by Gabrielle Angela T. Diaz Sales
Dr. ‘Andy’ and Dra. ‘Marie’ operating on a woman with a cyst in her ovaries. Photo from Dr. Andy
Doctors ‘Marie’ and ‘Andy’ (who prefer to keep their identities private) are both Obstetrician-Gynecologists living in Silang, Cavite. Dr. Marie sub-specializes in Gynecologic cancers while Dr. Andy sub-specializes in Obstetrics and Gynecologic Ultrasound. The two of them are among the many medical frontliners who have had to face challenges in their workplace because of the COVID-19 pandemic.
It is a 30 minutes to an hour journey from Silang, Cavite to their workplace in Alabang, Muntinlupa.
“In the first few months of the pandemic there was a challenge going through the checkpoints.” said Dr. Andy.
Once, he recalls, they were asked to alight from their vehicle and line up for a temperature check in the highway which he finds unusual. As the pandemic went on, however, it became easier for them to travel through the checkpoints.
Less patients, longer hours
“This pandemic has created such a huge impact in our work environment,” said Dr. Marie.
Due to the necessary health protocols, their 8am to 3pm clinic hours are now usually extended to 5 to 6 pm. Patients are no longer attended to on a first come, first serve basis, but require an appointment. Only one to two patients can also be accommodated every 30-45 minutes. Before entering the clinic, patients would also have to undergo temperature checks, disinfect their hands with alcohol, and wipe their shoes on a disinfectant mat.
For in-person services of patients like performing ultrasounds or surgery, the couple wear full-body PPEs. They have also installed a ventilation system in the room where they perform ultrasounds to lessen the circulation of aerosols.
Before being admitted in their care, patients are also required to submit a negative result for a COVID-19 test taken within two weeks.
“Since we are dealing with pregnant patients who may give birth anytime via normal delivery or cesarean section, it is mandatory for them to have an RT-PCR test before they get admitted or before they go into labor,” said Dr. Andy.
Because of the surge in COVID-19 in the NCR+ region, however, the hospital now requires patients to show a negative result for a test taken one week prior to being admitted. Patients with pending results are held separately in a room specifically for COVID isolation.
Online video consultations
As in-person appointments are risky for patients, online consultations also became more frequent.
“So in Obstetrics and Gynecology we are really visual and tactical. We use our hands and our eyes to really get a better look at the patient.” said Dr. Marie.
With the pandemic restrictions on in-person consultations, online consultations allow the doctors to examine their patients remotely and prescribe treatment. Platforms such as SeriousMD and MEDIFI will help put a patient in contact with their doctors.
“I am part of [these] two systems” said Dr. Marie. “But what I find more reliable and efficient is that [my patients] call the clinic through Viber, then my secretary would schedule a consult via Zoom.”
Video calls allow doctors to examine their patients remotely through phone or computer cameras. But since OB-GYNs diagnose and treat diseases for female reproductive organs, it may be sometimes uncomfortable for patients to allow doctors to examine them through video call.
“This is where us doctors use our senses to examine the patient. I need to see the lesions or the areas involved,” says Dr. Marie.
Still, online consultation can never replace the physical or face to face consultation. “Sometimes what happens is that after the online consult, I request for them to have a physical consult with me.”
One of their most challenging experiences was operating on a pregnant COVID positive patient.
“We did elective cesarean section on her to lessen exposure as compared when she [was] allowed normal delivery.”
The surgery was done in a specified COVID operating room with all personnel wearing level 4 PPEs. Fortunately, the baby tested negative for the virus but had to be separated from the mother until she tested negative. “Na-discharge naman kaagad yung mother together with her baby three days after,” Dr. Andy said.
Beyond the workplace
The changes in their daily routine extend to their homes. Both Doc Marie and Andy can no longer speak face-to-face with their two sons, aged 17 and 22, out of fear of exposing them to the virus.
“Gone are the days we eat together. Gone are the days we spend time talking to each other…. We usually communicate using our gadgets” Doc Marie said, “Nowadays, we [can] barely stay in one room together to talk.”
Thankfully, the two of them have already received their first dose of the AstraZeneca vaccine as of last March 16, 2021.
“The only effect we experienced was mild muscle ache lang. It lasted for a few hours,” said Dr. Andy. “For me it is important that people get vaccinated so that we are able to acquire herd immunity.”
“We urge the government to help front liners like us by listening to the suggestions of public health experts” said both Dr. Marie and Dr. Andy. “Take their opinions constructively rather than consider them going against government policies.”