About hannahpotmd

Internist-Endocrinologist. Dreamer. Child of God.

Lessons from a Feisty Little Dog

Tsiken is our tan and black teacup Yorkie. He was bought with a hefty discount somewhere in Ortigas because he was already old for a pup (4 months) and no one wanted to buy him, for reasons unbeknownst to us.

He was energetic, his fur was a mess, but we loved him anyway. He would be me and my husband’s first dog – and first foray into taking care of a warm-blooded living being.

His name was intentionally misspelled – the Filipino derivative of the word and animal – “Chicken”, with whom our Yorkie had a close semblance to when he was first bought. He weighs 3 pounds, stands a proud 8 inches tall and is a little more than a foot long from snout to his short bushy little tail.

Tsiken is a social media darling for his sheer cuteness. Videos and photos of him shaking hands, staring at a TV and choosing a meal garner an average of 50 likes in a span of 4 hours (better than my post about “why I chose Endocrinology as a field of specialty in medicine”). Heart/dog/smiley/kiss/hug emoticons fill the comments section – people apparently prefer to express their reactions to cuteness with drawings than words.

He is a hit at home too. His diminutive size demands that he be handled with care. This also means he is the most portable dog – one you could easily bring to a visit to a family friend who lives a block away for instance. His head turns sideways when you talk to him – like he is trying his darnest to understand the English language.

But what I most love about Tsiken is his daily show of GUMPTION. If anything ever embodied that word, I believe it would be Tsiken.

He shares our home with his larger brother – Weiner Dog (literally, a weiner dog), who almost always beats him to the ball, the bone, the toy dog, the race to the ocean, the capacity to stay in the water longer without feeling cold, the couch, the lazy boy…but Tsiken is not bothered. AT. ALL.

sweet doggies

Tsiken playing with Weiner Dog


Tsiken just keeps at it! He keeps joining that race, that swim, that quest for the squishy toy. He adapts. For instance – he cannot jump onto the couch like Weiner Dog can, so he manages to find the corner of the couch, squeeze his body sideways and claw his way up like his most hated animal, a cat, until he finds himself successfully a top the couch (which thankfully is made of sturdy, claw resistant material).

doggies on couch

The red couch of power


This feisty little fellow lives an UNFAZED life. His bark is a tiny, high pitched one that is easily drowned out by the rest of the five bigger dogs in the compound whenever they decide to morph into a canine chorale. But he still barks with all his might.

What’s my point here? If you feel you are small, whether in stature/influence or clout, don’t feel bad. Small does not necessarily mean useless. Small can mean you can show the world just how you intend to beat the seemingly ginormous odds against you. Small is a platform for greatness, for innovation, for resilience, and most importantly, for the cuteness that you’ll need to raise an army of loyal followers…


“I dare you to not hit the like button…”

Screening for Diabetes – Fasting Blood Sugar

The best way to know if you have diabetes mellitus is to have yourself screened by doing a FASTING BLOOD GLUCOSE (FBS) test.  It is also called the FASTING PLASMA GLUCOSE (FPG) test.  To prepare, do not eat or drink anything except water for 8 to 10 hours before your scheduled fasting blood glucose test.

The results are interpreted as follows: you have diabetes is your fasting blood sugar is 126mg/dl and above, you have pre-diabetes if it is 100-125mg/dl, and you have normal blood sugar levels at 99mg/dl or less.

If your results show that you have either diabetes or pre-diabetes, talk to your doctor right away, for advice on proper lifestyle and diet, and to start you on the right medication.

DM FBS cut offs

top photo credit: http://www.heart.org/HEARTORG/Conditions/More/Diabetes/AboutDiabetes/Pre-diabetes-Whats-the-Problem_UCM_461554_Article.jsp#.WN3zfRKGNvc

Foot Complications of Diabetes

Foot gangrene is one of the most dreaded forms of diabetic foot. It may initially present as frequent cramping of the legs with long distance walks. It is worsened with smoking, uncontrolled hypertension and high blood cholesterol levels. The risk of foot amputation is around 15x higher for diabetics (Gayle R, Benjamin AL, Gary NG. The burden of diabetic foot ulcers. The American Journal of Surgery 1998Aug 24; 176(Suppl 2A):65-105).

Diabetes complications like this are preventable with early diagnosis and good control of blood sugars (http://www.nejm.org/doi/full/10.1056/NEJMe0807625).

