An LVN from Blossom Ridge and My Home Care Aides

Macrine had been under the care of Blossom Ridge(BR) Home Health Care** Employees for the last 60 days. Visiting Nurses, LVN's, Physical and Occupational therapists as well as a home care aide( bathing) visit us twice a week. In addition, I have hired on my own, two home care aides from two private agencies ( Helping Hearts and Partners-in-Care). Helping Hearts aide comes MWF for 4 hours from 9:30AM to 1:30PM. She is a Mexican-American lady(LS) in her mid-50's. Macrine likes her because of her Spanish and their common love for Julio Iglesias music.

On Tuesday and Thursday, a Filipina-American(MR) helps me in taking care of Macrine for also 4 hours. Macrine also likes her. On Saturday and Sunday, a Tongan-American Lady(MT) in her mid 40's help us for 8 hours. I am not paying agencies fees for MT services, since she is a friend of David's coworker. May I reiterate again all these expenses for custodial care are not covered by my insurance.

Interactions between BR personnel and my hired home health aides occurs every now and then. One day an LVN (S) from BR who specialized in wound care came to visit when my Mexican-American (LS) care giver was also around. After the wound care visit, LS was upset so I asked her why. LS informed me she did not like the attitude of S who ordered her to move Macrine and not trying to help. When LS asked help from S to transfer Macrine from her wheel chair to the bed, S told LS she is not allowed to move Macrine because she is not a physical therapist. I can not believe this statement so we reported it to the Nurse Case Manager. The next day when S came to visit Macrine her attitude has changed. She offered to help my Filipina-American(MR) aide transfer Macrine from the wheel chair to the bed. Currently, I like to tease LS by telling her S is her best friend. LS gets upset when I told her S is her best friend.

There is another incident involving S that involved MR just today. When S came to the house this morning I was outside in the garage. MR was taking care of Macrine and was the one who opened the door for S. When S did not see me around she asked MR my whereabouts, asking MR where is the husband of the patient ( I guess S does not know that my name is David). Before MR could reply, she heard S murmuring that this visit is a waste of her time. MR did not like S attitude. When MR told S that I was just in the garage, S stopped murmuring and complaining about the visit as a waste of her time.

Overall we are happy with the other BR employees. We enjoyed the services of the Physical therapist (C) and the Bath Lady (A). We are also thankful for the services of the Nurse Case Manager(SB) who has ordered clinical supplies for Macrine in a timely manner. Special mention to C for arranging in a timely manner for the rental of the hospital electric bed. And to H -the occupational therapist for her short visits.

**https://blossomridge.net/

FDA New Approved Drugs for 2018-New Anti-Malarial Drug

A new drug as prophylaxis for malaria was approved three weeks ago-Arakoda. It is manufactured by 60 Degrees Pharmaceuticals, LLC. As a retired FDA Chemist and Team Leader, Anti-malarial Drugs was one of my expertise (for my GS-14 rating), so this approval still interests me, even though I have been retired since 2002(http://davidbkatague.blogspot.com/2011/12/fda-years-and-maryland-1990-2002.html).

Here's the announcement from www.pharmacytimes.com dated August 9, 2018.

"The US Food and Drug Administration (FDA) has approved tafenoquine (Arakoda) tablets manufactured by 60 Degrees Pharmaceuticals, LLC, for malaria prophylaxis in patients 18 years and older. This is the first new drug approved for the prevention of malaria in more than 18 years.

The approval comes on the heels of GlaxoSmithKline (GSK)’s tafenoquine (Krintafel) approval last month, which was the first single-dose medicine for the prevention of Plasmodium vivax malaria relapse in patients over the age of 16 years who are receiving antimalarial therapy. Krintafel is the first drug to be approved for the treatment of P vivax in over 60 years.

