Princess Cruise ship COVID-19 Miracles:    
Frank and Magdalena: two miracles!! They both got COVID-19 at the Diamond Princess cruise ship. Both in their 80’s. Frank, around 2-6-2020  tested positive was then transferred to Japan local hospital so he got separated from Magdalena. He had bilateral pneumonia the next day after and developed respiratory failure. He was in respirator  for weeks. That was very tragic for Magdalena since she didn’t know if Frank had succumbed and died from SSRS Co-2.  5 days  later, Magdalena tested positive and had pneumonia. She was very fatigued. Around 3 weeks later, she had a stroke: she had a large-vessel occlusion stroke ( LVO), the more dangerous one. Significant number of LVO stroke cases were documented during  SARS 2 illness. ( there is flooding of inflammatory chemicals/ cytokines during SARS, clots can form). She had massive brain swelling, became comatose, and a neurosurgeon had to remove a medium -sized piece of skull ( craniectomy) to give room for brain swelling. Their course in the hospital was very protracted , critical, and was difficult for everyone professionally involved in the case and for friends and relatives who  were always eager to hear an update.          
Now, cleared by Japan 2-3 weeks ago, and after several travel delays, they are finally home enjoying the warmth of family and friends. Frank and Magdalena lived a lot of their adult life in New Jersey. They bought a house in Las Vegas and planned on retiring here. Magdalena was a prolific, productive OB-GYN physician, and Frank managed the business. Prayers, faith, hope, love and God brought home miracles! ❤️🙏🏼💪🏼👍🏼👏🏼👌❤️❤️❤️ #covid19survivors #Sarscov2 #covidmiracles #lifeisbeautiful #diamondprincesscruise2020 #princesscruisecovid #japancruise #faith #love #godisgood

( I mentioned them in one of my posts in January. They’re very close friends of my friend Alicia Felicia, NP.. Alicia took this photo while they are having dinner. Magdalena is waving for me.)

COVID -19 and the Immune System By Arlyn Valencia, MD ( Board Certified Neurologist)

SARS CoV 2’s mortality and morbidity is heavily influenced by an individual’s immune system integrity. It is a disease of immune system gone awry. An immune system that has been challenged by chronic diseases ( such as hypertension, obesity), unhealthy living conditions, high levels of daily stress,  inability to recover from illnesses or stressful situations because of the demands of job, and other responsibilities and limited access to health care and good food. And of course, genetics has a role because bad or good immune system and propensity to develop medical conditions have genetic basis. New information and data are coming out to the surface, AND old information and data are revisited. THIS COUNTRY , of course as well as others, need to reorganize its priorities. US has the capacity to spend so much on trivial things, projects that benefit only a few, bailing out top corporations, lavishing the lifestyle of politicians BUT it can’t afford to better the delivery of health care and and health education especially to people that need them so badly.

Those of us, who know something about this disease and its FACTS should disseminate useful information and help others about the value of a good immune system. Let’s all be equipped and ready for when another COVID storm hits us, our bodies may be able to weather it with the help of better treatment to kill the virus and prevent its catastrophic cascade of havoc in the body. So far, COVID -19 is THE Katrina of the coronas. -  Arlyn Valencia, M.D. Diplomate American Board Of Psychiatry And Neurology

( The following article is well written and very informative. I highly recommend it).

https://www.theatlantic.com/health/archive/2020/04/coronavirus-immune-response/610228/

MIGRAINE HEADACHES ARE DEBILITATING: MIGRAINE PREVENTIVE TREATMENT THAT WORK by Arlyn Valencia, M.D. Neurologist, Headache Specialist and Migraine Sufferer

MIGRAINE PREVENTIVE TREATMENT THAT WORKS: CALCITONIN GENE RELATED PEPTIDE INHIBITORS AND RECEPTOR BLOCKERS 2 once-a-month injectables are available to date. 

I have had migraine headaches since I was 10 or 11, and I had motion and car sickness as a child ( which was a manifestation of migraine on the very young since migraine headache experience is not yet as developed in early childhood). My whole family, both parents and 5 siblings have migraine, and now my 2 children have it. My daughter has very severe attacks. 

I’ve tried several daily preventive medications and none has effectively worked. Sumatriptan ( 5 HT 1 agonist and migraine specific) works for me to get rid of almost all attacks but using it frequently is not good since it also affects the cardiac blood vessels ( it and the other triptans are contraindicated for those with history of stroke, coronary disease, atherosclerosis among others) and I sometimes had to take it frequently . Botox injections done every 3 months work for chronic migraine and have helped so many. 31 injections around the head and trapezius muscles are done as migraine protocol. It has helped me but not as much as I want it too and I didn’t like the routine of having to be injected. 

