There will always be people who will do this to you

But just continue to be strong, and keep moving forward.

I just wanter to let you know that even though it sometimes seems...

As if for every step we take forward, we're pushed back 10...

Just stay strong and we will get where we are destined to be..

And never forget that "Wat God has for you is for YOU"
Continue to trust God

The steps of a good and righteous man and woman are ordered by the Lord
So, order your steps in His word.
Jesus Loves you and me
Be strong!

Photos In The Middle of a Plane Crash

The world saw the disappearance of an A330 Air France during a trans Atlantic flight between Rio to Paris.

Two shots taken inside the plane before it crashed. Unbelievable!

The two photos attached were apparently taken by one of the passengers before the aircraft crashed. The photos were retrieved from the camera's memory stick. You will never get to see photos like this. In the first photo, there is a gaping hole in the fuselage through which you can see the tail plane and vertical fin of the aircraft. In the second photo, one of the passengers is being sucked out of the gaping hole.

These photos were found in a digital Casio Z750, amidst the remains. Although the camera was destroyed, the Memory Stick was recovered. Investigating the serial number of the camera, the owner was identified as Paulo G. Muller, an actor of a theatre for children known in the outskirts of Porto Alegre.. It can be imagined that he was standing during the turbulence, he managed to take these photos, just seconds after the tail loss the aircraft plunged. The structural stress probably ripped the engines away, diminishing the falling speed, protecting the electronic equipment but not unfortunately the victims. Paulo Muller leaves behind two daughters, Bruna and Beatriz.

Pain is Temporary

“Pain is temporary. It may last a minute, or an hour, or a day, or a year, but eventually it will subside and something else will take its place. If I quit, however, it lasts forever. That surrender, even the smallest act of giving up, stays with me. So when I feel like quitting, I ask myself, which would I rather live with?”
— Lance Armstrong, It’s Not About the Bike: My Journey Back to Life

Trip Log: Rancho Sta. Monica, Palawan

When I was still a kid, we used to go up this place a lot. The place is owned by the Mitras, a powerful political family in Palawan. You don't need to know people to get in. Their house simply has this breath taking view that they allow sightseeing on the grounds for free. From the area, you have a 360-degree view of the city proper, including a view of the Honda Bay.

Currently, they offer ziplines worth Php 500. If you ask me, the price is steep but there's a really fun part about this. Other than experiencing an exciting activity, you get to ride one of their horses to get back to the ranch. If you ask me, that's pretty neat by itself.

Getting inside the house though, is another story. This is where you need to know connections to get inside. After all, it is a house. So it would be awkward if people streamed inside the place day in and day out.

Inside the house, you'll see portraits of their mom and dad (left) and portraits of the good-looking boys. There are also the plaques and awards that the family has received throughout the years.

Fun fact: their dad was Ramos' opponent for presidency back in the day.

We were also able to absorb their backyard, which was still another vast area of green land overlooking the city. I was even lucky to meet the cutest dog ever!

Trip Log: Honda Bay, Palawan

First of all, I'd like to thank the readers out there (if there are any) for taking the time to browse my articles. I know my brain seems all over the place lately, but I'm back. :)

For our Honda Bay trip, we didn't actually get a agency reservation for it. Frankly, I hated the idea of following strangers around, the limited time for absorbing everything, especially the uncomfortable feeling of being around people you can't fart around.

Basically, we just dove into the waters.

ATTENTION: This part is important --- the cut-off time for the island hopping is at 2:30 in the afternoon.

It's important that you don't waste time on tours because you'd really want to savor the moment and the place, right? So you need to take very careful note regarding your time.

Some other tourists' van

We toured the city that morning so we had to do the island hopping in the afternoon. Fortunately, we arrived at 2:15 at the dock. We paid fees for the boat and the environmental taxes etc. Oh wait, scratch that. Dad paid. :D For four people, he paid Php 1200. We preferred to get the short trip because frankly, we had little time before sundown. The boatmen were instructed to have all boats docked by the port before six. For the long trip, the bill would just be around Php 2000, which is really not that bad when you think about it. There were also some forms that you had to fill up. Nothing fancy, just basic facts about you and your fellows. Other than that, we rented snorkeling gears, at a cheap price of a hundred bucks each.