Both approvals were made under the contingency that GSK, and now 60 Degrees, complete post-marketing studies on the safety and efficacy of the drug formulations. Specifically, according to the FDA, GSK is required to "conduct an active pharmacovigilance study to evaluate safety, including hypersensitivity, neuropsychiatric, and hematologic adverse reactions, in patients taking Krintafel (tafenoquine) for the radical cure of P vivax malaria." Likewise, 60 Degrees is required to conduct "postmarketing studies to assess the drug's efficacy in children, older adults, and heavier individuals, and to answer questions about psychiatric safety and other adverse events."

Arakoda (tafenoquine) is an 8-aminoquinoline antimalarial drug indicated for the prophylaxis of malaria in patients aged 18 years and older.

Dosage and Administration

Loading regimen: (for each of the 3 days before travel to a malarious area)
200 mg (2 of the 100 mg tablets) once daily for 3 days

Maintenance regimen: (while in the malarious area)
200 mg (2 of the 100 mg tablets) once weekly – start 7 days after the last loading regimen dose

Terminal prophylaxis regimen: (in the week following exit from the malarious area)
200 mg (2 of the 100 mg tablets) one-time 7 days after the last maintenance dose

Warnings and Precautions

Hemolytic Anemia: G6PD testing must be performed before prescribing Arakoda due to the risk of hemolytic anemia. Monitor patients for signs or symptoms of hemolysis.

G6PD Deficiency in Pregnancy or Lactation: Arakoda may cause fetal harm when administered to a pregnant woman with a G6PD-deficient fetus.

Arakoda is not recommended during pregnancy. A G6PD-deficient infant may be at risk for hemolytic anemia from exposure to Arakoda through breast milk. Check infant's G6PD status before breastfeeding begins.
Methemoglobinemia: Asymptomatic elevations in blood methemoglobin have been observed. Initiate appropriate therapy if signs or symptoms of methemoglobinemia occur.

Psychiatric Effects: Serious psychotic adverse reactions have been observed in patients with a history of psychosis or schizophrenia, at doses different from the approved dose. If psychotic symptoms (hallucinations, delusions, or grossly disorganized thinking or behavior) occur, consider discontinuation of Arakoda therapy and, evaluation by a mental health professional as soon as possible.

Hypersensitivity Reactions: Serious hypersensitivity reactions have been observed with administration of Arakoda. If hypersensitivity reactions occur, institute appropriate therapy.

Delayed Adverse Reactions: Due to the long half-life of Arakoda (approximately 17 days), psychiatric effects, hemolytic anemia, methemoglobinemia, and hypersensitivity reactions may be delayed in onset and/or duration.

For more information read the drug product insert.

For a list of other drug approvals for 2018 read the following site:

https://www.drugs.com/newdrugs.html

Kindness of a Stranger-Free Haircut for Macrine

Photo by J. Jesus
My barber is a young South Korean lady probably in her early 30's. She told me her parents immigrated to the US about 2 decades ago and she is a Roman Catholic. This is all I know about this personable young lady who cuts my hair every 4 to 6 weeks.

One day, I mentioned to her that my wife who is home-bound in a wheel chair needs a hair cut. I asked her if she does home service haircuts and if not if she knows of any one.

Without hesitation, she said she does this kind of work but for free as her humanitarian and charitable project. I insisted I pay her. She said if I pay her she would not come. I gave her my phone and home address.

The other day she called and dropped by our house after her work at the Barbershop. She complained she had a busy day with dozens of kids having haircuts all day and getting ready for the opening of the school year.

She came to the house just a few minutes after our dinner. The smell and aroma of the Kare sa Pata *( Pigs Feet with peanut sauce) that I cooked that afternoon was still permeating the whole kitchen and dining area. David III asked her if she eats pig feet.

Without hesitation she blurted out this response: I am Asian you know that so I eat anything. What a sense of humor.

David packed her a sample of my Kare with shrimp paste(bagoong) and orange juice to take home. She plans on cutting Macrine's hair every 4 to 6 weeks.

Thanks a million Agnes Chung for your generosity. I hope what you give will be returned a thousand fold!

