It hit me on the head

It has been ages since I wandered into this blog site but I thought I would give it a go again. I hope to just tell stories and let others who may face the same happy-sad situation I (our family) find my(our) selves in that they are not alone. I was hit on the head eight times last night. The eyes that looked at me were angry, had a lot of contempt and unapologetic. All this even though there were two people trying to dissuade those hands from punishing me. It was overpowering. As soon as it happened, it stopped. What did happen? A few minutes earlier, my typically sweet 21 year old boy-man (Lomi has autism) suddenly gritted his teeth and started wailing, hitting his head. In our family, I am the center of calm and when he goes into this mode (triggered by who knows), I usually am able to talk him through it and make him relax. Well, he did not. He raged. He raged. What shook me was that he even laid a finger on me. It was not because it was painful. "Mama Donna...cahh"...Cahh is "cry". He wanted to see me cry or rather, expected that I would do so. But I didn't. I still kept calm and showed him that I was not angry rather, sad. Very sad and he didn't like that. So he blew off some more steam. Jumping and yelling and hitting his head. His father was able to sit him down and started to massage him. He likes massage. And then he calmed down. "Mama Donna, sorry. Sorry." This was followed by a rain of kisses. Deep inside, I have a good son, a lovely boy with so much I still need to understand. It (again) hit me on the head.

a tall order

Life is short. We have to live it as fully as we can. Quite a tall order. Don't you agree? How does one start to do this?

Blunt

November 2. My five and a half year old daughter was perched on my lap and asked me all the sudden,"Where is lola Abing?"
She's in the cemetery.
"Why is she in the cemetery?"
She has gone to heaven.
"Why is she in heaven?"
I didn't want to say the word died, so...She got real sick and did not get better.
"Why did she get sick?"
Her body got this disease called cancer.
"Why did she get cancer?"
And I was grappling for the right way to explain when my daughter quipped,
""You know what, mama..I think she's in heaven because she is dead." "Yes", she said while nodding her head at me looking all knowing, "she died."
I really had no more words to say.

a shopping hazard

I went over to the Winners branch at College St. Winners is like Filene's basement, designer brands for less. I was hunting for two things in particular -- 1. a luxurious 800 count queen size sheet set (which I found for 79.00!!) and 2. a yoga mat (which I did not find but wound up instead with a pilates kit complete with figure of 8 ring and instructional DVD). I also wanted to get a pair (or two) of new khakis, in time for spring. Alas, a size 1 or 2 is a hard find in this part of the world. I did not give up so easily and the shopper in me wandered all throughout the store. Goodness, where did three hours go? I snapped out of my shopper's trance and made the beeline towards checkout. The guy infront of me had a pair of gray sweat pants in his hands. I spied that it was torn and had some dirt at the hems. Hmmm... Those sweats are either real cheap or is the latest rage in some odd fashion circles. Dare I alert this fellow customer to the consumer faux pas he is about to commit? His turn came up with the cashier. I was just about to call his attention but not before he reached from the inside of the pants he was wearing. It was a price/security tag. Ahhh....the dirty sweats are his, and now he is wearing his new pair. The checkout lady insisted that she needed the pants to unlock it from the security tag. Uh-oh. Without any qualm, the man pulls his new pants down and hands them over. Yikes!! He sought my eyes as he did his strip. I looked at him pointedly and raised an eyebrow, giving him a look that a schoolteacher might have given a naughty pupil. He shrugged back at me, got his pants back and sauntered away as if nothing happened. Thank goodness he wore boxers...easier to act unperturbed than if he was wearing jockeys. Whew!

breathe to your poses

Last month was harrowing for me. On average, neonatal transport requiring a fellow's attendance is three a month. I went to eleven. One of these days, I will make like a tourist and take pics of the equipment and huge packs we lug around...it really is a portable NICU. There is an adrenalin rush each time we are dispatched. However, out of the run, I feel my body complaining. It seems that each way I turn my neck and back, I hear a crack or crick or whatever. Tales of my woes reached Sabrina, a friend and an RT I work with in the team, and she introduced me to yoga. Vinyasa yoga. I have always known how I needed to tone up and strengthen but I did not appreciate just how much of a weakling I am...until now. Vinyasa yoga directs breathing as poses are assumed. You inhale as you do this then exhale with the following movement. It is supposed to be calming. My body was not a picture of calm at all. I struggled as I tremulously followed the instructor on the DVD. I swear parts of my body were fasciculating...including those which I thought incapable of any movement at all. Thank goodness, this all happened in the privacy of my apartment. I was in a sweat as I reached the end of the video. My body tingled most everywhere. What was I thinking? Well, now I am hooked...fascicuIating parts and all. I am on my way to pick out a yoga mat. Ohmmmm.....

ramblings

It always pays to be prepared.