DM Info campaign.jpg




🏥 Room 206, OPD 3, Lorma Medical Center, Brgy Carlatan, San Fernando City, La Union
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💻 doktora.hannah@gmail.com



Endocrinology is a sub-specialization in Adult Medicine, this entails:

  • 3 years of Internal Medicine Specialty Residency Training
  • 2 years of Endocrinology Fellowship Training

Fellowship training involves clinical (out-patients, in-patients and critical care patients) and research training.  Upon completion of fellowship, satisfactory marks on a written and an oral board examination are required to be conferred the status of “Diplomate” in Endocrinology.

Unusual diseases of the adrenal/pituitary/parathyroid glands, metabolic bone diseases such as post-menopausal osteoporosis and complicated cases of thyroid disorders and diabetes are best handled by an Endocrinologist.

Check out http://endo-society.org.ph/find-an-endocrinologist/ to find an Endocrinologist near you. 🙂

Facts vs. Feelings (lifted from “Experiencing God” Devotional by Henry and Richard Blackaby)

For we live by believing and not by seeing. – 2 Cor 5:7 NLT

By faith, not appearance; God never wants us to look at our feelings. Self may want us to; and Satan may want us to. But God wants us to face facts, not feelings; the facts of Christ and of His finished and perfect work for us.

When we face these precious facts, and believe them because God says they are facts, God will take care of our feelings.

God never gives feeling to enable us to trust Him; God never gives feeling to encourage us to trust Him; God never gives feeling to show that we have already and utterly trusted Him.

God gives feeling only when He sees that we trust Him apart from all feeling, resting on His own Word, and on His own faithfulness to His promise.

Never until then can the feeling (which is from God) possibly come; and God will give the feeling in such a measure and at such a time as His love sees best for the individual case.

We must choose between facing toward our feelings and facing toward God’s facts. Our feelings may be as uncertain as the sea or the shifting sands. God’s facts are as certain as the Rock of Ages, even Christ Himself, who is the same yesterday, today and forever.


Undulating and Flexing: Making Sense Out of the Senseless Killings

The You Version Bible App’s Life Journal Plan was designed as a guide for the user to be able to go through the New Testament twice and the Old Testament once within a year’s time.

Allan got us synced on it, and now we’ve gone through Zephanaiah, Jeremiah, and the history of the Israelites’ struggles against the Assyrian and Babylonian empires.


A noticable pattern appears throughout the lives of some of our Old Testament heroes and the chosen people as a whole – that of running to God and then running away from Him to go back to the idols they have created. The attraction being that these false gods and idols are controllable (the alternative true God is of course, above and beyond us). These “gods” allowed all sorts of perversions that catered to the flesh – sex worship (the Asherah poles) and child sacrifices (to the god Molech) as examples.

One God catering to the eternal, the other gods, to the temporal. The ultimate choice that every believer faced and continues to face every single moment of every single day.

These days, idols are no longer as obvious as the ones our ancestors had to contend with. Asherah poles have been replaced by the idol of the concept of pleasuring the “self” – the thought that anything that makes the self “feel happy” is right and justifiable and rational and it matters not that other people and most importantly, that we go against the commands of God. Molech worship has been replaced with wanton disregard for what is good and pure and just. These disguised idols further the danger of turning to men and might for help in times of unimaginable hurts and struggles, eclipsing our one powerful and true weapon – prayer to the sovereign God.

The Christian community calls it backsliding. C.S. Lewis’ devil Screwtape so succinctly puts it as “undulation”: “Humans are amphibians – half spirit and half animal…While their spirit can be directed to an eternal object, their bodies, passions, and imaginations are in continual change…Their nearest approach to constancy, therefore, is undulation—the repeated return to a level from which they repeatedly fall back, a series of troughs and peaks…”

leaf-margin-undulateIs there hope for the undulating Christian? Sure. Christ offers us never ending grace and strength to face the toughest and most hurtful of challenges while remaining steadfast in Him. We need but to trust Him and obey. History – ours and the ancients, show us just how difficult it can seem to be…

In the ancient days, the fearful Israelites turned to then world superpower, Egypt, seeking alliance to help fend off the Assyrians and Babylonians. Not only were they disappointed, they were decimated, and their survivors, displaced.

Lately, disturbing news from the historic lands of the Old Testament books have been peppering the internet and cable TV, that seem to be recapitulating the ancient terrors described in the Bible – something to do with the ISIS terrorist group’s activities in modern Assyria.

I had just recently found out about the extent of the atrocities in the ISIS’ persecution of Christians through my brother and Allan as they asked me one Sunday in the comfort of the air conditioned worship hall, “Do you know about what’s going on in Iraq?”

