Costochondritis

Costochondritis is an inflammation of the junctions where the upper ribs join with the cartilage that holds them to the breastbone or sternum. The condition causes localized chest pain that you can reproduce by pushing on the cartilage in the front of your ribcage. Costochondritis is a relatively harmless condition and usually goes away without treatment. The cause is usually unknown.

·         Costochondritis (with unknown cause) is a common cause of chest pain in children and adolescents. It accounts for 10-30% of all chest pain in children. Annually, doctors evaluate about 650,000 cases of chest pain in young people 10-21 years of age. The peak age for the condition is 12-14 years.

·         Costochondritis is also considered as a possible diagnosis for adults who have chest pain. Chest pain in adults is considered a potentially serious sign of a heart problem by most doctors until proven otherwise. Chest pain in adults usually leads to a battery of tests to rule out heart disease. If those tests are normal and your physical exam is consistent with costochondritis, your doctor will diagnose costochondritis as the cause of your chest pain. It is important, however, for adults with chest pain to be examined and tested for heart disease before being diagnosed with costochondritis. Often it is difficult to distinguish between the two without further testing. The condition affects females more than males (70% versus 30%). Costochondritis may also occur as the result of an infection or as a complication of surgery on your sternum.

·         Tietze syndrome is often referred to as costochondritis, but the two are distinct conditions. You can tell the difference by noting the following:

o    Tietze syndrome usually comes on abruptly, with chest pain radiating to your arms or shoulder and lasting several weeks. Tietze syndrome is accompanied by a localized swelling at the painful area (the junction of the ribs and breastbone).

Costochondritis Causes

Costochondritis is an inflammatory process but usually has no definite cause. Repeated minor trauma to the chest wall or viral respiratory infections can commonly cause chest pain due to costochondritis. Occasionally, costochondritis as a result of bacterial infections can occur in people who use IV drugs or who have had surgery to their upper chest. After surgery, the cartilage can become more prone to infection, because of reduced blood flow in the region that has been operated on.

Different types of infectious diseases can cause costochondritis.

·         Viral: Costochondritis commonly occurs with viral respiratory infections because of the inflammation of costochondral junctions from the viral infection itself, or from straining from coughing.

·         Bacterial: Costochondritis may occur after surgery and be caused by bacterial infections.

·         Fungal: Fungal infections are rare causes of costochondritis.

Prevent Swine Flu - not a joke

The only portals of entry are the nostrils and mouth/throat. In a global epidemic of this nature, it's almost impossible to avoid coming into contact with H1N1 in spite of all precautions. Contact with H1N1 is not so much of a problem as proliferation is. While you are still healthy and not showing any symptoms of H1N1 infection, in order to prevent proliferation, aggravation of symptoms and development of secondary infections, some very simple steps, not fully highlighted in most official communications, can be practiced (instead of focusing on how to stock N95 or Tamiflu):

1. Frequent hand-washing (well highlighted in all official communications).

2. "Hands-off-the-face" approach. Resist all temptations to touch any part of face (unless you want to eat, bathe, etc.).

3. Gargle twice a day with warm salt water (use Listerine if you don't trust salt). H1N1 takes   2-3 days after initial infection in the throat/nasal cavity to proliferate and show characteristic symptoms. Simple gargling prevents proliferation. In a way, gargling with salt water has the same effect on a healthy individual that Tamiflu has on an infected one. Don't underestimate this simple, inexpensive and powerful preventative method.

4. Similar to 3 above, clean your nostrils at least once every day with warm salt water. Not everybody may be good at Jala Neti or Sutra Neti (very good Yoga asanas to clean nasal cavities), but blowing the nose hard once a day and swabbing both nostrils with cotton buds dipped in warm salt water is very effective in bringing down viral population.

5. Boost your natural immunity with foods that are rich in Vitamin C (Amla and other citrus fruits). If you have to supplement with Vitamin C tablets, make sure that it also has Zinc to boost absorption.

6. Drink as much of warm liquids (tea, coffee, etc) as you can. Drinking warm liquids has the same effect as gargling, but in the reverse direction. They wash off proliferating viruses from the
throat into the stomach where they cannot survive, proliferate or do any harm.

