Community Medicine!

This was the reflection paper we submitted for the Department of Family Medicine regarding our first community immersion at an Aeta community in Floridablanca, Pampanga, and I just thought I had to share it on my blog. This was just a short write up because we were just given a maximum of 10 sentences to express ourselves. Now, that was a feat!

REFLECTION PAPER

(Community Immersion in Nabuclod, Floridablanca, Pampanga last July 2, 2016)

GROUP 5 JBLMRH PGIs

On a one sunny Saturday morning, we, the post-graduate interns of JBLMRH were given the chance to be exposed in an Aeta community together with the other residents and consultants of the Department of Family Medicine. The scorching and seemingly relentless heat of the sun did not stop us from seeing and reflecting on the real situation of the health care of our brethren residing in the mountains. The alarming situation with regards to the accessibility of health care among these people badly needs to be taken into account by the government and private sectors altogether.  As agents of change, we must mobilize everything in order to make the health care system become more accessible to them.

Aside from being able to sense the problem regarding their health care system, the interns were also able to experience first handedly how simple life can be, away from the technological advancements and advantages of the fast-changing and demanding world. It’s a scarcity nowadays to see people talk to each other not holding their phones on their one hand, and a rarity to see a family who collectively works hard just to get by each day, which is seemingly in pure contrary to the world where most of us want to have everything served on a silver platter. In a reality where most people seek for greater, but less superficial things, we hardly see genuine satisfaction.

That one-of-a kind community immersion we had last Saturday was something we don’t get to experience everyday in our social media-documented world.However, we realized that their simple, less colorful, and less festive world may somehow not be Instagram ready for some, but everything there cannot be more visceral, more tangible, or any less exciting than the next filtered photo on our Instagram feed.

Taking Chances

I have been staring blankly on this document, thinking how would be the best way to start this blogpost. It seems like I am lost for words, when I know for a fact that I have so much things in mind that I badly need to put into writing. I know this may sound as yet another blogpost about love, about a loss in particular. I am again to retell to the world a very typical love story which had a not-so-happy ending, how I lived my life past thru the heartbreak, and how I dealt with it with much pain, notwithstanding the fact how it prevented me from forming a new one, which maybe the reason why I am still single right now, or haven’t dated anyone exclusively after that breakup.

Once upon a time, I loved someone, and I felt loved. The days were you just couldn’t get off your phone because you constantly wanted an update from him, as he was to you, had been a thing of the past. You went out together, spent quality time with closest friends and family. You built your dreams with him, and naively made dreams for the both of you for the coming future. You were always in cloud 9. You felt that you are strong enough because no matter what would happen, there will always be that person aside from your family, who believes in you unconditionally. Being in a long-time relationship has been something that I enjoyed for the past couple of years-something that I never expected at all- to think I just met this wholesome guy from Grindr (such a paradox). I held on to every promise he made- I treasured each memory, each place we went to together, each kiss and hug. I never would have imagined that time will come that he would be soon leaving me, yet alone again.

Our relationship may have ended prematurely, but I believe it has been a nurturing one. I was able to experience so many things because of him- I got to go to places, receive gifts and letters on special occasions, and most importantly, I was able to make more mature decisions in life. I suddenly transformed from a typical, very naïve and innocent guy, to a more mannered, reasonable, and selfless man.

I have been single for 10 months now. And I am not going to deny the fact that I kind of miss the feeling of being in a relationship once in a while. I have met a couple of men after the break up and not a single date survived. Maybe because I feel like I wasn’t yet ready to form another lasting relationship with somebody. I wasn’t sure if I can handle another break up, or another failure at that.

I was able to meet my ex-partner 3 months ago personally after the break up. He was so wrong when he told me that I have moved on that fast-maybe because I never gave him the slightest clue that I was still struggling that time. Surviving a breakup from 3 year-old relationship is easier said than done. I thought I was ready to fall in love again- I tried, but to no avail.

I read somewhere across somebody else’s blog that there are 3 types of persons in this world. Runners who flee; Watchers, who sit on the sidelines; and Risk-takers, who commit.

Runners are afraid of failing or getting hurt. They fear the challenges that commitment brings, and so they run away. Watchers are the fence-sitters, also afraid of failing or getting hurt, but are fascinated by those who are in the game.