I have lately been searching for Philippine or any local data about the rates of late preterm (34-36 completed weeks of pregnancy), preterm births and other disease states in neonates, like jaundice, asphyxia, etc. The way I figure, I might as well focus on what would be the most common neonatal condition locally. I know, I know...Sepsis (systemic infection) would likely be reported as the most common. But is it early onset (< 7days of age) or late onset? Also, after this stint, I have full realization of why in residency, it pays to also consider the other stuff like a cardiac condition, metabolic problem, etc. (Yes, yes, by some miracle, I know have a general understanding of inborn errors of metabolism :)...ergo, it is not always sepsis!! I digress now. As I was saying, where is the data? I cannot really find it. The Philippine census lists some but clearly it is vague. There is nothing particulary specific with neonatal conditions. Does anyone know of where this repository of data is? Or is there even one?

cocoon

In less than three months, I will be back in the tropical climes of the Philippines for good. I have been looking forward to this ever since I came here to Toronto in June 24 2006 to start my fellowship. I look back now and I can't get over the fact that almost three years have gone by so quickly. I remember my first few weeks here thinking that I would never last. I have. Now my thoughts are filled with home. Time to catch up with family. Time to start my life again. I must admit that I now feel quite at ease with the system here at SickKids. I have found my niche and ensconced myself in this environment. Do I dare flee? I do. I am now close to breaking out from what has been my cocoon. Hopefully, when my wings have spread, it will be radiant as the coulours of the Monarch -- not only to uplift my own self but also those who will be around me.

a flying tale

Sudbury is a city in northern Ontario. Way North. When the deep freeze was here in January, Toronto temp was in -20'sC and Sudbury was in the -30'sC almost -40'sC, I think. This past week I have flown round trip for patient retrievals thrice now. It is a 45 miute flight with clear weather but conisderably longer if the weather is a not. Like today. I got woken up close to 7am to fly there with a team member. A five week old with a tachyarrhythmia unresponsive to adenosine and amiodarone. At the Toronto Island Airport, we were met by the flight crew (the pilot, his first officer and the air medic). We were told it was not the best weather. Hmmm.... The plane was tiny. Just three seats in the passenger cabin and an empty row for our 300 lb transport incubator and other equipment. The flight itself was smooth enough. Midway, the medic, who sat in the back with us, said that visibility in Sudbury was zero and we may have to land in an alternate airport. About close to an hour later, I felt the landing gear going down. I looked at the outside. Hmmm...it was all a white haze. Very thick cloud cover? I motioned to my partner who just woke from her nap. So, are we going to even attempt a landing? As I thought this, I felt the wheels hit land (thank you Jesus!). I swear, even though as the plane taxied on the runway, I could still not see much outside except for the thick white haze. I could not help but right then exclaim a thank you to the pilots. They were doing their own high fives. Apparently, there was another plane who attempted to land before us but aborted the landing as they had missed their spot for touch down. Whew! Now, the flight back is a whole different story. The short of it is, however smooth the flight coming in to Sudbury was, the trip going back to Toronto was a tad turbulent. With such a small plane, I felt every sway and bump. What's eerie too is to hear the propeller and the machine. I closed my eyes. Childhood memories flood into my mind. Paper airplanes. It sure felt like I was a passenger in one.

And I live to tell the tale...

small planes and the police car

My head is in a whirl.
I started my clinical service rotation for neonatal transport on the first of the month. What a first week.
I have been out on "runs" six times now. On two occasions, the venture was in northern Ontario so that we had to ride in a 6 seater plane...not the best thing in the world especially when there is a lot of turbulence in the air. Good thing, I was able to keep my insides in.
In another instance, the team was already out for a baby with a difficult airway, I was summoned in for assistance. The hospital was about a good 40-45 minutes away from the downtown Toronto core. So, how did I get to them in 25 minutes? Call for police assistance, of course. This was at 3 in the morning. As I approached the car, I said that I would not ride at the back. Who knows who and what has gone on in there. It looked pretty menacing. The patrol car "flew" on the hi-way 401 at 160 kph. The officer casually remarked about how fast we were going, looking sideways at me to check if I was alright. No sweat. Ahh..finally, someone who drives like a Pinoy!!
As he slowed in front of the hospital emergency room entrance to let me off (lights and sirens on), the ER staff jumped on to their feet...awaiting the worse, but then out came little me.
I write this now and I think, what awesome memories....

