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Friday, April 30, 2010

Who's Afraid of the Pandemic (H1N1) Vaccine?

One with PKD or chronic kidney disease should be aware that he or she has an increased risk of infection especially when end-stage renal disease sets in. It is to be noted that viral diseases like A(H1N1) flu have a tendency to become more severe in patients with pre-existing medical conditions.

Thus I submitted myself for the annual seasonal flu and A(H1N1) flu vaccination yesterday. (By the way, years ago, I had vaccination against Hepatitis B and Pneumococcus following the ACIP or the Advisory Committee on Immunization Practices' Recommendations for Chronic Kidney Disease patients).

Speaking of the H1N1 vaccine, some (non-kidney disease patients) are still afraid to have this vaccine. These include health workers who are at the frontline of patient care who are at higher risk of getting the pandemic flu from patients. It is because they fear this 3 letter word: "G-B-S".

More than 60 million Americans are said to have been vaccinated against H1N1 in 2009 and the number of  suspected GBS cases possibly-related to the vaccine are considered rare.

GBS or Guillain Barré syndrome is a rapidly developing, immune-mediated disorder of the peripheral nervous system that results in muscular weakness.

According to the World Health Organization (WHO),

"During the 1976 influenza vaccination campaign, about 10 persons per million vaccinated persons developed GBS."

WHO continues,"The reason why GBS developed in association with that specific vaccine has never been firmly established. The potential for the development of a similar risk with future vaccines can never be totally excluded. However, pandemic influenza vaccines are manufactured according to established standards, and are similar to recent well-studied influenza vaccines that have shown no association with GBS."


Therefore, no other clear association for GBS has been found with either seasonal or other pandemic influenza vaccines.


The H1N1 vaccine is expected to have the same safety record as seasonal flu vaccine.

However, WHO advises all countries administering pandemic vaccines "to conduct intensive monitoring for safety, and report adverse events".

I do not know about you, but I think I am better off having this vaccine than ending up with H1N1 especially with the return of students coming from a vacation abroad.


Instead of thinking about GBS, I will just enjoy watching Iron Man 2 instead. Iron Man, War Machine, Whiplash and Black Widow...here I come...


References:
  1. http://www.who.int/csr/disease/swineflu/frequently_asked_questions/vaccine_preparedness/safety_approval/en/index.html
  2. http://influenzamonitor.com/2010/01/h1n1-vaccine-safety-guillain-barre-syndrome-less-mysterious-more-manageable-and-very-rare/

Tuesday, April 27, 2010

Is Manny Villar Using Mom?

In yesterday evening's news broadcasts, one can see Manny Villar's 86-year old mom Curita surrounded by family coming out in front of the cameras to defend her son from various allegations. In the same reports, the family was also observed to show their displeasure towards the media.



An ad also came out showing Villar's mom defending her son. These prompted some to react against the move by Villar's family.

What is your on take on the issue? Is Villar using his mother? In allowing his mother to be captured by the cameras for an ad, did Villar make the right move?

Sunday, April 25, 2010

NBA Playoffs: Where Impossible Things Do Happen

The 1st Round of the NBA Playoffs are turning out  to be unpredictable.

So far, many unexpected things have happened.

The Spurs with the playoff-reliable trio of Ginobili, Duncan and Parker are leading the series 2-1 agains the Mavs who on paper appear to be the complete championship-caliber team with Nowitzki, Butler, Marion, Kidd, Terry, Barea and Haywood.

The Blazers tied their series 2-2 even with Brandon Roy unable to play the first 3 games of the series because of injury. Stoudemire played well offensively in Game 4 but his rebounding all series has been poor considering he is a power forward.

The injury-plagued Jazz is putting up a fight against the Nuggets.

The Cavs and Hawks are unable to sweep their respective opponents , the Bulls and Bucks minus Bogut.

Only the Celtics are lucky to have their series at 3-0 with Pierce's buzzer-beating shot in Game 3.

But none of the above outcomes is more surprising  than the Lakers-Thunder series with the record already tied at 2-2.

Kevin Durant, Russell Westbrook and company are giving the Lakers the fight of their lives.

Who would have thought that the playoff-inexperienced Thunder would test the mighty Lakers.

In Game 4, the Thunder won convincingly.