Now comes the anti- CGRP, 2 are available : Aimovig ( erenumab) and Aijovy ( fremanezumab). I had the advantage of being first to try the Ajovy, as well as another member of staff and few of my patients. I HAVE THE PRIVILEGE of saying here’s a migraine preventive treatment that works!! Now 2 months since I started it ( 1 injection a month), my migraine headaches only occurred 2x a month, one time was when I was in Lake Tahoe ( high altitude) and one when I was so tired and stressed. There were at least  1-2 “ beginning migraines” that didn’t become full blown and I didn’t need my sumatriptan to abort them which is extraordinary since in the past once my migraine start it would become full blown if I didn’t take a triptan. I used to have 2-4 migraine headaches a week and it is indeed hard to function and as I said, it is not good to take triptans or ibuprofen or naproxen that often. 

NOW, I AM SHARING THIS STORY SO OTHERS MAY BENEFIT. AWARENESS IS SO IMPORTANT. I AM NOT ONE TO BE CORRUPTED BY ADVERTISING FROM BIG PHARMA. I LOOK AT AND RESEARCH THE FACTS , AND LOOK AT THE SUTUDY DESIGN AND RESULTS OF THE DIFFERENT PHASES OF CLINICAL TRIALS OF EACH NEW MEDICATION. MIGRAINE IS VERY DEBILITATING. Migraine attacks can cause white matter ( brain) ischemic changes. I’ve suffered from migraine headaches all my life, and I’ve treated migraine patients in my 23-24 years of being a neurologist. I am presently treating hundreds of migraine and headache patients a month ( amongst others) and we’ve been helping so many of them. There are other headache disorders, as you all are aware. Migraine is the third most common disorder in the world. If I can help in anyway, I will. 

By Arlyn Valencia, M.D. 

FIREWORKS FOR FREEDOM By Arlyn Valencia, M.D. 

So sweetly explosive is the idea of freedom that John Adams had written to his wife Abigail: "The second day of July, 1776, will be the most memorable epoch in the history of America. I am apt to believe that it will be celebrated by succeeding generations as the great anniversary festival. It ought to be commemorated as the day of deliverance, by solemn acts of devotion to God Almighty. It ought to be solemnized with pomp and parade, with shows, games, sports, guns, bells, bonfires, and illuminations, from one end of this continent to the other, from this time forward forever more." And generations after that, American Independence Day, has been celebrated, on fourth of July. Nobody really cared about the 2 day difference. The "Fourth Of July" even took a more profound meaning when the two founding fathers of the United States, the only two authors of the "Declaration of Independence" to become presidents, John Adams and Thomas Jefferson died on the same day, the fourth of July 1826.

It is our birthright to feel and live freedom as we would like to taking into consideration that our ways would not cause offensive oppression of others. 

So with bells, noises, whistles, fireworks, guffaws, merriment, love and festivities let's all celebrate our Independence Day!! ❤️❤️❤️💥💥✨

SAVING THE BRAIN DURING A STROKE

By Arlyn M. Valencia, M.D.

When Joe woke up that chilly night, he knew something was terribly wrong. He tried to stand

up but instead, he suddenly slid to the floor as if his right body pulled him down. That’s when

he realized the right side of his body had gone “dead” on him. He tried to verbalize, orient

himself to his surroundings. He concluded his mind was still working. He tried “shaking off”

the problem on his right side but it would not go away. “Maybe”, he sighed, “I’ll sleep it off. It

should be OK by tomorrow.”

Joe just had a stroke which affected solely the motor pathway in his left brain. He got lucky

that the speech center, which is also on the left side (on right-handed individuals) was spared, 

thus, his ability to talk and comprehend remained intact.

Stroke is a toofamiliarword for everyone. It is unfortunate, however, that the majority

of Americans do not know the symptoms of stroke or those who knew do not know

the significance of early medical evaluation and intervention.

Stroke affects 750,000 Americans each year. It is the fifthleading cause of death and 

the leading  cause of serious longterm disability. The cost of care for strokevictims

approximates $43 billiona year and a significant proportion of this is spent on long-term

rehabilitation and nursing home care.

A stroke occurs when the blood flow to a part of the brain is impeded due to sudden

blockage of an artery supplying that area of the brain. The needed glucose and

oxygen will not reach that particular brain tissue which eventually will suffer and die

if the blood flow is not immediately restored. The result will be loss of function of the

part of the body which that part of the brain controls. This is called ischemic stroke.

Another cause of stroke is sudden bleeding into the brain substance when a

weakened wall of an artery ruptures. This is called a hemorrhagic stroke.

Stroke is also called “brain attack” to connote the necessity of seeking immediate

medical attention, that is as soon as the symptoms occur. However, compared to

heart attack in which the symptom seems universal (chest pain), a stroke can have

different manifestations, depending on what part of the brain is ailing or dying. For

example, if the verbal speech area on the dominant side of the brain (which is left on

righthanded individuals) loses blood supply causing death to the brain cells, the

patient will suddenly lose the ability to talk .

