VACATION

I usually go on vacation every 2 years outside the country and indulged on all the perks that I can afford: night golf in Shanghai, eco tour in Penang, night life in Mumbai, elephant ride in Bangkok and gold shopping in the suks of Amman, Jordan. But my clinical mind does not go on vacation. I worry about the patients I left behind in the care of my associates. And then, these patients have my mobile number. Not a vacation really.
One time I was in the middle of my golf swing in Singapore when my patient who had RIGHT HEMICOLECTOMY (partial removal of ascending colon ) because of colon cancer  called up to tell me that her poop was always watery ( normal post op with this procedure). Well, wouldn't you mind if someone is calling you because of that? I shank the ball and got a double bogey. Lost Php 3,000 on the bet. What did I do or say to her? Weigh her poop whether she could hit the Guinness. Hahahahahaha

PATIENT'S SURGERY DECISION

To this day, I still do not know why one patient agrees to surgery immediately or procrastinate. Is it to the tone of my voice which does not fluctuate or change whatever the situation is?
Take for instance 2 patients who need surgery of the breast with the same tumor size, same preoperative diagnosis, same financial situation, same stable psychological background. They both come on the same day; one after the other. And yet, one agrees to the excision while the other postpones it for a simple reason that she just don't want the surgery today. For 31 years, I have been searching for the bug or virus or wind or wall paint that could influence their decisions.  Since both of them come with their husbands who readily agree to the surgery, one agrees to the procedure and the other goes home.
Sometimes, I come to believe that two whisperers are influencing my patients; whether they be angels or demons do not matter.
And these musings have brought me to conclude that we could not be alone in this world and that Somebody is making the decision for  us.

EBOOK

In a few weeks from now, my publisher + Bob Bare will launch my book "SELF-MEDICAL DIAGNOSIS" under the management of his general manager here in the Philippines +Mecos Pacana.
We hope that with this book, we could help a lot of people who want to know what disease they have prior to going for consultation especially those who are living  in the third world where medical specialists are out of their reach financially and logistically.
<http://www.amazon.com/Self-Medical-Diagnosis-Self-Medicate-ebook/dp/B00ENIFKPU/ref=sr_1_1?ie=UTF8&qid=1380524831&sr=8-1&keywords=self-medical+diagnosis+dr+cagape>

THIS IS THE HAND NOW

This is the hand now after partial amputation of the  of the gangrenous fingers.

AGGRESSIVE APPROACH TO SURGERY

I have been aggressive in doing surgery lately. Because of financial constraints a lot of patients cannot afford to go to the hospital  to have a minor surgery done under general anesthesia. Most if not all minor surgeries go under general anesthesia because the patient cannot bear the pain and the size of the tumor is too big for a local anesthesia.  I have done hemorrhoidectomy, varicocoelectomy and excision of breast masses the size of a child's ball ( 10cm x10cm) under local anesthesia all because of the patient's limited resources.

The above tissue came from a a big subcutaneous tumor ( LIPOMA) on the side of the patient's abdomen the size of  12cm x 12 cm. I have become bolder and bolder nowadays. But it only took me 30 minutes to remove it sparing the patient to spend Php 35,000 for a hospital surgery.