I am back

I plan to return to blogging.  Just an outlet for my thoughts.  My life is different now.  So much older.  But not really wiser.  I am now a mother of two.  A boy who's 6 and a girl who will be soon  16 month old.  I feel blessed.  I have a good husband.  A good home.  A good job.  The world has become more dangerous but I am not losing hope.  I still see bright future as long as presidency will stay on the Democratic side (Go Hillary!).  Oh well...Here I am again with my political rant.  I'll come back soon.

Remembering

I am not a Catholic but I was until I was 10 years old.  So, I am familiar with All Saint's Day and All Soul's Day stuff.  Until about last year, I was not a big Halloween or remembering-the-dead kind of person.  This year is different.  Death struck my immediate family late last year.  I have this delayed response to grief but it refused to wane.   Working in healthcare probably contributes to my non-waning grief.  I am reminded constantly of the suffering that my father went through.  Learning over the weekend that my former patient was transferred to hospice care was the blow for me.  She's one of my all-time favorite clients.  We enjoyed each other's company. I met her 4 years ago.  A feisty woman in her 80s, she fired her first P.T.   So my boss sent me to take over the job.  I admit I was hesitant and nervous.  I had this presumption that she's hard to please, that I need to tip-toe around her.  Her house is also out of my territory.  When she heard my voice on the phone, she admitted that she thought she was being punished.  She sarcastically thought "Great.  Now they sent me a foreigner!"  But we had a great time together.  I love her and she loved me.  We lost touch though because things happened in my life and she does not answer her phone calls.   I stopped twice in her house but there was  no answer on the door.   I thought of her once in a while and wondered if she's still alive.  I looked for her name in obituaries. 

So, today after work and driving my mother to Walmart, Benji and I went to visit her in the nursing home.  I was nervous and excited to see her again.    When I arrived in her darkened room, the first thing I noticed was that she has not changed.  She's probably thinner but she still looks defiant and alert.  The sad thing is she does not remember me.  I explained to her who I was and my husband.  But  nothing clicked in her brain.  All my excitement drained quickly. She told me that she just wants to sleep.   We left her room in a hurry to give her peace.  I felt  deep sorow as I closed her door.

A tiny tinged of relief also found its way as I trudged the long hallway.  I felt guilt not keeping in touch with her.  Now,  I realized why we drifted apart.   She's been tired for a long time.  She wants to be left alone. 

My father seems to be a daily visitor in my thoughts.  I don't dislike the visit.  It just makes me sad.  Sad that I did not do more to take care of him when he was sick.  Sad that our relationship was not ideal.  Sad that I cannot take back time to correct my wrong.   I constantly think of his sacrifices for us, and  his disappointments toward me. 

I would like to believe that my father is in a better place.  I hope that he knows that I am thinking about him.  I cannot light up a candle overnight like they do in  the Philippines but I am remembering just the same.  Happy All Soul's Day!

P.S.  I just want to share this video about a doctor who experienced afterlife while in coma...

Over-education for nothing?

When I first came here in the U.S., most Physical Therapists that I worked with just have their Bachelor's degree. Then, after few years, they required it to be Master's Degree. Now, it is a Doctoral Degree which means it requires to have 3 years of Graduate education to become a Physical Therapist. New grads call themselves doctors.

My husband and I think it is a ridiculous and unnecessary way to raise the cost of health care. The title holds so much promise but delivers so little. We cannot prescribed any medications nor diagnostic test. Medicare still requires physician's order before we can start P.T. treatments. RN's who only needs 2 years (4 years to have BSN) actually have more responsibilities than P.T.'s. The only draw is that insurance companies pay more for P.T. services compared to other allied health services, hence, pay is better. Average P.T. in the State of Iowa makes more than $70, 000 annually compared to RN which pay about $50, 000.

I admit to toying this idea of getting my Post-professional Doctor Of Physical Therapy Degree which many schools offer online. What stopped me going with it is that it will not really benefit me professionally. It will not raise my salary nor position. Nor my confidence which seems to be lacking. Nor make me several inches taller so many patients will be comfortable of me lifting them. Nor make me a better and happier therapist (I think).

