May 17, 2024
May 17, 2024 — It is santol season once again. Beware of santol seed swallowing. Please do not, I repeat, do not swallow santol seeds. They will perforate your intestines after which you will be operated on. You can die just because of swallowing santol seeds.
I have been doing public awareness on the danger of swallowing santol seeds since 2001.
For details:
https://rojosonmedicalclinic.wordpress.com/category/santol-seeds/
Ms. Elena Hisoler was 80 years old in 2013 when I did an excision (carcinoma-in-situ) and then in 2015 modified radical mastectomy on her breast cancer (invasive mammary carcinoma) – Stage 1. Nodes were negative. ERA / PRA positive. No HER-2-HEU was done. No hormonal therapy. No chemotherapy. No radiotherapy.
2024 May – she is now 90 years old and there is no clinical evidence of breast cancer recurrence. In other words, she is now 11 years in remission. We both thank God for this long remission.
Ms. Hisoler requested to have her picture taken with me and to post it in my blogs to inspire other patients.
April 19, 2024
Yesterday, I did a total mastectomy and axillary dissection on a 62-year-old patient with breast cancer.
Yesterday, after the operation, I talked to the husband on my operative findings and what to do next – post-anesthetic monitoring; monitoring in the room; activities and diet and medications (particularly on pain medications and no need for antibiotics, etc). We also discussed the plan of discharge the next day and waiting time for the histopath result and the follow-up in my clinic and schedule. Lastly, I told the husband that I will make teleround today (April 19, 2024) at about 10 am.
So, April 19, 2024, at about 10 am, I made a teleround through a video-chat in Viber.
Before examining the wound, I asked the patient how is the pain (she said not so painful, tolerable, with intake of naproxen prescribed by the anesthesiologist). I asked for any other disturbing symptoms like dizziness, nausea, etc. (none – she is eating well). I asked her husband to assist me in taking a look at her wound and tube drain. I asked her husband to lift the gauze and elastic bandage covering the wound and I saw dryness, with minimal blood stain on the gauze; no signs of infection; no signs of flap necrosis, hematoma, and dehiscence. I looked at the tube drainage – not red just pinkish. and acceptable in amount.
Then, I asked her whether she want to go home already today (first postoperative day). She said yes. I instructed her on what to do at home. I said I will send her a link to my primer to read entitled “My usual discharge instructions after a modified radical mastectomy.”
To complete the round, I asked the husband to call the nurse to the room with the chart. I asked some questions to the nurse (I reviewed the postop order of the anesthesiologist – no parenteral pain meds, just oral naproxen and celecoxib on standby; intravenous fluid – just to keep vein open; etc.) I saw an IV bottle hanging on a pole and there is an intravenous line on the patient’s left hand. I made an order to discontinue the fluid once consumed or to discontinue if patient wants to go home already. I then gave a discharge order to the nurse.
To all queries of the patient and husband, I answered them through this teleround.
Those in essence are the components and activities of my teleround for this patient – assessing the postop course; giving instructions to patients and nurse; answering questions from patient and relative; etc. This particular teleround lasted for 30 minutes.
I have to mention that my teleround is supported by monitoring reports from my residents:
RM 755 xxxxx
Post-op Day 0
Back at room
Adequate pain control
Tolerating full diet without vomiting
Post-op site dry, no bleeding or discharge
JP 40cc/12 hours serosanguinous
Advised daily wound care and JP drain monitoring at home
Will check on wound and dress tomorrow morning
Will discharge patient tomorrow if no problems and okay with you po
RM 755 xxxxx
Post-op Day 1
Adequate pain control
Tolerating full diet without vomiting
Post-op site dry, flaps viable, no bleeding or discharge
JP 55cc/12 hours serosanguinous
Advised daily wound care and JP drain monitoring at home
Will facilitate discharge today po
Advised daily wound care and JP drain monitoring at home
Will facilitate discharge today po
Outcomes of Teleround:
CONVENIENCE for patient, nurse and ME.
AS EFFICACIOUS as a face-to-face medical round.
Foremost, DELIGHTFUL PATIENT EXPERIENCE – satisfied and happy patient (she told me at the end of the teleround, she will give me a gift).
Ms. Febe Caldino was 61 years old in 2014 when I did a modified radical mastectomy on her breast cancer. She opted for prophylactic mastectomy on the contralateral breast. Histopathology showed invasive ductal carcinoma with a tumor size of 4.5 cm and NEGATIVE axillary nodes. ERA / PRA – Positive; HER-2-NEU – equivocal. She took Tamoxifen for 8 years.
I saw her lately in April 2024. She is now 72 years old and there is no clinical evidence of breast cancer recurrence. In other words, she is now 10 years in remission. We both thank God for this long remission.
Ms. Febe Caldino consented to have her picture taken with me and to post it in my blogs to inspire other patients.
April 1, 2024 – I tried to request the Philippine College of Surgeons to issue a public health advisory on the dangers of swallowing santol seeds.
