Protection from Dengue

Hi, Leia!
I’m so glad to know you’re doing better. Where to start about Dengue? I feel like I need to respond to this because we, infectious disease specialists, deal with this, breathe this, lecture about this to doctors and the lay alike, as we are the ones called for the serious or undiagnosed cases of Dengue (i.e. when the regular doctors don’t know what they’re dealing with or how to deal with Dengue anymore). Bottom line stuff to remember are the ff:
1. There is no vaccine against it although we are doing researches to develop this. The best mode of prevention is to “understand your enemy”, which is to know the feeding habits and breeding places of the Aedes mosquito, thus knowing how to avoid its bite. The mosquitos are attracted to dark colors, the smell of sweat, warmth and moisture. I.e., the smell of our children when they’re playing. Mosquitoes feed early morning and late afternoons. Cittronella scent can repel a mosquito only up to 5 cms from where this is applied, therefore it is not protective. Protection against bites would entail wearing fresh (not sweat-smelling) longsleeves and long pants of light coloring during mosquitoes’ feeding hours. Studies have shown that only anti-mosquito lotions with DEET (such as your regular OFF lotion) or Neem extract (like BioNeem) are effective lotions to repel bites for so many hours. These lotions can be washed off with sweat and wear off during the day, so they have to be reapplied as needed. DEET containing products can be toxic, so make sure the child takes a bath at night to wash off excess lotion. Neem lotion need not be washed off. Those battery operated anti-mosquito devices, lemon, eucalyptus spray or aromatherapy, citronella candles, etc. don’t work. Yes, breeding grounds are clean pools of water, as little as 1 tsp will do. Make sure you have cleaned and emptied these collections of water at least once aweek, better if 2x a week based on the life cycle of the mosquito.
2. Dengue presents as fever of 2 days or more – the pattern can be anything, from on and off mild fever to high remittent fever, etc. It can involve other symptoms like colds, cough, tummyache, headache, joint pains, diarrhea, behavioral changes, anything goes. Not all patients have rashes, but those who do will be “flushed” during the early stages and later on will have the dark red rashes at the limbs at the final stages of the disease. I have pictures of the rashes in my lecture slideset but these are the usual descriptions. When in doubt, consult right away. The complications of dengue happen when the case is not detected at an early stage and just dismissed as ordinary flu. The hydration of Dengue patients is very crucial and must be monitored accurately, better if under the guidance of a doctor. Again, we all know of the horror stories of those who collapse and are brought to the hospital “too late”. Not all patients bleed, and those who do usually are those who are not monitored. In this day and age, mortality from Dengue is very rare for those who receive proper care.
3. Theoretically, you can have Dengue 4 times in your lifetime, so even if you got Dengue before, that is no guarantee that you’ll never have it again. If anything, the second case of Dengue in a particular patient is worse than the 1st, the 3rd worse than the 2nd, etc. So those who got Dengue must all the more protect themselves.
4. Dengue is all the more dangerous in the first 24-48 hours after the fever goes away, during which time the patient should be more carefully observed.
5. Dengue testing is available but the particular test ordered is based on the number of days from the start of the fever – therefore this is a decision best left to your doctor. There are several tests that should be done but individually tailored to monitor a patient adequately for the different problems in the components of the blood involved.
6. When in doubt, drink lots of fluids! Like any viral infection, lots of fluids in the body will help in the treatment of this disease. If a person does not urinate within 6 hours, has very dark colored urine, he/she may be dehydrated, needing hospitalization for IV fluids. There are other danger signs needing hospitalization also, like tummyache, bleeding from any orifice, increased sleepiness, cannot eat or drink anymore, or feeling of impending doom (no kidding, this happens), and platelet count less than 100.
Whew! All these and we’re not even discussing treatment! Prevention is most important for me, because honestly, there is no cure yet for Dengue, although we doctors anticipate and manage this disease best we can.
Personally, I kinda overreact whenever I see any one of my daughters with a mosquito bite – now you know why.
Hope this was useful!
Carmen

Designing your dream

The key to my dream of having peace and Security in life and to balance my work and family life for me consist of only 2 things. First i need a good management team to run the business on the daily level and at the same time have proper control process in place to ensure a check and balance system within the company.

First we need to consider to let go, train and empower our staff to be able to lead, decide, and do things. Authorize them to make decisions. Motivate them to motivate others. Grow them as you would your own children, that they learn and grow, then learn to let them go. Like our own children, they have to love each other and learn to grow together. Learn to work together, and help each other and watch each other’s back. They need to know that without one part, there’s no whole. Teach them also to be good parents that they may be able to teach and grow their own children and mold the rest of our staff according what our visions are for the company. If all our staff have the same vision of what we want our company to become, then all will work toward the same goal.

Controls should also be place to ensure that each one of them are following the path and no one falls off the road. To ensure that each one is travelling to the same direction.

We need to teach all our staff the simple principle that one person cannot do everything. To be able to achieve the company’s vision, we need everyone to be on board.

The simplest rituals that are important which we can impart are: Wake up early. In life, the only that doesn’t change is change itself. Eat anything that’s serve in front of you; Do all you can do, but accept things that you can’t do. Be happy and thankful with what you have, it can be worse; learn Patience.

Life is short, enjoy.

The possible dream

As part of our Resilliency workshop, we are now given time to dream. Dream of how beautiful the year 2020 can be. What do i want to see happening in the year 2020? That gave me a pause, i suppose, i really haven’t had the chance to dream enough. This definitely needs practice.

But Ivy, our facilatator had put us in a dream state mood. So here it is, I see my family happy, My daughters (mind you, it’s plural now) playing together in the garden and my son, maybe playing golf with his daddy. Everyone is healthy, the business is running like a well oiled machinery. I am now able to balance life between my family and work. There is now a sense of secuirty. Security not only at work but the environment around.

Now isn’t that a wonderful dream?

The art of blogging

Here we are, 10pm and still in the middle of our workshop on resilliency in preparation for the many changes we are expecting to encounter in our business. Change, as we are told, this is the word that we will learn to face and love as this is the constant thing in our industry.. and for that matter, Life in general.

So while outside, the typhoon basyang rages on, we are all still hunch over our laptops learning the ins and outs of blogging. From the computer savvy to the first timers, we’re all pushed to create our own little blogs.

It is Day 2 on our workshop and i am counting time til we will be able to finish this workshop and i can go back to my daughter.