Runners and watchers may never get hurt, never experience pain, but they will also never experience the thrill, the joy, the exhilaration of succeeding. Risk-takers get hurt, they get wounded, and they can in fact fail, but they’re the only ones who know what true victory and triumph mean. And they’re the only ones who will truly know what falling in love with another person or with life truly brings.

I guess I am being a runner now. I crave love but I never let my walls down to love someone. I crave intimacy but I shy away when someone shows me affection. I crave permanence but I end things before anything took root. I detest getting hurt but only let myself find love in doomed places. I am the largest walking contradiction I know. I am a coward.

I long for the day that somehow, I am willing to take chances again- that I can finally get out from the ghostly memories of my past, and be willing to commit myself fully to another relationship, whatever it takes.

My Rhinoplasty Journey

I may be one of the first few people who has the audacity to tell to the world that- yes, nagpagawa ako ng ilong! Haha :p I don’t want to sound like bragging or super proud of it, but when I am being asked, I politely just tell them the truth. I had been longing for this rightful time to come ever since I was quite young, and it finally came. So the big question was this- when did all this yearning to have a rhinoplasty start?

Basically, I had been dreaming to have my nose surgically altered since when I was in my highschool years. My nose was actually “ok” during the pre-rhino era, it has a bridge (thankfully, allowing me to wear eyeglasses without them sliding down on my face!), but the problem lies on my big alae (the lower part of the nose, enclosing the nostrils) and a not so pointed (or rounded at that) and unrefined tip. It always looked big in pictures whenever I flash on my million dollar smile. Honestly, it’s really not that scene stealing, but I was really annoyed by the fact that my face would have looked much better had my nose been in proper proportion with my face. But, being on my highschool year (a minor at that) left all my dreams for my nose hanging and suspended in midair temporarily until I reach the rightful age, time, courage, and of course, the resources which are all needed to make this dream into a reality.

I actually never thought of having a rhinoplasty this soon not until my senior year in medschool. Maybe all the tortures and rigors of clerkship made me into realizing that I needed that much needed make over whenever I see my reflection in the mirror every after a 36 hours duty. I wanted to reward myself after graduating. And instead of asking for a huge and special present for my graduation, I, without having second thoughts, asked for this one.

Of course, one of the perks of being in the medical field is that you get to enjoy some privileges- like discounts on professional fees. I was referred to a plastic surgeon by my mentor/friend general surgeon-who happened to be the first person I confided in about my plans of getting a rhinoplasty. I had my pre-op consultation a month before my graduation and had everything scheduled indefinitely after the supposed grad date. However, for the scheduling part, it didn’t help that the plastic surgeon had to go on a vacation leave for the whole month of May (I originally planned to have it on the first week of May), leaving me with no choice but to have the operation scheduled on the day after my graduation-yeah right, I missed all the fun that I was supposed to enjoy on the night after the ceremonies- I was even put on NPO (nothing per orem, meaning you are not allowed to eat and drink anything the midnight before the operation), and that really sucked, but I have to deal with it, tiis ganda as they say.

So on the morning of the 29^th of April, my rhinoplasty dream became a reality. The operation went well, lasted for approximately 3 hours. It was really weird at first, because I am used to seeing patients on their OR gowns as I lay them gingerly on the OR bed- this time, there had been switching of roles. I never thought of it at first not until I was lying in there, with my eyes wide open, looking directly to the overhead OR lights, the sound made by the pulse oximeter, the smell of cidex, etc. It was pandemonium! Thankfully, the Midazolam tablet (yes, I swallowed not half, but the whole tablet, haha) worked its wonders immediately. Everything was only under local anesthesia (well you basically have a choice to have everything being done while you are fast asleep, with the help of IV sedating medications, but that would entail another added cost as you are going to have an anesthesiologist added to the team, and would cost you around an additional of 15-20,000 pesos. So, yeah, I could pretty handle myself well.haha)

In the immediate post-op, as expected, there was a little bit of pain, albeit tolerable. And you have your painkillers with you so that wouldn’t be much of a big deal. However, it was the breathing part which made everything worse, due to the fact that I now had narrower nostrils (they did an alarplasty, google on it) and there were packings and tapes all over my face which blocked all my chances to normally breathe through my nose. I wasn’t able to talk properly (as expected), and my lips were drying out because I was left with only my mouth to breathe. Everything was working perfectly fine then, so I breathed a sigh of relief and told myself- ‘finally, it’s done’.