Some of the more common warning signs of stroke are: sudden weakness or

numbness of the face, arm and leg on one side of the body, sudden blurring of vision

or blindness in one or both eyes, sudden incoordination, trouble walking, dizziness,

sudden confusion, trouble speaking or understanding or sudden severe headache

with no known cause. Of course there are other less obvious signs of stroke like

suddenonset double vision, difficulty with swallowing, nausea and vomiting. These

latter signs are more commonly seen in brainstem strokes.

There is a nationwide campaign to improve stroke awareness. Every stroke must be

treated as a lifethreatening emergency. The available stroke treatment modalities can

only be administered if the patient is brought for evaluation and treatment within four

and a half hours of stroke onset for the intravenous clotbuster

(tissue plasminogen

activator, tPA) and within six hours of stroke onset for the intraarterial

clotbuster.

At comprehensive stroke centers, a procedure called thrombectomy/clot retrieval can be

done or the stenosed artery can be stented to restore blood flow. After acute intervention, 

aggressive medical management later, towards stroke prevention. Not all stroke patients are 

candidates for these treatments. It is very important that the emergency room (ER) physician 

and the neurologist adhere to the protocol and weigh the risk versus benefit. If given

appropriately to eligible patients, the treatment can decrease or even reverse the neurologic

deficits that the patient had at the onset.

Better understanding of the causes of stroke and the changes that happen in the

brain before, during and after stroke has led to better overall patient management. Even if

the patient is not a candidate for the clotbuster therapy, emergent medical

intervention can easily be started that may protect or save the ailing brain. It may be

as simple as maintaining a good diastolic blood pressure, controlling fever, treating

concomitant infections as soon as recognized (the latter is considered a risk factor

for stroke), normalizing the blood sugar, improving oxygenation especially on those

with preexisting lung conditions. These measures may help “protect the ailing brain

cells”. If these cells are not rescued, they will eventually die resulting in increased neurologic

deficits, thereby, increased disability.

Control of other risk factors should also be started acutely, such as treatment for

high cholesterol, diabetes and homocysteinemia. Cessation of smoking, controlling

other risk factors and compliance to stroke prevention treatment (taking the

appropriate antiplatelet medications and blood thinners), can not be overemphasized.

Healthy lifestyle, and consumption of food rich in antioxidants have a role in stroke

prevention.

Young people who suffered from a stroke should be worked up for clotting disorders

(hypercoagulable state), congenital or acquired heart problems or connective tissue

disorders as well as blood vessel inflammation (vasculitis). Drug abuse especially

methamphetamine and cocaine, especially the alkaloidal form (crack) CAN cause

strokes. Another important cause of stroke for young people is dissection of the

arteries supplying the brain either from trauma or from an inborn defect of the wall of

the arteries. Recently, there is a noted increased incidence of strokes occuring in young 

adults with the same risk factors more common in the adult population namely hypertension,

diabetes and high cholesterol. 

Each stroke patient is different. Joe, the patient I mentioned earlier, is my father. He

improved dramatically. It could be that the ailing part of the brain got rescued by

blood supply from other territories.

Our brain, although gifted with the power to autoregulate its own blood flow, can be

chronically challenged by several medical insults like hypertension, diabetes, heart

disease, cigarette smoking. This power of the brain can get exhausted. We still have

time to correct such things before our brain gives up on us.

Take care of our brain. Control the risk factors, help in disseminating information to

improve awareness. And at the first sign of stroke, seek immediate medical attention

(call 911). The faster we act the better chance we have of saving or protecting the

brain from the effects of stroke.

UPDATE: My father passed away. He initially survived a massive cerebral hemorrhage

and after recovering some functions, succumbed to rupture of aortic aneurysm.

Arlyn M. Valencia, M.D. is Neurologist, Stroke Subspecialist. She is a Diplomate of

the American Board of Psychiatry and Neurology, fellowship-trained in stroke and

neurorehabilitation. 

From "The Daily Dealings" By Arlyn M. Valencia, M.D.

Dr. Valencia is a board certified neurologist. She is

an Official Member of the INTERNATIONAL HIGH IQ SOCIETY.

She served as the stroke director at Sunrise Hospital and Medical Center in Las Vegas, 

Nevada and as an associate professor of neurology at University Of Nevada School Of Medicine. 

She completed neurology residency at Montefiore Medical Center, Albert Einstein 

College Of Medicine in  Bronx, NY and fellowship training in stroke And neurorehabilitation 

at the same institution. She did her post‐graduate internship in internal medicine at Metropolitan

Hospital in Manhattan, NY, the teaching hospital of  New York Medical College.

She is also an artist (oil, watercolor and acrylic painting; charcoal and pencil sketching), a writer and

a musician (vocals, piano, guitar, songwriting). 

