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What Does a Rainbow Mean To You?
Wednesday, May 28, 2008

I saw this rainbow the other afternoon. It is so perfect and so I felt that there's hope - that soon electricity will be restored (calling on DECORP!) in our place. Yes, it's been 12 days since the storm. Though we have our genset to give us light at night and provide us with cooler ( and bearable) environment, life still is not what it used to be.

We have given up on our refrigerator. Since we cannot stock any perishable thing on it and only drinking water is what's left inside, we decided to turn it off temporarily. That is until electricity is restored. The only problem is that we need to go to the market to buy anything to cook. And we don't find fresh items in the market everyday. We have resorted to canned goods for several days now but the kids are clamoring for something more delicious. I think that means something fresh like chicken and fish.

Anyway, there's nothing we can do but to wait. I just hope that it will not last a month. That would be too much to bear.

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posted by Amelyn R. Rafael,MD @ 11:13 AM   2 comments
Basketball as an Afternoon Fun
Tuesday, May 27, 2008
Basketball is such a popular sport. This is evidenced by the presence of basketball courts (big and small) in every place. The male community, young and old, love to play it, my sons included.

Except on a rainy afternoon, Raymund and Ralph make it a point to play basketball, always donned in their rubber shoes. They spend more or less an hour in the half court (in our backyard) made for them by their Dad. If my husband and I are present, he would play coach to them while I play the water girl. When the game is over, I play the waitress serving them their afternoon snacks.

This is my kids' form of exercise. My husband encourage them to do it regularly. Actually there is no pushing them as they have already fallen in love with the sport. They also have their personal NBA favorites in the person of Kobe Bryant, Lebron James, Derek Fischer to name a few.

Raymund plans to be a varsity player this school year. He had been planning to join ever since but was unable push through. I am sure this would be a fun alternative to his hectic academic schedule.

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posted by Amelyn R. Rafael,MD @ 8:20 PM   5 comments
After the Storm
Sunday, May 25, 2008
Two days after typhoon cosme brought havoc to our lives, the kids pestered me to go to Dagupan City just to look around. They wanted to see for themselves the condition of the place and the extent of the damage which is causing the prolonged brownout. So we decided to go that day and buy our groceries. They insisted to come (though I disagreed) thinking that it will be a walk in the park, maybe because they are too bored staying inside the house. They learned their lesson well for we had to wait in the queue four hours just to be able to reach the cashier and pay our groceries. They had to bear the heat and learn to be more patient.

My kids are so used living comfortable lives and staying in air-conditioned rooms is one thing they can't do without. That's why we chose a school with air-conditioned classrooms and we go to an air-conditioned church. I often wondered how they will adapt if these life's comforts are no longer in their midst. I would always think that they will have great difficulty coping. But life after typhoon cosme proved me wrong.

Of course the change wasn't immediate but slowly they are able to sleep at night with just the wind coming from the electric fan ( we have our generator set turned on at night). They also are able to take naps in the afternoon with the soft breeze blowing from the window. If before they spend most of their time during this summer break watching TV, DVDs, play station, surfing the net and playing computer games, with very little time spent opening their books, now it's the other way around. And I'm so glad that books I bought from Time Life did not go to waste. I hope that they will continue to appreciate good books as they move on in their lives.

It's now one week with no electricity. We have adjusted to the routine. In fact we haven't notice that it's already one week since then. Though we hope that electricity will be restored soon, I am so glad my kids are flexible enough, to be able to cope with life's imperfections.

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posted by Amelyn R. Rafael,MD @ 8:07 PM   0 comments
Are You Sure You're Healthy?
Wednesday, May 21, 2008
Many people will say they are healthy when asked by a doctor. But on further questioning if they undergo routine physical examination and laboratory work-up, obviously they don't. How then can we say that we are in reality, healthy? Does it mean only the absence of symptoms, or simply feeling nothing? Does that guarantee us of a long and symptom-free life ahead of us?

I guess not. Not because doctors want to have patients all the time that they want people to go to them and look for any kind of illness that will make these people go back time and again. Not because doctors make up illnesses for these people which are in reality not present. The truth is that nobody can guarantee he is healthy even without feeling anything.

There are lots of diseases common nowadays which are often accidentally diagnosed simply because a person does not feel any symptom. Let's take diabetes as an example. Most of the time nothing is felt. It is only during the late stages wherein signs and symptoms appear and oftentimes it is too late. There is no going back.

Hypertension, also a common geriatric illness, is oftentimes misunderstood. People are still waiting for headache or nape pain to appear before they go and have their blood pressure checked. And if the doctor found his blood pressure to be high on several occasions, they would question the absence of symptoms. What if the person's pain tolerance is high that's why he is unable to feel anything? Isn't the blood pressure reading evidence enough?

