zjhademarie

[zjhademarie]

Space and space and space.

We came to this place to see the view. I took a picture of the view, I just need something or someone to accent it. It just so happened that it was you. :p

[zjhademarie]

Fact about me is that my mind gets influenced easily.

As a patient told me “Dok, naa sa imo tanan na attitude. Dili ka pwede piklon.” Which means both good and bad are in me. After hearing it, I came to an agreement with my patient. In my head I said, “True”. Part of me wants to listen to this people, cause I myself don’t know myself. Sad but true.

It’s the same as this photo, I cannot maintain the same palette. I cannot stand the same way. My hair don’t fall the same way. I’m a moving object; and it’s very rare to be captured in stills.

Just a realisation, the I should keep going. Being constant. Same as how my heart is, it remains the same since the start. Just now, I have to kidle more fire inside.

[zjhademarie]

Happy Birthday Sanshine!

Go where the grass and trees are greener.

Spread your wings Batman! Day or night, fly!

[zjhademarie]

Not the most effective way of studying given this short period of time...

But definitely something I love ❤️.

[zjhademarie]

From first day of clerkship ‘till the last! Made it with flying colors! ^_^ We fought well and conquered this mountain.

Now both got the M.D. after our names.

Congratulations! Praise be to God! Alhamdulillah!

But then...

The day I feared and saddened me the most, finally came... the day you will leave.

Sige na lang. For we came to love someone more who is passionate for his dreams. And right now, our personal dreams are more important. So I will never be the perso who will stop you from leaving. I will push you to go beyond your borders, buuuuuut... take my heart wherever you go!

My Sun, remember, you shine brightly when you’re at the top of the sky, the peak of the day! So go forth and fly. And as a tree, I will grow stronger, tall and unshakable, constant and giving. I will be here to wait for you. (And later fly to wherever you are :p)

Remember, “follow your heart’s desire and the whole universe will conspire to help you fulfill you dreams.” “Surpass your limit”

Right now, it’s time for us to go our separate ways, let the universe does her magic... We study, ace exams, have our dream specialty, and be together for the rest of our lives.

Also have a picture of us both in white coats :)

See you soon, Doc Sun!

I 💙 You

[zjhademarie]

Counting days...

Thank you for climbing the same mountain with me. No matter how unfit and unprepared you were. You pushed through and climb the top.

The same in life, climb that mountain infront of you, search for beautiful wonders and conquer them... no matter how difficult, no matter how far. Always remember that the view is best with its up there!

We’re not the scripted couple to be still for photos, and it will always feel awkward to be chummy! Hahahaha but always alway always remember, I’m your cheerleader and you are my sun. 😘

[zjhademarie]

It was tough, but we learned to love each other more and more each day.

3 months more of being together physically.

But always remember, “you can go anywhere,babe. No matter how far. Because I know it’s written in the stars.”

We’ll have forever to be together, now, we first have to make our dreams come true... together despite the physical distance.

Even though we can’t be under the same sky for years, we love deeply to look forward for the days we’ll be under the same roof.

I love you 💙

[zjhademarie]

About 6 years ago, i had a conversation with my dear friend. She said [Ganahan kaau ko ana niya. Nice nga tao. Sa time naa ko problem siya ra jud ang wala nag comment ug unsa ako buhaton. Pero gi ask ko niya “Unsa ako matabang?”].

This sentence makes a whole lot of difference. In times we are lost, we all do need someone to not only help us but to ask us. Cause at times we do need someone to ask for us to realized what we need or what we can do.

And as an aspiring physician, this story reminds me again everyday to ask my patients, “How can I help you?”

A doctor discovers an important question patients should be asked

This patient isn’t usually mine, but today I’m covering for my partner in our family-practice office, so he has been slipped into my schedule.

Reading his chart, I have an ominous feeling that this visit won’t be simple.

A tall, lanky man with an air of quiet dignity, he is 88. His legs are swollen, and merely talking makes him short of breath.

He suffers from both congestive heart failure and renal failure. It’s a medical Catch-22: When one condition is treated and gets better, the other condition gets worse. His past year has been an endless cycle of medication adjustments carried out by dueling specialists and punctuated by emergency-room visits and hospitalizations.

Hemodialysis would break the medical stalemate, but my patient flatly refuses it. Given his frail health, and the discomfort and inconvenience involved, I can’t blame him.

Now his cardiologist has referred him back to us, his primary-care providers. Why send him here and not to the ER? I wonder fleetingly.

With us is his daughter, who has driven from Philadelphia, an hour away. She seems dutiful but wary, awaiting the clinical wisdom of yet another doctor.

After 30 years of practice, I know that I can’t possibly solve this man’s medical conundrum.

A cardiologist and a nephrologist haven’t been able to help him, I reflect,so how can I? I’m a family doctor, not a magician. I can send him back to the ER, and they’ll admit him to the hospital. But that will just continue the cycle… .

Still, my first instinct is to do something to improve the functioning of his heart and kidneys. I start mulling over the possibilities, knowing all the while that it’s useless to try.

Then I remember a visiting palliative-care physician’s words about caring for the fragile elderly: “We forget to ask patients what they want from their care. What are their goals?”

I pause, then look this frail, dignified man in the eye.

“What are your goals for your care?” I ask. “How can I help you?”

The patient’s desire

My intuition tells me that he, like many patients in their 80s, harbors a fund of hard-won wisdom.

He won’t ask me to fix his kidneys or his heart, I think. He’ll say something noble and poignant: “I’d like to see my great-granddaughter get married next spring,” or “Help me to live long enough so that my wife and I can celebrate our 60th wedding anniversary.”