SEARCHING Music and Lyrics By Arlyn Valencia

In the darkness of night
Just the stars burning bright
I'll be looking for an image of you..

All these thoughts passing by

All these songs in my mind

No matter how hard I try

I still can't find you

     I'll be searching, searching for you

     I'll be yearning, yearning for you

As I walk all these streets

There'll be faces I'll see

I'll be hoping to form 

An image of you

No matter how I try

It's so strange that I

I can't find any

Memories of you

     I'll be searching, searching for you

     I'll be yearning, yearning for you...

https://www.youtube.com/watch?v=Z2HDCsiiyMk

Foreword To THE IMPROVISING CHEF By JON BURR

FOREWORD


I have been waiting for a health and cuisine book that’s daring and honest to the core.
As a neurologist and a stroke specialist I’ve seen many medical emergencies caused by or heavily associated with faulty nutrition habits. It is very hard to address and “correct” issues relating to food since the public is being fed with half-truths and misinformation promoted by influential food corporations. American public health has deteriorated over the last decades,
with unheard-of increases in cases of adult-onset diabetes, obesity and strokes—affecting even our youths! This trend must be reversed; it will be a very difficult task. In my opinion, this book is going to tackle this task. It’s a revolutionary approach to cuisine, putting taste, nutrition and health together in a sustainable, enjoyable fashion.

Jon Burr devoted years delving first-hand into various cuisines of populations known to have fit and healthy lifestyles, researching and experimenting, finding why certain food preparations taste great and yet have health and weight-reduction benefits, and gathering nutrition and food facts to dispel myths that have plagued the nation causing untoward consequences to American health and body habitus*. Speaking as a person who grew up in a family and culture that enjoys food, has been fit and healthy all my life, yet been known by those close to me to enjoy gourmet cooking and eating, I have tried several of his food preparations and I’ll say Jon Burr can invite me to his lunches and dinner anytime.

There’s no other book like this. I will personally recommend this—not only to my patients who need to incorporate healthy, palatable and enjoyable eating habits to reduce their cerebrovascular and cardiovascular risk factors—but to everyone who will come across my path.

http://store.payloadz.com/details/970953-ebooks-food-and-cooking-the-improvising-chef.html#.TpPswjcaCzk.facebook


—Arlyn Valencia, M.D. Neurologist, Stroke Subspecialist

Secret Love The Debut CD By Arlyn Valencia

Vocal CDs make up a tremendous percentage of new releases, but Arlyn Valencia stands out from the crowd with this heartfelt collection. Performing a wide range of styles, she demonstrates her gift for uncovering the essence of each lyric. A native of the Philippines, ArlynValencia is a physician who makes her debut recording under her own name with this diverse, enjoyable CD.

Recalling her early years, Arlyn remarked, “My family is musical, I started singing as soon as I started talking.” She also found time to perform during her undergraduate and medical school years. “I opened for a number of main acts. My repertoire included Broadway, cabaret, jazz and folk. I was a vocalist for a band that performed six days a week at the Silahis International Hotel in Manila and also played private parties. I later became part of an elite group called The Entertainex. We were all-around performers, solo performers, actresses. Thousands auditioned, they chose 12. We performed on TV and first-class establishments.”

Valencia didn't plan on becoming a doctor. “After earning a Bachelor of Science Degree in Zoology, I took the medical school entrance exam and passed it. Although we didn't have money, my grandfather paid for my first semester and then I was awarded a Rector's scholarship that covered the remainder of my tuition.” She earned her MD in 1986.

Arlyn came to the U.S. in order to complete her internship and residency training. “I did neurology and stroke sub-specialization at Albert Einstein College of Medicine - Montefiore Medical Center in New York City.” Relocating to Nevada, she served as an associate professor and neurologist at the University of Nevada School of Medicine. Currently she is the Stroke Medical Director of Sunrise Hospital and Medical Center in Las Vegas.

When Arlyn changes her focus from medicine to music, you can appreciate her wide range of interests. Influenced by vocalists like Sarah Vaughan, Lena Horne, Patti Austin, Dionne Warwick, Lani Hall and Angela Bofill, her CD mixes standards, bossa novas, pop and music written for film.
“Secret Love” is the first of several time-tested standards. “I've always loved this song. My mother used to sing it. Jon Burr suggested the fast samba arrangement.” The French song “More” was a hit in both Europe and the U.S. “It was pretty popular in my childhood. I'm a passionate lover, so when Jon gave me this beautiful, yearning arrangement, I fell in love with it. I sang it as if I was whispering to that particular person.” Houston Person’s emotional tenor sax is also a nice touch.

