By Tedler D. Depaynos, MD
The patient was a retired kindergarten teacher who returned supervising their small farm in a nearby lowland municipality. She was also busy doing charity work at their neighborhood church when on several occasions she found out that she could no longer reach their church without resting once or twice along the way. She started experiencing chest heaviness and easy fatigability but no chest pains. She was then forced to consult their young lady Municipal Health Officer (MHO) who incidentally is their neighbor and graduated from our local medical school. She was given the diagnosis of “Myocardial Ischemia” confirmed by an ECG done at the MHO clinic.
According to the patient, their local MHO gave a very detailed explanation to the medicines she prescribed. The lack of oxygen (ischemia) may be due to her HPN which may cause spasm of the blood vessels supplying the heart muscles (coronary arteries) hence anti-HPN drugs were prescribed. It may be due to severe exertion and even excitement so she was advised to “relax”. The lumen of the coronary arteries may have narrowed due to old age and deposits of “fatty tissues” like cholesterol, triglycerides, lipids, etc. on its walls, hence anti- “cholesterol” tablets were prescribed and non-fatty diet was advised. It may also be due to “thick” blood so again tablets to lessen the blood “concentration” was prescribed. The patient faithfully took the medications for nearly two months but according to her there was no satisfactory relief of her complaints. Hence, on her own she came over for a 2nd opinion.
She was then referred to a cardiologist who did a further work-up. The cardiologist was very much impressed to the lady MHO who did an ECG on her own and especially when she learned that she was once one of her students. Actually, she remembered her pretty well because she was one of the students who always submitted her examination papers late.
She wholly agreed to the medicines that were prescribed with some additions to strengthen the heart but warned the patient that the medicines should be taken continuously as maintenance meds. Her problem is not like bacterial diseases like pneumonia so that when the bacteria is eliminated, there is complete recovery. The medicines maybe taken for life! She also emphasized that if she would stop taking her medicines, the coronary arteries may be gravely narrowed or completely blocked and this may be manifested by severe chest pains or “heart attack”. Her manifestations may be early warning signs so that with continuous medicines and with no “satisfactory” relief she may undergo “angioplasty” or the narrowed or blocked coronary arteries may have to be opened by placing a “stent”.
The patient was very much thankful and likewise very much impressed with their neighbor MHO as she handed the bag of medicine samples given by the cardiologist as starter doses for her other patients. She kept on relating her experience at their church gatherings which made the MHO parents always beam with unceasing pride.
PHILHEALTH corner
It was over a cup of coffee when my old classmate from high school was relating his experience in a local hospital. They have been doing “apostolic” work for quite some time abroad and when they came home for vacation, his wife underwent a simple excision of a breast mass under sedation. Prior to the surgery, their surgeon asked him if his wife is covered by PhilHealth. Since he has not been paying for the past decade since he retired, he simply answered “no”. While outside the operating room waiting for his wife, he suddenly recalled that his wife was one of his dependents when he was still employed and when his PhilHealth dues were being paid by his employer. This he mentioned later to their surgeon who advised him to see the PhilHealth “corner” at the hospital lobby.
From a distance, the PhilHealth lady appeared professionally serious which made him a little inhibited. Upon presenting his problem, however, the personnel was with all smiles and very accommodating as she verified his status in her computer. When she asked the name of his wife he said she is from Bontoc and he has to search for her senior ID before he gave his wife’s maiden name. He forgot it for a moment! He was smiling when he was relating it because obviously the lady noticed his transient memory loss. My smile was of course wider. Again when he was filling up the PhilHealth form he was writing his own data instead of his wife’s. The lady personnel was without further comment and trying to hide her smile when she just gave him another form and requested him to change what he had written. He was very thankful to the very helpful PhilHealth lady and extremely happy that their expenses were mainly covered by PhilHealth.
When I asked him the name of the PhilHealth lady, he said that he forgot to ask but it happened at SLU Hospital and she looked very healthy looking. At the same time he was very thankful to the agency for maintaining a very helpful “corner” in all hospitals.**