Allan shows me news of how they systematically behead children with knives, rape women and hang men, and then points out that the cycle of fear appears to be happening once again – in panic, world leaders call on the United Nations, the international community, and the United States to intervene. Much like the desperate alliances that Israel sought when they were oppressed by Assyria. Running to the UN and US now somewhat feels like running to Egypt then. It seems that even with the benefit of the Scriptures, history and hindsight – we have not learned one valuable lesson: in the final reckoning, it is God who saves. Not military might, not powerful economies, and certainly not influential leaders.

So while it is good and worthy for the good and powerful people of the world to flex their muscles and intervene in the whole sordid issue, for the rest of us, let us not forget to flex our knees, and pray with all our might, every single day for our brothers and sisters in persecution, for their faith and deliverance and for their hearts to continue to find hope and comfort in the sovereignty of the Lord.

And while it is true that we undulate, we find that our best counter to this would be to flex our knees and pray unceasingly…




Upang malaman kung tama ang iyong timbang para sa iyong height, o Body Mass Index (BMI):

Body Weight (kg) / Height (m2)

Halimbawa, ako ay 5’ feet at 4 inches = 1.62 meters (5 foot 4′ = 64 inches = 162 cm = 1.62 m), at ang aking timbang ay 58 kg:

58 kg / 1.622 = 22.1 (ang aking BMI)

Ikumpara sa susunod na chart ang resultang makukuha:

Mga Antas ng BMI para sa mga Pilipino

Underweight < 18.5 kg/m2
Normal 18.5 – 23.9 kg/m2
Overweight 24 – 27.5 kg/m2
Obese > 27 kg/m2

Ang normal na BMI para sa mga Pilipino ay nasa 18.5 hanggang 23.9. Mas mababa sa 18.5 ay underweight, at and sobra naman sa 23.9 ay overweight o obese.

Upang maabot ang nais na timbang natin, isa sa mga epektibong weight loss strategies ay ang pagbibilang ng calories. Ang ating pagkain ay may katumbas na caloric content at ang pagbabawas ng calories ay makababawas ng timbang.

Upang makabawas sa timbang, limitahin ang dami ng calories na kakainin at damihan ang calories na ibu-burn sa pamamagitan ng exercise. Narito ang ilan sa mga exercise at kaakibat na calories na nababawas kada uri ng ehersisyo:

Weight: 150 lbs Weight: 200 lbs
30 minutes a day Calories burned Calories burned
Basketball 153 153
Bicycle 272 272
Bowling 102 102
Dancing 153 153
Gardening 136 136
Running (5 mph) 272 272
Swimming (leisure) 204 204
Tai Chi 136 136
Washing Car 102 102
Yoga 85 85

* Adapted from Lilly Diabetes Personal Solutions Pamphlet

Heto naman ang ilang sa mga usual na pagkain natin at ang calories na nilalaman nila:

Food Caloric Content
Rice, cooked ½ cup 100 calories
Pandesal, 3 pcs small 100 calories
Pan Amerikano, plain, 2 pcs 100 calories
Chicken, no skin, 1 oz 41 calories
Shrimps, 25 gms 41 calories
Balut, 1 pc 122 calories
Bacon, 1 strip 45 calories
Fresh cow’s milk, 1 cup 170 calories

* Adapted from Lilly Diabetes Personal Solutions Pamphlet

Ang basic na principle dito ay kailangang mas malaki ang calories na nabuburn sa pamamagitan ng exercise at iba pang activities kaysa sa calories na dinadagdag sa pagkain. Para sa mas kumpletong listahan, maaring i-download mula dito ang: Calorie Count of Exercise and Food pamphlet mula sa lilly diabetes. Maari itong i-print at ipaskil sa bahay kung saan madaling makikita ito. Iba pang mga websites na maaring makatulong ang sumusunod:



Tantyahin kung gaano karami ang calories na kinakain bawat araw at bawasan ng 500 ito. Halimbawa, kung ang aking usual na calories sa isang araw ay nasa 1,700, babawasan ko ito ng mga 500 = ibig sabihin, dapat limitahan ko sa 1,200 na lamang ang aking kakainin para mabawasan ang timbang.

Kung ikaw ay may smartphone, subukan i-download ang app na myfitnesspal – kumpleto ito sa tips at charts para sa weight management.

Kung kayo ay seryoso sa pagpapapayat, disiplina, tamang pagkain, ehersisyo at tamang kaalaman lamang ang katapat nito. Sumangguni sa iyong doctor para sa iba pang detalye. Huwag mag-umpisa ng kahit anong weight loss regimen nang hindi muna nagpapa-clear sa inyong doctor upang makaiwas sa kumplikasyon.

