FocusSym

Napagsabihan ako sa trabaho✌️😅
Okey lang yan bawi sa susunod
(Newbie sa workplace)

Sino relate dyan?

TAG THAT ONE PERSON WHO NEEDS THIS POST EXPOSED.

They’re dead serious at work—professional, responsible, handling pressure like a boss.

But the moment the shift ends?

COMMON SENSE CLOCKS OUT TOO. 😭

Serious job.
Unserious personality.
Zero supervision. Maximum chaos.

Share this with the person who is qualified to save lives, run a company, or handle million-dollar problems… but can’t handle their own life.

FLAXIPARINE

Fraxiparine (nadroparin) used as anticoagulation during hemodialysis, timing depends on the dialysis protocol and prescribed dose.
💉 Typical HD timing
1. At the start of dialysis — most common
Nadroparin is generally given as an initial bolus at the beginning of the dialysis session.
The purpose is to anticoagulate the extracorporeal circuit before significant clot formation occurs.
In many protocols, it is administered into the arterial side of the dialysis circuit, usually after blood flow has been established.
2. During dialysis
Some protocols use an additional dose or infusion for longer/high-risk sessions, but this is not automatically required.
Whether a supplemental dose is appropriate depends on the prescribed regimen, session duration, bleeding risk, and the patient's response.
3. At the end of dialysis
A routine Fraxiparine dose is not normally given at the end simply because dialysis is finishing.
Giving anticoagulant late can unnecessarily increase post-dialysis bleeding risk.
🩸 Why the arterial side?
The arterial limb is the blood path from the patient → dialyzer. Giving the anticoagulant there allows it to mix with blood before it enters the dialyzer, helping prevent clotting of the dialyzer and circuit.
Simple flow:
Patient → arterial line → 💉 Fraxiparine → dialyzer → venous line → Patient
The exact administration technique can differ between dialysis units and product protocols, so follow the prescribed Fraxiparine regimen and your unit's anticoagulation protocol rather than substituting a UFH protocol.

🦋 Butterfly nila… butterfly ko… 😅

Sa kanila, colorful butterfly na lumilipad.
Sa atin, butterfly needle na nakakabit sa dialysis. 💉😂

Magkaiba man ang “butterfly” natin, pareho tayong may wings to keep going. 🦋❤️

Every dialysis session may come with needles, machines, and challenges—but every session is also another chance to keep fighting. 💪

Different wings. Same sky. Same hope. 🦋

— FocusSym | Make it Simple. 💙

Don’t shrink yourself to fit places you’ve already outgrown.

Sometimes leaving isn’t failure—it’s growth.

You’re allowed to outgrow a job, a relationship, an environment, or even the version of yourself that once felt comfortable there.

Make room for the person you’re becoming. 💙

— FocusSym 🩺
Keep growing. Keep moving. Keep becoming.

TAKE THE JUMP! | FocusSym

Minsan, kailangan mong lumabas sa comfort zone para makita kung hanggang saan ka talaga kayang dalhin ng pangarap mo. 💙

Yes, may risks.
Yes, may takot.
Pero walang growth kung hindi ka susubok. 🌱

Sa career, sa buhay, sa nursing journey—
huwag mong hintayin na maging ready ka 100%.
Minsan, kailangan mo lang magkaroon ng courage na tumalon. 🩺💪

Comfort zone → Risk → Growth

Kung may pangarap ka, take the jump.
Malay mo, nasa kabilang side pala ang opportunity na hinihintay mo. ✨

— FocusSym | Make it simple.

Patient: "Wow 14 ang Hemoglobin ko. Butina lang . Mas mataas mas maganda😄"

FocusSym :" ah eh, i think we need to clarify something"

Patient: "hindi ba tama ako?"

There are several common misconceptions about high hemoglobin (Hb) in hemodialysis (HD) patients.

Common misconceptions

Misconception vs. Reality

“The higher the Hb, the better.” Not necessarily. In CKD/HD, pushing Hb too high can increase cardiovascular and thrombotic risk.

“If Hb is high, give more ESA to keep it high.” ESA therapy is adjusted to avoid excessive Hb levels, not to normalize Hb like in a healthy person.
“High Hb means the patient is well hydrated.” High Hb can actually occur with hemoconcentration/dehydration, especially after excessive ultrafiltration.
“A high Hb always means the patient has too many red blood cells.” Not always. Fluid status can change the measured Hb concentration without a proportional increase in red-cell mass.
“If Hb is high, the patient doesn't need monitoring.” High Hb may require assessment of ESA dose, volume status, hypoxia, smoking, sleep apnea, or other causes.
“Stopping ESA is always the answer.” The cause matters. ESA dosing should be individualized based on the Hb trend, treatment, and clinical situation.

Important HD point:

A post-dialysis Hb that is higher than pre-dialysis Hb can sometimes reflect hemoconcentration from ultrafiltration, rather than a true increase in red blood cell production.

For example:

Pre-HD: Hb 10.5 g/dL
⬇️ Fluid removed during HD
Post-HD: Hb 12.0 g/dL

That doesn't necessarily mean the patient suddenly produced more RBCs—the blood became more concentrated because plasma volume decreased.

FocusSym takeaway:

“High Hb ≠ automatically healthy. In HD, always consider ESA therapy + fluid status + the Hb trend.”

" FocusSym ,Ayaw ko ng MUNGGO, tataas uric Acid ko"

Yes—this can be turned into a strong myth-busting post, but I’d slightly correct the wording: foods don't literally contain “uric acid”; some are high in purines, which the body breaks down into uric acid. Fructose can also increase uric acid production.

“Mataas ang uric acid ko kasi kumain ako ng munggo noong Friday.”

FocusSym:
Pero… ano naman ang kinain mo mula Saturday hanggang Thursday?

🍖 Pork liempo ( tapos massrap nyan naka barbecue pa)🤣✌️
Corned beef
🥤 Softdrinks / sugary drinks
🥩 Sisig
Papaitan( especially if it contains liver/other organ meat)
Pulutan no? Tapos malamig na Beer✌️🤣

🐟 Tinapa
🐟 Sardines

🍜 Iba pang pagkaing mataas sa purines
🍰 Matatamis / high-fructose foods and drinks

Hindi isang pagkain lang ang dapat tingnan.

Munggo contains purines, pero plant-based purine sources don't appear to have the same gout risk as purine-rich animal foods such as certain seafood and organ meats.

Meanwhile, fructose—especially from sugary drinks—can increase uric acid production.

💡 Remember:

Purines → uric acid
Fructose → ↑ uric acid production

So instead of saying:

“Munggo ang dahilan kaya tumaas uric acid ko.”

Think:

“Tingnan natin ang buong diet at lifestyle ko over time.”

And if someone has CKD or gout, dietary advice should be individualized—don't automatically eliminate munggo or all vegetables.

FocusSym Reminder

Happiness doesn’t have to wait for the perfect moment.

Sometimes we keep telling ourselves:
“I’ll be happy when I have more money.”
“When everything is finally okay.”
“When I reach my goals.”

But life is happening right now.

Learn to appreciate the small wins, laugh through the struggles, enjoy the journey, and find something good even in ordinary days.

Don’t postpone happiness until everything is perfect.
Because sometimes, the imperfect moments become our best memories.

— FocusSym