Dear Jani

 

My last message to you was that I won’t sleep until I hear from you. I never did, so now, my heart and my soul are restless. I haven’t stopped crying since yesterday, Jani. I miss you so much. Even as I write this, the tears won’t stop.

When your sister called me to tell me you’re gone, the first thing I did was to attend a book review as part of my work. I think I was able to adequately articulate my thoughts. I shared similar sentiments on the National Security Policy and the National Security Strategy with other analysts and researchers. I was productive. This has been my coping mechanism towards devastating news, even before: compartmentalize it to remain functional… until all the emotions come, screaming and weeping, and inevitable, like a flood of water destroying what flimsy walls I erected to contain it.

Yesterday, when I finally saw you after this goddamn pandemic has kept us apart from more than a year, those walls shattered almost instantly. Heaven took away your pain and your anxiety, but it also took my heart and left me with a throbbing emptiness I doubt anything can fill. It does not long for comfort or compensation or glory or success. It does not care for the people who are expressing their condolences or love for me. I am thankful, but those are not you. This emptiness longs only for you. I am self -aware enough to admit that it is selfish but I’m longing for you. I would rather have you here, despite the many challenges of your health, than with you gone. 

September 2021 is a cruel month. We both began it with challenges to our mortality – you with your health emergency and me with COVID-19. I was trapped in the four walls of my room, unable to be with you. I relied on your family’s updates. I was spared from seeing your decline, but I was tortured by my helplessness. Even after my 14-day quarantine, I was still trapped here because of severe asthma. The day I was finally feeling better – 28 September 2021 – you left me. I can never forgive myself for not being there with you on your last days. I may even come to hate the world for it.

People say that you’re lucky to have me. Maybe because you were sick and I wasn’t. But what people don’t see is that you loved me to the very extent of how much you can love. That you gave me everything that you can, to the best that you can. That we talked every night even when speaking is difficult for you, even if it’s just an exchange of good nights and I love yous. Even if to just tell me “bukas nalang ulit”. That you shared your blessings with me and thought of my happiness when receiving gifts, even if you had so little for yourself. That you were proud of me, and I basked in your pride, because no one’s ever been proud of me the way you were. That whenever I was having crippling self-doubt, exhausted with schooling, exhausted with work, exhausted with life, you’re the one who pushed me and encouraged me and believed in me. Others only saw the accomplishment, the speeches, the awards. You saw the struggle, the sacrifice. You told me to rest when everyone else wanted me to hustle. Right now, I am in the middle of my masters, which you encouraged me to take despite us having less time and money because of it. You’re the one who sacrificed the most for me to get this far and I won’t even be able to celebrate it with you when I’m done.

People say that because I’m the nurse and the healthier one, I took good care of you. But you’ve taken care of my heart – the most fragile and and the most broken and the weakest part of me – better than any other person in my past. In fact, it took more than a year of being together for me to tell you that I loved you, and you said those words first. I was so afraid you didn’t feel the same way. I was so happy you did. I hope you knew this before you left – that by loving me the way you did, you’ve taken care of me in the way no one else has. With you, I can be weak, because, despite your sickness, you were so strong.

I told you when we first started talking on the phone that I hated good byes, which was by we only ever said goodnight. For almost 3 years, I said that to you every night. Even when I was able to finally see you and touch you one last time, when they opened your coffin, I still couldn’t say good bye to you. Because maybe somewhere, someplace, I’ll get to see you again.

Our song is The Ditch by David Hause. Your Top 1 song in 2019. We both know what it’s about: living with “shakes”, the anxiety which you experienced on a daily basis:

“'Cause I shake shake shake shake alone
I'm shaking every night and day
Will my shake, shake, shaking ever go away?”

 

 These lines from the song are precious to me:

 

“If you held me close and lock the door
We could kick against the current
And hope we find a shore”

            I’ve held you close for almost three years and we’ve survived this current together until you had to go. You’ve finally found a shore where there are no more “shakes” and no more pain. You’re finally able to rest. I’ll be treading these currents without your warmth for a bit, Jani. Pahinga ka ng mabuti. Bukas nalang ulit, kung kelan man ang bukas natin ulit.

I miss you so much.

I love you. I love you. I love you so much.