OMG! Wag mawalan ng pag-asa!

OMG! Wag mawalan ng pag-asa!

For more information, maari ninyong i-download ang aking lecture on weight management: Weight Management

Sanggunian (Reference):

WHO expert consultation; THE LANCET • Vol 363 • January 10, 2004 http://www.thelancet.comhttp://www.who.int/nutrition/publications/bmi_asia_strategies.pdf

image credit:http://noalicious.blogspot.com/2012_03_01_archive.html

Rockin’ the Limbo Status

Between having to adapt to a freer schedule (yay!) and lack of tenure and hence uncertain economic capacity to feed oneself (yikes), having the status of a “recently graduated subspecialist or specialist” can feel like being stuck in a hazy intermediate state as I am recently discovering.

For most of us who will trail blaze the path of a physician for their families, it will be daunting. For those who will have a pool of patients to be inherited along with their family heirlooms, the challenges may be different, but not necessarily less difficult. As my current status is that of the former, I feel more qualified to speak for them.

Having been immersed in training for a good ten years, where academic and clinical skills were the focus of learning, I discovered a whole new world out here. For those who are still on their way, here are a few general tips from one who is right in the thick of things:

1.Save up NOW.

Practice not living from paycheck to paycheck while you are still being given a regular salary. If you have connections and/or are lucky, your first job comes right at the heels of your graduation given you also send out your CVs early (check out item #4 later). If you are neither, then at least you’ve saved up. You’ll be surprised at how fast money dwindles as the cash flow ebbs during the first few months.

2.Do NOT burn bridges.

This is not the time to go around saying “May the bridges I burn light my way”. One senior physician commented: “Not everything is WHAT you know, it’s also WHO you know.” While garnering awards and honors give prestige, a good work ethic and cultivating harmonious relationships while still in training will also score points, and sometimes matter more with your bosses and colleagues, who might eventually give you the break you need.


Put your laptop or smartphone or tablet to work and network away! Headhunters lurk in professional networks like LinkedIn. Attend medical conferences and mingle, your friend might have a friend of a friend who needs someone with your credentials. Various specialty and subspecialty societies post their calendar of events on their websites, take your pick.

4.Know and pay your TAXES

To paraphrase Ben Franklin, only two things in life are certain – death and taxes. With recent public pressure placed on the profession, we young doctors ought to take measures to not let anything besmirch our reputations – invaluable to clinical practice. Check out: www.bir.gov.ph for downloadable forms and their primer – more on this on my next blog ☺

5.Options for sustenance other than your mom and dad

Clinical practice
– Hold clinics near your residence to save up on commuting/gas money, if you have only one patient in a clinic that requires you to shell out 100++ for miscellaneous travelling expenses, your take home might be a pittance…worse if no patients come, which will happen every so often…
– Multispecialty clinics abound in the metro and are also budding in many regions in the country – drop in on one and talk to the clinic manager to know their vacancies and fees
– Be patient with your patients, they will be an important source of referrals.

Clinical trial. Try your luck as a medical monitor in one of the CROs (Contract Research Organization) in our country, like Parexel, Quintiles, Covance and Exodon. Those who’ve had experience working on a trial will have an edge here. The pay is considerable and part of your job may involve travel abroad.

Company retainer physician. Check out http://www.aventusmedical.com. For a fixed fee, the hours may be exacting and the number of patients to be seen many, but this is one job that pays regularly so it works for the meantime.

Industrial clinics, Hospital-based wellness centers, Ambulance conduction, Emergency room physician.

Medical school lecturer/preceptor. A welcome break for those who miss the academe. When pursued seriously, you might find yourself part of the faculty. This means tenure and benefits.

6. Endure

Be prepared for the times when your savings and mood dip. You’ll catch yourself thinking: “After 10 years of missing family events, wrecked sleeping patterns, physical, mental and emotional torment, this is what is waiting for us??” Just keep in mind that this limbo will not last. You are most definitely not completely helpless and you have the capacity to get out of it. They say all it takes is time, patience and the right attitude.

Occasional self-pity is normal but do soldier on, once you start earning and are able to give back to your family and the community at large, I am certain it will all be worth it.

For those who are or were in the same boat, feel free to add on to the list!

12 New Rules For Modern Weddings In 2014

I agree 100%. Budget considerations now balloon because of the nuances that go with it – prenup, postnup trash the dress etc…