Ways To Help Your Doctor Help You

“You know your body best, so if you want your doctor to help you even more, you need to tell him your story because you are the expert of your own life,” Margaret Bengzon, Head of the Strategic Services Group of The Medical City tells me one afternoon.

In the Philippines, the doctor’s word is often, God’s word. As parents of an ill child, the norm is usually to just take what the doctor says and go with whatever it is he or she wants done. However, we tend to forget that not everything going on in our child’s life is known to the doctor.

This is the paradigm that The Medical City wishes to break with its new advocacy campaign. One that will hopefully shift the way we Filipinos think about doctors and healthcare. A campaign that will probably resonate with many families who have lived the expereince of caring for a sick loved one whether it be child, parent, or spouse. Bengzon says that at The Medical City, every patient is considered a partner in the healthcare process. In a true partnership, where all things are equal, it is expected that communication flows freely both ways.

However, in a healthcare setting, this is often not the case. I have sat in too many family conferences to know where parents or the chief caregiver hesitates to ask questions or share stories and information, and anxieties for fear of thinking that what he or she has to say is irrevelant. Take for example, a child who is brought to the pediatrician complaining of stomachaches day in and day out. Tests are run and the child is checked but the doctor cannot seem to find anything wrong. Then the mother finally says, at the end of an almost half hour consultation, “Oh by the way, he’s also been complaining about this teacher who has been giving him a hard time in school…” Bingo. Suddenly the pediatrician has this new insight that changes the course or manner by which he or she views the problem. Child stress can be the root of many ills that is often not seen on a medical chart.

Another story, an elderly patient is taken to the doctor by her adult children. She complains of palpitations and vertigo (dizziness). A battery of tests are run to find out what is wrong. Her heart is checked, all clear. She is sent to several specialists and her tests indicate that she is as healthy as a horse. After a couple of consultations, in the course of a conversation, she finally admits to her primary doctor that she has been having sleepless nights worrying about her youngest child who is working overseas as a nurse and has been the subject of wife battery. Again, if the patient had only mentioned this at the very start, then perhaps, a lot of money could have saved and unecessary anxiety over test results should not have happenned.

Some doctors are experts at drawing their patients out. It is a gift, but it is also a skill, I believe that any doctor is capable of learning. However,the reality still is that not all doctors are as adept, and so, as parents of our children, or caregivers to our own parents, we need to ask the questions, to share our stories. Doctors are human beings and not mind readers. Not everything relevant can be seen on a patient’s chart. Yes, numbers and test results are significant, but definitely, in many cases, there are many significant issues about one’s life that need to be shared with your doctor. Questions are another issue. One needs to be pro-active. Research on what it is you or your loved one has and don’t be afraid to ask. Is there a better way? Are there alternative treatments? What is the best possible outcome if we do this or that? How much is this going to cost us?

Your doctor can help you best if you also help yourself, tell him or her what is on your mind and share what is in your heart or what it is that is going on in your life. We pay very good money to get the best health care. A doctor will appreciate it if he sees that you are open and interested to know more about your illness. Do not hesitate to share your fears. The best of doctors will not pooh pooh your concerns. They take the time to listen and show you compassion. Even if there is a whole gaggle of patients coming after you, the good doctor will not make you feel that you are being rushed. A CNN report suggests some ways how a patient can better help his or her doctor –

© Bring in a complete list of your medications. This list includes all the prescription and non-prescription medicines that you are taking and any and all health supplements and vitamins that you have been drinking. Write the name of the drug, the dosage and how often you take it. My personal practice is that whenever any of my children are ill with fever, I make a chart so I can track down the highs and lows of the fever (especially if it has gone on for a couple of days) and beside it the times I give the medication. Whether or not my doctor asks for it, I am ready with the information.

© Come armed with your personal health history. It always pays to know what illnesses you have had in yoiur bloodline. Do you have a history of cancer, heart disease, diabetes, hypertension, mental health problems? If your grandparents and parents are still alive, I suggest you sit down with them and find out what sickness has plagued them through generations. Some families have a genetic predisposition towards certain types of cancer, heart disease and even mental illness. If you have had a parent who died from a heart attack before the age of 50, your risk of having a heart attack yourself is higher than the general population. Having that knowledge will encourage you to hopefully be more careful aqnd vigilant about what you eat, how you exercise and taking care of your heart.

© Make a list of your concerns and share them. The reason you are seeing a doctor is because there is something bothering you about yourself or your loved one. However, sometimes, when you are already at the clinic, or in front of your doctor, fuzzy thinking sets in. The CNN report quotes Dr. Dana Frank, an internist as Johns Jopkins who says that she appreciates the patient who is ready, “like a boy scout” and is not afraid to ask the questions. If you also feel that something is not very clear to you, don’t hesitate to ask your doctor again – “Could you please run that by me again, doc?” Yes, doctors are busy people but it is a ptient’s right to get the facts straight and very clear. Write notes when necessary. It is best to be clear about your doctors orders, than coming out of the clinic and wondering for the rest of the day if you got it right.

