Stroke Care in Ilocos: Why Faster Treatment Matters

Stroke Care in Ilocos: Why Faster Treatment Matters

October 22, 2026

Stroke remains a major cause of death in the Ilocos Region, prompting government health officials, hospitals, and medical specialists to strengthen prevention, emergency treatment, patient referrals, and rehabilitation services.

A recent roundtable in La Union brought together healthcare leaders, government representatives, clinicians, and civil society groups to discuss how patients can reach appropriate care sooner. Among the proposed responses is StrokeLiNCS LU, or Stroke Linking Institutions for Network Care toward a Stronger La Union, an initiative designed to improve coordination between hospitals and other healthcare facilities.

The discussions highlight a concern that matters to families across the Philippines: recognizing a stroke is only the first step. Patients also need timely transport, access to facilities equipped to treat stroke, and support throughout recovery.

Why Is Timely Stroke Treatment So Important?

A stroke occurs when blood flow to part of the brain is blocked or when a blood vessel in the brain ruptures. Both can damage brain tissue and may cause death or lasting disability.

The treatment a patient needs depends on the type of stroke and how quickly medical professionals can assess the condition. Some patients with an ischemic stroke, caused by a blocked blood vessel, may qualify for clot-dissolving treatment within a limited time window. Other patients may require different medical or surgical interventions.

According to the healthcare professionals involved in the La Union discussions, some patients from remote municipalities may spend two to four hours traveling to facilities that can provide specialized stroke care. These journeys can delay treatment, particularly when symptoms are not recognized immediately or referrals between facilities take too long.

Dr. Mary Grace Fabia-Mistica, stroke program head of the Ilocos Training and Regional Medical Center Brain and Spine Center and the La Union Medical Center, said delayed symptom recognition, long travel times, and referral challenges contribute to patients arriving after the critical treatment window.

The roundtable announcement identifies 4.5 hours as an important treatment window for eligible patients. However, this is not a deadline after which all stroke treatment becomes impossible. Eligibility depends on the type of stroke, clinical assessment, imaging results, and other factors. Anyone showing possible stroke symptoms needs emergency medical evaluation immediately.

What Are the Warning Signs of a Stroke?

Stroke symptoms often appear suddenly. Knowing the warning signs can help families respond before valuable treatment time is lost.

A useful way to remember common symptoms is B.E. F.A.S.T.:

B – Balance: Sudden dizziness, loss of balance, or difficulty walking.

E – Eyes: Sudden changes in vision or loss of sight.

F – Face: One side of the face droops or becomes numb.

A – Arms: Sudden weakness or numbness in an arm, particularly on one side.

S – Speech: Slurred speech, confusion, or difficulty understanding others.

T – Time: Seek emergency medical help immediately.

If you suspect a stroke, call 911 or your local emergency medical service and follow the dispatcher's instructions. Note when the symptoms began, if possible. Do not wait for symptoms to disappear, and do not assume they are simply a temporary blood pressure problem.

Recognizing symptoms early is important, but access to emergency transport and an appropriate hospital is equally critical.

How Does StrokeLiNCS LU Aim to Improve Patient Care?

StrokeLiNCS LU is being advanced as a coordinated network linking healthcare facilities across La Union. The proposed approach follows a hub-and-spoke model, in which designated hospitals provide specialized services while other facilities recognize symptoms, stabilize patients, and arrange rapid referrals.

Under the proposed setup, the Ilocos Training and Regional Medical Center (ITRMC) and La Union Medical Center (LUMC) would serve as hub hospitals for advanced stroke services. Participating spoke facilities would help identify potential stroke cases and coordinate transfers.

The initiative aims to strengthen several parts of the patient journey:

Clearer referral pathways: Establishing procedures for transferring patients to facilities with the required services.

Hospital pre-notification: Alerting receiving teams before a patient arrives so they can prepare for assessment and treatment.

Workforce development: Strengthening healthcare workers' ability to recognize and manage stroke cases.