Central obesity, which is defined as waist circumference > or = 90 cm for South Asian men and > or = 80 cm for South Asian women, is in itself symptom free. But it is a part of a group of symtoms which make up metabolic syndrome or syndrome X. The most important component of this syndrome is diabetes mellitus. And in order for a person to be said to have the syndrome, he must have central or abdominal obesity ( as defined ) plus any two of the following: hyperinsulinemia, hypertriglyceridemia, hypertension, and hypercholesterolemia. And as you can see, most of these conditions are symptom-free. They are usually seen after a thorough physical examination. Now do you still consider yourself healthy?

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posted by Amelyn R. Rafael,MD @ 11:29 AM   0 comments
Knowing More on Photography
Since I was a child, all I knew was to point and shoot with my camera. I would go on taking pictures of anything that took my fancy without anybody telling me that all of it was wrong, that there is more to it than just mere pointing and shooting. That is how photography is with majority of people that I know and that was all my idea of photography until I attended a practical photography workshop last month sponsored again by LRI.

It was again a night full of memories. Me and my husband were invited and we were thinking it was just one of those scientific lectures. We were actually surprised to learn that the lecture was about photography by two of the famous photographers in the country. It was a totally different thing for the two of us and maybe to some of the doctors who were present that night. I got excited especially when they announced that there will be a photography contest right after the lecture with a brand new camera as the first prize. Since I always have my camera in my bag from the time I started blogging, I figured that maybe I was good enough to be able to take home a prize. Well, that was how I found out that there's more to photography than what I knew.

There are actually so many important rules to follow, and one of them is to be able to communicate through the picture. You must be able to impart your message through your photograph.

I often take pictures with my subject in the center of the frame. I learned that this should not be so as it creates a boring image. Putting it on the sides is the best thing to do. Try to experiment and you will know why.

We were also told to define the subject and give it more emphasis. Any other object taken along with the main subject must be given less importance. It should only be there to give visual support. Otherwise it will produce visual clutter rendering the picture effortless.

When you remove from the frame visual distractions, you are putting only the essential in the frame. To do this you should move closer to your subject or try to zoom in. Doing either of these two produce different effects.

Well, the best thing to do in order to get the best picture is to shoot and shoot. Practice makes perfect and by experimenting you will be able to make your pictures better, if not the best. The tips mentioned are not all. There is still the physical aspects of the camera, the light effects, and the visual elements. I'm trying my best to learn from experience and I'm not even halfway through. Photography really is an art.
posted by Amelyn R. Rafael,MD @ 8:00 AM   0 comments
Typhoon Cosme: During and After
Monday, May 19, 2008
The electricity was down since 4pm Saturday, May 17, 2008. We were supposed to attend an anticipated mass in Dagupan City but because the storm signal was raised to level three, we decided not to go. We turned on the generator at 6pm, in time for our early dinner, decided that we will turn it off at 9pm. While the generator was on, we read about the storm in the internet. It said that the storm had a velocity of 130 kph and that it will directly hit our area. We started to get ready by having first an early dinner, store some drinking water, take a bath and sleep early, thinking that we will be able to do so.

Immediately after our dinner, we started to feel the weather becoming really bad. Heavy rains started to pour and the winds becoming stronger and stronger with each passing time. I don't think the wind velocity was 130 kph. My husband estimated it to be around 200 kph. It was something I have never experienced yet in my whole life.

My family and I started to witness the blowing of the roofs of our neighbors. The sound of the strong wind muffled the noise coming from them, but I knew we were all in big trouble. We lighted all our outside lights so that neighbors can see their way and the damage to their homes being brought by the storm. I can hear babies crying in the distance and I can feel fear from the rest of us. What if......

Water started to drip from our roof, from our windows and from other openings (like the aircon) where it can pass through. We then put rags on all openings but our efforts were nothing compared to the non-stop heavy rains and gusty winds. I cannot even imagine how leaves are able to enter even with all doors and windows close. We spent some time mopping floors and transferring appliances from one place to another. Our plan of having an early bedtime did not materialize as we were anticipating what will happen next.

We were so afraid so we opted not to turn the generator off anymore. It was 2am and I still can't find sleep. I move up and down the house checking on things. The signage leading to the clinic was gone. Lots of trees uprooted and blocking the highway thus causing traffic to big trucks passing by. It was already around 4 am when sleep finally visited me.

I was awaken at 6am Sunday by the sound of people shouting, pounding roofs, and of trees being trimmed. I was relieved to see the morning and to know that we were all safe. Though still sleepy, I immediately got out of bed, got my camera and went outside to take pictures. What I saw shocked me. All the houses surrounding us were damaged, some partially others totally. It was still early but the clothes' lines were already full of wet clothing. More trees were down. Even the vegetable plantation in our backyard was gone. Everybody was busy cleaning and fixing.

containers for catching dripping water

houses with roofs blown away

my husband fixing the post where the signage used to be

a tree on the roof top

more trees brought down

a neighbor's house

our backyard

a neighbor's house

I went through our house, found out that there are minor things that needed fixing, and still no electricity. The news said that it will take several days before the electric company resumes service. That only means we need to store diesel for the generator. We went around to buy but all gasoline stations were close. That means we have to make do with what we have until normal operations resume.

