Kabaga Official Newsletter - Lung Center of the Philippines

Section of Lung Center of

the Philippines since 2009.

He is one of our most devoted

pulmonologists who have big con-

tributions in the success of our pul-

monary bronchoscopy section.

Dr.Gonong, a product of our own

institution, has served the LCP em-

ployees and patients since time he

became the Chief Pulmonary Fellow

back in 2003. Over the past 17

JOVEN ROQUE V. GONONG, MD, FPCP,FPCCP is the current

Head of the Interventional Pulmonology/Bronchoscopy

PHYSICIAN ON THE SPOT:

THE FIVE-STAR PHYSICIAN

WITH A HEART

Dr. Gonong with one of his mentors, Dr.Lee.

Kabaga Official Newsletter

of the

LUNG CENTER OF

THE PHILIPPINES

Volume 2, Issue 2 December 2020

CELEBRATION AMIDST THE PANDEMIC

Christmas is in the air. It would

have been as widely celebrated as the

previous years, if it weren’t for the

deadly and invisible enemy floating in

the air too. Of course, we are talking

about the dreaded SARS COV2 which

has spread throughout various regions

across the planet, and has invited itself

to every mass gathering known to man

since the start of the year. Weddings,

birthdays, graduations and simple get

together have all been cancelled or

rescheduled on its behalf. However,

this is where you see the creativity of

humanity especially Pinoys.

years, Dr.Gonong has done innumera-

ble number of interventional proce-

dures, outstanding clinical researches

and was integral to the development

of the MDR-TB program.

Getting to know Dr.Gonong

Someone who never forgets his origin

and always loyal. Dr.Gonong was

raised in a province of Nueva Vizcaya

“Practice,

practice,

practice.

More than

intelligence is

diligence.”

ASTHMA CLUB GOES VIRTUAL The OPD-ER Department contin-

ues to adapt to the ‘new normal’ set-

ting and slowly opened its doors via

face to face and online consultations.

The longest running Asthma Club

Workshop faced its biggest challenge

when its regular activities were put to

a halt because of the pandemic. The

Outpatient Department of the Lung

Center of the Philippines headed by

Dra. Eileen Aniceto (Department Man-

ager and Director of Healthy Lungs

Program) and Dr. Jessica Catalan

(Chairman, Asthma Club) conducted

the Training of Asthma Facilitators last

September 16 & 17, 2020 with Mrs.

Loree Mante. This 2-day training work-

shop of pulmonary fellows aimed to

develop the skills in facilitative teach-

Inside the Issue:

Five Start Physician 1

Asthma Club Goes Virtual 2

Sleeping w/ CoViD 3

Celebration Amidst the Pandemic 4

The 95-Year Old Superstar 5

Christmas Hugottttttt!!!!! 7

One Stop Swab with Dr.Sayo 8

The LCP OPD: New Normal 9

Trying for One - Relearning Empathy 11

The New Modular Hospital 13

Sustaining TB Services 14

Research Forum 15

MDR-TB, Interventional Pulmonology,

bronchoscopy, and EBUS both local

and abroad.

Being a doctor and an interven-

tional pulmonologist has always been

his choice and dream. His happiness

and passion is to treat the sick and the

ill to provide a safe and good out-

come. If not a human doctor,

Dr.Gonong might have been a Veteri-

nary doctor as he recalled it as one of

his childhood dreams.

A kind and caring Physician.

I remember there was one elderly

patient who came to the ER who

turned out to be one of Dr.Gonong’s

patients since fellowship training and

who never lost to follow up for sev-

eral years, showing a strong doctor-

patient relationship over the years.

Dr.Gonong is being liked by many

patients as he always treats his pa-

tients with kindness and respect. Not

to mention his empathy that he even

went to a wake of his patients.

A dedicated Team Leader

Dr.Gonong is always a positive

thinker. He always sees obstacles or

hardships as a road to success. He

paved new changes and development

for the benefit of all.

As the head of the Interventional

Pulmonary team, Dr.Gonong has

brought big contributions in the ac-

quisition of new technology in diag-

nostic bronchoscopy, EBUS, and cryo-

therapy. To mention the most recent

are the advanced navigational bron-

choscopy and ultrasound machines

that will surely bring more benefits to

the hospital, trainees and patients.

by his loving parents who taught him

the importance of learning and edu-

cation which he passed on to his

children. As someone born from a

province, he never forgets going

back to his family and visiting the

tranquility and beauty of his prov-

ince.

A bright student and a diligent

trainee.

He graduated with B.S. Medical

Technology and completed his Medical

degree in UST. When he was still in

med school, he initially dreamed of

becoming a Pulmonary fellow in Lung

Center where he actually finished his

training in Pulmonary Medicine and

Interventional Pulmonology. Since

then, he completed several training in

Kabaga

“Create your own path

for others to follow.”

The Gonong Family (L to R: Dr. Joven Gonong, Dra.Annabelle(his wife),

Danielle (daughter) and Patrick (son)

ASTHMA CLUB... ing and learning in preparation for the

Asthma Club Workshop.

The team aims to bring the Asthma

Club Workshop into the virtual network

where active and new members can

actively join nationwide. The main goal

is that an “asthmatic patient must be

competent to control and manage his/

her asthma and confident in his/her

ability for self management under the

doctor’s guidance”.

The Virtual Asthma Club activity

entitled “Kaibigan, Pag-usapan natin

ang Asthma” was successfully

launched on October 24 and Novem-

ber 28,2020 with the assistance of

Astra Zeneca. Participants from

across the country as referred by

their attending pulmonologist actively

participated in the lecture and work-

shop. The workshop was conducted

in a facilitative approach where the

lecturers and participants actively

participate in the discussion and

demonstration. The Asthma Club as

part of the Healthy Lungs Program,

will continue to conduct this virtual

activity next year and will find ways to

celebrate other activities in the virtu-

al platform. // JCL

Virtual Asthma Club attendees: Pulmonary Consultants and Fellows

with the club members via Zoom.