Girl Cries for Kitkat

The Fitmart Mall that time was filled with shoppers because it was payday and 5PM is always rush our. I picked up a kilo of cooking oil and hurriedly lined towards the counter. I noticed a woman carrying a 2-year old girl in front of me. She was holding a small box of milk, in which I was sure, it was for the girl. When they reached the shelf near the counter, the girl started to cry. At first I didn't mind her crying because kids often cry especially when they want something or feel warm or want to play. This time I noticed that the girl was pointing to a chocolate bar - Kitkat. She cried because she wanted to hold or maybe eat chocolate. But the mother would tell her in a whisper that they don't have money anymore for that chocolate. But the girl still cried and pointed her finger to the chocolate even if they were already at the cashier. This girl must be smart because she recognized that Kitkat is a brand of chocolate. Or maybe she saw it on TV. When it was my turn to pay, the girl still cried and pointed to the chocolate. They were in front of the packer then.

I told the cashier to hold and wait. Then I asked the girl if she want to eat chocolate and the girl said yes. The  mother grabbed her daughter's hand from pointing at the Kitkat. I picked up 2 bars of Kitkat and told the cashier to charge it to me. I saw the girl's eyes so happy when I handed her the chocolates. The mother was shy at first but when she saw how happy her child was, she said 'thank you.'

I grew up in a poor family in Davao. But whenever Christmas comes, my mother would always buy us chocolates. The well-known ones were Sergs, Nips, Pretzel (choco-coated), Curly Tops. I believe every child has the right to eat chocolate or even just a taste of it. That girl who cried for a small Kitkat bar was so happy. Just imagine a child's happy face looking at the chocolate in her hands.

Shoeshine Boy at Jollibee

That was October 23 at around 10:00 o'clock in the evening that I decided to go to Jollibee at RD Plaza for a glass of pineapple juice or maybe a choco sundae filled with brownies & nuts. It's my favorite and I feel like a child whenever I have that. I have already eaten dinner and no need to order a meal.

I sat inside and since I was still full, I enjoyed looking at the lights and the people siting at the city park which is just located in front of the said Jollibee store. My attention was diverted to a boy outside who was looking at all the eaters inside. I thought he was a beggar, since most cities in Philippines have beggars in the streets or outside the malls, restos, etc. It's "-ber" month and usually Badjaos go to the streets and beg for money or food. But the boy didn't look like a Badjao. Then I noticed that he went inside and stood at my back, since I was sitting near the entrance. So I turned my head and saw him looking at the pictures of the food above the counter. The security guard did not reprimand him because I was already talking to him when he saw the boy inside. I asked him if he had already eaten his dinner and he answered that he will eat when he's home. But that was already past 10 in the evening. I asked him what is he doing and he said he shines shoes. He further said that the security guards at the nearby Fitmart Mall are his clients. I was happy to hear it and asked him laughing why did he not shine the Jollibee's security guard's shoes. The boy said that the security guard does not want his shoes shined. The guard was smiling to me when he heard that. A pair of shoes only costs P10. That day the boy had already shined 4 pairs.

I asked him if he is hungry but he said he will eat at home. Considering he was looking at the food pictures and the time, I asked him if he wanted to eat and he nodded. I knew he was hungry. I told him to go to the faucet to wash his hands first. After few minutes he came back and still with dirty hands. He told me that the faucet was not functioning. So he went out and looked for water to wash his hands. Later I discovered that he just didn't know how to use the faucet - it was a "push style" faucet and not a "twist style." The crew just laughed.

I gave him P100 and instructed to go to the counter and point whatever he wants to eat, and go back to me if the amount I gave is lacking. The crews were looking at me. I wanted to test the crews too if they will entertain a dirty-looking boy. But maybe because I was there, they did. He came to my table with 1 pc. chicken barbeque, 1 cup rice and L cup of Coke. He still had a P1 extra which I told him to keep. He started eating, holding the plastic spoon and fork awkwardly. I asked him if it was his first time to eat at Jollibee, and he nodded. I remember an advertisement that the next word uttered by a baby after "mama & papa" is "Ja--bee." But this 10 year old boy had never been eaten at Jollibee.

I noticed that he already had eaten a quarter of chicken barbeque but never touched the rice. I asked if he doesn't eat rice, and he answered where is the rice. I told him that the one wrapped with a paper is rice. He just smiled because he didn't know that it was rice. It's a discovery on his part that evening.

While he was eating, I told him that what he is doing is good. I mean the shoeshine job. I also told him that he should not steal or beg, but work in order to have money. I also told him not to be shy to approach people for shoeshine, because it is a good job. I asked him about his family. His name is Abdul and his mother is a Muslim. He told me that his father is a drunkard, that he is the 5th child among 7 and that his teacher in school dropped him for always absent from class. I asked why and he said it's because he needs to shine shoes to help the family buy food. I appreciate what he is doing.

The following day, Sunday, after our church service, I thought of eating lunch at same Jollibee store just to see him and invite him for lunch as well, but the boy was not there that time. I still hope to meet him again and be able to to become a Channel of Hope to one hungry child.