Ron Artest is supposed to contain Durant. He appeared to do so in Game 1. But now Durant is having his way as exemplified by one sequence in the 1st half when Durant drove all the way to the basket amidst Lakers' defenders ending the drive with an authoritative dunk. And it was not just the Durant show.

The whole Thunder team did their share on both ends of the court being more aggressive than their Laker counterparts nullifying the size advantage of the Lakers.

Now the Thunder players who have nothing to lose have gained confidence as well as experience. No matter what happens in the rest of the series, the Thunder showed already that they can place with the best.

And the Lakers wounded and scarred, do not appear anymore to be invincible.

Wednesday, April 21, 2010

Voting off Tim Urban

Finally Tim Urban is voted off. Clearly, American Idol Season 9 contestant Tim Urban was vocally the weakest among yesterday's contestants.  And he was uninspiring during the "Inspirational" theme show.

Even at the start of the live contest performances, he was the weakest and he should have been voted off way before Didi Benami or even before one of my favorites, the very unique Lilly Scott. Urban was like the Terminator cyborg who just doesn't go away easily.

Well, what can I say..."Hasta la vista, Baby!"

I hope the same goes to the "political turncoats" in the Philippines. These turncoats are supposedly the principled leaders of our society.I just hope they will be voted off this coming May elections. It's obvious, their reason for transferring allegiances is self-gain or self-interest.

Also.....If I could just also vote off the pain I am experiencing because of my expanding cysts...It's been 4 days already. It is tolerable though. Good thing there is no hematuria. No fever too. Watching American Idol - The Best of Seasons 1 - 4, may help me forget about the pain.

You know what though? Between voting off the turncoats or corrupt officials and voting off my pain experience.... I would rather vote off the corrupt and the turncoats...never mind if the kidney pain stays.

I can live with the pain, thank you.

Friday, April 16, 2010

Jabbar, Dr. E.M. and Me

Last night was a very difficult evening for a PKD patient like me..... but first...!

Who is a well-known physician in Cebu City that reminds you most of the man in the photo? Of course, everybody knows the man in the photo. He is Kareem Abdul-Jabbar, a legend in basketball circles, one of the NBA's greatest players of Lakers fame.

Clue for the doctor?

He has almost the same features as  Jabbar. He wears glasses. He is associated to at least one movie (Jabbar starred opposite Bruce Lee in the Game of Death, the mystery doctor revealed he had a bit role in a Tagalog movie). and he is tall, as in basketball player tall. And both share the same birthday!

The good doctor is non other than.....(drum roll!)....Dr. Edwin Menguito!


Back to the first paragraph..I mentioned it was a very difficult night for me. Why?

It was Dr. Menguito's birthday and I attended his party and holy guacamole! The food was yummy! There's LECHON.

You know, yummy and lechon are synonymous in my case. and that's the problem..... Lechon is NOT PKD-friendly. Too bad. I don't wanna raise my creatinine further, thank you...

Anyway, there's fish, shrimp, crispy kangkong and fruits, and (c'mon...u can do it) I ate just a little piece of lechon skin.(Ayawg saba..)...Ya, I know...I know.

But I enjoyed the party. The mood was of the 60's and 70's with Ultimate Bee Gees  music and Beatles music being played. Reminds me of my folks and my auntie "Tita Ching" who was a "DJ" in the AM radio DYCB. The music throughout the evening were the same songs you hear as background music of afternoon radio dramas still prevalent in today's AM airwaves.

And I even took home a CD of the celebrant's favorite music. Plus 5 DVDs I won by answering one of the doctor's trivia questions.

When it was time for Dr. Menguito to talk, I learned never before known details of his life. He had a brother who is a priest. And he wanted to be a priest.

Turns out we actually have something in common....

He mentioned he has 3 incurable diseases and we share two.....Hypertension (the one that gave the 1st clue I had PKD) and .....(guess).......(sirit?)............Baldness.

By the way, Jabbar also has the last condition.

Happy Birthday Kareem!

Wednesday, April 14, 2010

Happy Birthday Mom!

It was 29 years ago when my mother had her last birthday. I was 8 years old then and in grade 2. What I can recall is she was already thin and pale at that time. She was still able to attend my sister's graduation day.

She had PKD but I have no knowledge whether she or my father knew that she had PKD. I do not know if doctors at that time knew about PKD. I wonder what year PKD was discovered?

