Labarda M.D.

10 - St. Mayeul

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There are no shortcuts. Work hard, be patient, consistent, and NEVER GIVE UP.

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a day in an OB-GYNE’s life

Once a girl reaches puberty, she will experience these red days for a long time coming. At times, we view it as an inconvenience, but essentially it is an important part of a woman’s life. It’s a part of a woman’s reproductive system where the uterine lining called endometrium is shed. However, there are occasions when these red days can be “red flags” of a hormonal problem.

I had a patient who has been having her period regularly. Then when she reached her golden year, her monthly period became intermittent and irregular. She consulted me one day and told me that her period has continued for two weeks with no sign of stopping and she was getting concerned as days go by.

(For your information, the regular cycle of these so called “red days” or menstruation usually happens 3-7 days for every 28-30 days)

I examined her and gave her medication to lessen the blood flow if not to stop it altogether. I asked her to undergo vaginal ultrasound. The result showed that her uterine wall was thickening when it should be thinning by reason of the continued bleeding. Thus, due to this abnormal bleeding, I advised her to undergo D&C or in other words, dilation and curettage. Through this procedure, I will dilate the cervix and remove or scoop out a portion of the uterine lining. I informed her that she can be an outpatient or she can be confined but she opted to be an outpatient. On the day of the procedure, she was sedated and I now went on with the procedure. The procedure was successful. My patient slept in the recovery room for a few hours.

So, that’s what happens in my everyday life.

ONCE AGAIN THIS IS LABARDA M.D. SIGNING OFF.

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pros & cons

As an obstetrics-gynecologist, of course I love my job. I love what I do.

But of course, there are still some pros and cons to it. And here they are:

CONS

1.      Long irregular hours

-          People usually think that after specialization you get a fixed schedule or you decide on what your schedule is going to be. Well, that’s what I thought too, when I was younger. But that is not the case for OB-GYNEs. We have long and irregular hours, in other words, we do not have a fixed schedule. This is because for example, we wait for our patient until she is ready for labor. That can happen anytime. We are the kind of doctors who does not have holidays because there might be a chance that we will be working on a weekend or on a holiday, we will never know. Because this is based on our patients. So we have to be ready all the time because we will never know when our patients will need us.

2.      Emotional stress

-          Despite our irregular schedule, we get emotionally stressed because there are times that we have to tell our patients that there are bad news to their situation. Of course, as their doctor, you want the best for them and you also want them to be aware of what is happening in their bodies. Although there are times that those bad news bring you stress because you are not ready to see the reaction of your patients. You will feel like you have failed them.

 PROS

1.      You get to help women

-          If you are interested in helping women and taking care of their health, this profession is for you. Because an obstetrics-gynecologist does not just help women give birth to their babies, they also check on the reproductive health of women as I have said in my first blog post.

2.      General patient care

-          I guess you are wondering why “general” but we only help women right? But no, that is not the case here. By general patient care, I meant that our patients, the women who see us for their check-ups for pregnancy or for their reproductive system, also see us as their primary doctors. This is because our medical training qualifies us to provide all kinds of routine preventive care. This includes pap smears, mammograms, and immunizations.

3.      Positive results

-          We get positive outcomes because compared to other specialists who often operate in emergencies, we also perform on many surgeries. Whenever we successfully help children come into the world, we get great satisfaction for it.

4.      Comfort and understanding

-          As a woman having women as my patients, of course whenever we will talk about topics especially about their reproductive system, they will not be uncomfortable to talk about it and be open about it. And when we talk about certain topics, they will not be just comfortable, but we will be able to understand each other.

There are no perfect jobs. There will always be some pros and cons to it. It depends on you on how you are going to love it despite those cons.

LABARDA M.D. SIGNING OFF.

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I had a patient who came in for a check-up due to pain in her left breast. I advised her to get a mammogram and a breast sonogram. The results revealed two cysts on her left breast and several small cysts in her right. Fortunately, all the cysts were fibrocystic and therefore benign. I told her that the formation of the cyst can be attributed to hormonal imbalance considering that she is in her early 50’s and nearing menopause. After an examination of her left breast, one cyst was bigger than the other and more pronounced. It was located in the lower areola.

During examination, the cyst felt like it was filled with fluid, so with her consent, I proceeded to aspirate in order to remove the fluid. The size of the cyst was reduced after aspiration.  I advised her to come back in order to monitor changes in her breast. After a few months, and another breast sonogram, the result showed that the cyst I earlier aspirated has grown a few centimeters. After examination, the same revealed that it is again filled with fluid, so I again proceeded to aspirate. As expected the cyst was reduced in size. I asked her again to come back for further observation.

After a few months and yet another sonogram, the result again showed that the subject cyst again increased in size and is again filled with fluid. I proceeded to aspirate again. This time I told her that she has two options: one, to come back regularly to monitor the cyst and aspirate if needed; or two, to have the cyst removed altogether, considering that it continues to secrete fluid. The only concern here is that it may develop into something more serious and we would be regretting the lost opportunity to have it removed earlier. I let her decide which option to choose and she chose to have it removed because she cannot lose more sleep over the existence of the cyst, so for her peace of mind she wanted it out. I assured her that it’s only a simple operation which only requires her to stay in the hospital overnight. 

On the day of the surgery, the anesthesiologist who assisted me during surgery, told her to do a fast for 6 hours prior to the surgery. I also ordered her CBC blood test and checked what medications she was taking.

The surgery went smoothly and I made an incision in a C shape around the left areola so that when it heals, it’s as if there was no incision or wound at all. The other assisting interns and doctors agreed with the incision that I made. When I showed my patient the incision I made after the surgery, she was happy and satisfied since she can barely see the thin incision on her areola. I gave her antibiotics via intravenous to prevent infection and pain reliever for the pain which she would surely experience once the anesthesia wore off.