Page 2

Physician on the Spot...

Regaining Lost Ground

After a few grueling months, the

Sleep Laboratory has finally been re-

claimed by the service. This was due

to the scaling down of CoViD opera-

tions which resulted in Ward 3A re-

turning to non-CoViD status. The

Sleep Laboratory (Rooms 3122 -

3124) and adjoining Sleep Clinic

(Rooms 3118-3120) are now being

used daily by the Sleep fellows in the

conduct of online consultations, PSG

readings, and other related training

activities. At its current state, the

Sleep Lab is fully capable of conduct-

ing two simultaneous sleep studies

per night.

Remnants

Despite the apparent

“homecoming” of the Section of Sleep

Medicine, there are still a couple of

holdovers in anticipation of any possi-

ble resurgence in CoViD cases. We

have retained our foothold in the pair

of modified rooms in the Pediatric

Ward in the event that Sleep studies

could not be conducted at the labora-

tory again.

Room 4041 is still presently be-

ing utilized by the service as the nerve

Physician on the Spot...

SLEEPING WITH COVID: The New Normal in Sleep Lab operations

Supportive and enthusiastic

mentor.

He gives most of his time in teaching

and training his fellows and is always

enthusiastic in doing new and charita-

ble procedures. He is very supportive

for the learning of his trainees. Ac-

cording to him, “Practice is very im-

portant. More than intelligence is

diligence.” His advice on young train-

ees: “Always be innovative. Create

your own path for others to follow.”

A self-motivated tenacious Re-

searcher.

Dr. Gonong has full of passion in

the field of research. He conducted

more than 50 research studies, both

clinical trials and analytical studies

which brought a great deal of contri-

“Be passionate and enjoy

what you’re doing”

butions in the management of Bron-

chial Asthma, COPD, TB, bronchiecta-

sis, pneumonia, and lung cancer. He

said he enjoyed the fulfilment and

satisfaction of knowing the research

outcome and its contributions to

knowledge and to the community. He

advised, “To do more research, you

have to be passionate and enjoy what

you’re doing.”

Compassionate community Physi-

cian.

His home in the center of his farm

in Quezon has always been open for

his community offering free medical

consults during weekends. Dr. Go-

nong is always a full-time doctor in

the hospital from Mondays to Fridays,

and always a community physician

and a humble farmer on Sundays.

A humble Farmer on Sundays.

Dr.Gonong is a nature-lover who

acquired a 3 hectares-farm in Quezon

as a fruit of his hard work. He loves

the view of the farm surrounded by

beautiful trees, green mountains and

wonderful animals. He used to visit

the farm on Sundays to plant trees

(especially bonsai), feed his pet ani-

mals, and enjoy the tranquillity of

nature to boost his strength for the

following week.

A Supportive Dad and a loving

husband.

FAMILY is one of the blessings

Dr.Gonong is most thankful for. He

mentioned that he became more

matured, more responsible and hard

-working when he got married and

had a family of his own. As a father,

he is all out for learning and tolerant.

He served as an inspiration to his 2

children who followed his footsteps

of becoming a doctor.

When asked what legacy he want-

ed to pass on to his children: he an-

swered, “passion for learning”. He

wanted his children to be hardwork-

ing, passionate in learning and suc-

cessful.

Dr. Joven Gonong has a remark-

able personality. He is self-motivated

with strong work values and great

passion for learning. From a humble

farmer and a nature lover to a defi-

nitely 5-star-physician who have

mastered the art of bronchoscopy

and research to share his success to

his fellows, trainees, and community.

He, definitely has created paths of

his own that others can follow.// LDP

Volume 2, Issue 2

Kabaga

Division of Thoracic Aneshtesia: (From Left to Right): Dr. Lizbeth Jacaban, Dr. John Robert Uy, Dr. Jun San Andres, Dr. James Monje,

Dr. Bienvenido Chu, Dr.Mc Deansem Pabalinas, Dr. Duran, Dr. Stephanie Balaoing, Dr. Von Ryan Mallari,

Dr. Arianne Ivy Cera

In lieu of formal events pushing

through in their actual venues, virtual

meetings like Zoom and Google meets

were born. Expectant families do gen-

der reveals in video conferences. We

have all been invited to a bunch of

weddings, baptisms, anniversaries and

random “e-numans” online. While

we see that everyone is being care-

ful not to transmit the virus to our

friends and families, Filipinos make

it a point to value these celebra-

tions. As the longest festive season

of Philippine culture looms around,

the belen in the Lung center of the

Philippines lobby stands proud. We

can already hear the beloved

Christmas hymn “Christmas Bonus”

alternating with the Oratio Imperata

being blasted by the PA system.

Indeed, no virus can crash the te-

nacity of the Filipino spirit.

“The people

working in the

medical field has

been among those

hardest hit by this

outbreak.”

Many have not seen family

members since the start of the pan-

demic in fear of bringing home dis-

ease. We have grieved the loss of

colleagues, family members, ac-

quaintances and even our own pa-

tients. Being always present in the

Dr. Hazel Crisostomo, the new

Thoracic Anesthesia Fellow

hospital has taken its toll on the

physical, psychosocial and mental

health. Fellows-In-Training are of

no exception. Despite all adversi-

ties, caring for those who have

been afflicted has remained the

top priority.