© Don’t be afraid to ask questions. Even at the risk of sounding silly, do not hesitate to ask questions of your doctor. Clarify the points that are not very clear to you.

© Know your doctor and find the right fit. In this day and age of HMOs it is hard to be picky about doctors. But here’s the trick, often, I first research and find out the list of MDs that the HMO has in a particular hospital. Once I have the names, I go around and ask colleagues, if they have tried out this doctor, or better yet, if I know someone from that hospital. I try to find out a little about this doctor that I am about to see. That way, I already have an idea about what to expect. In certain instances, for whatever reason, you may not be happy with your first doctor or with what he/she has to say. Remember that you have every right to seek a second opinion, and even a third one, especially, if what you are considering is a major procedure. Work with the doctor you are most confortable with. Only you will be able to tell who the right person is for you or your child. After all, it’s your body, and you know its quirks and idiosyncracies best. At the the end of the day, it’s your decision on whom you want to help you care for it.

Published in my Roots and Wings column in the Philippine Daily Inquirer, 6 July 2008

Disaster Mismanagement

Published in my Roots&Wings column in the Lifestyle Section of the Philippine Daily Inquirer, 29 June 2008

"Grief is a journey, often perilous and without clear direction, that must be taken. The experience of grieving cannot be ordered or categorized, hurried or controlled, pushed aside or ignored indefinitely. It is inevitable as breathing, as change, as love. It may be postponed, but it will not be denied."~ Molly Fumia

The manner by which Sulpicio Lines has handled the tragedy that is MV Princess of the Stars is a classic example of what disaster management should not be.

The actions shown by this shipping company whose track record for accidents and mishaps is now perhaps the worst in the Philippines has been deplorable, to say the very least. Sulpicio has not shown an ounce of compassion to the families of those who have died, the survivors, and those who continue to be missing.

As I write this, no clear-cut measures have been made to ensure proper identification of those bodies found floating days after the tragedy. Family members of missing passengers have not been properly housed, ferried, shuttled and advised about what is going on. Yes, as one banner story in this paper announced last Friday, ‘World stops for grieving kin of missing passengers”. When tragedy strikes, especially when it concerns the life of someone whom you love, everything else in your life becomes meaningless.

I ask myself, what kind of bereavement support is being provided for these families? At least over in Cebu, through the DSWD, the local government has been offering some form of debriefing or grief support to the survivors and those whose loved ones have yet to be found. Their loss is ambiguous, the kind of grief that takes forever to heal from, one where it is very difficult to find closure.

At this point in time, the best that Sulpicio Lines can do is get their act together and provide for the families of the 800 or so passengers that have yet to be found. Thank God for organizations such as the Public Attorneys Office (PAO) and the Volunteers Against Crime and Corruption (VACC) for stepping in and giving the bereaved families form of direction.

Sulpicio Lines offer of 200,000 pesos per victim is not the way to go with these families. In addition to this, or even over and beyond the financial assistance, genuine compassion, care and concern towards the families waiting would have been much laudable. Instead, these family members have gotten the opposite.

Gina Virtusio who was the Public Relations Manager at WG&A Superferry (now Aboitiz Transport Group) told me that the gesture most appreciated by families affected by a tragedy of this magnitude is the support and care shown to them by the shipping line. She recalls how when in February 2004, Superferry 14 was bombed by the Abu Sayaff, the entire company involved themselves in primarily caring for the victims families. “It was really tough and as employees you are only human too and so you are prone to break down. At first you will really get yelled at, cursed, almost to the point of being beaten, but you just have to ride it out and show them that you care,” she says. In the end, Virtusio says that the families eventually became very close to them and that she even remains in touch with some of those affected by the tragedy. “You must show compassion, there is just no other way,” she stresses.

I am reminded of what former New York Governor George Pataki said after TWA 800 crashed off the coast of Long Island on July 17, 1996, he said, “It became clear to me that, as Governor, I was going to make a difference – and in more ways than one. I began to realize that even in the darkest moments on the job, I could somehow bring light to someone, somewhere… When I heard the news, everything that seemed important just minutes before, suddenly became irrelevant. It occurred to me that one of the most important functions a Governor can fulfill,is to extend a caring hand to people in despair, and give them what they need most in times of sorrow: comfort, understanding, and a shoulder to cry on.”

Days after this horrible crash, a memorial service was held at the site attended by all the family members of the crash victims. The ceremony was broadcast all over the world, allowing others as well, to show love and support for the family members who needed it so desperately. Pataki says that he has never stopped thinking of those people. “The moments I spent with them are forever etched in my mind and in my heart. Many of them told me that the service and all of the state’s efforts on their behalf, helped ease their pain…One of the most important things we can do in life is to give a piece of ourselves to lighten the burden of others.”

