Thread by @theskinsensei, My heart aches when I have elderly patients (60yrs and up) who [...]

My heart aches when I have elderly patients (60yrs and up) who come to my clinic unaccompanied by their children or a relative.
My heart breaks more when I ask them to bring a child on ff up and they& #39;d say "Oh they& #39;re busy".

When it& #39;s a kid that& #39;s sick, everybody& #39;s concerned. There& #39;s usually 2-3 people with the child in the examination room. But how sad it is to see an 80yr old look at the prescription blankly despite explaining the treatment thrice.

I remember my own Lola. She was the light of our family. It was always a riot in her house in Makati during holidays because all 20+ grandchildren of hers would be running around her house.

She is the reason why we are not fond of Filipino restaurants. Our standard for Filipino food is up there.

Kare kare from scratch. What peanut butter? No. She used roasted ground peanuts.

Sinigang? Soup base from tamarind, kamias, and tomatoes. No sinigang mix.

Our halo-halo has at least 10 things in it. All cooked from scratch. Too many things in it that only 1/5 of a tall glass will have ice.

She is the reason why all of us in the family find it hard to cook in small pots. Our meals are prepared with guests, real or imagined, always in our mind. She& #39;s also the reason why a lot of us in the family are chubby. In Lola& #39;s house there is always food. Good food.

Lola sent all of her eight children to school and gave them a piece of land each. EACH. She event sent a lot of her grandchildren to college. Even at an old age, she was still supporting some relatives.

There& #39;s this trivia in our family that her favorite apo is her first apo, Ate E. But the truth is...I AM HER FAVORITE. HAHAHAHAHA! When we were young, everyone would have P50 from Lola during Christmas. I would secretly get P100-200

https://abs.twimg.com/emoji/v2/... draggable="false" alt="😂" title="Gesicht mit Freudentränen" aria-label="Emoji: Gesicht mit Freudentränen">

Sometime when I was studying in med school we arrived at Lola& #39;s house around 1pm. She was quietly crying. She had a misunderstanding with one of her children. She hasn& #39;t eaten lunch yet and she was just in her room. She was 88.

My knee-jerk reaction was to tell my Mama to get Lola to live with us since Lolo has died a few years ago already. We would be able to take care of her better if she were with us. It was one of the best suggestions I made in my life.

My Lola taught me to be a good doctor. I learned so many things that I didn& #39;t learn from school just by being with her.

Cough is associated with asthma and pneumonia. But my Lola taught me that in elderly, loss of appetite is a big clue. There could be no cough or fever at all.

You don& #39;t wait for the elderly to ask for food. You put food in front of them and feed them.

My Lola never asked for food maybe because she didnt want us to feel that she was a burden.

Also, you don& #39;t feed them regular food. They choke easily. Their soup has to be thick. If possible, they should drink through a straw to regulate the flow of water. You have to cut their food to smaller pieces.

You have to check their skin especially where there are folds. They are prone to fungal infections and irritation from sweat. As a derm trainee, I was very proud that my Lola had great skin, hair, and nails for her age. No infections. Well moisturized.

The elderly needs to hear words of affirmation too. It was a must for me to do my Lola& #39;s hair and make up. I would also pick her clothes and jewelry when we would go outside. And then when I& #39;m done I would say "Ang ganda mo La!" complete with big eyes and a big hug.

Lola would always tell me "Baka akalain nila malandi ako. Wag mo na ko lagyan ng blush."

"Ok lang La, para mabilis mabenta!"

And then laughter!

And I would see her eyes light up when I bring her in her wheelchair to the mirror.

I learned so much from Lola without her doing anything. I saw how we should take care of our parents as I watched my Mama take care of her 24/7 for 8 years.

And that& #39;s why I will never forget the morning of Sept 11, 2015. We brought Lola to PGH earlier that week for her pneumonia. She was gasping for air. Her asthma was also on. I decided not to visit her Sept 10 so I could prepare for a big exam on Sept 12.

Sept 11 7am. Phone rings.

"Lab, ipa catheter pa ba natin si Lola?"

"Oo naman. Bakit hindi?"

"Kasi kung hindi naman siya gagaling, bakit pa?"

"HA? BAKIT?!"

"Hindi na siya gumigising Lab. Akala namin finally nag improve na kahapon dahil nakatulog na. Pero di na siya gumigising"

"HA?! Bakit di niyo ko tinawagan?!"

"Di namin alam Lab"

I didn& #39;t cry. I was actually furious when I arrived at the nurses& #39; station. I reviewed the chart. And I saw " Do not intubate. Do not resuscitate"

I talked about DNI and DNR orders with Lola some years before. It was her wish. But I wanted to erase it from the chart this time.

I dragged myself 50 meters to go to Lola& #39;s room. I entered the suite. At the door, I gathered all my strength and said "La?"

She didn& #39;t respond. She was just sleeping quietly. I walked a few steps.

"La?"

I reached her bed.

"La..."

I cried and hugged my Lola. I went on the bed and hugged her.

"La...I& #39;m sorry! Hindi ako nakapag I love you nung isang araw! La!"

Nubayan. Crying right now

https://abs.twimg.com/emoji/v2/... draggable="false" alt="😭" title="Laut schreiendes Gesicht" aria-label="Emoji: Laut schreiendes Gesicht">

And so my heart breaks for every unaccompanied old man and woman that visits my clinic. I don& #39;t know all the reasons why you& #39;re alone but at the very least I& #39;m going to make you laugh...because laughing with you reminds me of laughter with Lola.

Here is my adorable Lola. She attended ALL my graduation rites from nursery to med school. Not once did she make me feel weird because I& #39;m gay.

Her first day of hospital admission before she said goodbye Sept 11. Told her to wave for her fans. If only I knew, I wouldn& #39;t have left her side.

I miss you La!

https://abs.twimg.com/emoji/v2/... draggable="false" alt="😢" title="Weinendes Gesicht" aria-label="Emoji: Weinendes Gesicht"> I miss giggling with you and playing with your hair. Please continue to pray for us in heaven.

Her first day of hospital admission before she said goodbye Sept 11. Told her to wave for her fans. If only I knew, I wouldn& #39;t have left her side. I miss you La! https://abs.twimg.com/emoji/v2/... draggable=

I miss giggling with you and playing with your hair. Please continue to pray for us in heaven." title="Her first day of hospital admission before she said goodbye Sept 11. Told her to wave for her fans. If only I knew, I wouldn& #39;t have left her side. I miss you La! https://abs.twimg.com/emoji/v2/... draggable="false" alt="😢" title="Weinendes Gesicht" aria-label="Emoji: Weinendes Gesicht"> I miss giggling with you and playing with your hair. Please continue to pray for us in heaven." class="img-responsive" style="max-width:100%;"/>

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