“Time After Time” has long been a favorite among vocalists, although it is Chet Baker’s version that sticks in Arlyn’s mind. “Every time I'm in love, I find myself singing this song!” Valencia expected to sing “Time After Time” in at a slow ballad tempo, but she learned Jon Burr’s swing arrangement on the fly in the studio. She takes a different approach to Jon Burr’s “If You Were Mine;” the folky Latin touch gave this song the quality that serenade songs in the Philippines are known for, yet this song is so timely. “Thanks, Jon, for letting me ‘breathe’ your words,” she wrote. John Hart adds a lovely solo chorus on acoustic guitar.

“Love is Stronger Far Than We” was written for the film “A Man and a Woman,” by Pierre Barouh, Jerry Keller, and Francis Lai. Arlyn has long been captivated by its haunting melody and lyrical focus on obsessive love. Person’s deft responses to the end of each vocal line provide the perfect complement. “One Hello” was penned by Marvin Hamlisch with lyrics by Carole Bayer Sager for the film I Ought to Be in Pictures. Its best known recording is by Randy Crawford, another of Arlyn’s favorite singers. The doctor jokes, “It's THE audition song. Every time I sing this, it lands me the job!”

“Like a Lover” has long been a popular Brazilian song. Written by Nelson Motta with Portuguese lyrics by Dori Caymmi (English lyrics by Alan & Marilyn Bergman), Arlyn notes, “‘Like a Lover’ has very fresh, crisp melody and delicious bossa nova beat. The simpler the vocals are, the more beautiful the song gets.” Antonio Carlos Jobim’s “Waters of March” is another favorite of vocalists. Arlyn says, “It's a song of vignettes which may not be related, but if I step back and look at the overall picture, they all fit into the puzzle called life. Every time I sing it, I find a different meaning to a phrase.”

Arlyn is equally effective with pop. She sings its lyrics as if she has lived them. Bonnie Raitt had a hit with “I Can’t Make You Love Me,” though it was new to Arlyn. She captures its essence with an emotional interpretation, though the singer admits, “It is only of late that I profoundly related to its story.”
Stevie Nicks’ “Landslide” was a hit for Fleetwood Mac in 1975. Arlyn suggests, “This is my life in a song. The abstract nature of it gives us the freedom to interpret it according to our own experience, our own truth. The melody is so beautiful, so timeless.” Her soft, folksy rendition of The Beatles’ ballad “I Will” and sensitive performance of Don McLean’s tragic “Vincent” also merit praise.

Singer/songwriter James Jones sent Arlyn his “Learning to Fly” on YouTube. “It’s a story of love, of dreams and hope, the elation that comes when we are on the brink of realizing a dream.”
With Secret Love, Arlyn Valencia has realized a dream of her own.
—Ken Dryden
Ken is a regular contributor to All Music Guide, All About Jazz New York and Hot House

"Landslide" For Daddy (Jose Valencia, Jr. 1933-2009)

JOSE VALENCIA, JR (JUNE 18, 1933 - NOVEMBER 4, 2009) : A Poem For My Daddy: I Hope I Made You Proud

I hope I made you proud
You hoped to make me be
The warm and kind person that you are
A selfless man that's free


Judge Grandpa told me one day 
"Share your gifts to the world 
Give what you can give"
And I said, "I heard that too, from Daddy"

I hope I made you proud
As I've always tried to be
As kind as you are
As honest I could be

When I sleep tonight,
Will you tell me again, Daddy
"Honey, you've made me proud
"YOU JUST HAVE TO LET YOU BE"

THE BEAUTIFUL LAKE TAHOE: Photography By Arlyn Valencia, M.D.

Still Not Over Michael Crichton's Death By Arlyn M. Valencia, M.D.

NOTE: I reiterate: I wrote this in November 2008. The Obama delusion has since blurred down)


I can't believe I didn't even have a chance to mourn for Michael Crichton. Weird that this politico-legal-media obsessed world didn't even thrive on this "event" even after the global excitement over "rise of a real/legitimate, biethnic, multicultural, with some- real- ASIA- exposure HERO" died down. I was beyond excited/euphoric over Obama's triumph (esp. now, with some promise of economic repair, look at the market today, and with the naming of his economic team and some introduction, too, today of the economic rescue operation--- (couldn't wait for that jolt in economy), BUT then not to give Crichton the mourning he deserves is beyond comprehension.


Well, I still think he's the best doctor-writer even though he went straight to do fellowship in public policy, and his discipline of choice (maybe not first choice) was computer ops/prog, whatever.

STATE OF FEAR is one of the best contemporary books I read in 7 years, it is like a reference book with a complete bibliography on global warming, ecoterrorism, politico-legal-media agenda. I still would have loved to see him debate Al Gore. The latter sort of maligned him in the latter's book AN INCONVENIENT TRUTH, which I had the misfortune of reading maybe 3 times (it was my son's choice for his book report).

Just to think that I thought Crichton was very corny. I had the misfortune of reading his very first novel (was it really his first?): A CASE OF NEED. He even developed a habit of NOT including this novel in his list. For me that novel big-time sucked. And I really think that ER is so made-up.