The following day before her discharge, I checked her wound and found the same dry and clean with no bleeding, so I signed her discharge papers. I also prescribed her medication if ever she is in pain and told her to see me after a week. I informed her that she can take a bath despite the operation as the bandage I put on her wound is waterproof. I told her not to remove the bandage as I will be the one to remove or change it when she comes back for check-up. A week later, she came back and I removed her bandage. Her wound was healing nicely and the incision on her nipple is hardly recognizable. She said that she still feels some pain but that is to be expected. Upon removal of the bandage, I did not replace it anymore and told her there is no need to put a bandage anymore and to let the wound heal naturally. I advised her to see me after 6 months for another mammogram and sonogram to monitor her breast health.

THIS IS LABARDA M.D. SIGNING OFF.

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14 hours

I just delivered a baby from a patient with a unique case. 

Months before she went to me for pregnancy test. When she tested positive, I advised her to undergo regular ultrasound. On the second month, the result of her ultrasound showed a cyst on her left ovary. I advised her to continue undergoing monthly ultrasound.

However, on the fourth month, I observed that the cyst was growing bigger, and it would be a danger to her and her baby. So, I advised her to surgery to remove her cyst. She was hesitant at first because she was afraid for the baby. But, after I assured her that it is relatively simple and safe procedure, she agreed.

 So, while four months pregnant, I operated on her ovary and removed the cyst. After she was discharged from the hospital, I asked her to come back one week later. On the said date, I checked on the wound and found it to be healing well. I removed the sutures on her wound.  I also checked the heartbeat of her baby.

For the succeeding months, she went on regular ultrasound and check-ups to check the size and weight of her baby, as well as the heartbeat. She had regular blood tests and urinalysis and depending on the result of the tests, she was given the appropriate vitamins.  

 On her due date, she had “false alarms”. She experienced pain and thinking that it was labor pains, her family brought her to the hospital and informed me of the same. However, after checking proved that it was not yet time and I sent her home.

Finally on the fated day, she felt pain in her abdomen and there was a bloody discharge on her underwear. At the wee hours of the morning around 4 am, her family took her to the hospital where she was again checked. This time the labor pains were continuous and consistent. Before I arrived at the hospital, I gave instructions to monitor her condition and her dilation. After hours of checking her dilation and, when she was fully dilated, she was brought to the delivery room. However, despite the fact that she was fully dilated, the baby was not coming out. We gave her medication to stimulate the delivery but to no avail.

As the baby is already in distress, I advised her mother who was outside of the delivery room that I have to make an emergency C-Section as the baby is already in distress and the longer for the baby to come out the more danger both of them.

After informing the mother and my patient’s family, I made a C-Section. At around 6 p.m. in the evening, I finally delivered a healthy baby girl. I was afraid that the baby’s umbilical cord might have wrapped around her neck which caused the difficulty in her coming out. Good thing that was not the case.

So that’s enough unique cases for now..

LABARDA M.D. SIGNING OFF.

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my first blog post

Hello! My name is Caitlin Frances Labarda and I am just one of your local OB-GYNE doctors. 

I graduated from University of the Philippines Manila. I started with Public Health as my pre-med course. And then continued on with Medicine school. After residency, I will now practice my area of specialization which is OB-GYNE. One of my clinics is in Asian Hospital in Alabang, Muntinlupa.

but first..

 WHAT IS OB-GYNE?

OB-GYNE (or OB-GYN as other people would spell it) stands for Obstetrics-Gynecology. We are doctors who specialize in women’s health. The female body experiences many different biological functions like having their periods, childbirth and menopause. We are the one who provide care for those and many more. Others offer general health care like the one you can get from your primary care doctor. While some just focus on the female reproductive health. We also provide routine medical services and preventive screenings. Although when you mention OB-GYNE or OB-GYN, it could mean either a doctor who is an obstetrician-gynecologist or the sciences that the doctor obstetrician-gynecologist specializes in.

 WHAT IS AN OBSTETRICIAN AND A GYNECOLOGIST? WHAT’S THE DIFFERENCE BETWEEN THE TWO?

           Well, first of all an obstetrician studied Obstetrics which is a branch of medicine that focuses on caring for and maintaining a woman’s health during maternity. Obstetrics is also related to the medical and surgical care of a woman’s pregnancy all throughout her pregnancy. They are the one who watch over the woman’s health before, during, and after she gives birth.

           A gynecologist on the other hand studied Gynecology, a branch of medicine that focuses on the bodies of women and their reproductive health. Gynecology also includes the treating of the issues with women’s breasts. They are the doctors whom people with problems, like a cyst in their ovaries or irregular periods, go to and have their check-ups.

 BUT OUT OF ALL SPECIALIZATIONS, WHY OB-GYNE?

           Actually, when I was still in high school, probably in Grade 10, I had 3 choices or options to choose from. I had those choices because I was not yet sure what to specialize. That’s why whenever people would ask me what I want to be when I grow up, I tell them those choices with explanations on why I want those 3.

Those 3 choices were being a pediatrician, because I love children. A dermatologist, because I was curious on how people say they were one of the most paid doctors. And last but not the least, OB-GYNE. Although, I really didn’t have an explanation why I like OB-GYNE. I just liked the thought of being the one helping the mother give birth to their child.

But actually as the years went by, I thought that being an OB-GYNE wasn’t a bad thing after all. It is also a plus since most of my family members are women. That’s where I realized that, “yes, I am going to be an OB-GYNE”. I wanted to help women with what they are experiencing whether it is abnormal bleeding, the start of their pregnancy and more.

THIS IS LABARDA M.D. SIGNING OFF.