This is an old feature of the PLDT phone system. To avoid bill shock from unwanted “long distance calls”, it may useful to use this feature.
I was curious if it is still working.
Instructions:
Your default PIN is “1234”
To change code: *85*Present Code*New Code# To lock: *54*Four digit code # To unlock: #54*Four digit code #
As of today, it still works.
Day 33 of #100DaysToOffload. Find out more about it here.
Around this time, four years ago, I recall being very stressed by my thoughts. So many what ifs and even detractors. I had just applied to a residency program. This was a new program and is most cases a tabula rasa. There was not even an actual date of the exact day to start. There was just a call for residents. There was much hope for it and much energy surrounding it. Certainly, we had birth pains. But I was confident with the people around me.
Right now, I’m probably just as stressed. Except this time with a different perspective to things. And nothing renews hope more than a fresh perspective.
During my residency, I've come to realize that the caliber of my medical dilemmas serves as a good gauge of the quality of my training as a resident. Because of this, whenever I encounter issues that are specifically mind boggling, I try to remember that this is a baptism, and I should call myself lucky to experience such matters. If they did not admit in Ciudad Medical Zamboanga I may not have the chance to learn and interact with them.
I've also learned how to apply this in my private life after learning that, in some ways, my difficulties led to my development. It gives me new inspiration to stick with things and persevere through both good and bad days. Looking back, it was indeed challenging phase during the first few months of the 2nd year. The overwhelming surges of covid-19, the uniquely challenging assimilation with the junior’s obnoxious expectations, the juggling of responsibilities both in work and real life, and the death of my mother. The last event made me really contemplate if there was really a point to all the hassles and struggles.
I am grateful for the leadership roles that fell on my lap, I hope it made me a better person in the process. It was indeed a great effort to balance every other person’s egos, wishes, requests, and personalities.
I now have more faith in the process and am more tolerant of my constructive criticism if there are any. I try to keep in mind that I'm not just going through this period. Each choice I've made has brought me closer to my goals. I believe that God's plan, whatever it may be, operates on a scale that is too great for human sight to fully comprehend. As such, the best we can expect and pray is some measure of grace that will allow us to play each moment and make sense of the cards that are dealt to us. And sometimes have the courage to mulligan.
I have become more trusting of the process, more accepting of my good problems. Reminding myself that my going through this phase is no accident. Every decision has led me to a good place. I suspect that God’s plan, whatever it is. works on a scale too large to fit our mortal eyes and the best we can do is to try to align ourselves with what we feel is right and construct some meaning out of our confusion, and hopefully we earn some grace to play at each moment and to make sense of the hand that we're dealt.
It feels just like yesterday when I first started my training. Today it is finished though unceremoniously. And so, like the other days, I have no reason to doubt that the dots in the bigger picture will align and coalesce.
So, I walk with the fervent hope that Providence will provide the direction that needs to be treaded upon. Walking in faith, sometimes with clarity, other times blindly, but every time with the assurance that there is guidance from above.
Day 32 of #100DaysToOffload. Find out more about it here.
Looking for an inspiration to lose weight. Here’s something I found in one of textbooks.
Risk of certain cancers appears to increase modestly (relative risks generally in the 1.0–2.0 range) as body mass index (BMI) increases beyond 25 kg/m2. A cohort study of >5 million adults included in the U.K. Clinical Practice Research Datalink (a primary care database) found that each 5 kg/m2 increase in BMI was linearly associated with cancers of the uterus, gallbladder, kidney, cervix, thyroid, and leukemia.*
Made me want to exercise and eat less for a moment.
* Pg. 444, 20th Harrison’s Principles of Internal Medicine.
Day 31 of #100DaysToOffload. Find out more about it here.
The point of having an external rotation is to be like a sponge and absorb as much scientific knowledge and appreciation as much as you can. However, in those surreal moments, my interactions with fellow, I have also picked up a thing or two about life as a fellow and in general.
When asked about what fellowship would you like to pursue, I still find it difficult to answer.
Get into a government hospital and enter as a lateral entry for fellowship.
The oldest that went into fellowship in PHC is 39 years old. This was comforting.
I was thinking that age was factor in the training. Likely to be a great factor, but determination and commitment is also key.
Fellowship training is grueling. To survive, take it one day at a time.
It is refreshing to here this even in higher institutions.
While certainly, I overhear negative comments or exortations from seniors to their juniors, it is always meant to build up “character”.