From stories of my relatives though, i think they know she had end-stage renal disease. It was said that dialysis was recommended to her at that time. But dialysis was in its early stage in the Philippines and it was very expensive at that time. It was said that she declined to save our family from economic crisis.

September of that year, she died at a young age of 39. But boy, she accomplished a lot already.

She laid the foundation for us siblings and raised as well. I can remember her putting me on her lap and personally supervising me in my homework. And here I am having her teacher's instincts.

With current advances in medicine and research efforts on PKD, hope has certainly shined among us PKD patients. Dialysis's costs have decreased. And among our relatives on my mother's side, awareness has increased unlike during my mother's time.

I'm sure my mother is watching over me in the heavens..smiling. Happy Birthday mom! You will always be in my heart. I will continue to be brave. I will continue to be hopeful. I will continue to live my life to the fullest.

Monday, April 12, 2010

A face for PKD in the Philippines


It's almost a month now since former Philippine Budget secretary Emilia Boncodin passed away. She was widely respected as a good, honest and dedicated public servant, a model of professionalism and integrity which seems to be a rarity in Philippine government nowadays. I just learned she was a PKD patient.

Below is a link to an ABS-CBN report on Boncodin's demise.

Her life may be relatively short but she lived a full and fruitful life. Despite her condition, she continued to work. A good role model indeed for me and other PKD patients.

I just hope that her death could be a spark to bring to light awareness on PKD. I noticed that in the Philippines, there is still little awareness on PKD perhaps even among physicians and this is despite the fact that Autosomal dominant (ADPKD) is one of the most common life-threatening genetic diseases. It affects approximately 1 in 500 and it does not skip a generation. Perhaps many other Filipinos have this condition and yet, there are no local PKD groups that I know of.

Online or offline, I do not know of any local support group. Many local PKD patients may not be aware that they have it. Or if they are aware, they are still in need of a fellow PKD patient to walk with them in their journey to give them strength.

Without a supportive and "strong" companion, the journey is hard alright.

The meds alone are heavy on the pocket. Potassium citrate to alkalinize urine and prevent stones, antihypertensives, bicarbonate, calcium carbonate, allopurinol, antibiotics to treat or prevent UTI, B vitamins and iron.

The pain in the abdomen and flanks and the other symptoms is something else....The big abdomen...and other manifestations.

However, the journey becomes easier with supportive family, friends and other PKD patients.

The journey is worth taking seeing that some had made their own journey a fruitful one.

Such is the journey made by Madame Emilia Boncodin who now joins the ranks of well-respected and beloved departed public officials like President Magsaysay or Haydee Yorac.

Emilia Boncodin is just the face of PKD that Filipino PKD patients need.

*Classmates, friends, if you know someone with PKD, please let me know. Initially, I want to start an online PKD support group if not a plain group for PKD patients to gather online. Let them leave a comment or an email to this blog.

Sunday, April 11, 2010

The "Walking Style" in Local Newscasting



 It has become my routine to watch the morning shows in GMA 7 (Unang Hirit and Buena Mano Balita) to start the day to provide me with the latest news and updates on local and national issues. Call me a "Kapuso" if you want for it (Channel 7) is the clearest channel that can be seen in our television sets.

As I watched Lou-Anne Mae Rondina and Alan Domingo deliver the local news with a map of Visayas showing clearly Cebu in the background, I can't helped but notice their style of newscasting. If you are observant, you will notice Loa-Anne walking slightly forward and sideways, stopping in front of Cebu's location in the map (a variation of Pia Guanio's walking the catwalk style at the start of delivering the showbiz news in the evening's 24 Oras). The corresponding video of the news report will then be flashed as Lou-Anne's continues to be heard followed by the view of the camera shifting to Alan Domingo walking this time from the opposite side also walking towards the front of Cebu's location in the map with Lou-Anne not already in the camera's focus perhaps taking a few steps backward to accomodate Alan who is occupying the area where Lou-Anne was standing prior.

Then the news video report is flashed and then you see Lou-Anne walking again until she reaches "Cebu" as Alan disappears from view. This goes on as both news anchors alternate.

I could just imagine them going to and fro doing the atras-abante or the cha cha. Too bad I cannot find a youtube video showing one of their recent newscasts.