longer days

Since I came back from my short vacation, I have been quite closeted with work in the hospital. I am back on my routine....well, not quite. I am not on clinical duties, per se, but do attend the neurodevelopmental follow up clinic. So I have the luxury of going to work at 9am instead of 730am. Thank God for small mercies. The thing is though, I have been catching up on my research work that I find myself leaving the hospital almost always nearing 7 in the evening. Today is a different story though. The last two patients in clinic did not show up. I could not believe that I am stepping out at 3pm!! And just to make it real sweet, I decided not to do any research today :p
Unbelievable. It is 430pm and there is still daylight...okay, it looks overcast as it has been raining the whole day. But still, a few weeks ago, it would be pitch black by now. And with the light of day, I can appreciate that most of the snow has melted away.
Could it be? Winter is over?!
As Balki (Bartokomous of Perfect Strangers -- remember this one?) would exuberantly say, "It is time for the dance of joy!!"
Woo-hoo!

stuck

I have been sitting in front of the computer practically the whole day. And the tragic thing is, I haven't been surfing the internet at all. Well, okay. I may have browsed a few minutes here and there. I have been struggling with putting a presentation together and have been stuck with slide 7 since 5pm!!!
What to do? what to do?
Spend a sleepless night in the hope of getting unstuck?
Or just sleep on it?

national anthems and the superbowl

I was down the past weekend with a cold and felt crappy. To top it off, I was on call and went to a community hospital to attend to a sick baby on Saturday which had its sad and tragic ending. On Sunday, I needed a pick me up. My nose was all red and raw, a consequence of the growing mound of used tissue at my bedside. Having Nyquill RTC did not help me get over my jetlag. I was in a continual haze of drowsiness.
I turned the TV on and caught Jennifer Hudson singing the Star, Spangled Banner. Now, I am one of those people who, regardless of the originating country, always feel a swelling within my chest and a catch in my throat when I hear a national anthem being sung. The way I figure, I sense the patriotism and the loyalty attached with every revered song and is a source of pride for any citizen of the world wherever from. I share in these feelings. Weird? That is just me.
It was Superbowl XLIII. It has been years since I have seen an American football game. And just what I needed to see.
I was talking to one of the staff neonatologists today. He asked me how I was. I began to describe my lousy weekend but had a great time watching the superbowl. He is a distinguished and scholarly type and expressed great surprise at my choice of a "great time". And this is how I explained it to him. Granted, it is all very much gritty bodies banging to each other with all the grunting and all is very raw, muscled, earthy and grimy, dirty. But that all seem to make it very grounded and human. The part I love best though is the moments of exhausted triumph and jubilation. An accurate bullet pass completed after having evaded a sticky defense and the wide receiver trotting midfield to a sprint for the endzone. Or barreling through a wall of bodies and at the very bottom of a flesh pile up, successfully scoring a touchdown. Those are great moments. The body is exhausted and yet the spirit is resoundingly alive. Wow.

iba na ang may miles

Since 2006, I have crossed the Pacific Ocean eleven times. It is no jet set lifestyle. Any travel I do is out of necessity...for my own sanity.
Air Canada is very happy with me.
I, on the other hand, was not very happy being cramped in economy each and every time.
But, things took a different turn on my last trip.
I remember Ma saying before, "Why pay extra for First Class? When the plane crashes, everyone has the same fate regardless of class."
Well, Ma, Executive First Class is fine, indeed. Worth every penny...had I paid for it. With all the global criscrossing, I earned my hefty share of miles and the upgrade.
Fully laid out on my own "bed", a warmed plate for every meal, limitless wine, being waited on hand and foot, were merely a few of the perks I enjoyed.
Travel has taken on a new level and I could easily get used to it.
It's a good thing, I have a couple of more upgrades up on my sleeve.
Iba na ang may miles! :)

