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Feelings of Acceptance
Wednesday, July 16, 2008
One Sunday afternoon, my hubby told me that my dad called him up because of difficulty of breathing. He said that dad had it immediately after a short jog. Initially, of course, Randy don't know what to think. He has been dad's doctor for his hypertension and diabetes ever since we got married but dad was lost to follow up since he stopped coming home. It was a surprise for Randy to know that dad was still taking the same medicine he prescribed on his last visit. Randy requested for a chest x-ray, prescribed antibiotics for his cough, and asked him to visit us in our clinic.

The next morning, after bringing the kids to school, he again received a call from dad. He was already near our house but dad asked him to go back to Dagupan where he lives. Being the obedient child that he is, he obliged though patients are already waiting in his clinic. He had a short chat with dad over a cup of coffee and assured him that he'll be back the next day with his bag to examine him more thoroughly.

Of course I was surprised to know that he met with him, entered his house, and that he was going back. I was pressing him to tell me what the house look like, how dad looks like, how he is, who was with him when he visited, etc. But he said that I was going with him when he returns to dad's. I don't really know what to say or feel so I didn't answer. But honestly I was thinking about my feelings. What if there's somebody there aside from him when we visit? I was skeptical about going but Randy just laughed when asked if dad wants me to go with him.

I was still undecided but I know that I feel happy just thinking that I was gonna see him. In fact I even bought fruits for him. Maybe this is how it feels if a person finally accepted the situation.

Classes was canceled that Tuesday morning because of heavy rains. So instead of bringing the kids to school and visiting him afterward, the boys came along with us.

It was raining heavily. The maid opened the gate and instructed us to park inside. It is a big house with two cars in the parking space. Dad was in the front door waiting for us. He smiled when he saw the kids stepped out of the car.

My heart was pounding heavily. I hastily approached him, got his right hand and paid him respect. He looked at me and smiled, patted the boys and led us all to the receiving area. His adopted son was there and sat with us. Randy immediately examined him while I scanned the place sitting down.

Dad looked very different from when I last saw him months ago in Manila. He is skinny now. And his blood sugar is way too high. I instantly felt there is something really bad happening to him. After an explanation, he finally agreed to come with us in our clinic for more thorough examination. That was after we had a hearty breakfast with him and prepared by him.

After taking ECG, it saddened me to know that dad is suffering from myocardial infarction. This means that the artery supplying his heart is already blocked making his heart to malfunction. We advised hospitalization but he declined and just asked for medications instead. We advised him on the gravity of his condition and that he is free to call us anytime. He went home after taking his lunch with us.

I felt sorry to see him in this condition. Now I am praying that God will give him more days. To enjoy life with me and my family. To patch up whatever misunderstanding he had with mom and my sister, before it's too late. My feelings for him have not changed at all. I still love him despite his shortcomings. Now I'm sure that I have forgiven him.

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posted by Amelyn R. Rafael,MD @ 2:36 PM   2 comments
No Internet Connection for Days
Saturday, July 12, 2008
I cannot imagine living nowadays with no internet connection. My entire family depend on it- the kids for their research works, me and hubby for our updates, e-mails, blogs, etc.

We are subscribing from Digitel DSL for several years now and we had no problem. After typhoon Cosme, people in our area learned that selling stolen cable lines will give them large amount of money (it's actually Php250 per kilo). And that's how all this problem started.

I had no problem with Digitel. The manager in their Dagupan City office was really sincere in telling us that they will do their best to restore connections. But it's the people in San Fabian, our town, particularly in Cayanga (our baranggay) and its neighbor, Longos, who are the problem. The moment the lines are replaced, they immediately steal them after the linemen left. They gave Digitel people hard time financially as well because these lines are actually expensive. I don't know what Digitel resorted to but it took them two weeks to restore everything.

Two weeks without internet connection was too long to bear. We had to go to internet cafes if there was really a need. The problem was that I don't have much free time to stay in the place because of my work and so I was not able to update my blogs.

During those two weeks, changing internet provider crossed our minds. But we had to pay around Php 3000 if we terminate our subscription from Digitel. I thought that was too much. So we managed to wait. But the next time it happens again, it's definitely bye-bye from Digitel.

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posted by Amelyn R. Rafael,MD @ 8:58 AM   2 comments
Smart Kids
Saturday, June 28, 2008
It was Wednesday afternoon. Randy and I decided to meet in CSI City mall, a more convenient place for us to meet, instead of him fetching me in the medical school. It is faster that way, with less traffic because we will not be passing the downtown area.

When the kids learned that their Dad will see me in the mall, they called me up and asked permission to come. I insisted that they stay behind and just rest. But they insisted to go with their Dad.

When they approached the mall's parking area, the kids thought that they saw me walking in the lobby. They asked their Dad to drop them in the spot. Then Randy proceeded to look for a place to park.

The kids then walked towards the direction of the lady that they thought was me. After noticing that it was a stranger, it was too late to go back to the car. Their Dad was nowhere to find.

Being the kuya, Raymund thought of a way to find me. He felt that his brother was his responsibility as the younger one started to cry. He first thought of calling home to tell the maids where their exact location was. Because he left his cellphone at home, he asked the guard where to find a payphone. The instruction was so vague to him so he started to think for another way. The guard asked him who he was looking for and so he began to describe me. The guard told him that he saw a woman in violet pass by and went in the direction of the National Book Store. Since he knew I needed to buy some school supplies for both of them, he led his brother to the National Book Store. And it was there where they found me.

I was looking for a sketch pad when I heard the word "Mommy!" from somewhere near. I was very sure it was Raymund's voice. I turned around and saw my kids- Raymund wet with too much perspiration holding the hand of his brother. Ralph was crying and wrapped his arms around me immediately after he saw me.