Telemedicine support: Using remote consultation where appropriate to help connect facilities with specialist expertise.

Shared stroke registry: Improving the collection of information that can help stakeholders monitor care and identify gaps.

These measures are intended to improve coordination and reduce avoidable delays. Their actual effect on treatment times and patient outcomes will depend on implementation, resources, staffing, and continued evaluation.

Why Does Stroke Care Need to Continue After Hospital Treatment?

Surviving a stroke is only one part of recovery. Some patients experience weakness, difficulty speaking, changes in memory, or challenges with everyday activities. Others need help managing medications, reducing the risk of another stroke, and returning to their usual routines.

Rehabilitation may involve physical therapy, occupational therapy, speech and language therapy, and other services based on a patient's needs. The type and duration of support depend on the effects of the stroke and the person's progress.

Access to these services can be difficult for families living far from major hospitals. Travel costs, time away from work, caregiver responsibilities, and the availability of rehabilitation professionals can all affect continuity of care.

The La Union roundtable identified uneven access to neurologists, rehabilitation providers, and long-term follow-up as continuing challenges across the region. Strengthening referrals between facilities could help patients move more smoothly from emergency treatment to rehabilitation and ongoing medical care.

For families, this means asking about follow-up appointments, rehabilitation referrals, prescribed medicines, and warning signs that require urgent attention before leaving the hospital.

How Does the Initiative Fit the Philippines' Universal Health Care Policy?

The Department of Health's National Policy Framework on the Prevention, Control and Management of Acute Stroke in the Philippines sets out a coordinated approach to stroke prevention, diagnosis, treatment, and recovery.

The framework, issued through DOH Administrative Order No. 2020-0059, supports the development of organized stroke services and referral pathways. It aligns with the broader goals of the Universal Health Care Act, which seeks to improve access to quality and affordable healthcare.

The La Union discussions focused on translating national policy into local action. Dr. Ivy Ico of the Provincial Department of Health Office in La Union emphasized the continuing need to improve referral pathways, specialist availability, public awareness, and integrated stroke management.

UHC Watch, a civil society organization involved in health policy advocacy, also stressed collaboration across government, healthcare institutions, professionals, patient groups, and the private sector.

The key challenge is implementation. A national framework can set the direction, but patients benefit when local facilities have the staff, equipment, transport arrangements, and referral procedures needed to deliver care.

What Stroke Care Developments Are Planned in La Union?

The Provincial Government of La Union and local stakeholders are working to incorporate dedicated stroke pathways into the forthcoming version of the province's healthcare provider network referral manual.

The province has also included plans for a Level II general hospital and a neurological rehabilitation center within the proposed La Union Medical Hub. According to the announcement, these facilities are intended to complement existing stroke services and expand rehabilitation capacity.

These are planned developments, not confirmation that the facilities are already operational. Their future contribution will depend on implementation, funding, staffing, and the services ultimately made available.

The roundtable was organized by UHC Watch with support from Boehringer Ingelheim, which works with healthcare stakeholders on initiatives related to stroke care and access to treatment.

What Can Families Do to Reduce Stroke Risks?

Although access to emergency treatment is essential, prevention remains an important part of stroke care. Families can discuss individual risk factors with healthcare professionals and follow advice on managing conditions such as high blood pressure, diabetes, and high cholesterol.

Practical steps include:

1. Attend routine health checks and follow medical advice.
2. Take prescribed medication as directed.
3. Discuss smoking, alcohol use, physical activity, and diet with a healthcare professional.
4. Learn the warning signs of stroke and share them with family members.
5. Know how to contact local emergency services and which nearby facilities provide emergency care.

These measures cannot eliminate every risk, but managing known risk factors and recognizing symptoms can make a meaningful difference.

Stronger Stroke Networks Could Help Close Gaps in Regional Care

The La Union discussions point to a central issue in stroke care: patients need more than medical advances. They need a coordinated system that connects communities, emergency services, hospitals, specialists, and rehabilitation providers.