Anyway, I am ranting about this because it's not just P.T.'s who are over-educated but also Pharmacists. I think they keep on raising the educational standard to keep the supply low and demand high. Purely capitalistic intention, in my opinion.

The other day, I called a pharmacist to clarify if my patient's new Fentanyl patch is a new dose prescription or an added dose to the existing patch he already has. The wife reports that she applied both patches which caused too much sleepiness. The wife refused for me to contact the primary physician who prescribed the patch because she is not very happy with that physician. So, to clarify the dosage, I called the pharmacist who filled the prescription. She (the pharmacist) told me that she doesn't know and that I should call the physician to clarify. I was disappointed by her response. I am a Physical Therapist( my medication knowledge is limited) and ,for Pete's sake, it's her responsibility to clarify the order, or, at least, know the answer to my simple question. Is she incompetent or just lazy? Maybe, she just doesn't care. Anyhow, this kind of mediocrity or indifference is not only annoying but downright dangerous. A non-professional person (pharmacy technicians) can dispense medications but what separates a professional from non-professional is the knowledge that they should impart to the clients, and their intermediary role between the prescriber and the client. The latter she clearly neglects. Anyway, I did the calling to the physician myself, going against the wife's request.

The same situation happens to me many times over working in home health. So many occasions, I found out that many pharmacists are not checking drug interactions despite the fact that they have the list of client's other medications. At one time, when I was working as a nurse in Dallas, a new pharmacist asked me what solution she's supposed to dilute the medication with. What in the world! Isn't she supposed to know this? She's the pharmacist. Or, at least, she should call the doctor or ask another pharmacist!

My point is people who are in charge in setting standards should evaluate their motives. I think the best education for healthcare professionals is the clinical experience. I don't deny the need for strong academic background but there are times you don't need to be in school for such a long time burdening students with astronomical loan when a bachelor's or master's degree sufficed.

The 1st 13 years

Time flies. I'm a bit embarrassed sometimes when people asked how long I'd been in this country. My English grammar did not improve much. However, I am a different person from that younger, slimmer and ignorant person that I was.

Unrealistic expectations were gone. Gratefulness took its place. I came to accept that I am not in heaven but in a wonderful place where opportunities are still plentiful. Opportunity to improve myself and my life is what I cherish most.

Before leaving the Philippines, my colleagues and I were examined by a psychiatrist to determine our fitness in performing our job. I was told that my intelligence is above average which was good to know but I was also told that I will not survive in the United States because of my passive personality. That was a blow to the gut. What she said hounds me up to this very moment. However, I have more understanding of her "diagnosis." What she failed to tell me is that people are malleable; that we are products of our environment and experiences. Maybe she didn't know that because she is not familiar with the American Experience of self re-invention. I no longer dispute or work to disprove her. I know now that I can survive -- actually more than survive. I thrive in this wonderful country.



April 1997. Photo taken in dowtown Dallas with the people I came with.

On Faith

One day it just came to me. Maybe organized religion is for me, or maybe not. My view on this is wishy-washy at best. The last time I was in church was almost 9 months ago. My excuse on stopping the last time was the H1N1 outbreak. I was pregnant then and I didn't want to be in a place where I could catch it easily. Now that I am not pregnant anymore and the dreaded virus is no longer a health threat, my almost 5-month old baby becomes my alibi. Due to the Easter holiday and and having glanced at the movie Ten Commandments, I recently started pondering again on my spiritual direction or (more appropriately) mis-direction.

I considered myself religious from age 14 to 23. As a teen, I struggled with chronic depression and identity crisis. Attending church gave me temporary relief from my so-called suffering. Then, I came to the United States. I was initially excited to look for a "home" church but I immediately was overwhelmed by so much choices. I believe that there is a church in every other corner of this country. I attended several Protestant, Evangelical and Catholic churches. I find church people to be mostly friendly and welcoming but I just did not feel I belong to any that I visited so far. Lately, I tend to choose mega churches for anonymity. Then, there's my husband who was born and raised atheist. He never stops nor criticizes me from attending; he even accompanies me so I don't feel lonely.