I was then in a daze. I forgot everything on my list and just proceeded to pay what I was holding. Then I led them out of the book store into the parking area where their Dad was.

There is no blaming anybody. I consoled my kids and was just glad nothing bad happened to them. Yes, it was a bad experience for them but it was a learning experience.

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posted by Amelyn R. Rafael,MD @ 8:00 AM   4 comments
Nutrition for Diabetics: Glucerna SR
Wednesday, June 25, 2008
High blood sugar is such a problem especially if one is used to eating sugar-rich food such as cakes. Most diabetics will just skip desert in order to avoid these sugar-laden goodies. But there is no room for deprivation even with high blood sugar as long as you watch what and how much you eat. The most important thing to do of course is exercise.

There is this new product in the market named Glucerna SR from Abbott (this is not a paid post). It's not actually that new as it is already in the market since last year. It's just that not many are using it either because they still haven't heard of it or because of the price. It is a low calorie drink in powder form which provides complete and balanced nutrition. It is high in monounsaturated fatty acids which help lower blood cholesterol. It also promotes a healthier heart. Though I am not a diabetic, I've tried it and I can say that it gives you the sustained energy that would last you for the rest of the day. You won't be looking for more food in between meals as diabetics often do. Therefore, it allows you to comply with your diet.

The good thing about it is that in can be used also for cooking once you get tired of using it plainly as a beverage. It can be used in making soups (like cream of tomato, cream of mushroom, cream of corn, broccoli soup, or carrot soup), in baking (as a substitute for chocolate in making brownies), in desserts, and in milk shakes if you want to add a twist to your beverage.

Here is a sample recipe using Glucerna SR (taken from the fliers given by Abbott).
Broccoli Soup
Ingredients:
  • 6 scoops Glucerna SR powder
  • 1 small head broccoli
  • 200 ml water
  • salt
  • pepper
Preparation:
  • Wash broccoli. Cut into small pieces
  • Steam broccoli until soft
  • Put steamed broccoli, Glucerna SR and water into blender
  • Blend ingredients together until well-incorporated and smooth
  • Add salt and pepper to taste
  • Heat to serving temperature. DO NOT BOIL
  • Serve in a soup bowl
Taste may differ from what you are used to but at least you are eating healthy. A healthy lifestyle is a must in diabetics. That includes a healthy diet, weight management, and exercise.


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posted by Amelyn R. Rafael,MD @ 10:53 AM   5 comments
Experience with Frank
Tuesday, June 24, 2008
After that horrible experience with Cosme, I felt nervous and apprehensive of what's going to happen to us with Frank going in our direction on Sunday afternoon. It was a terrible feeling. A result of bad days we had after Cosme - what if there will be no electricity for countless days, what if our roof gets blown up this time. You know the feeling. Even others had it too as several women were rushed to our place because of chest pains. Just the sound of the strong wind blowing hard on your roof and making that unmistakable rattling sound on your windows and doors makes you shudder.

Frank's path was so erratic even people from the weather bureau had difficulty predicting it. It was just good it turned out to be less strong as Cosme - there was no need to move appliances away from windows and doors. The good thing was that electricity was restored just after six hours of brownout though it continued to rain that day.


The thing that worried me most was the cancellation of classes. Friday was Dagupan City Day, hence a holiday in Dagupan City. Then classes were suspended Monday because of possible floods brought by the typhoon. If the rains continued, classes might be suspended up to Tuesday, the news said. This will then result to several Saturday-make-up classes for my kids. It's good today, Tuesday, is a sunny day. Though it rains often in the afternoon, there is no more typhoon. At least for now.

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posted by Amelyn R. Rafael,MD @ 9:55 AM   0 comments
Nutrition: Know the Glycemic Load
Saturday, June 21, 2008
I have mentioned and even explained metabolic syndrome several times in this blog. And maybe by now, you must already have an idea of what this condition is all about. It is a common condition so that we all must be aware of its complications.

Metabolic syndrome is the end result from years of taking in foods high in refined carbohydrates such as breads, starches, and sweets. And all these result in high blood sugar levels which we all know is toxic to the body. This boils down to the fact that we need to control our blood sugar level and one way (there are lots of other ways) is to be more watchful of what we eat. How? We must know if the food we eat convert quickly to sugar. If it is, then this food has high glycemic index and needs to be avoided.

Glycemic index measures how rapidly glucose is absorbed from the intestines into the blood. The higher the value, the faster the rate of absorption of glucose. It is a fairly easy guide to follow, isn't it? All we have to do is to look for the glycemic index of the food before we eat them. And most diabetics use this guide to watch their sugar intake. But there is a more important parameter that can be used in place of glycemic index. It is best that we should also know the glycemic load of the food that we eat.

Glycemic load is the percentage of carbohydrate the food contains. Each unit of glycemic load is equivalent to the effect of 1 gram of pure glucose on blood sugar. This is important because there are some foods that have high glycemic index but have low glycemic load. Therefore, they are safe to eat as well if you are watching your blood sugar level. Let's take carrots for example which has a glycemic index of 92. A 100g serving has 5.2g of carbohydrate resulting in a very low glycemic load of only 4.3 (GL= (92 x 5.2)/100 = 4.3).

Knowing the glycemic load then gives us wider food choices. Most fruits and vegetables like apple, watermelon, orange, and cantaloupe, tomatoes, asparagus, broccoli, spinach, green beans and cabbage all have low glycemic load. Watermelon have high glycemic index but very low glycemic load (only 4 per serving).

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posted by Amelyn R. Rafael,MD @ 11:35 AM   0 comments
About Me

Name: Amelyn R. Rafael,MD
Home: San Fabian, Pangasinan, Philippines
About Me: Family Physician, and Associate Professor (Clinical Anatomy and Medical Physiology)
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