Sent messages to at least 4 members of the Board of Regents of the Philippine College of Surgeons with this request:
“xxxx (nickname of BOR), I am glad to see this relevant and timely advisory from PCS on safety during the Holy Week. How about an advisory from PCS on the danger of swallowing santol seeds? The santol season is fast approaching. We will still continue to have cases of colonic perforations secondary to santol seeds. I have been publicizing this danger since 2001. Dr. Willie Ong has picked it up. How about one coming from PCS? DOH has not picked it up. PSGS has not picked it up too. Thanks.”
I attached the following:
My Masaya Moments – Joyful Moments when I got these responses from 3 members of the Board of Regents:
“I can’t agree more Sir. Let me talk to PSGS or Colorectal Society about it.“
“Hi Sir, sure po!
I will discuss with the Board of Regents po.
And will let you know po. Thanks Sir.”
“Thank you very much for this Sir… I will bring this up in our BOR meeting po… I will see as to which committee this may fall into po… I will also ask PSGS to look into this po… will share this poster to them. Thanks and God bless po.”
Will wait.
Since 2001, I have been issuing advisories on “BEWARE OF SANTOL SEED SWALLOWING.”
2001 to 2024 (23 years now).
Will start a ROJoson Breast Wellness Clinic Infographics – March 18, 2024.
Target: once a month posting.
File: breast_wellness_clinic_infographic_roj_24mar18_21.ppt in USB (ROJ-DOC-24) and G-Drive (Sharps).
Facebook – ROJoson Breast Wellness Clinic
ROJoson Breast Wellness Clinic – Infographic – 2024
March 18, 2024
March 12, 2024
Today, in my ROJoson Face-to-Face Medical Consultation in my clinic in Manila Doctors Hospital, I was made aware of the categories of patients who I was seeing which elated me and made me self-contented.
On that day, I had 3 categories of patients.
All these three categories of patients were treated equally without discrimination: they were given booking appointment as arranged and on first come first serve basis; they were alloted the needed time for consultation; they were managed according to my standard patient management processes; etc. Foremost, they were all treated equally without consideration whether they were paying or not paying for the medical consultations.
I was elated because it dawned on me that I have incorporated or integrated my compassionate patient management and patient-centered care program in the my face-to-face medical consultation management system. I will definitely continue this practice.
In March 12, 2024, I had 3 categories of patients as mentioned above. I will definitely have a fourth category which will include patients whom I will not charge out of courtesy. These are patients who are my relatives, medical colleagues, close family friends, etc.
So, four categories of patients in ROJoson Medical Consultation, either face-to-face or telemedical consultation:
Elated to blog this to let people know the types of patients that I am seeing in my medical consultations.
The patient with financial disability mentioned above was a patient with parotid cancer whom I operated for free in 2023 and came for checkup.
There were two patients who used vouchers that I issued them for a free medical consultation. Circa 2021, I have been issuing vouchers as motivating awards in my ROJoson PEP Talk (Patient Empowerment Program), Cancer Crusaders Club Annual Meet and other patient-centered care projects that I have. See samples of vouchers.
December 2023
Mitch Melendres – December 2023
I organised a Christmas party for my cancer patients last Dec. 2019, unfortunately because of the pandemic we were not able to do it again. I’m planning to do it this Christmas again but due to some unavoidable circumstances, I cancel it. But I plan to do it this Valentines instead po.
I have been giving vouchers for ROJoson Medical Consultations since 2020.
These vouchers are essentially motivating awards in the ROJoson Cancer Crusaders Club Virtual Meet Program and ROJoson PEP Talks.
The giving of vouchers for Free ROJoson Medical Consultations, aside from its motivating reason, constitutes part of my ROJoson Compassionate Humanitarian Program (essentially, encouraging patients to consult as needed and as early as possible).
Starting 2024, I will change the requirements of OLETE (Online Learning cum Evaluation Test Exercise) Certificates associated with the ROJoson PEP Talks from 50 to 25. So, starting 2024, obtaining 25 OLETE certificates will entitle one mentee to a voucher for a free ROJoson Medical Consultation either Telemedical Consultation or Face-to-Face Medical Consultation. This is to strengthen my ROJoson Compassionate Humanitarian Program, encouraging patients to consult as needed, as early, and as often as possible.
The counting of OLETE certificates using the 25 to 1 voucher rule shall start with the first PEP Talk held in January 2024. The counting using the 25 to 1 voucher rule will be extended only to those who have at least 50 OLETE certificates already on December 31, 2023. Those who have at least 50 OLETE certificates and are interested to accruing more should inform me in writing (a short note will do) before March 31, 2024. Otherwise, all counting using the 25 to 1 voucher rule will commence with the first PEP Talk held in January 2024.
See this link for the official count of ROJoson PEP Talk OLETE passers from May 15, 2021 to December 2023.
Mentees with OLETE CERTIFICATIONS in ROJoson PEP Talks (from May 15, 2021 to December 31, 2023)
Although I have records of OLETE passers, since I posted all the OLETE certificates in the ROJoson Patient Empowerment Program Facebook Page, it will be incumbent upon the mentees to keep track of their OLETE certificates and present to me their number of certificates in their request for a voucher.
Starting 2024, there will be no more catching-up taking of OLETEs from May 15, 2021 to December 2023. Starting 2024 also, mentees who want to take the OLETE should do so not more than 2 weeks after the date of the live streaming of a PEP Talk.
For any query, contact ROJoson (rjoson2001@yahoo.com)
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