He wrote ANDROMEDA STRAIN when he was a medical student. How and when did he do that? During his radiology rotation?

TIMELINE was so believable you'd think Crichton time-machined himself to the medieval period.

DISCLOSURE disclosed the malignancy of corporate and human competitiveness.

NEXT had the twists and turns of a DNA molecule.

AIRFRAME proved that benign neglect is an oxymoronic phrase.

THE GREAT TRAIN ROBBERY robbed me of my belief that there is always an iota of goodness in everyone.

JURASSIC PARK and THE LOST WORLD... well, other people would have a better one-liner to these. But both novels are so imaginative and anxiety-provoking. This was when science scared the living shit out of me.

I guess I'm writing all these because I know nobody would tolerate my mental diarrhea.

I guess this is just my way of quasi-expressing some kind of mourning, albeit disjointedly, over a hero of mine. Too bad my literary love affair with him was just of late.

Arlyn M. Valencia, M.D.

INDEPENDENCE FROM OPPRESSION By Arlyn M. Valencia, M.D.

So sweetly explosive is the idea of freedom that John Adams had written to his wife Abigail: "The second day of July, 1776, will be the most memorable epoch in the history of America. I am apt to believe that it will be celebrated by succeeding generations as the great anniversary festival. It ought to be commemorated as the day of deliverance, by solemn acts of devotion to God Almighty. It ought to be solemnized with pomp and parade, with shows, games, sports, guns, bells, bonfires, and illuminations, from one end of this continent to the other, from this time forward forever more." And generations after that, American Independence Day, has been celebrated, on fourth of July. Nobody really cared about the 2 day difference. The "Fourth Of July" even took a more profound meaning when the two founding fathers of the United States, the only two authors of the "Declaration of Independence" to become presidents, John Adams and Thomas Jefferson died on the same day, the fourth of July 1826.

With bells, whistles, fireworks, guffaws, merriment, love and festivities have we all chosen to celebrate the freedom from oppression! It is this day that I would take time to celebrate my own freedom from the oppressive ties, that a majority of us know too well: the searing ties of loneliness and discontent. They restricted me from experiencing life as I did when I was a wide-eyed kid growing up, from having gratitude for all the blessings I had and had to share, and from loving to wake up, every morning, just for the sheer pleasure of it.

For the enjoyment of freedom can not be attained unless we are free from our oppressive selves.

"The Nearness Of You" By Arlyn Valencia

STROKE LECTURE By Arlyn M. Valencia, M.D. Associate Professor University Of Nevada School Of Medicine Diplomate, ABPN

This lecture may save your life.

STROKE LECTURE By Arlyn M. Valencia, M.D. Associate Professo University Of Nevada School Of Medicine, Diplomate American Board Of Psychiatry & Neurology

View more OpenOffice presentations from Arlyn Valencia, m.d..

"The Doctor-Show Phenomenon" By Arlyn M. Valencia, M.D.

I came across an article " An Injection Of Hard Science Boosts TV Shows' Prognosis" and I couldn't help but write my take on this doctor show phenomenon. I think ER is not believable as far as the physician's general attitude and behavior are concerned. (I will not even comment on the inferior doctor shows. ) Now, there may be rare physicians, medical professionals and paramedical personnel who have that kind of a make-up, and this may be obvious in certain situations. But not all situations. If that kind of drama is what prevails in emergency rooms (ER's) and wards, then patients' care and prognosis will definitely be compromised. ER is overly dramatized. The medical situations are turned into a bonanza of ill-reacting doctors, nurses, patients and janitors.


Don't get me wrong. I watched ER knowing that Michael Crichton, one of my favorite writers, wrote for the show.I very much value his work or whatever work he may be involved in even peripherally. Every time I see an ER episode, I try to see his imprint on the story twists. I read all his books (and I am beyond excited when I learned that the last novel he wrote, right before his death, was discovered in his PC and is now awaiting publication), admired his honesty, adored his wit, "sided" with his no-side, agenda-less take on the global warming issue. In this blog, I would just like to blurt out my humble opinion on the doctor show phenomenon.


As far as medical facts are concerned, I salute the consultants/researchers with coming up with the most esoteric, zebras of a diagnosis that even clinical experts would have a hard time blurting them out just like that. Although there may be the "ideal" ER's/wards manned by clinicians who are also academicians, rarely, would there be such a situation like that. This is more apparent in the series House, which I just happened to watch last night. Not only is this attending and residents not neurologists, rheumatologists, neuroradiologists,or endocrinologists (I still don't know what medical specialties they practice, or maybe I missed a very important episode when they revealed what they are, especially House), but the way they talk, argue, manage patients, and even perform the procedures they do, made me conclude they're specialists (and even subspecialists in some fields) in all the above mentioned disciplines. And all these in a community hospital setting.


