Category Archives: Experts view

How to discipline a hard headed child

Disciplining a child maybe a tough call for both spouses because of different approach but it is best to keep it consistent with patience. Here are some techniques to use in disciplining your stubborn child.
• Allow the child to reflect on his behavior by punishing him to stay in a certain place and ask him to think through what he has done.
• Make limitations and consequences if he does disobey your rules like using the new samsung gadget without your permission. Remember to keep calm always when punishing.
• Show him that you have the authority but also allow him to express his freedom and make simple decisions on his own so he can learn by himself.
• Don’t rely on physical punishment because he may see it as a tolerable act and may latter do it on others.

Tales of two women with cancer

These women are close to my heart, they are my family. And this is their personal battle with the Big C.

An aunt underwent chemotherapy treatment for lymphoma. Her daughter is currently undergoing chemotherapy for breast cancer.

My maternal aunt was was diagnosed with lymphoma in 2006. She underwent chemotherapy treatment, but she has yet to be declared in complete remission.

My aunt (with my daughter) before cancer

The Sign
It’s been months since I last saw Tita Saning, my 64-year-old maternal aunt. Although we’re both living in Quezon City, I rarely visit her in her house since I became busy with family life.

She is frail, but her hair is a lot thicker now unlike when she was undergoing chemotherapy. She used to have a healthy body, not fat, but heavier than her present weight. She barely weighs 100 pounds.

In the middle part of 2006, Tita became sickly and started to lose weight. She gets cough and cold almost every month and my cousins notice a growing lump in her neck. Tita’s family never realized those signs were already warning signals of a serious health condition.

When she was taken to St. Luke’s Medical Center for checkup, the doctor who saw my aunt advised her to undergo biopsy right there and then. Tita said a needle was initially inserted to the lump to remove a tissue sample. It was done without anesthesia so she felt the painful procedure.

After the needle biopsy, doctors have ordered the removal of her lump. The procedure was called open biopsy.

Painful Revelation
Everyone was praying that the disease would not be as serious as cancer. Although the result showed Tita has lymphoma, we were relieved that it was in the initial stage of development and the chance of being cured remain high. My aunt’s family are hopeful that Tita will get well with the proper and immediate medical intervention.

Based on research, Stage I lymphoma means “the disease is present in only one group of lymph nodes, or, more rarely, in a single organ that does not belong to the lymph system”. This means that Tita’s lymphoma can be cured by chemotherapy.

Chemotherapy treatment is the simple administration of drug into the blood that kills that tumor cell.

My aunt tries to hold back her tears as she slowly recalls her experience from day one.

I cried when my daughter told me I have cancer. I couldn’t accept the fact that I will be leaving my grandchildren. Who will take care of them when I’m gone?” she said in the vernacular.

It’s difficult for me physically and emotionally when I know I have to stay in bed after the treatment and no one will cook and take care of my family,” she added.

Sickness doesn’t stop my aunt from looking after her family. She is the same typical caring Tita that I know.

My aunt and cousin Cez

Chemotherapy Treatment
Tita Saning’s treatment started when her biopsy test was completed. She was given Mabthera through slow infusion into a vein or intravenous infusion. Each session lasts for three hours.

She is currently taking a maintenance medicine called B.P. NORM 10mg once daily for her blood pressure, and Vitamin C to boost her immune system.

My aunt completed six sessions of chemotherapy treatment given every three weeks from July to October 2006. And another four sessions every three months for one year. Each chemo treatment costs a whooping P100,000.

They are not financially well-off, in fact, Tita only earns from repacking charcoal and selling processed meat. But her family was able to support her chemo treatment. Thanks to her daughter who happens to be working at St. Luke’s.

Cez shoulders half of the expenses through salary deduction. Also, they were able to secure a guarantee letter from the Philippine Charity Sweepstakes Office (PCSO) pledging the amount of P800,000.