Withstanding hardships and

challenges in this times, the Anes-

thesia Division celebrates its “hot

off the fire” blessings. In-Training

Anesthesia Fellows, Drs Von Ryan

Mallari and John Robert Uy

passed the Oral and Practical Ex-

aminations and have recently been

awarded Diplomate status in the

field of Anaesthesiology by the Phil-

ippine Board of Anesthesiology

(PBA). Dr. Mc Deansem Pabalinas,

our ex-officio Chief Fellow has com-

pleted his training and is pegged to

graduate. Also, the Anesthesia Di-

vision welcomes Dr. Hazel Crisos-

tomo, who has completed her train-

ing in general anaesthesiology and

has decided to take on the chal-

lenges of fellowship even in uncer-

tain times. All these accomplish-

ments show not only resilience, but

utmost dedication and passion in

their calling.

We continue to celebrate big

triumphs as well as small wins on a

daily basis amidst this pandemic.

These celebrations should not be

seen as mere selfishness, but as

proof that even we face such or-

deals, we maintain our stance

that there is a Higher Power above

us. No one knows what this conta-

gion accords, still we fervently

hold on to hope and faith that this

too shall pass and more rejoicing

shall come. From the Thoracic An-

esthesia Division, a Blessed Christ-

mas to all!// KAN& LJ

Celebration...

Volume 2, Issue 2

The 95-Year Old Superstar My heart sank. She was 95 years

old. As I went inside her room, a bub-

bly old lady greeted me, “Good morn-

ing Doctor. What is your name?” With

a muffled voice, I introduced myself.

“How are you?” I asked. “I’m feeling

okay,” she answered. She did not look

okay, she could hardly move. Her eyes

beamed with pride when I asked her

about her family.

She was a teacher married to a

politician. Her children are practicing

doctors and nurses both here and

abroad. She hails from Nueva Viz-

caya. There were pauses in between

phrases. She was catching her breath

as she speaks. It did not stop her.

Everyday she would tell us of new

stories. One could tell that she had a

vibrant busy life. Her frail body be-

trayed her brilliant enormous mind.

She was calm, fearless and full of

wisdom. Her private duty nurse in-

formed me that her children would

like to have a conference call with her

attending doctors. They had so many

questions about the disease and

management. Despite her age, they

wanted to do everything for her. They

were aggressive. They agreed to re-

ferrals to Cardiology and Nephrology

services. They consented for use of

investigational drugs, IJ catheter in-

sertion, hemoperfusion, hemodialysis,

and yes, they asked about convales-

cent plasma transfusion. It is admira-

ble that all throughout the scary expe-

rience they were polite and well-

mannered just like their mother. Being

the Fellow-in-charge, there was so

much pressure on me. She has to live.

I wanted her to live past 95 years old

and by God’s grace be a centenarian.

There were many dreadful possibilities

for this case, worst would be death. I

prayed hard to God to help us win the

battle. Her children’s love and respect

for her are worth fighting for. I secretly

called her “The Superstar” because of

the outpouring of love from so many

people asking updates about her daily.

In the end, she proved to be a real

star, her light shone so bright it could

not be dampen by the darkness COVID

brings. Asthma exacerbations and nos-

ocomial pneumonia failed to bring her

down. On the day of her discharge, she

looked so excited coming out from the

elevator. On her interview with CNN,

she was generous with words of

encouragement and appreciation

for the doctors and nurses who

attended her.

The thought that she is back

home with her children celebrating

birthdays and holidays gives me

joy, pride, and optimism. This story

have made me realized that a

mother is never too old to be let go

of easily. I will never ever be ready

to lose mine. Her story inspired me

to be the mother that my children

will fight for and to be the daughter

that my parents will be proud of. I

have also realized that age indeed,

is just a number. She was an old

lady with the spirit of a horse.

COVID is cruel, it is a disease

that knows no boundaries. It is

like a thief in the night. It has left

gaping wounds in the hearts of

many all over the world that only

time can heal. But there is nothing

that is more powerful than love. It

is her children’s love that survived

my patient from COVID. And I

dream to have that kind of love

from my children, the kind of love

that lives even when I am gone. //

HCR

Our 95 year old Star During her interview after she was discharged home

“In the end, she proved to be a

real star, her light shone so

bright it could not be dampen by

the darkness COVID brings.”

Dr. Chan-Reyes (Middle) and Dr. Francisco(right) the attending fellow and the attending Pulmonary

consultant

Kabaga

Sleeping with COVID...

center of Sleep Lab operations, and

can still be reached at local 4100

for scheduling and inquiries.

Adaptations

I have to admit that making all

these changes to the way business

was normally conducted at the Sleep

Lab was quite jarring at first. From the

point of view of a former Pulmonary

fellow who had had experienced rotat-

ing in the Sleep Lab a few years back,

the things we are doing now, though

fundamentally the same, are so much

different fromwhat I had experienced

before. During pre-COVID times, the

questionnaire is filled up by the pa-

tient/companion themselves when

they come in person for a consultation

at the Sleep Clinic. Now that telecon-

sultations are the norm, the Sleep

fellow conducts an initial interview of

the patient to complete the Sleep

questionnaire prior to the actual con-

sult. We have experienced using a

wide variety of platforms to facilitate

the consultations, with FB messenger

and Zoom being the most popular.

Share-screen is our friend, as it allows us

to show images and results to the patient

(provided that the patient is using a large-

enough device like a tablet or laptop. We

had encountered hiccups along the way,

but as the months have gone by, I would

like to think that we have now settled into

the routine and have gotten better at it as

well.