 

 

 

A Month-Long Affair with Health Issues

It’s September 26, 2021 and for the first time in 26 days, I feel comfortable. It’s been a long time since I’ve felt this way. You see, on the final stretch of August 2021, I was exposed to someone who turned out to be COVID-positive. A Reverse Transcription Polymerase Chain Reaction (RT-PCR) Test showed that I was finally suffering from what I have been dreading for more than a year: I was COVID-positive. It didn’t help that at the tail-end of the quarantine, I developed severe asthma, which I’m still dealing with at the moment.

I’m documenting my experience through this blog as a celebration of surviving this infection, despite the fact that I have a co-morbidity (#asthmastories are something you can definitely find in this blog). I also hope that by putting this down on (digital) paper, I’ll be able to help someone like me in the future.

 

Let’s get this out of the way: VACCINES. WORK.. Prior to getting infected, I had already completed my two doses of Sinovac[1]. Can you get COVID-19 despite being vaccinated? Depends on the vaccine. I certainly did. Nevertheless, the vaccine most likely saved my life. The Department of Health relates that the Sinovac is 5-% effective in preventing mild symptoms, 78% effective against moderate symptoms, and 100% effective against severe symptoms. What Sinovac decreases is the risk of developing more severe – and fatal – COVID symptoms. As someone with asthma, this was what I was most afraid of. During my stint as part of the statistic, I only suffered mild COVID symptoms: body pain and headache were most persistent, some cough and colds, and fatigue, which, to be honest was the most challenging part. Other vaccines have different mechanisms of action, so check out what kind of protection you got… from legitimate sources only, please.

 

Home quarantine is effective if you and your family have the right mindset, the right facility, and the right equipment. Fortunately, I only experienced very mind symptoms (albeit it got a bit worse as the infection progressed). I was advised to do home quarantine instead. Being the paranoid Registered Nurse that I am, I was already doing self-quarantine that I was exposed to somebody who turned out positive. Here are some realizations:

You need to speak to your family clearly, coherently, and calmly about your status so that they can support you while you are on isolation and protect themselves for the disease. I’m infinitely grateful to my mom and my adopted brother who understood that I needed to physically distance myself from them and that I could not leave my room for the duration of the quarantine. They prepared all my meals and snacks, provided me with my daily supply of water, asked about my condition several times a day (we talked through FB messenger), and basically provided for all my basic needs. At the same time, I took it upon myself to be compliant with all the medications I needed to take, take my temperature and oxygen saturation religiously, and make progress report of all my symptoms throughout the isolation period. I also regularly contacted the contact tracer assigned to me regarding my symptoms.

It is important, however, to know that home quarantine is actually a luxury. There are only 3 people in our house. My adopted brother’s room is not even inside the main house. My mom and I had separate rooms and we had two bathrooms. Plus, I had boxes of surgical masks, literally liters of alcohol and hand sanitizers, several spray bottles Lysol, a pulse oximeter (#SalamatShopee), a stethoscope, a thermometer, and the window in my room is actually a sliding door which opens to a small lanai, so the ventilation is pretty good. Not everyone has my kind of setup. Some families only have one-room houses, making home isolation impossible. This is why more facilities conducive for rest and recuperation should be available even to patients with mild cases of COVID-19.

For a more clear-cut guideline of managing COVID-19 at home, check out this online brochure my Makati Medical Center: https://www.makatimed.net.ph/promos-and-events/event/home-quarantine-instructions-for-covid19-confirmed-patients-and-their-contacts

 

You have to be your own health advocate. If you’ve been following my journey, you’ll know that I’ve been in the health advocacy since the early 2010s. My niche, of course, has always been sexual and reproductive health and rights. Healthcare workers, especially nurses, are expected to advocate for patients, but really the best advocate for the patient is the patient. COVID-19’s symptoms may range from mild to severe and, if you’re not lucky enough to dodge the bullet, you may be lucky enough to dodge more life-threatening manifestations of the infection. Regardless of severity, the fact is that you are still sick, and your body is doing its best to fight of an infection that has killed millions worldwide. Help it, for goodness sakes. It’s important to rest, eat well, monitor yourself, and generally put yourself first. If you’re in government and you have COVID-19, please take note that you have the right to excused absence for the duration of your quarantine and/or treatment. Note that excused absence means “period when government personnel are not required to report for work (required quarantine and/or treatment, and work suspension), but are entitled to pay, as declared by the President or the appropriate and competent authorities”[2]. If you’re in the private sector, talk to your supervisor and/or your human resource officer regarding similar mechanisms of support. There should be one instituted, and if there isn’t, it’s time you lobby for such policy to exist.