Thank you Lord for all of the interactions.
Day 30 of #100DaysToOffload. Find out more about it here.
The Culprit Lesion Only PCI versus Multivessel PCI in Cardiogenic Shock (CULPRIT-SHOCK) trial was designed to test the hypothesis that PCI of the culprit lesion only, with the option of staged revascularization of nonculprit lesions, would result in better clinical outcomes than immediate multivessel PCI among patients who have multivessel coronary artery disease and acute myocardial infarction with cardiogenic shock.
Clinical Question: Among patients who had multivessel coronary artery disease and acute myocardial infarction with cardiogenic shock would PCI of the culprit lesion only than among those who underwent immediate multivessel PCI result to better outcomes?
P: Patients were eligible for the trial if they had acute myocardial infarction with cardiogenic shock. Additional eligibility criteria were planned early revascularization by means of PCI, multivessel coronary artery disease (defined as at least two major vessels [≥2 mm in diameter] with >70% stenosis of the diameter), and an identifiable culprit lesion.
Criteria for cardiogenic shock included a systolic blood pressure of less than 90 mm Hg for longer than 30 minutes or the use of catecholamine therapy to maintain a systolic pressure of at least 90 mm Hg, clinical signs of pulmonary congestion, and signs of impaired organ perfusion with at least one of the following manifestations: altered mental status, cold and clammy skin and limbs, oliguria with a urine output of less than 30 ml per hour, or an arterial lactate level of more than 2.0 mmol per liter.
Exclusion criteria were resuscitation for longer than 30 minutes, no intrinsic heart action, an assumed severe deficit in cerebral function with fixed dilated pupils, an indication for primary urgent coronary-artery bypass grafting, single-vessel coronary artery disease, a mechanical cause of cardiogenic shock, the onset of shock more than 12 hours before randomization, an age of more than 90 years, shock with a noncardiogenic cause, massive pulmonary embolism, known severe renal insufficiency (creatinine clearance, <30 ml per minute), and other severe concomitant disease associated with a life expectancy of less than 6 months.
I: Either PCI of the culprit lesion only, with the option of staged revascularization of nonculprit lesions, or immediate multivessel PCI. In all the patients, PCI of the culprit lesion was performed first, with the use of standard interventional techniques. In patients in the culprit-lesion-only PCI group, all other lesions were to be left untreated at the time of the initial procedure. In patients in the multivessel PCI group, PCI of all major coronary arteries with more than 70% stenosis of the diameter was to be performed. This included efforts to recanalize chronic total occlusions during the acute phase; the recommended maximum dose of contrast material was 300 ml.
O: PCI of the culprit lesion only (with the option of staged revascularization of nonculprit lesions) was superior to immediate multivessel PCI with respect to a composite end point of death or renal-replacement therapy at 30 days. The difference was driven mainly by significantly lower mortality in the culprit-lesion-only PCI group
Day 29 of #100DaysToOffload. Find out more about it here.
Today is the day of accreditation for the Internal Medicine department. Sending out good vibes to my fellow residents and consultants.
What I see in workspace right now.
Day 28 of #100DaysToOffload. Find out more about it here.
Imagine a sick doctor. Imagine her coughing. Imagine her having a runny nose. Imagine her having febrile episodes. Imagine her down with her illness.
Now, imagine her in front of you, working with you, communicating with you.
And you, you just had to ask yourself, “What the fuck is she doing here anyway?”. Rage, rage, rage against the dying of common sense.
55-word short story #3 #55wordshortstory
Day 27 of #100DaysToOffload. Find out more about it here.
Today, marks the third time that I’m on solo duty.
Wunderbar!
I will survive.
Day 26 of #100DaysToOffload. Find out more about it here.
Whether you believe in God or not, some simple truths are hard to come by.
The person who is trustworthy in very small matters is also trustworthy in great ones; and the person who is dishonest in very small matters is also dishonest in great ones.
- Luke 16:10 ( New American Bible)
Something I try to live by. And I believe this verse still holds true today.
Day 25 of #100DaysToOffload. Find out more about it here.
I was to receive a patient in that particular room. This was the room when I last saw you breathing, crying, gasping...
When I saw chart number of the room, every vivid memory came flashing back, flickering a memory of you. I just couldn’t enter. I’m probably not ready yet to enter that room.
I’ll visit you sometime. I promise.
Day 24 of #100DaysToOffload. Find out more about it here.