag nalaman mo yung dalawang hilig nila na yun e parang nahuli mo na ang kiliti nila. Ang una, pagkain. Ang pangalawa, mas madami at masarap na pagkain. Kaya pag lunch break, ang saya! Pinagbubuklod ng kainan na may kasamang kwentuhan at halakhakan. Minsan nga may halong chismis pa. At minsan, hindi ako maksabay kung tunay na buhay na ba ang chismis o yung napanuod lang nila sa telenovela nung gabe. Tapos patong-patong na kwento dahil nagsasalita ang lahat ng saby-sabay pero mauuwi naman sa sabayang tawanan. Walang kapantay 'to! Mas masaya pa 'to sa pinaghalong Goin' Bulilit at Bubble Gang (Kung may edad ka na, mas masaya pa 'to sa pinaghalong Going Bananas at... student canteen siguro! haha!).

At kung personalidad din lang ang usapan, e talagang nagsta-standout ang lahat. May madaldal, meroong naman malakas ang boses, merong bibong-bibo, merong pasaway, may balidoso, pero lahat siguro maingay o makwento. Lahat mahilig kumain pero konti lang ang marunong magluto. May designated kusinero pa nga kami e. At gaya nga ng sabi ko, iba-iba man e solid naman ang samahan. Kayang-kaya ko sabihin na nagustuhan ko naman ang pakikitungo ng bawat isa. Ang galing nga nila e, napasayaw (kung maitatawag na sayaw) nila ako ng gwiyomi nung anniversary ng program sa Bayleaf Hotel. Walastik, sobrang hiya ko nun.

Ang mga ilang di ko makakalimutan na nangyari sa labas ng laboratoryo e yun mga kakaibang outing namin. Yung unang outing na nasamahan ko sa Laguna, nagulat ako. Mahigit 15 kami nun pero parang pang 4 na tao lang yung pool! Ang kakaiba din siguro e yung baon namin. Kung ang usong baong ulam sa outing e ang walang kamatayan adobo, sila ay sinigang na baboy ang dala. Hanep! Yung pangalawa naman nung Christmas party. Sumakay kami sa shuttle/bus nung institusyon namin. Dahil nga siguro gobyerno at nagtitipid, e parang pwede na dalhin sa junk shop yung shuttle. Hindi ko malilimutan nung umusok yung shuttle ng amoy nasusunog na goma sa SLEX. Ang kapal ng usok, ang baho at dumidikit sa damit.hehe. Iniwan na lang namin yung shuttle sa police station at binalikan kinabukasan. Pero ang mas nakakatuwa e yung sigla ng grupo na hindi nawala. Sumakay kami ng dyip na pampasahero. At imbes na ma-bad trip e lalo pa kaming nagkatuwaan. Gumawa pa nga kami ng laro sa loob ng dyip at sinali pa yung ibang pasahero na hindi naman namin kilala. Adventure din na matatawag yung lakad namin sa Siquijor at Dumaguete. Mahabang kwento 'to. Basta sobrang saya din. At walang aswang sa Siquijor! Ang dami ngang dayuhan na pakalat-kalat e. It's more fun in the Philippines!

Madami talaga akong natutunan, lalo na sa Microbiology. Ang dami naming nasalihan na EQAS. Meron sa Hong Kong (4 na beses sa isang taon), meron sa Salmonella, at meron din sa gonorrhea. Yung kaalaman mo bilang Med Tek, talagang lalawak ng husto. Nahirapan talaga akong sumabay dun sa galing nila. Siguro nga kahit papaalis na ako e hindi ko pa din naabot yung standard nila. Advance na kasi talaga, pang reference lab na talaga. Kaya kung nasa microbiology ka man ngayon or hindi at gusto mo ng training, dito kita i-rerefer.

The Transition

Change. It is the only thing that is constant in this world. In a field like Medical technology, we always tend to search for improvement. Looking for new discoveries, researching something new in healthcare, and finding the latest technologies and updates. As a professional, we are never satisfied so we broaden our horizons, open our minds and look for something not necessarily better but something great.

I have worked inside a clinical laboratory ever since I graduated college and passed the boards. I decided it's about time to try something new and challenging. From being a phlebotomist to a rotating Med Tek staff to a Histopathology staff to a Microbilogy staff (reference lab), I might say that I made it to all the corners of a clinical laboratory. And so, I sought for something different and new for me. Hence, I found a challenge and accepted it.

Perfusionist. Wikipedia defined it as "a specialized healthcare professional who uses the heart-lung machine during cardiac surgery and other surgeries that require cardiopulmonary bypass to manage the patient's physiological status". From the clinical lab to the cardiovascular OR. To be honest, I would see myself more as a researcher working for a private company rather than a perfusionist. After all, the latest job I had was at a reference laboratory in a research institution. It's going to be a big transition for me. That's for sure. But just like any other Med Teks, we adapt. It's in our nature. For example, if there's no more reagent for our machines, we do manual. If there is less supply, we make sure it's enough until the next delivery. If there's few syringes left, we make sure we never miss an extraction. It's in a Med Tek's DNA: the ability to survive, the ability to change and the ability to be better.