For my other blog on Kindness of Strangers please read:

https://davidbkatague.blogspot.com/search?q=kindness+of+a+Stranger

Read this site for the recipe of my Kare: *myfavoritepinoydishes.blogspot.com/2016/04/my-simple-recipe-for-kare-de-pata-pork.html

A Brief Tribute to Olga Nieva Luarca Quiazon

chateaudumer.blogspot.com/2018/08/a-brief-tribute-to-olga-nieva-luarca.html

A Short Tribute to Dr.Rudy Jao-MI, Inc 25th Anniversary

Top Picture: From Right to Left: Dr Jao(RIP), Sister Emma Garcia, Mama Ellen Jambalos( RIP), Sister Guia Jambalos, Macrine Katague and Sr Tessie Soriano(RIP).

Visiting Sr Guia Jambalos at the Cenacle with Dr. Rudy Jao, Warrenville, Illinois, December, 1963.

Bottom Picture: From Left to Right: Sister Guia Jambalos, Sister Tessie Soriano(RIP), Mother Superior of the Cenacle and Macrine Katague, Winter, 1963 in Chicago, Illinois.

Welcoming Guia Jambalos from the Philippines to start her postulancy at the Cenacle, Chicago O'hare Airport, Winter of 1963

This is Macrine's Katague tribute to Dr Rudy Jao in connection with Marinduque International (MI), Inc.* celebrating its 25th Anniversary to be held in Chicago this coming Saturday, August 25.

I know Rudy since our childhood years. We grew up in Boac and socialized up to our college years in Manila. After our college years we did not have much contact until the early 1960's in Chicago, Illinois. At that time, David (my husband for 61 years) was doing his Ph.D in Pharmaceutical Chemistry at the University of Illinois Medical Center Campus and at the same time worked as Instructor in Chemistry in the College of Pharmacy. Dave and I were surprised when we learned that Rudy was also doing his post graduate research and internship at the College of Medicine in the same campus of UI in Chicago.

He was our constant visitor and guest at the university apartment where Dave and I resided and raising 3 young kids. One day he borrowed our old 1957 Mercury ( our first car) to drive around the city. He was shocked and terrified when the muffler of the old junk conked out while he was driving it and almost had an accident because of the loud noise. He had it fixed but told us, he will never borrow an old car, especially from us.( Note: Dave and I purchased our first car (1957 Mercury) from another graduate student for only $500 cash. As a graduate student that was big money then).

Another incident that he told us, he will never forget: One day, our youngest son David III had a fever. We called him for advise as a physician. He confirmed David had Chicken Pox(CP). This happened about two weeks before his wedding in Indiana. Rudy later informed us that he was so scared he will get David's CP and will not be able to bear children. This event was indeed just a scare, knowing the number of children (9) Rudy and Tessie had raised here in the US.

Rudy and Tessie: We will never forget our overnight stay in your residence in Indiana. That night we went to the Casino. I( Macrine) won $1000 is the slots, just about one minute before we checked out of the Casino.

Dave and I missed you Rudy. Rest in Peace! Macrine Katague, Past President, MI, Inc

Here's Dr. Jao's obituary published in Las Vegas, Nevada dated February 18, 2018: https://www.dignitymemorial.com/obituaries/las-vegas-nv/rodolfo-jao-7777666

For more information on MI, Inc visit their FaceBook page:

*https://www.facebook.com/mdqintl/

Carenna Seven Years Ago and Today

Carenna vacationing in Hawaii with the Chalfins and with Merlet Perlas last week

The first video show Carenna's musical talents when she was only 8 years old.

https://www.facebook.com/ditas/videos/10150249511981270/

This second video was just taped recently. Enjoy

https://www.facebook.com/ditas/videos/10155764378696270/

It is Expensive Getting Old in the United States of America

Last year, when Macrine required long term care assistance I finally realized that it is very expensive getting old here in the United States in spite of my Federal Medical Insurance and Medicare A Benefits. I searched the Internet and confirmed that the US is ranked poorly compared to other 10 countries in terms of seniors health care benefits.