His daughter, looking tense, also faces her father and waits.

“I would like to be able to walk without falling,” he says. “Falling is horrible.”

This catches me off guard.

That’s all?

But it makes perfect sense. With challenging medical conditions commanding his caregivers’ attention, something as simple as walking is easily overlooked.

A wonderful geriatric nurse practitioner’s words come to mind: “Our goal for younger people is to help them live long and healthy lives; our goal for older patients should be to maximize their function.”

Suddenly I feel that I may be able to help, after all.

“We can order physical therapy — and there’s no need to admit you to the hospital for that,” I suggest, unsure of how this will go over.

He smiles. His daughter sighs with relief.

“He really wants to stay at home,” she says matter-of-factly.

As new as our doctor-patient relationship is, I feel emboldened to tackle the big, unspoken question looming over us.

“I know that you’ve decided against dialysis, and I can understand your decision,” I say. “And with your heart failure getting worse, your health is unlikely to improve.”

He nods.

“We have services designed to help keep you comfortable for whatever time you have left,” I venture. “And you could stay at home.”

Again, his daughter looks relieved. And he seems … well … surprisingly fine with the plan.

I call our hospice service, arranging for a nurse to visit him later today to set up physical therapy and to begin plans to help him to stay comfortable — at home.

Back home

Although I never see him again, over the next few months I sign the order forms faxed by his hospice nurses. I speak once with his granddaughter. It’s somewhat hard on his wife to have him die at home, she says, but he’s adamant that he wants to stay there.

A faxed request for sublingual morphine (used in the terminal stages of dying) prompts me to call to check up on him.

The nurse confirms that he is near death.

I feel a twinge of misgiving: Is his family happy with the process that I set in place? Does our one brief encounter qualify me to be his primary-care provider? Should I visit them all at home?

Two days later, and two months after we first met, I fill out his death certificate.

Looking back, I reflect: He didn’t go back to the hospital, he had no more falls, and he died at home, which is what he wanted. But I wonder if his wife felt the same.

Several months later, a new name appears on my patient schedule: It’s his wife.

“My family all thought I should see you,” she explains.

She, too, is in her late 80s and frail, but independent and mentally sharp. Yes, she is grieving the loss of her husband, and she’s lost some weight. No, she isn’t depressed. Her husband died peacefully at home, and it felt like the right thing for everyone.

“He liked you,” she says.

She’s suffering from fatigue and anemia. About a year ago, a hematologist diagnosed her with myelodysplasia (a bone marrow failure, often terminal). But six months back, she stopped going for medical care.

I ask why.

“They were just doing more and more tests,” she says. “And I wasn’t getting any better.”

Now I know what to do. I look her in the eye and ask:

“What are your goals for your care, and how can I help you?”

-Mitch Kaminski

Source

[zjhademarie]

CONGRATULATIONS!!!

Magic 6!!! The team might not have won the first place but still, we are proud of you all, for the team who aren’t prepared to fight, partida huh!

And me specially of you! :)

Now we can mo longer say “Next time”.

It was a good fight. And you know what trophy is more important.

So set you mind to that goal... no more procrastination, no more cramming.

For this, be the best!

This time, NEVER DOUBT YOURSELF!

Baby, you got a lot of potentials in you so go take spread your wings and show it to the world.

And always remember we are proud of you. We’re just not the loud ones who shout out. But always keep in mind we are proud of you!!! And shouting out now in my simple special way! 💙

[zjhademarie]

To my New Year’s Gift.

I love you.

It was a journey where I knew a part of me I never knew existed.

Someone inside of me who was already tired of the world.

It was though loving me.

But thank you. Thank you.

I’m sorry I can never return the same amout of love.

[zjhademarie]

I have a confession to make...

I’ve always wanted to be a surgen. One thing i never realized...

...until i wanted to grab every needle holder with needle and pick-ups whenever someone is suturing.

I wanted to cut and suture everything there is. I wanted to try every technique I see right at the moment. I wanted to... i really want to!

It’s not because I’m self-proclaimed skillfull, it’s just something which makes my heart excited, like falling inlove over and over again!

[zjhademarie]

10-11-18. Oh the rare time!

[zjhademarie]

😊 cause being beside you...

... means surviving another day...

...means something to look forward to...

...means everything’s perfectly fine 😚

[zjhademarie]

I once loved and set everything ahead of me. Then things turned out the way I never expected.

Including meeting someone who will make my heart full again,

Someone who makes me run around on unlikely places,

Someone who makes surprises that even surprised himself,

Someone so kind I always think like I could not be good enough,

Someone who makes me really happy everyday of my life...

I always hoped for a guy who buys me clothes cause he thinks i’ll look good on those. Not just because I Iike dresses or cause he likes the dress... simply because he thought of me.

I would not care if it’s too big or small, I would still wear them... but cause it’s him who thought of me, everything fits me.

What can you not do? What is there not fall inlove everyday?

No-ne.

[zjhademarie]

Another session in the XTR. All the free spare moments we could share. All the times we look forward to. Every emotions we put into. It was still the best feeling. To spend that little time together.

[zjhademarie]

If only

If only I could turn back time

I would have used it for myself

If only I could turn back time

I would have prepared things for myself

If only I could turn back time

I would have done better for myself

If only I could turn back time

I would prefer to meet you earlier

[zjhademarie]

People turned their back when you need them, just remember, it’s not you. They chose to not help. It was their choice not yours.