If you want the whole effect (snorkeling gears, swimming shoes, and those fin thingys they use) you'd have to pay Php 300 for the whole set.

Another important tip: BUY BREAD. Lots and lots and lots. I'll explain in a few.

So we loaded the boats. Palawan has these neat, spacey boats fit to accomodate tourists. They build them so the passengers could face each other, unlike the ones that we rode in Surigao. Each passenger were instructed to wear bright orange life-vests, and we were set to go. If you're going on a long trip, it's recommended that you bring food with you, in case you'd get hungry.

Then the real fun begins.

It actually depends on what you talked to your primary boatman with. We opted to go to Pambato Reef and LuLi Island. In each stop, you need to pay a certain amount of fee, per pax. This is where things can actually get expensive. If, for example, you go to 5 different islands with 10 people. And the average fee would amount to 50-100 Php, you'd pay quite a lot. Still, the experience will be priceless. For some, it would be a once in a lifetime trip so might as well make the most of it.

Pambato Reef is actually a new attraction. They put up a floating 'kubo' in the middle of the ocean, which is awesome by the way. It has this large 'Pawikan' sitting on top. This is where they actually 'warm up' the tourists. You won't have to worry if you don't know anything about swimming, i don't too. With your trusty lifevest, your boatman leading you, and another floating device they'd make you hang into there is no way you can drown. On top of that, they have like a dozen people watching over you. All of which are ready to dive if anything goes wrong.

When I placed my 'alien-looking' mask on and saw the hidden beauty of the ocean, I screamed. Which was awkward because I had the gear on, and I was submerged in the waters. But, people heard, and I heard chuckles. :)

It was breath-taking. I was floored to say the least. To see the schools of fish so near you could touch them, is definitely worth everything you'd pay for. If you don't know, I am actually a big fish-person. I've tried a couple of times to take care of the little ones, but the city living really doesn't fit them.

The next island is the LuLi Island, short for 'Lumulubog, Lumilitaw' the tagalog terms for sinking and appearing. At high tides, the island disappears, leaving only the cottages behind. I personally like this one because we were able to do more here. First of which is the fish feeding. This is where your bread comes in. Again the boatman guides you as you snorkel and see the wonders of nature beneath you. A tip my dad gave us is to place the bread directly at your face, so that the fish nibble at you.

But, no. I didn't do it. I mean, ew.

To give you an idea, for three people (my dad didn't go feed the fish) we used three packs of bread. And that's for only a single island. So, if you're planning to go far you better go big.

Other than that, the island also has these cute picture ideas that they offer. This was my favorite detail for the whole trip: in every place we went, locals were experts on taking souvenir photos for tourists. And when I say experts, I mean SLR-techy. You'd only teach them few of the camera specifics and away they go.

Disclaimer: This shot was not in any way sponsored by SMB

After that, we found ourselves tired from all the activities and found ourselves packing to go home. :) It was definitely a fun experience, and you'll make it more special if you spend it with your loved ones.

Bringing My Heart to My Home

I am a true-blue Palawena, and I'm I am more than proud to share that fact off with anybody who's anybody. It's fun looking at different reactions when I say, "I'm from Palawan". The responses go from dull as "Oh", to shocked: "Really?!", and there will always be reactions like, "Dalhin mo naman kami dun!"

But when you're in a relationship, you just want to share every experience with your better half. It's like if you're going to enjoy something alone, you get that nagging feeling that you're just not doing it right. Even if you text him every minute of that day, guilt simply sets in.

So what better idea than to bring him to my hometown? The place I grew up in, where people saw me as the fat kid who never learned how to ride a bike.

The last week of November marked my grandmother's 88th. Of course I have to be there. I haven't attended her birthdays in such a long time and I wanted to be by her side.

When the moment came, we immediately booked a flight from Cebu Pacific's Promo Fares a month away. Of course, this presented us with a whole lot of problems. The first one was the schedule conflict. Unfortunately, Cebu Pacific's Promo Fares are non-refundable and non-transferrable. And frankly, we paid Php 6,000 for our round-trip fare. And to have it rebooked for another date would cost us Php 5,000. Which would ultimately erase the fact that we bought it on a promo fare, to spend less.