Side Effects
Unlike other chemo patients, my aunt was spared from the “nightmarish” side effects of chemotherapy such as dizzy spells, nausea and vomiting. Besides losing her hair in the course of treatment, she said she only have to deal with her forgetfulness which she pointed to the chemo medicine as the culprit. Other than that she doesn’t feel anything awful after each treatment.

She stays indoors for 10 days while wearing facial mask to protect her from acquiring infections that will weaken her defenses against cancer cells. She also wears bandana to cover her thinning hairline.

She also underwent CT scan after the full cycle of her chemo treatment to see how she has responded to the treatment.

Cancer runs in the family
Ironically, my cousin Cez, who is doing all she can to support her sick mother, is also undergoing chemotherapy for breast cancer. She was diagnosed last year and underwent mastectomy to remove the affected breast. From the initial stage of treatment, my cousin said she has lost her appetite and could only tolerate soft food diet.

Despite what happened to her and her family, I never see a trace of sadness in her eyes. My cousin said she has come to terms with her fate. “I cried it out and leave my fate up to God,” she said.

Early detection and treatment
Tita Saning is thankful that her condition has been detected in its early stage. The doctor attending to both mother and daughter has been very helpful to explain to them all the information that they need to know about their illness.

Meantime, I would like to share some information pertinent to this post. I was able to interview Dr. Gracieux Fernando of the Philippine Society of Medical Oncology in the past and she talked about cancer detection and treatment.

She said majority of cancer patients in the Philippines learn about their condition in later stage of the disease so that treatment becomes costly.

For his part, Dr. Alan Paul Olavere, of the Chemotherapy Unit of the Medical City Hospital, said 50 percent of expenses incurred for cancer treatment go to chemotherapy alone.

Chemotherapy is the simple administration of drug into the blood that kills the tumor cell.

Aside from early detection and diagnosis, Fernando stressed the importance of patient empowerment.

Patients should be taught to become active partners in treatment decision making. This means that patient should talk to his doctor, learn to ask questions. Doctors are presenting the treatment options and let the patients choose what kind treatment that suits his financial capability,” Fernando told the author in a previous interview.

Fernando also urges fellow oncologists to recommend generic medicines to their patients to decrease cost of treatment and explore other options like putting the patients under drug trials.

Be sure that you get your money’s worth as possible. Make sure that the doctor is open to open dialogue because like everyone at the end we are not here to tell you what treatment you need we are here to propose options. It is up to you to select. We really advocate second up to fourth opinion,” he said.

Prevention
The World Health Organization noted that one-third of cancers (all types) are preventable, one-third is curable and one-third depends on palliative care.

The best way to cure cancer is prevention. How do you do it? Have a healthy lifestyle – no carcinogen like tobacco smoke, eat the right food – vegetables and fruits,” said Olavere.

Also, try to have an annual checkup even if you don’t feel anything, you can detect the possibility of cancer.

Learning from their experience, my aunt and cousin, share the same advice for those who suspect they have cancer: “If you suspect something in your body, seek medical help. This way, any abnormality can be detected and treated early.

My aunt ended our interview by leaving a word of advice for those undergoing chemotherapy treatment, “never lose your faith and pray for miracle healing“.

Treat depression

Depression is almost always a sign. About 25 percent of patients with depression have thought of committing suicide. And 10 to 15 percent of them have actually committed suicide, most of the time unsuccessful.

Depression is a mental illness involving deep, unshakable sadness and diminished interest in nearly all activities. It also means temporary sadness and loneliness common to most of us from time to time.Almost everyone gets depressed at one point. But in contrast to “normal” sadness, severe depression can dramatically impair a person’s ability to function in social situations and at work.People with severe depression often have feelings of despair, hopelessness, and worthlessness, as well as thoughts of committing suicide.

So says Dr. Genuina Ranoy, the psychiatric consultant of the Children’s Welfare Specialist Group of the Department of Social Welfare and Development.

Local study

There are no national data on suicide and depression in the Philippines. But Ranoy cites a study at the Medical City from 1996 to 2000, where at least 150 suicide cases have been recorded.