StrokeLiNCS LU aims to address part of that challenge by improving coordination between facilities and supporting clearer referral pathways. Planned additions to La Union's healthcare infrastructure may also help expand services if they move forward.

For adults and families, particularly those caring for older relatives or people with chronic conditions, understanding stroke symptoms and preparing for emergencies are important steps. For the healthcare system, sustained investment in staff, referral coordination, rehabilitation, and public awareness will be essential to turning policy into better access to care.

When a stroke occurs, every minute matters. Better-connected services can help ensure that more patients receive timely assessment, appropriate treatment, and support throughout recovery.

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Camella Honors GenSan Heritage and Homegrown Spirit at Tuna Festival 2026

Camella Honors GenSan Heritage and Homegrown Spirit at Tuna Festival 2026

September 27, 2026

Camella joined General Santos in celebrating the Tuna Festival 2026, which brought together the people, professions, talents, and traditions that define the vibrant identity of the Tuna Capital of the Philippines.

From seafood and sports to skills, service, and song, the Tuna Festival reflects how this celebrated industry enriches everyday living in General Santos. Dynamic events like the Tuna Marathon, Fish Fest sa Fishport, and Sugbahan sa Dalan offer visitors an immersive experience of the city’s lifestyles and local flavors.

Camella joined the celebration to honor the culture, commerce, and continuity moving General Santos forward. Through an interactive exhibit at the Oval Plaza, Camella invited guests to explore premier house-and-lot communities such as Camella GenSan and Camella Trails GenSan. This on-ground presence successfully brought lifelong homeownership opportunities straight to buyers and investors during the city’s most anticipated gathering.

Of people and place

The Tuna Festival celebrates a multifaceted industry inseparable from GenSan's economic growth. Commercial fishing, processing, trade, transport logistics, and culinary enterprises support diverse livelihoods across the region, bringing these sectors together in a vibrant, shared setting. What begins with the sea directly extends into local businesses, workplaces, and family tables.

This year's activities successfully highlighted that shared story. Events like the Job Fair and Headline Summit drove local employment and corporate exchange, while culinary showcases, cultural gatherings, and cross-generational competitions reflected a progressive city shaped by hard work, hometown enterprise, and a deep sense of belonging.

Homes for generations of Generals

Camella has established its footprint in General Santos through communities created around the changing priorities and preferences of Filipinos.

It offers settings where house-and-lot, lifestyle amenities, landscaped spaces, security features, and proximity to workplaces, schools, retail parks, healthcare facilities, and road networks support suburban living. It serves buyers looking for a primary residence, families seeking more space, OFWs preparing a forever home upon their retirement, and investors building property assets for the future.

These multigenerational neighborhoods find a natural parallel in Tuna Festival. Just as local culture and practices are passed forward, communities can provide continuity through homes where milestones happen, memories remain, and legacies last lifetimes.

Extending enterprise through VLink

Camella's participation in the Tuna Festival also introduced another pathway for progress through VLink, Vista Land's sales recruitment and accreditation program for real estate brokers and sales professionals.

A portmanteau of vision and linkage, VLink welcomes new entrants and seasoned organizations seeking to establish their practice in Philippine real estate. Through simple steps and planned phases, business partners gain product knowledge, access to marketing materials, sales support, training, mentorship, and access to the residential offerings of Vista Land.

For real estate brokers and sales professionals in GenSan and surrounding markets, the platform creates opportunities to strengthen capability while helping homebuyers and investors find homes suited to different life stages, lifestyles, financial objectives, and future plans.

From the festival grounds filled with food, fellowship, livelihoods, and local pride to the homes where everyday life continues beyond the Tuna Festival, Camella remains part of the progress in General Santos. By joining the events, the housing brand honored what continues to define the city: heritage carried forward, homegrown spirit shared widely, and family aspirations finding lasting addresses.

Learn more about Camella communities nationwide. Visit www.camella.com.ph and follow @CamellaOfficial.