            I did not make use of my excused leave. I was working from home even prior to the diagnosis. (Newsflash, by the way: the only people who think that those who are working from home aren’t working are most likely the ones aren’t working while they’re supposed to.) I worked despite the headache, body pain, fatigue, and all other symptoms. I went on overtime and did work on weekends. I powered through it. Two things: I was not alone in this predicament and this was not something to be proud of. By the end of my quarantine, which was September 14, 2021, I had developed severe asthma, which I am still managing with an apothecary of medications administered through half of my facial orifices.

            If you think I was smart enough to finally get some damn rest, then you over-estimate my intelligence, dear reader. I only stopped to take care of my health when I was already gasping for air while confined to my bed. That was stupid. Do not be like me. Self-care comes first.

COVID-19 has physical and mental repercussions. Oh boy. Here we go. My mental health has always been out of whack, although I’m glad to say it has significantly improved over the years. I’ve always been an introvert. I can go for months just hanging out in my room with very little physical contact with other people. I don’t even mind long stretches of silence from friends and family. However, the very nature of COVID-19 intimately intertwines the infection with isolation. It was though, to say the least

This year has been especially challenging: My grand uncle passed away in April this year, while his family desperately looked for a hospital that will admit him. We a close family friend to the infection as well, and my godmother to Cancer.

 We also lost almost all of our dogs this year: Jamjam, Panda, Theo, Mocha, Chuchay, Burrito, Liit, Orange, Lenlen, and Choco. Theo, Liit, and Choco’s deaths were the most devastating to me. Choco was the only one I had with me physically during my isolation. Amidst physical and mental anguish, Choco was the one I had, physically. I derived all my laughter and warmth from him. He died a few days after I was “released” from quarantine, but I was too sick with asthma at that point that I couldn’t even do anything for him. I’m still dealing with the pain guilt, and hurt at this point. They say pets die to save their hoomans from pain and suffering. My body may be healing, but I don’t think my heart will.  

            I really appreciate the small gestures of kindness: messages from my colleagues who were also sick with the virus, packages of food and medicine from my sister-in-law and our other close family friends, requests for updates from my best friends from different parts of the world, understanding from my professional organization of my need to just step back, and the many others who told me to get some rest and wished for me to get better. To be honest, I was unable to respond well to these people, especially after Choco’s death, because I was - and still am - physically and emotionally exhausted, but these really did make a difference. If you’re reading this, thank you. You’ve made this near-month-long ordeal a bit more bearable.

 

COVID-19, regardless of severity, affects you physically and mentally. It takes a toll on your resources. It endangers and adds additional burden to your loved ones. I hope no one else will have to deal with this disease, but this is an unrealistic wish. We are far from controlling this pandemic. The truth is, many more will get sick and many more will most likely die. For you, who is reading this little rant, let us take care each other, but take care of yourself more. Be kind to one another, but remember to be kind to yourself more. I hope to see you on the other side.

---

[1]Department of Health (n.d.) FAQs on CORONAVAC (SINOVAC) COVID-19 Vaccine- English. Retrieved https://doh.gov.ph/node/29361

[2]Civil Service Commission (2020). Memorandum Circular No. 08, s.2020. “Revised Interim Guidelines on the Use of Leave Credits for Absences Due to Quarantine and/or Treatment Relative to the Coronavirus Disease-2019 (COVID-19)”. Retrieved: http://www.csc.gov.ph/phocadownload/MC2020/MC%20No.%2008,%20s.%202020.pdf

I wish I can say this is all just a bad joke

 

It has been years since I posted in this blog, and to be perfectly honest, I never thought I would go back to writing for myself because I’ve been so busy writing for others (it’s the job, after all). Things have changed so much since I last made a blogpost and the biggest change of all is that it’s 2021 and we’re in the midst of a global pandemic that turned everyone’s life upside down.