Another new adaptation by the Sec-

tion to the changing times is the introduc-

tion of the HSAT (Home Sleep Apnea

Testing) service to our armamentarium. A

portable monitor would be brought to the

patient’s house and allow the patient to

have the diagnostic study done in the

comfort of his/her own home. The porta-

ble monitor available to us is basically a

type 3 sleep test, but has the added fea-

ture of EEG leads. This addition would

provide a much better evaluation of the

patient’s sleep as compared to conven-

tional type 3 monitors. A caveat of this is

that the monitor would require a Sleep

Tech to initially attach the leads to the

patient when it is brought to their home.

Looking Forward

In the past few months, we

have seen a progressive increase in

the number of consultations to our

service. The Sleep study census

has been slowly increasing as well,

with studies now being scheduled

weekly, which is a far cry from the

slow trickle of studies we had previ-

ously experienced during the height

of the pandemic. It is hoped that

the Sleep census would improve as

the local CoViD census goes down.

Saving the Best for Last

The Section of Sleep Medicine

is proud to announce that the two

latest graduates of the program, Dr.

Liza Marie R. Lomigo and Dr. Kathe-

rine C. Paras, have passed the re-

cently concluded Diplomate Exami-

nations in Sleep Medicine that were

held last October 25, 2020. As an

added bonus, Dr. Lomigo placed

FIRST during the Written and SEC-

OND during the Practical examina-

tions! Congratulations!!//BNO

Page 6

Above: (Standing from L to R) Dr. Katherine Paras, Dr. Monica Madera, Dr. Maria Francia Alexandria Caparas,

Dr. Virginia delos Reyes, (Seated L to R) Dr. Liza Lomigo, Dr. Maria Cecilia Jocson, Dr. Rose Ann Roque, Dr. Jonalyn Ang

Left Upper: Zoom meeting with the Pulmonary Fellows-in-Training, the Sleep Fellows and sleep technicians

Left Lower: Conducting Sleep Study in the Sleep Lab with the Sleep staff wearing PPE

Volume 2, Issue 2

CHRISTMAS HUGOTTTTTTTTTTTT!!!!!!!!!!!!!

If you remember the theme of my

last article, it was all despair and

fear. But now, we managed to over-

turn all the negativities, and learn to

live with what has to become a nor-

mal part of our lives, that is COVID

19. So now, let me talk about the 10

things that we should do (or what I

have to do) during this COVID19

Christmas Season.

1. God. God has to be the first in

everything we do. Behind all the

chaos of this pandemic, we have

to be steadfast in our faith, un-

endingly trusting God’s plans to

prosper and protect us always.

This pandemic is just a phase, a

small kink in our history, it will be

over soon. In God’s time, in His

precious and rightful time.

2. Family. This is the time to appre-

ciate our families more. Hug your

kids. Kiss your significant other.

Make them feel loved every day.

And please wash your hands, use

alcohol, and make sure that you

do not have flu like symptoms

before you do this.

3. Friends. This may be the time to

reconnect with your friends. We

may not be able to be with them

face to face, but well we may use

the internet to reconnect (pun

intended) with them.

4. Continue caring for our patients.

This one needs no further expla-

nation. Laban Lung.

5. Donate to charities in support of

those who were affected by the

recent typhoons. 2020 has been

very challenging. Aside from this

pandemic, some areas of our

country had been flattened out

by numerous typhoons in recent

months. Bayanihan.

6. Kobe! Watch re-runs of the

games of the late great Kobe

Bryant, second to the GOAT.

2020 you have been so cruel. I

promise myself I will never buy

myself a helicopter.

7. Listen to EVH, Jamir Garcia.

Well, again 2020. What can

I say. You have been so cru-

el. I will JUMP with AGENT

ORANGE and say ADIOS and

get to PANAMA and find my

QUEEN PARANOIA. =)

8. Learn new guitar riffs. Con-

tinue to be a bedroom rock-

star.

9. Enjoy all the moments with

my Co-Fellows. My people,

the brave soldiers of this

COVID pandemic. Salute to

all of you, to all of your hard

work and sacrifice. Through-

out all our days, we will wear

the battle scars brought to

us by this pandemic. We will

sing of our victories on two

bottles of Corona (again pun

intended, I’m sorry =)), weep

and empathize for the

deaths, for those people we

were not able to save. You,

my brothers, Co-Fellows, all

of you will be forever en-

graved in my heart. When all

of these are over, we may

proudly say to ourselves,

and to other people, that we

manned the frontlines, and

held the fort for them. Sa-

lute!

10. God. Everything starts and

ends with God. We live your

purpose. We live for your

plans.

And these are the 10 things

that I will do during this COVID

19 Christmas season. Merry

Christmas!

“A moment of GRATITUDE

makes a BIG DIFFERENCE in

your ATTITUDE.”// AL

Kabaga

Digital marketing pioneer Ann

Handley once said in an interview:

“When we create something, we think,

‘Will our customers thank us for

this?’”

Undoubtedly one such creations is the

One Stop Swab (OSS) of the Lung Cen-

ter of the Philippines. So, in one hazy

afternoon, as the sun was about to

set, sprawling the sky with golden

hues, and the number of clients at the

OSS dwindled, we asked the golden

girl Dr. Treah May Sayo, who spear-

headed the project, her thoughts.

How did the idea for a One Stop Swab

come about?

As the pandemic shook the

nation, the LCP Sub-National Labora-

tory for Emerging and Re-emerging

Infectious Diseases (SNL-EREID) was

among the first to respond altruistical-

ly to the call of DOH, offering free and

accessible COVID-19 RT-PCR tests to

LCP patients and DOH-designated

health facilities. As months passed,

with the gradual loosening of the quar-

antine protocols and rekicking of the

economy, there came the need for RT-

PCR testing for travelers: domestic,

overseas contract workers, and sea-

farers who reached out to the Lung

Center of the Philippines for their trav-

el and employment requirements.