This overlooked yet to-your-face aberration, may be due to the fact that a significant number of the show's consultants are researchers and "technically- minded" , and the necessary input from a long-time, experienced clinician is lacking. Or it may have been that if too much of a real clinician's input is considered, the over-all effect might be that the show would lack appeal and drama. If it would help soften the above comment, Dr. House's effect on me is, and I know the majority of the House-watching populace would agree: I, myself, wouldn't mind being assessed (but maybe not admitted) by the Vicodin-addicted Dr.House. He reminds me so much of the cocaine-using yet brilliant Sherlock Holmes.

Don't get me wrong; House is the only doctor show I really enjoy. But the episode I saw last night made me cringe. Not just because of the blurting of a mouthful of diagnoses that are "interconnected" but also concluding that there may already be a complication (vasculitic) that is confounding the over-all problematic picture. These only from plain deduction.

There's one aspect that I cherish, though, not just in that episode I recently watched but in almost all of House's episodes, and that is at the end it makes it all clear that the physicians' viurtues of "looking" at the patient, at the entire picture and addressing every aspect of patient care are the real "stars" of the show.

A Friday Visit With The Lagascas

Gemma Lagasca is growing up to be a beautiful lady. Intelligent and athletic, with a good heart, she is the pride of Emma and Aldo Lagasca.

Filipinos are well known for their gregarious nature. Sharing is not a task but a privilege. We share our love for the simple yet precious things in life: we share snippets of stories that delighted and touched our heart, laughter that seems to come from nowhere, food that nourishes the body and feed our soul, chores not to burden but to involve. And at the end of the day, the emotional yoke we carried prior to the visit, is lightened and seemed so small.

SAVING THE BRAIN AFTER A STROKE: Time Is Of The Essence

When Joe woke up that chilly night, he knew something was terribly wrong. He tried to stand up but instead, he suddenly slid to the floor as if his right body pulled him down. That’s when he realized the right side of his body had gone “dead” on him. He tried to verbalize, orient himself to his surroundings. He concluded his mind was still working. He tried “shaking off” the problem on his right side but it would not go away. “Maybe”, he sighed, “I’ll sleep it off. It should be OK by tomorrow.”

Joe just had a stroke which affected solely the motor pathway in his left brain. He got lucky that the speech center, which is also on the left side (on right-handed individuals) was spared, thus, his ability to talk and comprehend remained intact.

Stroke is a too-familiar word for everyone. It is unfortunate, however, that the majority of Americans do not know the symptoms of stroke or those who knew do not know the significance of early medical evaluation and intervention.

Stroke affects 750,000 Americans each year. It is the third leading cause of death and the leading cause of serious long-term disability. The cost of care for stroke victims approximates $40 billion a year and a significant proportion of this is spent on long-term rehabilitation and nursing home care.

A stroke occurs when the blood flow to a part of the brain is impeded due to sudden blockage of an artery supplying that area of the brain. The needed glucose and oxygen will not reach that particular brain tissue which eventually will suffer and die if the blood flow is not immediately restored. The result will be loss of function of the part of the body which that part of the brain controls. This is called ischemic stroke.

Another cause of stroke is sudden bleeding into the brain substance when a weakened wall of an artery ruptures. This is called a hemorrhagic stroke.

Stroke is also called “brain attack” to connote the necessity of seeking immediate medical attention, that is as soon as the symptoms occur. However, compared to heart attack in which the symptom seems universal (chest pain), a stroke can have different manifestations, depending on what part of the brain is ailing or dying. For example, if the verbal speech area on the dominant side of the brain (which is left on right-handed individuals) loses blood supply causing death to the brain cells, the patient will suddenly lose the ability to talk .

Some of the more common warning signs of stroke are: sudden weakness or numbness of the face, arm and leg on one side of the body, sudden blurring of vision or blindness in one or both eyes, sudden incoordination, trouble walking, dizziness, sudden confusion, trouble speaking or understanding or sudden severe headache with no known cause. Of course there are other less obvious signs of stroke like sudden-onset double vision, difficulty with swallowing, nausea and vomiting. These latter signs are more commonly seen in brainstem strokes.

There is a nationwide campaign to improve stroke awareness. Every stroke must be treated as a life-threatening emergency. The available stroke treatment modalities can only be administered if the patient is brought for evaluation and treatment within three hours of stroke onset for the intravenous clot-buster (tissue plasminogen activator, tPA) and within six hours of stroke onset for the intraarterial clot-buster. Not all stroke patients are candidates for these treatments. It is very important that the emergency room (ER) physician and the neurologist adhere to the protocol. If given appropriately to eligible patients, the treatment can decrease or even reverse theneurologic deficits that the patient had at the onset.