To think about it, it would be wise to get these Promo Fares if you're (a) Really really sure or (b) You spend less than 500 on it, so you won't get sad if things go south.

First of all, this event was especially special for us. It was our first plane ride together. I was extra happy that he was all giddy and stuff. Just like a toddler would be.

In Palawan, we were able to go to lots of different places together. But the thing that mattered most for me is that he was able to meet with the family. Seeing him interact with people I love, makes my heart go mushy all-over again. It's hard to explain, and I guess some people just won't understand. But, I'm pretty sure it's love.

A shot outside the window from our plane

I think I found my guy!

I don't know where I'll stand after a few years, but right now I feel blessed. I am thankful to be with the guy that I am most comfortable with.

I don't want to promise forever with him, but if I'm given that chance I'd take it in a heartbeat. I know that he's far from perfect. But the best thing about him is that he tries make things right for me. He works things out with me.

We may not be the best couple out there, but we're happy together. And I'll admit, I hate him at times. But I love him more.

The best thing? We put God above all, even above our relationship and above ourselves.

Basic Formulas for Nurses!

Nursing Formulas and Conversions

Drugs and Dosage Formulas and Conversions

Volume 60 minims = 1 dram = 5cc = 1tsp 4 drams = 0.5 ounces = 1tbsp 8 drams = 1 ounce 16 ounces = 1pt. 32 ounces = 1qt. Weight 60 grains = 1dram 1/60 grain=1mg 8 drams = 1 ounce 15 grains=1g 12 ounces = 1 lb. (apothecaries') 2.2 lbs.=1kg Household Apothecary 1tsp = 1 dram 1tsp = 60 gtts (drops) 3tsp = 0.5 ounce 1tbsp = 0.5 ounce Household Apothecary Metric 1tsp=5cc 1fl.dram=4cc 5cc=1tsp 3tsp=1tbsp 4drams=0.5oz 15cc=1tbsp 1tbsp=0.5oz or 15cc 8drams=2tbsp(1oz) 30cc=2tbsp(1oz) 2tbsp=1oz or 30cc 16minims=1cc 1cc=16minims 1pt.=16oz or 480cc 500cc=0.5L or 1pt. 1qt=32oz or 960cc 1000cc=1L or 1qt. Temp. Conversion C= F-32/1.8 F= 1.8*C-32 Lifted from: http://www.nurse-center.com/studentnurse/nur11.html

All There is to Know About Insulin

Type of Insulin & Brand Names	Onset	Peak	Duration	Role in Blood Sugar Management
Rapid-Acting
Humalog or lispro	15-30 min.	30-90 min	3-5 hours	Rapid-acting insulin covers insulin needs for meals eaten at the same time as the injection. This type of insulin is used with longer-acting insulin.
Novolog or aspart	10-20 min.	40-50 min.	3-5 hours
Apidra or glulisine	20-30 min.	30-90 min.	1-2½ hours
Short-Acting
Regular (R) humulin or novolin	30 min. -1 hour	2-5 hours	5-8 hours	Short-acting insulin covers insulin needs for meals eaten within 30-60 minutes
Velosulin (for use in the insulin pump)	30 min.-1 hour	2-3 hours	2-3 hours
Intermediate-Acting
NPH (N)	1-2 hours	4-12 hours	18-24 hours	Intermediate-acting insulin covers insulin needs for about half the day or overnight. This type of insulin is often combined with rapid- or short-acting insulin.
Lente (L)	1-2½ hours	3-10 hours	18-24 hours
Long-Acting
Ultralente (U)	30 min.-3 hours	10-20 hours	20-36 hours	Long-acting insulin covers insulin needs for about one full day. This type of insulin is often combined, when needed, with rapid- or short-acting insulin.
Lantus	1-1½ hour	No peak time; insulin is delivered at a steady level	20-24 hours
Levemir or detemir	1-2 hours	6-8 hours	Up to 24 hours
Pre-Mixed*
Humulin 70/30	30 min.	2-4 hours	14-24 hours	These products are generally taken twice a day before mealtime.
Novolin 70/30	30 min.	2-12 hours	Up to 24 hours
Novolog 70/30	10-20 min.	1-4 hours	Up to 24 hours
Humulin 50/50	30 min.	2-5 hours	18-24 hours
Humalog mix 75/25	15 min.	30 min.-2½ hours	16-20 hours
*Premixed insulins are a combination of specific proportions of intermediate-acting and short-acting insulin in one bottle or insulin pen (the numbers following the brand name indicate the percentage of each type of insulin).