But walking seems to be becoming a trend in local newscasting as you see also in the afternoon (Balitang Bisdak) newscast, Cecille Quibod doing the walk while doing the talk.

Well is that a sign of being a good physician? (Naks!ubo!ubo!) Having a "clinical" eye on things? Being observant or "himantayon"? Himantayon lang jud.hehe.

Thursday, April 8, 2010

What is it with Wheat Grass?



2 days ago , my wife and I went to Watson's and she bought this Wheat grass product which costs around 30plus pesos upon the advice of some of her friends. Naintriga tuloy ako sa product na ito... I see some posters involving wheat grass even outside our house with Dian Castillejo endorsing the product. Some more are seen on the streets rivalling Manny Villar's posters.

Appearance-wise, when the product is dissolved, the resulting drink is greenish in color and from the taste, you can really tell its a herbal product. I just took a sip though. A chronic kidney disease patient could not just take in anything without knowing the ingredients.

What are the reported benefits of wheatgrass? What does it contain? After doing my research, I found out that wheat grass is actually a young grass of the common wheat plant, Triticum aestivum which contains chlorophyll, amino acids, minerals, vitamins, and enzymes.

From what I understand, chlorophyll is the star ingredient and it is said to be beneficial because of its structural similarity to hemoglobin. (Matanong nga si Dr. Meneses tungkol dito.) It helps daw blood flow, digestion and general detoxification of the body with emphasis on DAW..Bakit kaya di na lang tayo kumain ng damo? Why not eat grass na lang? From the picture wheatgrass and grass appear to be the same. Ordinary grass also has chlorophyll and it's even free.

It appears though that wheatgrass is becoming a hit. My wife seems to be a fan.

Marlene Aguilar Heads March for son Jason Ivler

GMA news reported earlier this AM that Marlene Aguilar-Pollard headed a march in support for the release of his son suspect Jason Ivler joined by a group of their relatives and perhaps friends.

They marched from Aguilar's house in Katipunan to the Quezon City Hall complex, the venue of the hearings on the murder case filed against Ivler. Aguilar-Pollard had vowed to march daily near the jail as long as his son is still incarcerated.

Ivler, is the main suspect in the road rage killing of Renato Victor Ebarle Jr, the son of a Cabinet official. Ivler was transferred Tuesday afternoon to the jail from the Quirino Memorial Medical Center, on orders of the Quezon City court .

Ivler's mother if I recall objected to the doctor's nod for Jason to be transferred to the city jail. Prior to the transfer, Jason was examined by a doctor...Guess what helped convinced authorities that Jason was fit enough to be transferred to the city jail?...Jason was logged on to Facebook and playing military video games.

After my own Good Friday, Back in Action

It was just last week or Good Friday that I had another episode of gross hematuria (with blood in the urine). To recall my prior readings, rupture of a cyst into the collecting system is thought to be responsible for it and urinary tract infection or stress may be a likely precipitating factor. It may possibly reflect a faster cyst expansion.

Anyway, I managed it with bed rest and hydration, in my case, with oral and intravenous fluids. Those days, I got the best care and support from my loving wife who always gives me strength...and the comic relief from my ever loyal but slowly aging dog- Bacter. Of course, I got prayer support from my family and friends. I know God was helping me carry my cross those moments.

No use for being depressed and all.

This week, the Medical Education Unit (MEU) of the Cebu Institute of Medicine (CIM) conducted a seminar-workshop on clinical teaching to Cebu Velez General Hospital residents who are expected to guide the senior and junior clerks during their own rotations. You can see me in the above picture smiling as if nothing "scary" happened to me a week ago. In the background are the residents having their workshop. I discussed one topic on Adult learning Strategy by Knowles and the Clinical Learning Cycle by Cox. I myself got to review these concepts which are very useful in clinical teaching. I particularly liked Ken Cox's clinical learning cycle which emphasizes the importance of preparation, briefing, debriefing and reflection aside from the patient encounter itself to have effective clinical learning. My other colleagues discussed assessment including the OSCE. By the way, for a step-by-step guide on Mastering the OSCE, Click Here!

On the same day of the workshop, at day's end, I got to have dinner with my 2 of my classmates from medical school years whom I haven't seen for a long time. The best part was...the dinner was their treat! Sarap pag libre ano? (lol) ...and yes...they are "more chubby" than me. Hope they don't get to read this blog...

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