Thus, One Stop Swab was conceptual-

ized in order to accommodate the

market demand, and as a service op-

portunity for LCP to gain income on

top of its charitable work.

Why do we need a One Stop Swab?

One Stop Swab has a simple

business strategy, with an aim to pro-

vide clients stress-free, safe, and effi-

cient transactions, all under one roof.

Beginning from swab bookings, client

registration, and verification, payment,

swabbing, expedited specimen pro-

cessing, and result releasing are being

smoothly managed and executed.

What are the difficulties you have ex-

perienced in putting up such estab-

lishment?

OSS was built with a lot of

support and trust from the LCP man-

agement and the Laboratory Depart-

ment who also recognized the neces-

sity of establishing such structure that

will separate low risk OSS clients from

high risk LCP patients who were previ-

ously sharing the same waiting ground

at the OPD complex.

However, this surge for RT

PCR testing for job/travel require-

ments was initially unexpected that

we were not prepared to deal with this

new business venture, but the situa-

tion demanded creativity and innova-

tive ideas. Surprisingly, some compa-

nies generously donated items such

as chairs, tables, speaker system,

aircons, printers, and barcode scan-

ners. With everybody’s efforts and

cooperation, project difficulties were

barely felt.

Furthermore, OSS embodies

this powerful principle of establishing

pleasant rapport and long-term rela-

tionships with key companies that will

remain partners beyond the pandem-

ic. Services are individually molded

and personally delivered according to

the demands of the clients, such as:

less than 24-hour results, laboratory

certificates, country certificates, re-

sults with QR verification codes, and a

lot more. Not to mention, we have

staff on stand-by that can be reached

during the wee hours at night, on

weekends, and on holidays. With firm

business principles, consistency, and

competitiveness, I believe that OSS

will remain the bread and butter of

this institution amidst this world crisis.

A Short Stop at the One Stop Swab with

Dr.Sayo

“Just simply

Dream, Believe,

Dare, and Do”

-Dr.Sayo

Dr. Treah Sayo at the LCP One Stop Swab

Volume 2, Issue 2

What did you realize about yourself,

given what appears to be an insur-

mountable task?

When I was faced with a tremen-

dous task like the OSS, I was remind-

ed with how Walt Disney, the great

storyteller and innovator inspired oth-

ers through his simple life principles:

a) To dream and express creativity

beyond the boundaries of today, b) To

believe in sound values c) Dare to

make a difference d) and then just go

out and do it! Just simply Dream, Be-

lieve, Dare, and Do.

What are your future plans for the

One Stop Swab?

OSS is on the verge of improving

and strengthening its data infor-

mation system platform. The primary

challenges I see for now are minimiz-

ing encoding errors that sometimes

render a huge negative impact and

failure in what appears is a flawless

system. We are awaiting the imple-

mentation of an online Covid infor-

mation form submission system, re-

sult audit trail, and a stable data

management system. This technology

will further reinforce our services, level-

ing us up from other institutions.

Indeed, the OSS is another feather on

Lung Center of the Philippines’ cap as

an excellent customer-centered institu-

tion. The One Stab Swab is open every

day, Monday to Sunday, including holi-

days, from 7:00am to 4:00pm. Inter-

ested parties may walk-in anytime or

call to schedule. For queries and more

information, please call 8924-6101

local 1227 or 2085. // GT

The Lung Center of the Philip-

pines has long been providing out-

patient services to address our pa-

tients’ pulmonary concerns. At the

height of the COVID-19 pandemic,

we experienced an interruption of

important services such as the Out-

Patient Department (OPD) and Doc-

tor’s Clinics from March to Septem-

ber 2020 - a total of 6 months. This

was done as a response to the na-

tionwide lockdown, to adhere to the

community quarantine guidelines

from our government, and to pro-

vide less exposure between pa-

tients and healthcare workers.

Despite these hurdles, our insti-

tution began to adapt to the current

situation and looked for ways to re-

open the OPD to attend to our non-

COVID patients’ concerns. We be-

gan with te leconsultat ion/

telemedicine which enables remote

healthcare and makes it possible

for physicians to see and treat pa-

tients by using a computer, tele-

phone, or smartphone. Eventually,

the easing of community re-

The LCP Outpatient Department in the New Normal

strictions and decreasing number

of COVID-19 cases has pushed the

hospital to strategically plan the

opening of the OPD. Headed by Dr.

Eileen Aniceto, the Department of

Emergency Medicine and Out-

Patient Services have modified the

OPD and Doctor’s Clinics to the

current public health standards.

A rotation schedule has been

devised at the Doctor’s Clinics and

Pulmonary Fellows’ OPD to lessen

crowding on the area. A designat-

ed Pulmonary Consultant will be

assigned at a specific time

(08:00AM to 12:00NN and

01:00PM to 05:00PM) and only

their patients will be accommodat-

ed at that time. Walk-in consulta-

tions will also be decked on the

Pulmonary Consultant assigned on

that date and time. For the Fel-

lows, a similar designated timeslot

was also done (09:00AM to

11:00AM and 11:00AM to

1:00PM) to accommodate service

patients. A negative SARS-COV

swab test done within 7 days prior

to the day of consult is required,

and a limited number of patients

will be accepted per timeslot and

per fellow. Patients will be accom-

modated on an appointment ba-

sis.