Cleaning started. That was a totally different Sunday from what we used to have but I am very thankful to God for what we have. We still have a home, we still have each other.
My laundrywoman came over early this morning telling me that houses in their area were all blown away including hers. "Mabuti pa kayo tumulo lang, kami wala nang tirahan", she said. Even concrete houses along the shoreline were blown away, according to her, yet the news reports say only small figures were totally devastated. I cannot believe what's on the news. What we experienced was far from just signal number three. It was a super super typhoon accompanied by a tornado. That is how I see it and we were not even warned. It was signal number two the whole day of Saturday and was just raised to three two hours before it hit us.
The sky was still gloomy the whole day yesterday, we thought it will still rain. But thank God there was not a single drop of rain, allowing people to clean and fix houses. Today is a sunny day but everything is still far from over. I hope everybody is able to pick up the pieces and face life all over again.

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posted by Amelyn R. Rafael,MD @ 10:15 AM   4 comments
Belated Happy Mothers' Day!
Monday, May 12, 2008
Yesterday was Mother's Day and as expected I was still busy with work that I almost forgot all about it. It was good my sons greeted me before I had a chance to go downstairs and have breakfast with my mom. I was able to greet her before anybody else could.

She was scheduled to go to Manila yesterday together with my sister but I was able to convince them to postpone it for today instead, so they can join us to a special dinner last night. It was a very enjoyable one.

To all the mothers out there, belated happy mother's day to all of you. I want to share with you the following poem given to me by Bong of Getz pharma. Here is how it goes.........

A Mother's Love
A Mother's Love is like an island
In life's ocean vast and wide,
A peaceful, quiet shelter
From the restless, rising tide...

A Mother's Love is like a fortress
And we seek protection there
When the waves of tribulation
Seem to drown us in despair...

A Mother's Love's a sanctuary
Where our souls can find sweet rest
From the struggle and the tension
Of life's fast and futile quest...
(author unknown)

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posted by Amelyn R. Rafael,MD @ 11:30 AM   1 comments
Medical Mission: Operation Libreng Tuli
Friday, May 09, 2008
Medical missions are numerous during the summer months. I use to hold mine in my own clinic also during these months. I do it by giving samples for cough, colds, diarrhea, fever, deworming, and multivitamins. I ask samples for such project from drug companies, and they send me boxes of these so generously. When samples do not suffice because of high turn-out of patients,or when samples do not arrive on time, I buy these medicines using my own money.

The problem with this kind of medical mission is that most people who come are not actually sick at the time. They just come to ask for medicines for their future use. They hoard these medicines for use of all family members. And since dosages differ in every individual especially in children where they are based on the patient's weight, the actual purpose of the mission is defeated. That's why most doctors lose interest doing this type of medical missions. Aside from saving money, the patients do not really benefit from such kind of practice.

Operation Tuli (circumcision) is another kind of medical mission. Unlike just giving medicines for patients to take home, doctors perform the operation on-site. And since the procedure is expensive if done in clinics, patients and their families really appreciate it. But just like anything free, this also has a down side to it. Transmission of diseases (like Hepatitis B) are not 100% prevented.

This summer, my husband and I were part of several operation libreng tuli. One of these was hosted by Alfonso Lee Sin Memorial Lodge no. 158, F. & A. M., at Bonuan Boquig, Dagupan City, Philippines. They'll be hosting another one this weekend, May 11, 2008. For those who live near the area and are still uncircumcised, this is another chance before the school days begin.
posted by Amelyn R. Rafael,MD @ 8:00 AM   5 comments
Visit to Subic via SCTEx
Monday, May 05, 2008
It was in the year 2005 when I first visited Subic. I had to accompany my son Raymund at that time during their school field trip. We went to Zoobic Safari and Ocean Adventure on a bus (Victory Liner) from Dagupan City. It was a long ride, but a very enjoyable one. My son had a grand time riding the Safari jeep, seeing the live iguanas, crocodiles, turtles, snakes , lizards, and other animals in the Serpentarium and Savannah. And he was overjoyed as much as I was watching the whale and sea lion shows at Ocean adventure. Though very tired at the end of the day, we had to bear the long ride again going back to Dagupan City where we were fetch by my husband to bring us to San Fabian, our final destination.

That was when the SCTEx (Subic Clark Tarlac Expressway) was not yet around. Now with its construction there is less traffic, and it cuts the travel time by an hour or so (Mabalacat to Subic). Its not yet completely passable though as some areas are still under construction. But this is really a great help to the motorists. We went there just recently to attend the Philippine Association of Academic Biochemistry (PAAB) of which my husband was inducted as a new member.

Since the place is mountainous, they had to bring down some parts of the mountain as you can see in the photo. The place is awesome, so nicely built. I wish there is one like this extending from Manila going to the north.

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posted by Amelyn R. Rafael,MD @ 9:06 PM   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)
See my complete profile
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