Facing a new phase in one's career is nothing ordinary to a Med Tek's life. You take a new course, you learn and you grow. Switching from one job to the other is difficult, it's probably harder if you're going abroad.  It's hard to make a change. It's even harder to resign and make a resignation letter. It is a process, as one of my colleague would say. Transitions are never easy. But it would be great and fulfilling if you could overcome it. I guess as I start a new path in my career, I would use all the skills and knowledge that I acquired from my past experiences. As a Med Tek, I have always believed that it is innate to us that we are always ready for any changes or transition.



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*Shoutout to ARSRL (Antimicrobial Resistance Surveilance Reference Laboratory) of DOH-RITM! Thanks for sharing your knowledge, thank you for all the laughter, thank you for all the adventure, and of course, thank you for all the priceless moments! Thanks for the memories guys!

Stocks are down... A good time to invest?

I almost had a month of silence. No post for my blog this June. Well, as you have read my last post, I just felt a little discouraged and depressed after the incident that happened. I just didn't feel like blogging about healthcare pros. I guess we just have to move on.

Speaking of moving forward, the stock market is moving... backwards?! Well, if you have been watching the news lately, you already know that the PSEi is down. The usual explanation they give is that foreign investors are massively selling. What does this have to do with medtek101? Nothing really. But I did wrote a couple of post that invited my fellow Med Teks to invest in the stocks. My stand now with the stocks going down is still the same. Invest wisely. Experts are even saying that this is the best time to buy stocks because market prices are cheaper. Again, make your own research or ask some people who you believe knows about these stuff. If you have a financial adviser, the better. Happy investing!!!



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Disclaimer: Investments involve substantial risks. Medtek101 and/or the author of MedTek101 does not make any guarantees or promises as to any results obtained from reading this blog. The reader should not make any investment decision without consulting his/her financial advisor or conducting his/her own research.

A disappointing return

Last week, I returned to the government hospital where I had my Med Tek internship. We transferred a relative who will undergo a possible brain surgery due to a traumatic head injury. Being back after five years or so, I could say that the hospital had a very few improvements. Not much renovations I should say. The quality of service is still far behind from that of a private hospital. It might seem unfair if I compare government and private hospitals but does it mean that our less fortunate fellow countrymen should be deprived of an excellent quality service? If I would not compare them, then it is as good as saying that the government should not improve the quality of healthcare services and hence do nothing.
Before I give my opinions to this matter, I'll share some few things that happened in the ER, in the OR, and the ward. First of all, I want to mention that the government hospital is a tertiary hospital with approximately 300 bed capacity which is located in Manila. (DAY 1) At the emergency room, we were endorsed to the neurology department but later transferred to the ER surgery department. They were evaluating our relative and after the evaluation, the doctors did not bother to tell us what's going on. We were asking nurses, and doctors as well, but we seem to be invisible to them. Of course, we got a little bit anxious and just like any hospital, they immediately respond to anxious relatives. They told us that they needed to run another set of exams, x-ray and CT scan. After these tests, they concluded that surgery is needed. They gave us a list of medicines needed for the operation. We bought it and gave it to them and they told us to wait outside the hospital until the operation was done. When the operation was done, we still could  not see our relative, even when she was transferred at the ICU. And yes, we were still outside the hospital waiting to be called in case anything was needed. (DAY 2) When she was transferred to the ward, we finally saw her. After 24 hours of staying outside the hospital and restlessly waiting if our names would be called, we were finally able to go inside the hospital. The ward was clean, as they claim it. The small cockroaches freely crawling around the ward would say otherwise. Nurses can be frequently seen, I guess the RN heals project of our government has proved its efficacy. I do hope that they are compensated justly. Ironically, the response of the nurse's station is slow. Frequent follow-up is needed.
But the slowest response became the fatal one. (DAY 3) It was around 2 a.m. when we told the nurse station that the patient seems to have difficulty in breathing. The nurse in charge claimed that she already called for the resident doctor. As we have timed it, the doctor came more than 1 hour after we reported that the patient seems to have trouble breathing. After a few minutes after the doctor came, our relative was pronounced dead due to cardiac arrest probably secondary to acute myocardial infarction (heart attack).
The doctor did not even had the courage to explain what really happened. We only found out that cause of death was cardiac arrest secondary to AMI when we had the death certificate.  
I don't know how to start and give comments about this matter. It's hard to separate your professionalism from your own personal experience as a patient's relative. I will try to be fair in choosing my words.
First, doctors or any health workers for that matter should be fair to all types of patients: rich or poor, charity patients or paying patients, indigent or not. It would also be easing for the relatives if doctors would talk them and give them an idea of what the patient is going through. Being uninformed makes the patient and the relatives restless. ICU and OR are restricted areas of the hospitals. Its sterility have to be maintained. But I have to point out that it would be decent if there is a proper waiting area for the relatives. "Cleanliness is next to godliness" as the saying goes. For crying out loud, it is a hospital. Being clean is not an option. It is a must. And get rid of your pest problems. I was actually pleased with the performance of the nurses especially the ones in the RN Heals program. I got nothing but praises. Finally, the biggest issue here is the response time. I don't know how many residents are supposed to be monitoring the wards. But all I can say is either the doctor is trying to revive another patient during that time or the doctor is simply negligent. It is your duty to save people's live. You made an oath, not the patient's relatives nor me. I have to strongly address that being late for more than one hour after being informed is unacceptable. 
Going back memory lane and meeting old friends brings smile. Losing a loved one in a hospital you used to work for bring tears. Not just ordinary tears. These are tears of sorrow, tears of anger and tears of disappointment. I was hoping for something great when I re-entered that hospital especially after seeing some  good old friends. But the story was different, there might have even been some patient negligence. It was a disappointing return indeed.
To all my fellow Med Teks and health workers, please treat every patient with utmost respect. Never mind if the patient is paying or indigent. Always remember that the patient is someone's relative, brother, sister, mother, father, best friend, family, or a loved one. To all the nurses, Med Teks, health pros and doctors to that government hospital that are giving their best everyday, thank you and job well done. To a certain Dr. G of that hospital, may you always sleep well at night.        

