Joanna Marie N. Medina, MD, FPOGS

09/07/2025

This healthy baby girl was delivered via normal spontaneous vaginal delivery to my 33 year-old patient.

Her first pregnancy was delivered via NSD also almost 8 years ago.

During this pregnancy, she had gestational diabetes mellitus requiring insulin injection 3 x a day.

We decided to have her undergo induction of labor at 38 weeks gestation.

After giving her evening primrose oil for cervical ripening, she was admitted with the following internal examination: cervix soft (2), posterior (0), 1 cm dilated (1), 50% effaced (1), (+) BOW, cephalic, station -3 (0).

Her Bishop score was 5, +1 for having one previous vaginal delivery.

Induction of labor with oxytocin drip was started after a normal labor admission test.

After 4 hours of labor induction, she went into active labor with moderate to strong uterine contractions and achieving a cervical dilatation of 3-4 cms.

Amniotomy was done after 3 hours into active phase of labor to augment her labor.

At this point, her labor became protracted prompting us to do amniotomy to augment her labor and check the character of her amniotic fluid.

After 9 hours of oxytocin induction, she delivered to a bouncing baby girl.

Yay! Grateful for a successful and uneventful induction of labor 🙏

02/07/2025

01/07/2025

This is a case of a 56 year old lady who always has blood in her urinalysis (hematuria).

She is already menopause for 4 years and neither experienced frank vaginal bleeding nor spotting.

She was referred by a urologist to an OB-GYN who did a transvaginal ultrasound.

Ultrasound showed thickened endometrial lining.

She consulted me for a second opinion, and we agreed to have hysteroscopy.

On hysteroscopy, her endometrial lining was indeed thick for her age. A polyp-looking mass was also incidentally seen in the endocervical area.

Polypectomy, targetted biopsy and curettage was done, waiting for the biopsy results.

29/06/2025

I will be on a long vacation leave on July 13-26,2025.

For any concerns, you may send a message to my FB Page.

For immediate concerns, please proceed to the emergency room.

Clinics resume on July 28, 2025.

Thank you!

29/06/2025

Announcement.

I will be on leave for a short vacation on

JULY 1-5, 2025.

For any concerns, you may reach me through my FB Page.

For immediate concerns, please proceed to the emergency room.

Salamat po.

29/06/2025

This is a case of a 33 year old nulligravid who had prolonged and profuse vaginal bleeding for 9 months
prior to consultation.

She had a history of polycystic ovaries and been advised endometrial curettage two years ago but was hesitant and indecisive.

She consulted me for a second opinion.

Her ultrasound showed thickened endometrial lining , to consider endometrial polyps.

I advised her to have hysteroscopy, which is the gold standard procedure in abnormal uterine bleeding secondary to thickened endometrial lining.

On hysteroscopy, the endometrium was indeed thickened with polypoid and fungating projections.

There were also an abundance of blood vessels everywhere.

We removed the thickened endometrium and the abnormal intrauterine masses and submitted them for biopsy.

Now waiting for the biopsy result and praying for a benign outcome.
🙏🙏🙏

-M
-P
-O

20/06/2025

This is a case of a gravida 2 para 1 (1-0-0-1) patient whose 1st delivery was almost 10 years ago and was unremarkable via normal spontaneous delivery.

This pregnancy, however, she experienced gestational diabetes mellitus, controlled by diet alone.

At 39 weeks gestational age, her bag of water spontaneously ruptured prior to labor.

We augmented her labor and tried to have the baby delivered by NSD.

After 3 hours of labor augmentation, she went into active labor.

After 7 hours into active labor, however, her cervical opening remained at 8cms.

An emergency low transverse cesarean section was done delivering to a live baby girl weighing 3.6kg.

Incidentally, there was also a tight nuchal cord coil which was easily removed upon delivery.

The baby's weight is still appropriate for her Ballard Score, but it's a little big for an average Filipino woman such as this patient.

20/06/2025

On point nmn si doc.

WHY SOME DOCTORS BILL MORE THAN OTHERS

Title: “Just Five Minutes?”

Mila stormed out of the clinic, clutching the white prescription paper in her hand and shaking her head in disbelief. “Five minutes. I paid ₱800 for five minutes,” she muttered, eyes wide with exasperation.

She sat on the nearest bench and began venting to her husband over the phone.
“Alam mo, he just asked me three questions — ‘Saan masakit? Kailan nagsimula? May lagnat ka ba?’ Then he listened to my back, looked at my throat, and wrote this! That was it. I didn’t even get to finish explaining everything I googled!”

On the other end of the line, her husband tried to calm her down. “Baka naman magaling ‘yung doctor?”

“Magaling? E ni hindi ako tinanong tungkol sa diet ko o lifestyle,” Mila snapped. “I could’ve done that myself.”

What Mila didn’t see — and what many never do — was the unseen work behind that “five-minute” consult.

The doctor had reviewed her chart the night before, recognizing her name from previous visits. His years of internal medicine practice told him which symptoms pointed to something serious and which ones didn’t. He noticed her breathing pattern as she walked in, the slight hoarseness in her voice, the subtle wince when she shifted in her seat.

He asked the right questions, examined the right places, and gave the right treatment — not because he was rushing, but because he had trained for decades to be that precise.

What took him five minutes took him twenty years to master.

And that’s what many patients don’t understand: you're not just paying for time — you're paying for expertise.

That’s also why some doctors bill more than others. It’s not just the title "doctor" that sets the fee, but how much they’ve invested in their training, their subspecialty, their experience, and the accuracy and safety they can offer in return. A more experienced doctor can often make the right call faster, with fewer tests and fewer errors — and that kind of efficiency isn’t cheap.

Mila’s ₱800 paid for more than five minutes. It paid for the confidence that she didn’t need an unnecessary lab, or a wrong medicine, or a week of worrying. It paid for a quick diagnosis made with precision — the kind only possible through long years of study, failures, learning, and patient care.

Sometimes, the best doctors make it look easy.

That’s the cost — and the value — of true medical expertise.

08/06/2025

Teleconsult be like...

Me: Ok, cge, send mo nlang sakin sinasabi mong latest ultrasound, then I'll send you prescription, ok?

Patient: ok po Dra.

"Merci pour votre confiance"

🙏😅🥰

04/06/2025

Congratulations again,

Abegail and Laurence!

One boy, one girl na!

After 2-3 years pa dapat ulit 😅🤭🤞

Grateful for an uneventful delivery 🙏