Administrative and engineering

controls were also modified to

maximize patient and healthcare

worker safety. A triage area prior

to entering the main lobby of LCP

was set up, where patients are

required to fill up a Health Declara-

tion Form for self-reporting of

symptoms and to monitor their

temperature to check for fever. All

of those who enter the OPD and

Doctor’s Clinics are required to

“MedCheck is type of plat-

form so we can

easily improve

productivity and

efficiency, and also to re-

duce costs through de-

creased paperwork.”

A Short Stop...

Kabaga

wear a face mask. Adequate social

distancing will be monitored in

waiting areas. At the OPD, acrylic

barriers were set up on consulta-

tion tables to provide less expo-

sure between patient and physi-

cian.

Another breakthrough of the

new OPD set-up is the develop-

ment of Electronic Medical Rec-

ords (EMR). With the use of the

software program MedCheck, doc-

tors can consolidate clinical data

on the computer and store it in the

“cloud” for quick access. This soft-

ware program can also be an ave-

nue for telemedicine through se-

cure video calls. MedCheck is spe-

cifically beneficial for the fellows in

our institution since all fellows can

access service patients’ charts

through this platform with ease. It

is encouraged that we use this

type of platform so we can easily

improve productivity and efficien-

cy, and also to reduce costs

through decreased paperwork.

The COVID-19 pandemic may

have forever changed the way we

deal with patients, but no chal-

lenge is insurmountable as long as

we keep our patients’ welfare in

mind. Let us embrace the new and

improved OPD in the new nor-

mal. // EDV

Top Left: OPD set-up with acrylic barrier ; Top Right: Pulmonary fellows using MedCheck, an EMR software for their OPD consults ;

Bottom Left: Social distancing maintained on OPD waiting area; Bottom Right: MedCheck is an EMR software that consolidate clinical data

for OPD consults

The LCP OPD...

Volume 2, Issue 2

11:35AM and I'm on my way to

Tagaytay for the wedding of a good

friend when my phone lights up. I'd just

come from duty and was half asleep in

the passenger seat of a friend's car,

reading words that were now all too

familiar, "if you’re not busy, can you

help me with intravenous insertion?"

Residents, fellows, and consultants

have made a habit of asking this of me,

and I'm usually more than happy to

help.

Intravenous line insertion is one of

the first procedures we learn as young

doctors and I happened to learn from

the best of my peers then be further

sharpened by the warzone that is the

ward as a first-year resident in a tertiary

pediatric referral center. Pediatricians

are supposed to be “sharp shooters” of

IV insertion.

I clearly remember my first month

as a resident. I was assigned to the

Hematology - Oncology ward. I distinctly

remember a particularly deflating night

when nothing was going right and I

needed to bow out and finally ask a

fellow resident to help insert an IV line.

He did it in one shot and didn't make

anything of the added work. I was

grateful, especially because these pa-

tients were sicker than most. But disap-

pointed in myself. I was supposed to be

good at this. My pride was hurt, but that

was nothing compared to knowing that

I caused more pain in a child who's

already had a lifetime's worth. Shame.

The day after, I made a rule for

myself-of always choosing "the second

shot". I would look for veins, take my

time, look for the best choice and then

backtrack to find one that appeared

second best, and proceed to try to in-

sert an IV line there first. Going for the

second choice may sound cruel but it

actually made me calmer, knowing that

a better vein was waiting in the wings.

It turned out that I rarely needed the

better vein. And the constant challenge

of making do with that second shot

Trying for One - Relearning Empathy made me better.

No matter how straight you keep

your face or how level you keep your

head, a failed attempt here can't be

saved by saying, "sorry, tahan na, pero

kailangan" or reassured by a confident

"isa na lang, promise". There are no do

-overs. Your words are the scalpel.

Your voice, the shaky hand that holds

them. And the room for error isn't shift-

ing the cannula a millimeter right or

left. It's smaller. Miniscule. Infinitesi-

mal.

Reading while half asleep is our

bread and butter. Remembering on an

empty stomach during residency was

our every day. Our professors in medi-

cal school would always say that Medi-

cine is a Science and an Art. The sci-

ence is reviewed daily in the interpre-

tation of results and the making of

clinical decisions. It is applied in the

examinations, of paper and of pa-

tients; the prodding, pricking, cutting,

swabbing, and other skills refined a

thousand times over. But the art was

always the more difficult task.

A COVID infected child is unique in

that he or she is rarely allowed the

care of a parent or guardian. Children

aren’t spared from this disease, its

complications and, at times, even its

deadly nature. Some parents camp

outside the hospital — the best they

can do given the circumstances, and

the least they can do, I guess, to keep

sane. And it's our daily encounters

with them that I dread the most. I wish

there was the opportunity to choose

the best time of the day, and an ideal

location, and all the right words to say

(or better yet a rewind button), espe-

cially when tired, to get through these

conversations, and relieve rather than

add to anxiety. I wish that if or when

we fail, there could also be that better

way waiting in the wings.

But no. There isn't. There is only

ever going to be one try. There's one

shot to share news with kindness and

compassion. There is one shot to col-

lect yourself behind your mask and

goggles, before heading out to face

mom or dad who hurriedly comes after

a page or call. Studies show that the

emergency room and hospital corridors

are the least preferred venue for break-

ing the bad news - I wonder if "outside"

or "outdoors" should now be included

as an alternative. There is only one shot

to say a sincere sorry. That we did eve-

rything we could. That we don't want to

cause any more pain. Or, hopefully, that

everything will be alright.