Facial swelling became much worse on the 2^nd-4^th day, and there were occasions that when I inadvertently lean forward (a big no no post-rhinoplasty), there would just be bleeding all over. It was frustrating and alarming at first, but I got used to it. So I desperately tried to live my life in normalcy as days went by.

Probably, the only thing that I failed to fully comprehend before I decided to have rhinoplasty was the downtime after the surgery. Surely, there had been some minor improvements from the day of the surgery up until today (I’m on my 5^th week post op btw). However, the changes were not that drastic prompting praises-well, just yet. I naively thought that the effects of a nosejob can be enjoyed right after, if not, few weeks after the operation. I was wrong. The literatures/books (and even my surgeon) say that the full effects of a rhinoplasty won’t be evident until 6 months to a year after surgery, for the swelling, especially on the tip part (I had tipplasty btw), would resolve for a longer period of time. In fact today, it still feels hard and looks unrefined, and I can’t even touch it because it still hurts. And now the bulbous tip ruins everything whenever I smile because it looks odd and unnatural. Perhaps, all surgeries have their downtime, and cosmetic surgery is not spared on this. I can safely say that my rhinoplasty journey hasn’t officially ended just yet.

So for now, I try my very (very) best to remain patient and see if the rhinoplasty will deliver its promises. Some people who know me personally may be asking why the heck have I subjected myself to this procedure when my nose was basically ok to start with. Believe me, I have asked this question a couple of times already, and I always end up with a quite perplexing yet a reality-based answer. “It was in my bucket list”, I told to them. “I wanted to fulfill that dream of having a rhino for once in my life. I don’t want to die with what ifs.” It may really sound cliché-ish and unconvincing, but I really wanted to look and feel good-for myself, not to please others. I did not do this to fit in in a society where everything is judged based on how you look. I was just fulfilling a childhood dream, and I thank the good Lord that stars have aligned to finally turn this dream into a reality.

PS: I won’t be posting in here the cost of my rhinoplasty experience (btw, I had an Open Rhinoplasty, with Tipplasty and Alarplasty) But just in case you wanna know, please comment here and I will respond. Hope this blogpost helps those who are planning to have rhinoplasty soon. God bless you on your journey!

This was me pre-rhino era. As you can see, the bridge was ok, but my nasal alae were flaring and the tip was unrefined.

Immediate post op. I can't believe I'm posting this. haha

One week post-op

This was one month post op-worm's eye view. The nares look amazing when viewed underneath. This was because the tip was elevated via a cartilage graft.

This is the front view, one month post-op. It kinda looks unnatural because of the still-bulbuos tip.My upper lip also feels numb and has reduced mobilization. This is quite an expected result up until few months post op.

Back, from Outer Space!

Finally! I'm back to my old love- writing blogposts! Two months before the post-grad internship starts! (oh wait, one month already out, and I don't want to reevaluate on how productive that month was haha). Finally had some degree of normalcy in my life after being burned alive with junior internship (certainly one of the phases of my life that I wouldn't dare to experience again). Now I am bound to trudge a definitely more challenging phase of my medical career, and lately I have been asking myself constantly if I am really ready to go out there with my white coat and stethoscope. But hey, I had 4 years in med school- I think I have mustered more than enough knowledge, skills, the right attitude, and of course, the confidence, for me to be able to do what is expected of me to do. Surely the uncertainty is there, but who knows? Maybe, I really can. haha

finally, a white coat with my name embroidered on it.

Cause what if I never love again?

It's been 5 months. And this song still brings tears to my eyes..


ALL I ASK
By: Adele


I will leave my heart at the door
I won't say a word...
They've all been said before, you know
So why don't we just play pretend
Like we're not scared of what is coming next or scared of having nothing left!

Look, don't get me wrong
I know there is no tomorrow
All I ask is...

If this is my last night with you
Hold me like I'm more than just a friend
Give me a memory I can use
Take me by the hand while we do what lovers do
It matters how this ends
'Cause what if I never love again?