Dedicated to our Ate Helen... May you Rest in Peace!

Evangelina "Ate Helen" Barroso (06/06/1950 - 05/15/2013)

Pic na naman?

Isang post na walang kinalaman sa pagiging Med Tek pero napapanahon naman. Pansin ko lang... Ang daming tao na ang hilig kunan ng litrato ang sarili. Animo'y tuwang-tuwa sa mukha. Ang daming solo pic! Mahal na mahal yata ang sarili. Hindi pa nakuntento at sige ang bira sa pag-video sa sarili. Hindi pa kaya sila nagsasawa sa kanilang imahe na nakikita naman araw-araw mula sa pagising sa umaga? Syempre maghihilamos ng mukha sa harap ng salamin at sa paguwi ay magsisipilyo bago matulog sa harap ulit ng salamin. Tapos meron din syempre yung sa pagitan sa tuwing bibisita ka sa banyo o di kaya'y magrere-touch ng make-up kung kababaihan. Walang sawa na nakikita ang sarili pero kukunin pa din ang digicam o ang cellphone o tablet at walang habas na kukunan ang sarili. Gagawing wallpaper ng telepono, profile pic, ikakalat sa facebook o kaya'y mabilisang upload sa instagram. Ayos! Galing kasi ng teknolohiya e!
Dati kasi... Nung panahon ng betamax... Mahilig lang kumuha ng litrato yung tao pag kasama ang pamilya o mga kaibigan. Hindi uso ang solo pic. Maliban na lang siguro kung dalawa lang kayo. Pag may espesyal na pagsasalo-salo, handaan, pista o madalas pag birthday, dun maraming kodakan. Pwede din naman yung bakasyon o gala lang sa kung saaan. Maliban sa maiiwang magagandang memorya ng isang okasyon o handaan, nakakatuwa din na may maiiwang mga litrato para sa araw na gusto mo maalala.
Hindi naman sa naiinis pero siguro nakakairita lang. Bawas-bawasan lang ba... Maganda na din yun para makalaya ka naman sa cellphone mo paminsan-minsan. Baka kasi nagsasawa na yung gadget mo sa kaka-picture at video mo sa sarili mo. O di kaya'y sawa na din yung iba sa mukha mo. Konti lang siguro na diversity. Magsama ka ng kaibigan, ka-tropa, kapamilya, kapuso, kapatid para maiba lang. Opinyon lang naman. 

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ESBL producers

Extended Spectrum Beta-Lactamase (ESBL)

The picture below is a method to detect ESBL producers by using disk potentiation technique. Aztreonam (ATM 30ug) disk and Amoxicillin/Clavulanic acid or Augmentin (AMC 30ug) disk are placed 1.5 cm apart on a susceptibility plate. Incubated for 18-24 hours. Positive results can be seen as shown exhibiting a "keyhole effect" between Aztreonam disk (ATM) and Augmentin disk (AMC). *A keyhole effect can also be seen between Ticarcillin/Clavulanic acid (TIM) disk and Aztreonam (ATM) disk.

    * I will try to upload more (and better) pics of ESBL positive screening results.

ESBL are enzymes derived from mutations of TEM-1, SHV-1, capable of hydrolyzing extended spectrum cephalosporins such as cefotaxime, ceftriaxone but not cephamycins such as cefoxitin and cefotetan. These may be present and detected among enterobacteriaceae.

ESBL detection is very important in the surveillance of antimicrobial resistance. In 2007, CLSI (Clinical and Laboratory Standards Institute) recommended that all confirmed ESBL-producing strains should be interpreted and reported as resistant for all penicillins, cephalosporins (except cephamycins and Beta-Lactam/Beta-lactamase inhibitors, carbapenems) and Aztreonam regardless of in vitro results. This means that back then, an aztreonam with a zone of inhibition of 25mm, which is suppose to be susceptible, would be reported as resistant if confirmed as an ESBL-producer. But in 2010, these was changed. All results of confirmed ESBL-producers should be reported as is. This is still the recommendation up to now.  




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