Nurses Notes on Diabetic Ketoacidosis

Diabetic Ketoacidosis (DKA)

Develops when there is an absolute deficiency of insulin and an increase in the insulin counterregulatory hormones. Glucose production by the liver increases, peripheral glucose use decreases, fat mobilization increases, and ketogenesis (ketone formation) is stimulated. Increased glucagon levels activate the gluconeogenic and ketogenic pathways in the liver. In the presence of insulin deficiency, hepatic overproduction of beta- hydroxybutyrate and acetoacetic acids (ketone bodies) causes increased ketone concentrations and an increased release of free fatty acids. As a result of a loss bicarbonate (which occurs when the ketone is formed), bicarbonate buffering does not occur, and a metabolic acidosis occurs, called DKA.

DKA involves four metabolic problems:

·         Hyperosmolarity from hyperglycemia and dehydration

·         Metabolic acidosis from an accumulation of ketoacids

·         Extrracellular volume depletion from osmotic dieresis

·         Electrolyte imbalances (such as loss of potassium and sodium) from osmotic dieresis

  

Risk Factors:

·         Infection such as diarrhea, vomiting, and/or high fever (40%),

·         missed or inadequate insulin (25%)

·         newly diagnosed or previously unknown diabetes (15%).

·         heart attack

·          stroke

·          trauma

·          stress,

·         alcohol abuse,

·         drug abuse, and surgery

·         Approximately 5% to 10% of cases have no identifiable cause

Signs and Symptoms

ü       Dehydration (from hyperglycemia)

·                  Thirst

·                  Warm, dry skin with poor turgor

·                  Soft eyeballs

·                  Dry mucous membranes

·                  Weakness

·                  Malaise

·                  Rapid, weak pulse

·                  Hypotension

ü  Metabolic Acidosis (from ketosis)

·                  Nausea and vomiting

·                  Ketone (fruity, alcohol – like)

·                  Breath odor

·                  Lethargy

·                  Coma

ü  Other Manifestations

·         Abdominal Pain (cause unknown)

·         Kussmaul’s respirations (increased rate and depth of respirations, with a longer expiration; a compensatory response to prevent a further decrease in pH)

Management:

a) When teaching the diabetic client about foot care, the nurse should instruct the client to avoid walking barefooted.

b) Blood Glucose Monitoring should be done to detect hypoglycemia and hyperglycemia. It also  helps the client with diabetes reach a desired level of glycemic control.

c) During blood glucose monitoring, the nurse must collect a blood sample from the side of the finger (adult); Outer aspect of the heel (infant).

d) Blood sugar monitoring must be done early monitoring before breakfast.

Diagnostic Tests to Monitor Diabetes Management 

·         Fasting blood glucose (FBG). This test is often ordered, especially if the client is experiencing symptoms of hypoglycemia and hyperglycemia. In most people, the normal range is 70 to 110 mg/ dL.

·         Glycosylated hemoglobin. This test determines the average blood glucose level over approximately the previous 2 to 3 months. When glucose is elevated or control of glucose is erratic, glucose attaches to the hemoglobin molecule and remains attached for the life of the hemoglobin, which is about 120 days. The normal level depends on the type of assay done, but values above 7% to 9% are considered elevated.

·         Urine Glucose and ketone levels. These are not as accurate in monitoring changes in blood glucose as blood levels. The presence of glucose in the urine indicates hyperglycemia. Most people have a renal threshold for glucose exceeds 180 mg/dL; that is, when the blood glucose exceeds 180 mg/ dL, glucose is not reabsorbed by the kidneys and spills over into the urine. This number varies highly, however.

·         Urine test for the presence of protein as albumin (albuminuria). If albuminuria is present, a 24- hour urine test for creatinine clearance is used to detect the early onset of nephropathy.