Marrying an atheist is an eye-opener. I believe that I am more open minded and see the world differently since knowing him. My husband is the epitome of contentment and decency. I learned from him that you don't need religion to be morally upright.

As a Christian, it was a taboo to doubt the existence of God or even ask the age-old question "If God is good, how can He let innocent people suffer?" Christians offer different explanations but nothing is intellectually gratifying.

Each Sunday morning, upon hearing the hymn time on the radio, I can get overcome by guilt for not going to a service but once I get to the church, I wish to be somewhere else. My mind constantly wanders.

When I think about my son, I start thinking about spirituality. Should I raise him with religion? Should I teach him about Christian faith? Or, is it a form of brain washing?

I was showering one day. It was one rare time that I was able to linger because my husband was with the baby. I started to sing and without thinking about it I was singing a Christian song about knowing Jesus. Tears started to flow and it felt really good.

What I think, that is...

Knowing what I know now, would I still wait to be in my 30's to try to have a kid? The answer is a definite yes! Knowledge and experience were gained through years of living and making unintentional mistakes. I know I am having difficulty now with my fertility but I think it would not matter anyway. I believe that if I am infertile now, I was probably infertile then. Also, I am a late bloomer. I feel like I entered adulthood just few years ago. I think now I am more matured and has the capability as well as patience to nurture another human being who will depend entirely on me for existence, if that would ever happen.

My life is a constant evolution. I am different person from what I used to be 10 or even 5 years ago. I want to think that I change for the better (hopefully). So, wherever, life takes me, I hope to just go with the flow... It is easier that way.

Melancholy

Lately, I am noticing myself so uninspired and just trying to exist. My creativity seems like caught in a quagmire of everyday life. At times, I felt trapped in a tragedy of middle class America which include working, paying your bills, looking forward to weekends and retirement then die. You can add getting married, having children, living in suburbia, and owning 2 cars. I know lots of people will be happy to have that life. I should not be complaining. At least, I have a job, a home and good husband.

For last couple of weeks, I have been dreaming of Philippines. Well, not exactly Philippines but everything seems like Philippines. I was listening one Saturday to Rick Steves, the travel guru in National Public Radio. In that particular program, he and his Italian guest were discussing about Sicily. That night I had a dream that I was on a bus trip in Sicily but the surroundings looked like we were in Cubao with its dilapidated shanties, sari-sari store, young coconut (buko) stand and a McDonald's. The only Italians in my dream were the policemen eating pasta at McDonald's. Then, the other night I dreamt of trying to catch a bus to go somewhere I don't remember. In my dream, I was outside Garden Village, the place where I grew up, and then this big camper bus driven by an American woman stopped and let me on. There, I found my sister and our school bus seatmate back when we were in elementary. Through the bus windows, I could see mountains like the ones in Rocky Mountain National Park. The woman drove a short distance and when we got to Phase 3 of Garden Village, she stopped and asked us to get out. Then, I realized, we did not really need to hitch-hike because I have a car and I can drive. Then I woke up feeling relieved.

I probably miss the Philippines. But what is there for me? Probably nothing! Most of the time I romanticize living in the Philippines. The thought of white sand beaches, coconut and mango trees, tropical fruits, sampaguita, warm rainy days and Filipino foods is enough for me to feel homesick. After eleven years, I, sometimes, forget the reality of living in the Philippines -- pollution in Manila, difficulty in landing a job, poverty, government corruption, traffic, etc. Friends and family from home tell me repeatedly how lucky I am to be here and that I am in a greener pasture. I feel lucky and I try not to take what I have for granted. However, inside of me, there is this urge to do more and to learn more. Of what? I don't know. The sad thing is I don't know myself. Did I lose myself in this quagmire called middle-class America?

On Being 30 something part 3

We seldom go to the mall these days. It was 7 mos since the last time. However, today after our early morning dental appointment and due to the fact I was just paid yesterday, I finally gave in to my shopping craving. We were in the mall for couple of hours but I came out empty handed. What happened? Well, aside from having more self- control, I found out that my size has increased and clothes just do not fit me well. I am actually thinking of liposuction, just in my midsection. Also, I found out that I am more picky with materials. I want clothes to be made of natural fibers and those clothes can cost you tons of money. I have no nerve to buy new clothes made of natural fiber in this new size because I am still hoping to lose weight (don't trump my hopes please).