my girl

It is my fourth day back in the country. I relish being mom again. As I am still quite jet lagged (read: waking up at 2 or 3 am), I have more than ample time to prepare for Maxine's morning start off before her school bus picks her up. As she eats her breakfast, I brush her thick hair and tame it as much as I can. We do this in silence. Our bonding time together.
This morning though, Jun and I took her to school. For the first time, after much cajoling, she has agreed to use the wheeled back pack I bought for her some months ago. It seems that she avoided to use it because a 4th grader like her does not use a wheeled bag... that is reserved for kindergarten and lower grade pupils who wow each other with their colorfully decorated/ designed rolling bauls. She is an ate na. However, she has been complaining of how heavy her pack has been lately. The few days I have been back, I see how famished she seems to be when she eats and mystified at where all the food goes. I figure though it all gets expended as she goes to and fro bearing her burden of a bag, like a sherpa really. And so today was the bag's first outing. I got the bag from the back seat with full intention of bringing Maxine to her second floor classroom. When we were at the gate, she turned to me and said, "Dito na lang, Ma."
I remember my little girl wanting me to take her all the way to her homeroom.
Ouch.
"Maxine, this bag is so heavy, I will help you and take it up the stairs."
We reach the top of the flight of stairs to the second floor. She turned to me again and said,"Dito na lang, Ma. Ok na ako."
I felt a stab.
Back in the car, I tell Jun my little woeful tale.
I let out a sigh.
My daughter's growing up.

boxing day

This is my third winter in Canada. My second christmas. My first boxing day.
What is boxing day?
As I understand, from a business' point of view, after the Christmas rush, instead of boxing up their stock, they would rather clear it.
And from the consumers' point of view, it is time to box up their old stuff and time to replace with the new.
So how do these objectives marry? A ridiculous (in that prices can go unbelievably low and also in the way people behave) and frenzied shopping spree.
In the US, this is equivalent to black friday, the day after their thanksgiving each November. Remember the Wal-mart employee who was crushed to death? That was really a black friday.
As for me, I now reflect on my buys and grow aghast at how much I have spent.
Reality check. Cheap buys upon buys equal a mounting expense tab.
Ca-ching for Bestbuy, Futureshop and the Source... but this is nothing for me to sneeze at.
I'm glad this was my only boxing day.
It may just as well mean boxing (read: beating) yourself to pay up.
Time to condition myself now. Mantra: It is all worth it. Repeat 100 times.

a christmas like none before

The past couple of days has been snowy and icy. Yesterday was overcast and rainy. Whatever Christmas spirit I had went down the drains much like the slushy snow that melted with the precipitation. I got invited to a Pinoy family get together last night, Christmas eve. The invite was from a co-worker in the unit. I did not want to go but she was insistent. Admittedly, my well thought plan was to stay in my pyjamas and drink all the hot chocolate I wanted. Lenny (my new laptop and friend) and I needed to get seriously acquainted. Oh well...
I had my leche flan and cassava cake on hand (yes, homemade! and I make a mean banana bread laden with chocolate chips) as we waited at the porch for the door to open. There were dreadfully sombre looking snowbanks and despite the festive display of lights on each homestead, it seemed isolated...I did not see a soul. Quite a complete contrast to the multitudes of loitering people back in the P.I. on this same occasion. Finally, the light from within swathed and beckoned us to come in.
The family is big. Think three generations. The patriarch is a 92 year old who has as much vigor as a 20 year old. He and his jovial 86 year old wife bore eight children. Among all of them, I lost count how many children there are ranging from 9 to 29 years old. I felt like an intruder. But they were so warm and genuinely happy to have me there. I felt so mopey inside that I held back tears threatening to break my ducts. This is what Christmas is about. Sharing. Giving. Laughter. Love. Family.
I wondered how my dad would do...how we all would do. First christmas without Ma.
As per our tradition, more of Ma's really, the piece de resistance was turkey and stuffing, gravy and cranberry sauce prepared then by aling Miling and now, aling Rosa. It was a great ceremony for her to carve it as we sit down for noche buena after coming back from midnight mass. I remember finishing my share and yet I always find my plate brimming with more.Then after dinner, we would pose for pictures galore as per our in-house photographer, Ma. Exchange of gifts that followed would never fail to elicit squeals of glee and delight from the kids. More pictures for Ma to take.
This christmas would be one like none before. Melancholy and remembering.
A time to be thankful for what and whom we have cherished. A time to further enrich existing relationships and embark on new ones.
Strains of "I'm dreaming of a white christmas" could be softly heard then.
I shivered.
"I'll be home for christmas" played in my head. Next time. For sure.