·         Serum cholesterol and triglyceride levels. These are indicators of atherosclerosis and an increased risk of cardiovascular impairments.

·         Serum electrolytes. Levels are measured in clients who have DKA or HHS to determine imbalances.

Treatment of DKA

·         Alterations in level of consciousness, acidosis, and vomiting are common necessitating intravenous fluid placement. The initial fluid replacement may be accomplished by administering 0.9% saline solution at a rate of 500 to 1,000 mL/h. After 2- 3 hours (or when blood pressure is returning to normal), the administration of 0.45% saline at 200- 500 mL/h may continue for several more hours. When the blood glucose levels reach 250 mg/dL, dextrose is added to prevent rapid decrease in glucose; hypoglycemia could result in fatal cerebral edema.

·         Regular insulin is used in the management of DKA and may be given by various routes, depending on the severity of the condition. Mild ketosis may be treated with subcutaneous insulin, whereas severe ketosis requires intravenous insulin infusion.

·         Potassium replacement is begun early in the course of treatment, usually by adding potassium to the rehydration fluids.

Zinc Sulfate Drug Study

DRUG	CLASSIFICATION		DOSE	ACTION	CONTRAINDICATIONS	SIDE EFFECTS	NURSING RESPONSIBILITIES
Generic Name: Zinc Sulfate Brand Name: Orazinc	Classification: Essential Trace Element Indication: Zinc is used for treatment and prevention of zinc deficiency and its consequences, including stunted growth and acute diarrhea in children, and slow wound healing. It is also used for boosting the immune system, treating the common cold and recurrent ear infections, and preventing lower respiratory infections. It is also used for malaria and other diseases caused by parasites. Some people use zinc for an eye disease called macular degeneration, for night blindness, and for cataracts.		Dose: 5mL Route: PO Frequency: OD	Zinc plays a key role in maintaining vision, and it is present in high concentrations in the eye. Zinc deficiency can alter vision, and severe deficiency can cause changes in the retina (the back of the eye where an image is focused). Zinc might also have effects against viruses. It appears to lessen symptoms of the rhinovirus (common cold), but researchers can’t yet explain exactly how this works. In addition, there is some evidence that zinc has some antiviral activity against the herpes virus. Low zinc levels can be associated with male infertility, sickle cell disease, HIV, major depression, and type 2 diabetes, and can be fought by taking a zinc supplement	Pregnancy and breast-feeding: Zinc is LIKELY SAFE for most pregnant and breast-feeding women when used in the recommended daily amounts (RDA). Pregnant women over 18 should not take more than 40 mg of zinc per day; pregnant women age 14 to 18 should not take more than 34 mg per day. Breast-feeding women over 18 should not take more than 40 mg of zinc per day; breast-feeding women age 14 to 18 should not take more than 34 mg per day. · HIV (human immunodeficiency virus)/AIDS: Do not take zinc if you have HIV/AIDS. Zinc might shorten your life.	Zinc is LIKELY SAFE for most adults when applied to the skin, or when taken by mouth in amounts not larger than 40 mg per day. Routine zinc supplementation is not recommended without the advice of a healthcare professional. In some people, zinc might cause nausea, vomiting, diarrhea, metallic taste, kidney and stomach damage, and other side effects. · Taking high amounts of zinc is LIKELY UNSAFE. High doses above the recommended amounts might cause fever, coughing, stomach pain, fatigue, and many other problems. · Taking more than 100 mg of supplemental zinc daily or taking supplemental zinc for 10 or more years doubles the risk of developing prostate cancer.	The Institute of Medicine has established Adequate Intake (AI) levels of zinc for infants birth to 6 months is 2 mg/day. For older infants, children, and adults, Recommended Dietary Allowance (RDA) quantities of zinc have been established: infants and children 7 months to 3 years, 3 mg/day; 4 to 8 years, 5 mg/day; 9 to 13 years, 8 mg/day; girls 14 to 18 years, 9 mg/day; boys and men age 14 and older, 11 mg/day; women 19 and older, 8 mg/day; pregnant women 14 to 18, 13 mg/day; pregnant women 19 and older, 11 mg/day; lactating women 14 to 18, 14 mg/day; lactating women 19 and older, 12 mg/day.