You would think that after a spate of tragedies that began with the MV Dona Paz, Sulpicio Lines would have mastered the art of crisis and disaster management. Apparently, this is not so. Pain and anguish cannot be swept under the rug by 200,000 pesos. Compassion and care far outweighs money in times of tragedy.

I think of the 800 families affected by such a deep and searing loss that will change their lives forever. I end this by sharing with them a poem written by Janelle Davis whose sister Rose died in an Alaska Airlines crash in January, 2000.



HOPI PRAYER

Do not stand at my grave and weep.
I am not there, I do not sleep.
I am a thousand winds that blow.
I am the diamond glints on snow.
I am the gentle Autumn’s rain.
When you awaken in the morning hush,
I am the sweet uplifting
rush of quiet birds in circled flight.
I am the soft stars that shine at night.
Do not stand at my grave and cry:
I am not there, I did not die.

How Lulu Orena Survived Her Daughter's Abduction

“I was always against her going to Mindanao because I knew it was very dangerous,” Lulu Orena tells me with a smile a few hours before Ces was to check out of The Medical City. “But Ces has always had a mind of her own. Minsan she will tell me that she’s going there for an assignment, when she does, I always remind her – ‘Ces, paano na ang mga anak mo pag may nangyari sa iyo?’”

Dressed in a white cotton tunic over slacks, Lulu was still visibly tired but terribly relieved that the worst was now over for her eldest daughter, Ces. She recalls how on she became hysterical upon finding out on the morning of June 9 that Ces had been kidnapped. “Chary Villa called me to confirm that she was missing and that she had been kidnapped. When I heard the news I knew that my worst nightmare had just begun.” On the ride from her home in Fort Bonifacio, all the way to the ABS_CBN studios in Quezon City, she says she was a wreck. “I was shaking all over and having palpitations like crazy. Nanginig talaga ako,” she recalls.

On day one of her abduction, she had the chance to speak briefly to Ces, whose first words to her were, “Mommy, mommy, please don’t cry,” Lulu shares. The nine days that followed were the most difficult days of her life. “One more day was just a day too long,” she says looking back. “I was so hungry for news the whole time that I kept the television on at our house 24/7. One television was tuned in to ABS-CBN and another one to GMA-7. The radio was constantly tuned in to DZMM. “I really wanted to go to Sulu. I didn’t care. I just wanted to be near my daughter. To be in the same place with her. When I saw on television, the things she had left behind in her room, it really broke my heart and I wanted to board the next plane to Sulu but my children would not let me.”

Lulu is grateful for the blessing of her children. Daughter Grace kept her company all throughout, while only son Frank and youngest daughter Joyce were busy with the negotiations. The rest of the Orena brood had been tucked away in a safehouse with Ces’ three sons, while Lulu and Joyce, opted to remain at home. “I would just be crying at makakagulo lang ako sa negotiations.” Each day that came and went was sheer torture she says. When nightfall would come, she would break down in tears, thinking of how Ces was faring in the jungle. “Pag uulan, lalo na akong nalulungkot and I would really storm heaven with my prayers. I would ask God, all the saints, Mama Mary, Ces father (who passed away in a helicopter crash in 1993) to please keep her safe from harm.”

Sleep would come fitfully and only when her body could no longer take the tiredness. “They gave me sedative but it did not work,” she smiles. A mother’s anguish and worry, far surpasses the effects of any drug. Lulu clarifies that there is no truth to the news that she had a stroke or a nervous breakdown. “I was close to it, I guess. I became very depressed and lost all desire to eat and exercise – things that were part of my daily routine. All my thoughts were focused on Ces.” Respite would only come briefly when her grandchildren would return home from school and wrap her in their hugs, saying that it was going to be okay and that their aunt would be home soon. “I don’t know what I would have done if my children and grandchildren were not around. Siguro patay na ako ngayon,” She shivers at the recollection.

At the time of our interview on Friday afternoon, Lulu was still feeling the effects of the stress from the last nine days. “Medyo nanlalambot pa rin ako but I cannot stop thanking God for carrying us through,” she shares, her tired eyes, beaming with joy. She is also very grateful to everyone who prayed for her daughter’s safety. She made special mention of her late husband’s classmates, members of PMA Class ’61 and their wives who threw their full support behind her. “I am just so grateful and having gone through an ordeal such as this, I realize that the most important thing in life is really just family. Money will come and go. You can always earn it. Material things will lose their value. To have a strong faith in God and having your family intact, safe and sound, that is what’s most important.”