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Healthy Aging: Why Facial Aging Is About More Than Wrinkles

Healthy Aging: Why Facial Aging Is About More Than Wrinkles

September 25, 2026

The conversation around aging is gradually moving beyond the idea of simply removing wrinkles. A growing focus in aesthetic medicine is healthy aging, an approach that considers how the entire face changes over time and why two people of the same age may need very different approaches to aesthetic care.

At Cosma Institute, aesthetic physician Dr. James Co advocates for an individualized approach that considers facial anatomy, proportions, skin condition, lifestyle, and a person's own goals before deciding whether any intervention is appropriate.

“Aging is not a disease we need to cure,” Co said. “It is a biological process.”

That distinction changes the question from How can I look younger? to something more specific: How is my face changing, and what, if anything, should be done about it?

Why does the face change as we age?

Facial aging involves changes in multiple layers of the face, including the skin, fat, muscles, supporting structures, and underlying facial skeleton. These changes happen at different rates and contribute to changes in facial shape and appearance over time.

A review published in Facial Plastic Surgery describes facial aging as a process involving changes to bone, ligaments, muscles, fat, and skin. Another review in the Aesthetic Surgery Journal examines how changes beneath the skin eventually contribute to visible changes on the surface.

Even facial fat is not simply one continuous layer. Research published in Plastic and Reconstructive Surgery has identified distinct anatomical fat compartments that can change in volume and position over time.

This helps explain why treating a single visible wrinkle does not necessarily address every factor contributing to an aging face.

“When you only look at the wrinkle, you are looking at the surface of a much bigger anatomical process,” Co said.

Why is there no standard face for every age?

Age is only one factor in how someone's face changes.

Genetics, skeletal structure, facial anatomy, fat distribution, skin characteristics, sun exposure, lifestyle, and environmental factors can all influence the way aging appears. As a result, two people of the same age can have very different facial characteristics and concerns.

That makes standardized aesthetic treatment plans difficult to justify without individual assessment.

“Two patients can be the same age and come to me with completely different anatomy, lifestyles, concerns, and goals,” Co said. “Why would we expect their treatment plans to look exactly the same?”

The distinction is particularly relevant as aesthetic procedures become more visible on social media.

A treatment that appears effective on one person may not address the same underlying concern in another person. Recognizing a facial feature from an online video is therefore different from understanding why that feature appears in a particular individual.

What does healthy aging mean in aesthetic medicine?

Healthy aging does not mean trying to preserve one fixed version of the face indefinitely.

As different facial structures change, the relationship between facial features also changes. What looks harmonious at one age may naturally evolve as a person gets older.

For Co, this makes whole-face assessment an important part of responsible aesthetic care.

Instead of focusing exclusively on an isolated wrinkle, hollow, or contour, a physician can consider how different areas of the face relate to one another and whether an intervention would support the person's overall proportions.

Someone may want to look rested or refreshed without wanting to look substantially younger.

Those are different aesthetic goals.

“Someone can want to look refreshed without wanting to look 20 years younger,” Co said. “Those are completely different goals.”

How should patients approach aesthetic treatments?

The growing availability of aesthetic information online can be useful, but it also creates a potential problem: consumers may begin diagnosing themselves based on what they see on social media.

Co argues that recognizing a concern is not the same as determining its cause or deciding which treatment is appropriate.

“Patients should not have to diagnose themselves from social media,” he said.

A more informed consultation can instead begin with several questions:

• What specific change is the patient concerned about?
• What could be contributing to that change?
• What does the patient actually want to achieve?
• Is an aesthetic intervention appropriate?
• What are the potential benefits and risks?
• Would treatment preserve the person's natural facial proportions and identity?

These questions shift the conversation from chasing a particular procedure to understanding the individual.

Does aesthetic treatment have to make someone look younger?

Not necessarily.

The source material points to a broader definition of success, one based on whether the result meets the patient's expectations while maintaining recognizable features.

A 2022 review of minimally invasive facial aesthetic procedures examined patient-reported outcomes including satisfaction with appearance and aspects of psychological and social well-being. However, the review also noted limitations in the available evidence, making it important to interpret these outcomes carefully.

