THE DAILY DEALINGS By Arlyn M. Valencia, M.D.: 2009

Thursday, December 24, 2009

Saturday, November 14, 2009

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

Thursday, November 5, 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"

Thursday, October 1, 2009

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

Sunday, July 26, 2009

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.

Saturday, July 4, 2009

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.

Thursday, July 2, 2009

"The Nearness Of You" By Arlyn Valencia

Friday, June 19, 2009

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..

Thursday, June 11, 2009

"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.

Saturday, June 6, 2009

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.

Thursday, June 4, 2009

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.

Monday, May 25, 2009

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

Friday, May 22, 2009

Summer Days!

Monday, May 18, 2009

Arlyn Valencia' cover of "Landslide" by Fleetwood Mac

Saturday, May 16, 2009

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).