When the chopper carrying Ces finally landed on the helipad of The Medical City that rainy Wenesday afternoon, Lulu says that it was a miracle made real. She shares that the very first thing a tearful Ces whispered in her ears when they hugged was, “Mommy, I’m sorry, I’m so sorry.” Forgetting all the anguish she had just been through, just like any mother faced with a repentant child, she told her eldest daughter, “Don’t say sorry. It’s all right. You’re home now and that’s all that matters.”

Ces Is Free! The Medical City's Official Statement

Ms. Ces Orena Drilon arrived at The Medical City this afternoon at 2:30 PM. She was flown in by helicopter from the Centennial airport.

Ms. Drilon is in good spirits and requests that she be given time to rest. She is accompanied by her immediate family members. Her two companions, Mr. Jimmy Encarnacion and Angelo Valderrama are also confined here in the hospital. The Medical City respects and values theprivacy of its patients and requests that the media extend the same to Ms. Drilon, her companions, and their respective families.

After an arduous and very difficult nine days in captivity, Ms. Drilonwishes to spend some quiet and private time with her family members. The Medical City is committed to extending to her the best possible care during this period. We will update you on Ms. Drilon's condition as she authorizes us to do so. Thank you very much.

Ces, is a TOWNS sister. It gave me great joy to witness her arrival today from my office window and to be able to deliver this message tonight. We are so glad she is back and safe. Now her journey to healing begins.

Gabriel Garcia Marquez_A Letter To My Friends

Tonight I am wistful. H has just left for Vietnam and once again we are apart.

I am wistful too because tonight, I looked intently into a dear friend's photograph and saw great sadness masked behind a smile. I know those eyes so well. And my heart breaks to see you in such pain. I wish to share in your sadness but for reasons only known to you, you refuse to let me into your life at this point. And so I share in your sorrow from afar. I pray for you and storm the heavens for your loved ones. I find comfort in knowing that God stands in the gap, in the chasm that you opt to build between us, for now.

Nothing by accident...Tonight I stumbled upon this beautiful letter, written by Gabriel Garcia Marquez who has been diagnosed with terminal cancer. My friend Ardy, from whose blog I discovered this piece, says that we should not wait until the last minute to write a letter such as this. Marquez's words shine through the darkest of nights. His sorrow has given birth to such wisdom that leaves us breathless and inspires us to do just as he has written...

This is for H, and all my loved ones, and my dear friend... may this illumine the dark night of your soul. If God, for a second, forgot what I have become and granted me a little bit more of life, I would use it to the best of my ability. I wouldn't, possibly, say everything that is in my mind, but I would be more thoughtful of all I say. I would give merit to things not for what they are worth, but for what they mean to express. I would sleep little, I would dream more, because I know that for every minute that we close our eyes, we waste 60 seconds of light. I would walk while others stop; I would awake while others sleep. If God would give me a little bit more of life, I would dress in a simple manner, I would place myself in front of the sun, leaving not only my body, but my soul naked at its mercy. To all men, I would say how mistaken they are when they think that they stop falling in love when they grow old, without knowing that they grow old when they stop falling in love. I would give wings to children, but I would leave it to them to learn how to fly by themselves. To old people I would say that death doesn't arrive when they grow old, but with forgetfulness. I have learned so much with you all, I have learned that everybody wants to live on top of the mountain, without knowing that true happiness is obtained in the journey taken & the form used to reach the top of the hill. I have learned that when a newborn baby holds, with its little hand,his father's finger, it has trapped him for the rest of his life. I have learned that a man has the right and obligation to look down at another man, only when that man needs help to get up from the ground. Say always what you feel, not what you think. If I knew that today is the last time that that I am going to see you asleep, I would hug you with all my strength and I would pray to the Lord to let me be the guardian angel of your soul. If I knew that these are the last moments to see you, I would say 'I love you'. There is always tomorrow, and life gives us another opportunity to do things right, but in case I am wrong, and today is all that is left to me, I would love to tell you how much I love you & that I will never forget you. Tomorrow is never guaranteed to anyone, young or old. Today could bethe last time to see your loved ones, which is why you mustn't wait;do it today, in case tomorrow never arrives.

I am sure you will be sorry you wasted the opportunity today to give a smile, a hug, a kiss, and that you were too busy to grant them their last wish. Keep your loved ones near you; tell them in their ears and to their faces how much you need them and love them. Love them and treat them well; take your time to tell them 'I am sorry';' forgive me','please' 'thank you', and all those loving words you know. Nobody will know you for your secret thought. Ask the Lord for wisdom and strength to express them. Show your friends and loved ones how important they are to you. Send this letter to those you love. If you don't do it today...tomorrow will be like yesterday, and if you never do it, it doesn't matter either, the moment to do it is now. For you, With much love, Your Friend, Gabriel Garcia Marquez Thanks to my online buddy and friend, Ardy Roberto, for leading me to this beautiful reflection.