Of these cases, 117 or 78 percent are women while 33 are men.

The most common mode of suicide for women is wrist-slashing and drug overdose. It’s the same mode of suicide form men.

But generally, men use the more lethal form: using a gun to shoot themselves, intentionally causing vehicular accidents and jumping from heights.

The study observed that the common reason for women to commit suicide is a problem with the opposite sex. For men, it is often financial difficulty.

Ranoy said that suicide can also be determined genetically. “If you have a first-degree member of your family who has committed suicide, there is a greater increase for you to commit suicide, too,” she said.

“Lalo na kung mother or father mo, especially when you were physically involve, or you saw how your mother kills herself or you father kills himself. Mas magiging acceptable for you and suicide,” she pointed out.

If the coping skills needed to handle stresses does not develop during childhood, this increases a person’s vulnerability to commit suicide.

SIGNS

Suicide knows no class barriers. “Whether you come from a well-to-do family or a poor one, you can develop the same depression and commit suicide,” she pointed out.

She said patients who are severely depressed don’t commit suicide because they don’t have the initiative to do it.

“It should be noted that when patients recover from severe depression, it is the time that they commit suicide. This is called paradoxical suicide,” Ranoy said.

Described as strings of down emotions, depression is seen in people who are unable to sleep or has the tendency to oversleep; unable to eat or could overeat in the process.

“Almost everyday parating down ang feeling. They don’t have the energy. The usual activity that they take delight in previously is no longer enjoyable,” said Ranoy, managing editor of the Philippine Journal of Psychiatry (at the time of the interview).

She disclosed that a big percentage of patients with suicidal behavior also have homicidal tendencies.

“Persons with homicidal behavior think of hurting or killing somebody else not just themselves. It is more acceptable for them to kill other people than to kill themselves. People should take not onlysuicidal precaution but also homicidal precaution,” Ranoy said.

She said some medicines for chronic illnesses could also trigger depression. Medication for hypertension, diabetes, neoplasti, steroid and anti-cancer drugs, for example, may cause depression.

INTENTION

The attempt to kill oneself depends on the intention of the person to commit the act.

“There are suicides wherein the intention of killing themselves is low. They are called the borderline personality disorder. They try to commit suicide at the slightest feeling of depression or frustration in their lives. They attempt to kill themselves just to gain attention. This suicide act is also described as suicide gesture or threat,” Ranoy explained.

The mode of suicide, on the other hand, determines the intent of a person to commit suicide.

“Drug overdose or intake of corrosive materials, that’s a high intent of suicide. They really want to die because corrosive materials that include clorox and muriatic acid, once you have taken them, the chance for you to heal is low,” she said

A suicide letter left by the patient also shows the high intention of the person to die.

“It is more acceptable for the person who will commit suicide to leave a letter with the knowledge that their family know why they did it,” Ranoy said.

Some persons are extremely happy before taking their own lives.

“This is because they have already accepted the fact that they are going to die and don’t want anybody to know this.”

Then there are those who explicitly state the intention.

“There are others who will call a friend or relative before they do the act. However, the intent of killing themselves is low compared to the other one who stays in the room and don’t want to be bothered by anyone.”

PAIN

People around or close to the person who commit suicide experience a third-degree pain.

“Guilt is always there…I should have done this to prevent this kind of condition. Although most of the time its not their fault, they could have done something,” Ranoy said.

SUPPORT SYSTEM

Patients with depression undergo drug therapy. Through psychotherapy, psychiatrists also help patients look for the causes of depression.

A support system plays a major role in preventing suicides. “Those that are vulnerable to suicide and depression are those who do not have any support system. They are single, divorced or don’t have any active relationship with anyone so they are the most vulnerable,” Ranoy noted.

Support system could also come from friends and colleagues in the work place.Some government hospitals are offering therapy for poor patients suffering from depression.

Experts said the best way to prevent depression is to live a stress-free life by having a balanced lifestyle and by learning how to breathe or relax.