Better understanding of the causes of stroke and the changes that happen in the brain before, during and after stroke has led to better over-all patient management. Even if the patient is not a candidate for the clot-buster therapy, emergent medical intervention can easily be started that may protect or save the ailing brain. It may be as simple as maintaining a good diastolic blood pressure, controlling fever, treating concomitant infections as soon as recognized (the latter is considered a risk factor for stroke), normalizing the blood sugar, improving oxygenation especially on those with preexisting lung conditions. These measures may help “protect the ailing brain cells”. If these cells are not rescued, they will eventually die resulting in increasedneurologic deficits, thereby, increased disability.

Control of other risk factors should also be started acutely, such as treatment for high cholesterol, diabetes and homocysteinemia. Cessation of smoking, controlling other risk factors and compliance to stroke prevention treatment (taking the appropriate antiplatelet medications and blood thinners), can not be overemphasized.

Each stroke patient is different. Joe, the patient I mentioned earlier, is my father. He improved dramatically. It could be that the ailing part of the brain got rescued by blood supply from other territories.

Our brain, although gifted with the power toautoregulate its own blood flow, can be chronically challenged by several medical insults like hypertension, diabetes, heart disease, cigarette smoking. This power of the brain can get exhausted. We still have time to correct such things before our brain gives up on us.

Take care of our brain. Control the risk factors, help in disseminating information to improve awareness. And at the first sign of stroke, seek immediate medical attention (call 911). The faster we act the better chance we have of saving or protecting the brain from the effects of stroke.

Arlyn M. Valencia, M.D. is a Diplomate of the American Board of Psychiatry and Neurology, an Associate Professor of Neurology, Department of Medicine, University of Nevada School of Medicine, and a Fellowship-trained Stroke Neurologist.

To Those Who Served: We Do Remember

Above is a photo of the 24" X 28" sketch I did of my ex-husband's father. Plucked from his family, and his profession, he served his country in a selfless way.

I don't have a photo of my grandfather (that I could sketch from) and I don't know what he looked like. I could only illustrate in words how he was in his last days.  He was in the Death (Bataan) March, WWII, knowing that that would be the end of his life. He would not see his newborn daughter, my mother, again. My grandmother said that he died not instantly , as a bullet and bayonet would have ensured, but had a slow death caused   by dysentery. The soldiers had no food and water, and they just  had to lick the water on the ground. I could only surmise not just the physical suffering he may have had but also the suffering of his soul. His body was never found. Only a few lived to tell the tale.

The very  reason for his  absence now in this world, i.e. giving one's life for one's country,  is pervasive . We mourn for the lost lives and lost souls. Freedom is a dream that  seemed elusive to some but not to them. And that is the very reason they fought for, choose to fight for, and forced to fight for. The war continues and  the dream of freedom lives. 

Life's Simple Pleasures: From The Album "Weekend Matters"

Weekends Spell FUN!

 Aldo Lagasca prepared the ribs.

 ...with  Juliet and Cesar's helping hands..

 ...with some more helping hands from Julius (and I thought Aldo was just pulling my leg when he told me their names).

 Raymond is enjoying the burger.

 Rachel is chatting with Emma, who is a great and generous cook. The Lagascas are a generous, open-hearted  and kind lot. They're a perfect example of a Filipino family.

  Just enjoying the sun (May 25, 2009)

Raymond took a break from his computer (May 24, 2009)

Taking a break from Lea Salong's concert at the Silver Legacy's Grande Expo Hall, May 24, 2009

  

This dinner is also to celebrate my birthday belatedly. Thank you Emma and Aldo, and my other Filipino friends who are now family.

May 20, 2009 at Tuscany Village, Peppermill., Reno, NV

Summer Days!

Arlyn Valencia' cover of "Landslide" by Fleetwood Mac

THE ARTIST IN ME

HYDRANGEAS

One warm, lazy afternoon in July of 2008, in Atlanta, Georgia, my friend (Linda)' sister visited Meadow Springs and brought this freshly-cut bouquet of hydrangeas. I was so inspired by it's beauty that I started sketching it, with only a 10-cent 2-B pencil on regular 9" X 12" white paper. This may be just a plain old sketch of those beautiful hydrangeas but the emotions it evokes and the memories surrounding it are precious.

THE SAXOPHONE PLAYER"

24" X 28" sketch/drawing of my friend (Emilia)'s saxophone instructor. He lives in NY. I used charcoal, white gouache (for bright values) and regular black pentel/sharpie pen to SHORTEN drawing time. I finished this in 1 1/2 hours. I spent more time, 5 hours, sketching the smaller version, 
9" X 12" because I only used graphite pencil. I gave the original of the latter to my friend Emilia.

DAVID RAPS

24" X 28" portrait of David Raps, my ex-husband's father, done in charcoal, pencil. I achieved lighter values and whites by using pointed erasers. This was covered in glass, thus the reflection. (University Of Nevada School Of Medicine (UNSOM) Exhibit).