Today, we struggle to find different

ways of conveying the care necessary

to deal with children and their ever-

anxious families. It is a challenge as

empathy seems nearly impossible to

express with shielded eyes and a muf-

fled voice behind a mask. And all that,

strictly, one meter apart. Now, more

than ever before, the art is like painting

the Mona Lisa with a dirty rag and the

lights turned off. Bed-side is now out-

side. A mother's worry has now grown

to anxiety, depression, or all of the

above. A child's struggle need be sup-

ported without a mother's warm em-

brace. We need to learn on the fly. We

are supposed to be good at this. Our

pride may get hurt, but that is nothing

compared to knowing that we might

cause more pain in children and, may-

be more so, parents already enduring a

lifetime's worth. Let the constant chal-

lenge of making do with one shot make

us better.

Just Once. Promise.// JFN

Kabaga

It was during the meeting with IATF

Head Secretary Carlito Galvez when the

need for additional hospital beds was

mentioned. At that time, the COVID

beds at the Lung Center of the Philip-

pines were full and patients had to be

kept at the Emergency Room while

waiting for accommodations.

There was a need for isolation

rooms which were capable of handling

patients on mechanical ventilators.

Immediately, Secretary Galvez gave

instructions for a modular hospital to

be constructed at the Lung Center of

the Philippines. DPWH Undersecretary

Emil Sadain and DOH Undersecretary

Dr. Leopoldo Vega who were present

during the meeting and both men-

tioned a facility which was at the de-

sign stage.

USec Sadain and his group from

The New Modular Hospital

DPWH went to the parking lot right

after the meeting and drew up the

plans for the modular hospital.

After several weeks, the project

started. It was a container van

based structure which did not actu-

ally looked like one. The LCP Engi-

neering group was asked for its in-

put which was incorporated in the

design.

It was in November 11, 2020

when the IATF DPWH DOF LCP Mod-

ular Hospital was inaugurated with

USec Sadain in attendance. Dr.

Vince Balanag received the complet-

ed project in simple ceremonies.

USec Bong Vega later inspected the

facility and expressed satisfaction

with the project.

The new modular hospital has 8

rooms with 2 beds each. Each room

has its own toilet and bath with hot

water. All the rooms and the hallway are

equipped with CCTV. Each room has Wi

-Fi access and has a large screen smart

TV.

The whole facility is air conditioned

and has adequate air change rate. The

nurses station is at one end and pa-

tients can be monitored via a large

monitor.

Oxygen is supplied via LCP’s system

and the same is true for the suction

system.

The modular hospital is now ready

to accommodate our patients after all

the other requirements are put in place.

The Lung Center of the Philippines

is grateful to the IATF, DPWH and the

DOH for this additional facility which will

allow us to serve more patients during

the pandemic.// TR

Left: Dr.Vince Balanag with DPWH Usec Mr. Emil Sadain. Right: Dr.Tony Ramos with Mr. Al Tengco of Nationstar, Builder of modular hospital.

Volume 2, Issue 2

Left: Air-conditioned Rooms with 2 beds each with Wi-Fi access and has a large screen smart TV

Right: Own toilet and bath with hot water per room

Sustaining TB Services in the Time of

COVID19 Pandemic

Challenging Times

These are daunting times replete

with unique challenges. As enhanced

community quarantine (ECQ) was de-

clared in the evening of March 16, the

staff at the Public Health and Domicili-

ary Division (PHDD) of the Lung Center

of the Philippines (LCP) felt the wave

of potential difficulties coming consid-

ering our main goal of providing tuber-

culosis (TB) related services that in-

clude drug resistance cases. We were

committed that these should be un-

hindered and be as seamless as pos-

sible without burdening these afflicted

individuals.

We are aware of the core princi-

ples of DOTS Therapy which are de-

signed to ensure compliance and the

concept that revolve around a patient-

centered approach.

However, these frameworks may

be tough to implement considering the

“new” context that we have to contend

with on top of the limitations in the

current realities. A mixture of anxiety

yet firm determination was very appar-

ent in the attitude of the staff early on.

Even during mid-March, the PHDD

staff was ready to adopt an “out-of-the

-box” thinking. An open-minded ap-

proach was thus espoused with a col-

laborative and consultative frame-

work.

Core Strategies

1) Anticipate then React

We know that our “usual” patients

(both new and

follow up) will have a hard time

leaving their communities and coming

over to LCP. We anticipate that the

various security checkpoints being

implemented will really hinder their

mobility. So, in anticipation of this sce-

nario, quite early on, we provided

them with at least a month’s worth of

first line medications.

Of course, this was done with spe-

cific and explicit instructions.This was

especially facilitated among those

whoexhibited good compliance and

those nearing their end-of-treatment

period.This strategy was communicat-

ed with our local government counter-

part.

2) Harness Available Technology

Facetime? Facebook? Viber?

Email? Simple SMS messages? What-

ever platform was available to the

patient or their family, our staff adopt-

ed and utilized to ensure compliance

and constant communication. Our

The New Modular Hospital...

Kabaga

patients were very appreciative of this

genuine effort from our nurses and

volunteers to accommodate them with

whatever means necessary. Rapport

was further strengthened during this

period. Consistent dialogue was en-

sured and any potential problem was

discussed.

3) React but Always be Willing to

Adapt

In some instances, the well-

crafted strategy may hit a blank wall.

In this setting, the staff member holds

a dialogue with the patient. Problems

with possible missed doses, drug reac-

tion, or symptomatic treatment were

promptly addressed.

Available solutions may involve

linking them with nearby DOTS cen-

ters, prescriptions to be transmitted

via e-mails, or possibly our staff taking

the drugs to their actual residence.

The best and most feasible solu-

tion was always arrived at after due

consultation with involved parties.

4) Bringing DOTS Services to their

Doorsteps

Our partner from PBSP was quite

generous in terms of providing

transport services when needed. This

enabled our staff to go to areas with

very limited transportation services and

actually deliver the patients’ drug sup-

plies directly to them. In the process,

their total wellbeing was likewise exam-

ined.