I am not ready for a new relationship

On December 20, a vital part of my existence (at least while I am here in Toronto) died. I am talking about my 3 year old Dell laptop. She has been my reliable link to the world and more importantly, to my family back home. A year ago, she suffered a minor meltdown but after appropriate therapy, bounced back. But this time, it is the motherboard and I'm afraid the inevitable has come. It pains me because I made a commitment to a DIY upgrade (from 512MB to 1.256 GB RAM and 80GB HD to 160 GB HD) and we've been happy for months now. I went to Best Buy for a diagnostic just in case I was wrong but my suspicion was confirmed. At that time, I was still mourning my loss. I was caught off guard when the Best Buy geek said, "If you buy a new laptop now, I will waive the diagnostic and data extraction fee." And he waved an in-store flyer at me. "Whoa, I completely am not ready for this. I need time. I don't want to make a hurried purchase...it'll be like I am on the rebound, y'know." Boy, that sounded nuts but I said it anyway.

PS. My recovery didn't take long. I am waiting for my new Lenovo to arrive. Here's to a more lasting relationship.

wanting release

As of now, I am loving being on research and not being on clinical service. Don't get me wrong. I love dealing with pathology and wracking my brain (and if that falls short, the on-line journals) for the pathophysiologic mechanisms and corresponding treatment. It is simply a thrill to find out what to do for a patient which ultimately impacts on his/her family and also on my own knowledge / experience. The downside to this is the opposite. That is, not knowing what else to offer a patient and inflict on a family a pain so deep that is beyond fathomable. In my current hospital setting, we get the sickest babies in the province. Often, we find ourselves bearers of the bad news.
So, there I was today, quietly passing along the patient rooms' corridors when I saw a familiar figure. I had met this grandma before when I was taking consents for my current study. Her eyes looked sad. I have heard that her grandchild, an ex 24 weeker and now 11 weeks old post natally, is not doing so well. He has never been able to tolerate extubation for more than 6 hours and has had a series of serious infections. It is bad. The level of intensive care support has been escalated. And they have gotten "the talk."
I stopped. "How are you?"
She recognized me. "My grandchild is really sick this time. I just want him to rest. He has been through so much since he was born. You understand? I just want him to rest. Is that so bad?"
What could I say? I understood. I knew her pain. Memories of my mother flood back into my mind.
We sit down.
I let her have her release...if only for this moment.
I quietly said a prayer.

the quest for a planner

Since December came round and the prospect of the new year is a looming reality, I have been on the search for a journal / planner. The sticky "post it" method has become too messy and at times, made me miss out on things. I think I have gone to four different stores, only to come out empty handed. At first, my eye caught a leather bound one in an amazing rich chocolate colour. Alas, the price tag was way too rich for me. Going the complete opposite direction, I went towards the handy paperback ones made by Hallmark and American Greetings. Hmmm...the spaces were way too small. And still for CAD 7.00! I have to stop doing price conversions in my head. And then there were all sorts of planners in between. There was the zen inspired planner that was just too beautiful to write on. The MOM organizer with every date accompanied by a blank to do list for home, kids' activities etc....we all know why I would not buy that one. I felt too old (!?) for the Far Side planner and the Anne Geddes was, well, I already see a lot of babies in my everyday.
It sounds now that I am making all these excuses. Well, I did.
If I were back in Manila, this would not even be a problem. My mother-in-law, who is a top insurance provider, gives out planners every year.
But I still am on a quest, that is, until today.
To my complete surprise, I received a package at work.
I had the biggest dopey smile and tried hard to quell the tears.
It was a Starbucks planner. From Jun. And everything was made perfect.

sweet

For the first time in weeks, I actually made my way back to the apartment at 5 pm...woo hoo! My mind was preoccupied with what ingredients I need to make cassava cake for my team meeting tomorrow. As I entered the elevator, I thought about how delighted I was, while shopping around in Chinatown last Saturday, to come across a particular brand of thick coconut milk which would make my cake really yummy. Ang babaw.
Yummy.
I became aware of a couple sharing the elevator with me. Nordic twin towers if I hazard a guess. In such a confined space, they were quite oblivious of my petite presence. It is cliche but they only had eyes (and other bodily parts) for each other. Gooey. And more than ever, the lift seemed to have gone on slower motion ascent than usual. Ay-yay. It was hard not to look anywhere else and my eyes roamed the ceiling.
I got out at my floor. Finally.

I am no prude but that was way more than I could handle.