It’s been about a year since COVID-19 hit the Philippines, and as of March 2021, Manila and a bunch of other places including Bulacan, Cavite, and Laguna, now called NCR+, are back on lockdown. Enhanced Community Quarantine, they call it, one of the many CQ qualification we’re placed under depending on how bad the numbers are. It got really bad this month. The worst. Recently, we hit about 10,000 new cases a day, the highest so far. On Facebook posts by news agencies which reported these numbers, it’s a combination of fear, frustration, and fucking COVID denialists. In real life, I see people flopping around like fish out of water, not knowing what to do, even if we have all the available models and studies and resources that tell us what we should be doing. I suppose some people think that this this global health crisis that already claimed hundreds and thousands of lives will resolve itself eventually. It’s a stupid strategy, but what do I know. It would be funny if it isn’t so terrifying.

I guess I am writing this in the hopes that one day, I’ll get back to it, laugh and say how fucked up the 2020 and 2021 were, then proceed to shoot down with the zombies moaning for brains outside my fortified house. Sorry guys, I only got despair to share. If I ever had readers, most of them will know that I often write articles peppered with facts and figures. Admittedly, I was less skilled at citations when I was a younger blogger, but I like well-constructed content. I don’t think I have the energy or emotional stability to go into such level of academic writing. Maybe later, if there is a later. I am just here for the comfort that writing has always given me.

You see, this week, I found out that my great uncle, my Amah’s brother, was having flu-like symptoms and difficulty breathing. He was around 80 years old and living with his wife in Cavite. His daughter and her daughters live next door. Mom showed me pictures of him using an oxygen tank and a pulse oximeter.  They were able to get in touch with a doctor but they could only manage his illness at home. For days, they searched for hospitals to admit my uncle but failed. They did a swab test but as of this writing the results haven’t come out yet. It may be just an ordinary flu, I said, but given his age, he should still be monitored closely especially because he was having trouble breathing.

Last night, after talking with my friend whose uncle is at a very similar situation, mom called from her room. She had been chatting with another of my great uncle’s daughter. They called an ambulance for him and practically hospital hopped, looking for somewhere that will accept him. I heard the words “40% oxygen” and “revive” and I knew, as a nurse, that it was over. The part of me that could not be protected by my clinical training and rationality felt like it was stabbed with something cold and poisonous. I stuttered as I explained to mom what those words meant. I told her he could probably be revived, but that the efforts could also fail. My mom, who only allowed herself to cry a handful of tears when my Amah, my Tita Jean (her sister), and my Papa died, was quick to snap back after my explanation. She knew her place in the family. She knew that her strength was needed. We were met with the worst news within the hour. My great uncle was gone. I am writing this on April Fools and I wish I can say this is all just a bad joke. 

My family and I are no strangers to death. We’ve lost loved ones, with my Papa being my most devastating loss. But it’s much more different now. We can’t even comfort each other physically or say good bye to our great uncle properly. In the face of a global health crisis, we need to put physical health as a priority over the process of grieving and healing as a family.

I do not blame the hospitals and the healthcare workers. I’ve been working on a paper on frontliners amidst the pandemic and even if I no longer serve in the clinical area, at a shallow, academic level, I understand their struggles. An overwhelmed healthcare system and an exhausted health human resource cannot render the same level of care consistently, for almost a year, without reprieve. I was talking a doctor friend and her words, “isang taon ng pagod” (exhausted for one year) summarize the situation. I know hospitals are in full capacity. I know healthcare workers are tired. I wrote the very same lines just a couple of days ago with flourish, the final addition to my paper. I know that both COVID and non-COVID patients are struggling to access medical care. But it’s different when it hits closer to home. It's raw and  it bleeds, and you can taste the bile in your mouth. Your voice cracks when you speak. Your eyes sting with tears. The desperation is real and your chest feels like like it's being crushed.

At this point, I really don’t have anything smart to say. I haven’t got the data to share or citations to make. I may do so, once I’m in a better state of mind. Once I am no longer holding back the tears. I will just repeat what I’ve also told my family, while wearing my façade of clinical coldness and rationality: The best thing we can do is to keep ourselves and our families safe and healthy. Let us make it our personal responsibility. Let us take it upon ourselves to help end this pandemic, not even for grand aspirations like patriotism (although that is great too), but for the protection of the people we love.

See you on the other side.