"The most notable way the U.S. differs from other industrialized countries is the absence of universal health insurance coverage. Other nations ensure the accessibility of care through universal health systems and through better ties between patients and the physician practices that serve as their medical homes. Source: The Commonwealth Fund Mirror 2014 Update".

For more details visit the following site:

https://www.forbes.com/sites/danmunro/2014/11/30/u-s-healthcare-for-seniors-ranked-poorly-compared-to-10-other-countries/#1410013f339e

Personal Note: I have a Federal Medical insurance (BCBS) which covers most of Macrine and my short term medical needs and drug prescriptions. I am paying $500 monthly premium for this benefit. However I do not have long term insurance coverage or long term custodial care insurance. In addition, Macrine and I have Medicare A which covers all Hospitalization costs, but not incidentals etc.....Every time Macrine goes to the Emergency Room or Hospital, my pocket expense ( not covered by Insurance) totals to about $1000 to $3000 per episode. In addition, Macrine long term custodial care is not covered by my BCBS or Medicare. Right now I am spending about $2800 a month for Macrine's custodial care. All these expenses are coming from my own SAVINGS, since I do not have long term care insurance which is super expensive. However the 60-day home care visits after hospitalization by a nurse, physical and occupational therapies and home care aide( bathing) is covered by Medicare. I am paying only $8 a month for the rental of an electric hospital bed-an excellent benefit.

It is indeed very expensive getting old here in the United States of America! May be we will move to Canada or the Philippines! Comments anyone?

Here's the site showing average costs for long term care in the US:

https://longtermcare.acl.gov/costs-how-to-pay/costs-of-care.html

Just Discovering FaceBook Groups

Recently I joined two FaceBook groups associated with our second-home( Boac, Marinduque) in the Philippines with more than 7000 members. In addition I also joined three alumni groups, Universities of the Philippines, Illinois and California, Berkeley. I notice that traffic to my blogs and Hubpages account increased thus also increasing my AdSense Account for a few cents a day. So today I did some Internet search on FB groups and here's the list for your information.

Let me hear from you if you used FB groups to advertise products and events etc...

https://techwebsites.net/facebook-groups-list/

My Story at Boac-Childhood Memories

The Calesa in Boac

Marinduque International, Inc headed by President Agnes Lardizabal Apeles is now getting ready for the next medical mission to Marinduque, this coming February, 2019. The several fund raising activities prior to this humanitarian project reminded me of an article written by Jorge Bunag (RIP-2013)* in 2008 when he returned to the island to join the medical mission in Boac and in the other 5 towns of the province.

This article is a testament that childhood pleasant memories will never be erased in our minds.

http://marinduqueonmymind.blogspot.com/2008/11/my-story-at-boac.html?showComment=1453058800476#c5476080815569145401

Here's Jorge obituary on October, 2013:

*https://www.legacy.com/obituaries/app/obituary.aspx?n=jorge-l-bunag&pid=167497991&fhid=27080

Sunset and Twilight at Chateau Du Mer, Boac, Marinduque

My favorite time of the day in Marinduque is at sunset and at twilight. During this time and up to midnight, I could show case my more than 50 solar lights of various types around the resort. Besides the solar lights, I have installed spot lights in all of the statuary's and garden sculptures near the Conference Hall and also in the Main House. The three photos( taken at twilight) above focused on the bridge lighting (red and white). The bridge is the focal point of the landscaping design of the beach house.

The creek under the bridge is filled with native fish, crabs and snails during the summer season. Two years ago, I seeded the creek with tilapias in November. By May, it was already about 3 to 5 lbs. I feed the tilapias twice a day with commercial fish food. I told Edwin, my caretaker to harvest them before the rainy season, otherwise they will be flushed into the ocean, when the monsoon rains start around July-August. Edwin was able to harvest more than a dozen for his table. A couple of tilapias that remained in the creek were flushed into the ocean by August.

The second photo from top is one of my favorite sunset picture taken from the balcony of the beach house. Macrine and I hope to see you soon in Marinduque-our island Paradise. I wrote this article originally in 2009.