I also found out that I read more the ingredients of processed foods and cosmetic products. I have conversation like this with my husband in store:
"What is this BHT?"
" Better not buy it if you don't know it."
"I found out that DMDM Hydantoin is made of formaldehyde. They use it in lotions and soaps as a preservative"
" Don't buy it then. We can get cancer from it."

To make long story short, we are limited on what we can buy from normal stores. We spend more money now as we are very particular in using natural products. We used to buy generic brand products but they do not suffice anymore. Is it because we have more buying power in our 30's or just more pretentious?

On Being 30 something Part 2

What should I do next to advance myself? I can go back to school to get a graduate degree but "of what?" is the big question. To go for my Doctorate degree for Physical Therapy is not really practical. It will not get me anywhere in terms of pay and position. Perhaps I could go to Public Health as I am both a nurse and a physical therapist, but I don't know if there is any opportunity for that kind of education. To go back to be a medical doctor? Forget about it as it requires me to be a full-time student and I would probably need to get some prerequisites, and it will take several years before it pays off. I found out that it is not that easy anymore to just drop my job and head back to school. I am not getting any younger and it is time to be serious about retirement. It would be difficult to make up for those years of no income. I could probably go to school part-time and still work. Do I really need that stress when I am trying to have a child? Everything changes when you reach this almost mid-thirty age. There is your biological clock ticking reminding you that it is now or never to pro-create. Time is not on my side. Women cannot really have it all at the same time.

On Being 30 something

I am exhausted!

We spent our 4th of July weekend trying to finish our master bathroom remodelling project. Our goal was to do as much as we could, so we could enjoy the next weekend. We sanded the drywall, tiled, painted, installed a new toilet and put on trim. We did not really finish everything. The toilet is still leaking and we cannot figure out what's causing it. We tightened every nut and bolt and checked all the washers but we cannot figure out where it is coming from. Thank God that the leak is small and we could probably wait another day to figure that out. I am actually tempted to call a plumber but Jason told me to hold off.

It seems like my body gives out more easily now that I am in my thirties. I don't have the stamina that I used to have when I was younger. Then, when we first bought our house, we painted and installed a parquet wood floor in one bedroom on weekends and weekdays after work. Now, I could only do it during the weekend. This bathroom project will probably be the only project this year. I used to be more ambitious (or probably foolish) in planning projects. Reality sets in eventually! This year is the most physically active year for both of us since we got married but this is also the heaviest I've ever been in my life! Metabolism is slowing down but my appetite continues to be horse-like. I am also noticing a few wrinkles at the outer side of my eyes when I smile. They call it crow's feet. I am actually considering to have botox injection if it gets worse.

I am not in my best physical state in my 30's compared to my 20's. The good thing is that I am less conscious on how I look and I am more aware of what I want. I also feel more comfortable in my own skin and more confident which I lacked when I was younger. It is probably from experience. My life has not been easy but whose life is. Those hardships make me stronger, wiser and more interesting. I assume less frequently, accepting whatever gets in my way and act accordingly. I am more at peace to know that I am not special! Each one experiences success and trials. We are equal. I used to say "It sucks to be average." I thought if only I am extraordinarily intelligent or creative like Bill Gates or angelically kind like Mother Teresa, my life would be more fulfilling. Now, I think being average is good. There is less expectation. I don't mean mediocrity but just knowing my limits and being realistic on what I can do. Having no pretention is peaceful.

Slob Confession

Yes, I admit I am a slob. Take note, not dirty but a slob. Sometimes I wish I could be more prim and proper and more organized. It's just that my nature is the opposite. I envy people who work in an office because they can dress up nicely and look professional. You see I do not need to dress up for my job. All I need to wear are shirt with Mercy logo and black pair of scrub pants . I don't even wear make-up or fix my hair nicely. Okay, that's laziness in my part. A lot of times I feel why bother when I just get dirty in my work. My poor husband, he has not seen me dolled up for quite a while!