I don't need your honesty
It's already in your eyes and I'm sure my eyes, they speak for me
No one knows me like you do
And since you're the only one that matters
Tell me who do I run to?

Look, don't get me wrong!
I know there is no tomorrow
All I ask is

If this is my last night with you
Hold me like I'm more than just a friend
Give me a memory I can use
Take me by the hand while we do what lovers do
It matters how this ends
Cause what if I never love again?

Let this be our lesson in love
Let this be the way we remember us
I don't wanna be cruel or vicious
And I ain't asking for forgiveness
All I ask is...

If this is my last night with you
Hold me like I'm more than just a friend
Give me a memory I can use
Take me by the hand while we do what lovers do
It matters how this ends

'Cause what if I never love again?

Hello. It's me.

Hello..

How are you holding up, my dear self? It's been two months since your heart was torn into pieces. Has it healed already? 

I'm sorry I have to put you through this. My heart aches whenever I see you staring blankly at the window, wondering what's on your mind-though I'm damn sure it's always a painful thought. I see that struggle when you push

yourself to live life how it should be. I witness all those charades, and those make-believe moments. I can sense the difficulty of you trying so desperately to make that smile last on your face at least for a day. You look like a fool when you try to make the people around you believe that you are 100% ok, when in reality, you are damn shattered inside. I get that weird feeling when you feel like you are helplessly suspended in mid-air, with no purchase on the ground far below. I know that each time you put on those headphones, it's always that Adele album that lulls you to a deep sea of sadness. There will always be that special song that once you get to hear it, all of the emotions locked inside will just emancipate like a dam bursting open. And you just breakdown, and cry.

I am seeing everything, and it pains me to see you do those stupid things over and over again.

As they say, time heals all wounds. But will we ever get there? 

Picked all my weeds, but kept the flowers.

Leaving the community medicine rotation today with a heavy heart. Aside from the fact that I got to enjoy things that I badly missed doing when in hospital rotations, it was also in this rotation when I lost my more-than 3 year-relationship with my partner. It was a torture waking up each day knowing that there are some things that you both used doing for the past years that you just can’t do now, something that you once thought you can’t live without-and then reality brutally strikes back at you.  All along, I had thought that the word “heartbreak” was just a metaphor to describe deep sadness. I didn’t realize it was an actual descriptor. That person who promised he would never let me get hurt, who said he would always be there for me, whom I trusted with all my heart. He turned out to be the same person who hurt me the most. I wanted to be strong. I wanted to be unaffected despite what happened. No pity parties, no sob stories. I was no sap.           

I wanted to stand up tall and overcome whatever was before me. And for the most part, I did. On the outside, I dealt with it very well., appearing unfazed. I seemingly moved on with little downtime. But inside me, was a little boy; small, vulnerable, angry and hurt. I was crushed. As much as I tried to be strong, I couldn’t stop myself from crying.

Trying not to be overly nostalgic of the memories and f*cked up what if’s was like setting fire to the rain. But eventually, I went an hour without thinking of them, then a few hours, then a day, then a week.

Yet, a part of me still thinks about him. This tend to arise in certain moments, such as when I am by myself, when my friends talk about their relationships, when I see couples together, or when I am down. I would think back about the past, and the times we were together. Thinking about him would trigger different emotions. Sweetness and nostalgia from the happy times. Confusion over why exactly he acted that way. Frustration, sadness and disappointment from how things turned out. Regret over what could have been. Hatred for how he dealt with the situation and breaking me on the inside. Over time, these emotions had dried out into numbness.

Perhaps, to forgive is to set a prisoner free and discover that the prisoner was you. The final closure I needed was with myself. Looking back, it has been a long journey these past 3 years. A journey filled with happiness, hope, sadness, self-hate, and at the end of it, deep revelations, growth and an all new self-awareness. I have realized that whenever we refuse to move on, we prevent new things from entering into our life. The one’s we are punishing isn’t the other person, but ourselves. When we let go of the past, we are in essence allowing new things to enter into our lives. If we want to attract new possibilities, we need to first release the old baggage we are hanging on to. It’s never too late to start afresh.

When two lovers finally decided to part ways, their promise of forever doesn’t necessarily end up just like that, for the romantic memories of their yesterday will surely linger within their hearts and minds forever-just like a tattoo.