5) Open Lines of Communication

Any available means of communi-

cation were harnessed. This was not

just true between patient and health

providers. This was also observed

among PHDD doctors, nurses, adminis-

trative personnel, and volunteers. Clear

communication was very crucial espe-

cially during this pandemic which im-

posed a lot of limitations in the tradi-

tional ways of performing tasks. This

allowed everyone to relay clear expec-

tations and the goals at hand which

needed to be met.

The “New Normal” for DOTS Services

As we transition from the various levels

of quarantine, provision of TB-related

services will not be the same as we

have known it. Definitely, a lot of

changes will be expected.

These may involve but not limited to

the following:

Maximum use of various social

media platforms to engage pa-

tients and other stake holders.

Screening of patients going to

DOTS and PMDT centers. Layers of

screening strategies may be imple-

mented: questionnaires, tempera-

ture checks, or even possibly re-

questing for RT-PCR swabs for

SARS CoV2 virus. The same re-

quirements may be imposed for

workers in these facilities. Certain-

ly, turn around times for this test

will be critical.

Requirement for various levels of

PPEs.

Accessibility and availability of

GeneXpert machines which may

also be used for COVID19 diagno-

sis.

Sustaining TB Services….

Ensuring constant manpower

complement.

Anticipation of more web-based

meetings, discussions, and con-

ferences.

It is quite ironic that PHDD re-

ceived its accreditation certificate

from PHIC during this period. It is a

testament to the consistent quality of

TB services that this unit strives to

provide especially during these chal-

lenging times.

Nobody knows for certain when

will this pandemic end. What is un-

doubtedly clear is that TB continues to

be a nagging social and health prob-

lem and control efforts should not wa-

ver during these times. Let us not

forget about this ancient scourge that

has plagued mankind for ages.

COVID 19 compelled the PHDD of

LCP to innovate and persevere. We

certainly hope that our experience the

past few months proved that TB con-

trol services need not be stopped or

delayed “just because of COVID

19”.// JPB

2020 RESEARCH FORUM

On December 7, 2020, The

Lung Center of the Philippines Clini-

cal Research Department conduct-

ed this year’s medical research

forum. With the help of our Clinical

Research Department Officer-in-

charge, Dr. Norberto Francisco and

Pulmonary research committee

head, Dr. Glynna Ong-Cabrera, our

pulmonary fellows managed to

prepare high-quality researches

that can provide reliable infor-

mation and updates helpful to the

community.

Ten studies were presented at

EMG auditorium while two were

presented online via Zoom. It was

the first ever virtual research

presentation done to bridge the

distance brought about by the pan-

demic.

Sustaining TB Services….

Volume 2, Issue 2

Kabaga

LDP– Leah dela Peña, MD

KAD- Kristine Ann Duran, MD

LJ- Lizbeth Jacaban, MD

HCR– Honeylet Chan-Reyes, MD

JC– Jessica Catalan, MD

TR– Tony Ramos, MD

EDV– Edison de Vera, MD

JPB- Jubert Benedicto, MD

AL– Darbene Sanchez, MD

KT - Kathy Jane Tripole, MD

GT- Gerard Tejada, MD

JFN- Gabriel Francisco Nibungco, MD

Writers

DIRECTORS

Executive Director

VINCENT M. BALANAG, JR., MD

Deputy Executive Director IV

Medical Services SULLIAN SY NAVAL, MD

Deputy Executive Director IV

Hospital Support Services VICTORIA C. IDOLOR, MD

Deputy Executive Director III

Nursing Services ELVIRA N. BAURA, RN

Editors

Maria Cecilia Jocson, MD

Carlo Alberto Non, MD

Hospital Administration

Newsletter Content Group

Chair: Maria Cecilia Jocson, MD

Co-chairs: Genevie Ombao, MD

Carlo Alberto Non, MD

Antonio Ramos, MD (Administrative)

Arlene S. Dy-Co, MD (Pediatrics)

Gerard Tejada, MD (Pathology)

Edmund E. Villaroman, MD (Surgery)

Lizbeth C. Jacaban, MD (Anesthesia)

John Michael V. Opeña, MD (Radiology)

Jessica Catalan-Legarda, MD (ER-OPD)

Gerardo I. Lirag, RN (Nursing)

This was a momentous event bring-

ing everyone an interactive virtual expe-

rience in the field of medical research.

During the event, Dr. Virginia de los

Reyes, the training officer of pulmonary

medicine fellowship delivered an inspi-

rational message while Dr. Vincent Bal-

anag, Dr. Sullian Sy-Naval and Dr. Norb-

erto Francisco graced the awarding of

certificates to the presentors.

Some of the studies presented

include relevant topics on intervention-

al pulmonology and common diseases

such as tuberculosis, asthma, obstruc-

tive sleep apnea and most importantly,

COVID19 disease.

Despite the hurdles of training in

the midst of the pandemic, our young

fellow researchers worked hard to

gather data, analyze and present their

studies not just as part of the require-

ments in training but as crucial contri-

bution to the growth and advancement

of research, especially in this time of

outbreak where reliable and evidence-

based facts are necessary to find solution

to health problems.

This event presents both as a

challenge and an opportunity to adapt

and innovate in the face of uncertainty.

During this time of great struggle, when

the pandemic was throwing lemons, we

truly fought, found ways and turned

difficulties into lemonades. Kudos to all

research presentors, mentors and all

who took part in making this research

forum a great success. //KT

RESEARCH FORUM...

Kabaga Official Newsletter - Lung Center of the Philippines

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Transcript of Kabaga Official Newsletter - Lung Center of the Philippines