It's not just in my physical appearance; my car is also a mess! I spend most of my working day in my car. I eat my lunch and do my computer work there. So, it is full of crumbs from my perpetual peanut butter sandwich lunch, papers, pens, paper clips, walkers, restorator, and other things I use for work. My husband suggested to use a crate but it did not help. It's even difficult to haul groceries as there is no room for it in my poor car. Also, I am the cause of why the left tail lights in both of our cars are broken! Please check out pictures.

Realizations

I arrived to the final realizations of certain aspects of my life so far...

• It does not matter how long I live in the United States, I will never be an American. I have American citizenship but Filipino is the nationality attached to me for the rest of my life.
• I will never lose my Filipino accent. I have tried my best to train my tongue and lips to pronounce words in American way but at the end of the day when fatigue sets in, I revert back to my Filipino accent. I am not ashamed of it as I heard different accents of English language. No one can tell me that my accent is wrong.
• I need to eat rice at least once a week. However, I learned that I love brown rice more than white rice. Aside from brown rice heartier than white, it is more nutritious. Rice is a very versatile food as you can eat it with almost everything. Though my consumption decreased since I came to live here, it remains a staple in my household.
• Iowa is my home away from home. I tell people that I probably know Iowa better than the Philippines. Driving makes you more oriented to a place. When I first came here in Iowa, I felt like I was thrown in the middle of nowhere. There are no big cities and high skyscrapers that I imagined America would be. Instead, I found acres and acres of flat corn and soybean fields. People will argue that it is not really flat as it has rolling hills but it is for me compared to the Philippines where you can see a mountain silhouette from a distance. To make matter worst, Filipinos are small in number compared to other bigger states. However, Iowa has grown on me. I love its four seasons, the peacefulness, big sky, small towns, low cost but high standard of living and nice people. I cannot live anywhere else for now.

Emotions

Warm rainy spring evening, sitting in our new Adirondack chairs on our open front porch, Jason and I were winding down from a busy weekend of bathroom remodeling. Our unwashed tired bodies, enjoying the coolness of light mist of the rain, were feeling the healing power of fresh air and joy of this simple pleasures of togetherness and peacefulness. Recovering from a roller coaster feeling of despair and elation at various points of our remodelling, I cannot help but uttered these words with a smile and sense of contentment, "This is heaven." Forgotten for that several minutes were dim realities of an impending busy work week, the unending household chores needed for survival and the unfinished and gutted master bathroom.

Things I learned in America

• Using north, south, east and west in giving direction.
• How to read map.
• Use the word pop instead of soft drink
• It's okay to say hi and smile to strangers
• To be direct and honest
• Flattery will get you nowhere.
• It's okay to say no
• Driving and driving defensively in every road conditions especially winter. I learned how to drive at the age of 23.
• How to grow vegetables and flowers. I learned about topsoil , compost and composting, as well as proper watering. I still have long ways to go.
• Procrastination will lead to stress.
• To be on time.
• To choose my battle.
• To accept my situation.
• All jobs are the same. It's my attitude that I can change.
• To be assertive.
• To listen to my gut feeling.
• To caucus.
• To do more for the environment.
• To be a skeptical consumer and citizen.
• To listen more.
• America has opportunities but you need to work hard for it.
• Not personalize negative stuffs from everyone.
• It's okay to say I don't know and ask questions.
• How lucky I am!
• I cannot do my best at all times. (It's from a friend, L)
• Life is not all or none...or black and white...
• Schooling is expensive.
• Do-it-yourself attitude
• Self-sufficiency attitude.
• How to manage finances.
• How to prepare for retirement.
• To live below my means.
• Be myself.
• I cannot please everyone.
• How to cook.
• Listen to NPR.
• Watch Public TV.
• Listen to BBC for another perspective.
• To be liberal in thinking yet conservative at heart.
• Mother Earth Magazine.
• Not to be judgmental.
• Use the public library.
• There is poverty in America
• Importance of buying locally
• How to make soap.
• How to make lotion.

No Control

Life is fragile. With all the advancement in technology, we continue to have no control of mother nature.

Myanmar....about 35,000

China...about 10,000

Missouri and Oklahoma ....22

Number of people who lost their lives in just a week due to natural disaster. My problems seem so insignificant in comparison.