That nuance matters.

Aesthetic procedures can affect appearance and how patients perceive their results, but individual experiences vary. Patient expectations, clinical assessment, treatment choice, and the quality of available evidence all matter when considering outcomes.

For Co, the desired result is not necessarily an obviously altered face.

“I would rather someone tell my patient, ‘You look well,’ than immediately ask, ‘What did you have done?’” he said.

What should change in the conversation around aging?

Perhaps the most useful shift is linguistic as much as medical.

“Anti-aging” implies that aging itself is a problem to be defeated. “Healthy aging” allows for a different perspective: aging is inevitable, but people can make informed choices about how they care for themselves and whether they want aesthetic intervention.

That does not mean every person needs treatment.

In fact, Co's approach places medical judgment and patient education alongside available aesthetic tools. His position is that understanding when an intervention is appropriate is as important as knowing how to perform it.

For consumers, that is a useful distinction.

The growing number of aesthetic treatments available does not necessarily mean that more treatment is always appropriate. A consultation should help establish what is actually happening, what the patient wants, and whether an intervention makes sense.

The goal may be to look like yourself

The face will continue to change with age. No procedure can permanently freeze it at one particular point in time.

The more realistic goal, from the healthy-aging perspective described by Co, is to understand those changes and make decisions that respect natural facial proportions and individual identity.

“Aging cannot be stopped, and I don't think that should be the promise,” Co said. “What we can do is understand it better.”

That may be the more useful direction for aesthetic medicine: not treating age itself as something that needs to be erased, but giving people better information to decide how they want to navigate the changes that come with it.

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Natural Ways to Relieve a Stuffy Nose at Home

Natural Ways to Relieve a Stuffy Nose at Home

September 17, 2026

A stuffy nose can turn an otherwise ordinary cold into an exhausting few days. Breathing becomes harder, sleep can be disrupted, and even simple activities can feel uncomfortable.

The good news is that natural ways to relieve a stuffy nose can help ease the discomfort while your body recovers. Rest, fluids, saline nasal spray, humidified air, and warm liquids are among the measures recommended by health authorities for managing cold symptoms.

For adults, most common colds improve on their own. The Centers for Disease Control and Prevention (CDC) notes that cold symptoms usually peak within the first few days, while most people recover without specific treatment.

Why does a cold make your nose feel blocked?

A stuffy nose is not simply a matter of having too much mucus.

During a viral respiratory infection, the tissues and blood vessels lining the nose can become inflamed and swollen. That swelling narrows the nasal passages, making it harder for air to move through.

This is why you can feel congested even when you are not producing a large amount of mucus.

A common cold is caused by a virus, so there is no medication that simply makes the infection disappear. Treatment generally focuses on managing symptoms while the immune system does its job.

What are natural ways to relieve a stuffy nose?

You do not necessarily need to reach for medication every time your nose becomes congested. Several simple measures can make you more comfortable.

1. Try saline nasal spray

Saline nasal sprays or drops are among the simplest options for nasal congestion.

Saline helps moisturize the nasal passages and loosen mucus, making it easier to clear. Unlike medicated decongestant sprays, saline does not work by shrinking blood vessels in the nose.

For adults looking for a straightforward addition to their cold-care routine, saline spray can be especially convenient because it does not require heating water or taking medication.

If you use a nasal irrigation device rather than a ready-made saline spray, use distilled, sterile, previously boiled and cooled, or appropriately filtered water.

2. Add moisture to the air

Dry air can make an already irritated nose feel worse.

A clean cool-mist humidifier can add moisture to the air and may help ease nasal stuffiness. However, the device needs regular cleaning because dirty humidifiers can disperse mold, bacteria, or mineral deposits into the air.

This can be particularly useful at night if congestion is making it difficult to sleep.

If you use a humidifier, follow the manufacturer's cleaning instructions and avoid allowing excessive humidity to build up indoors.

3. Take a warm shower

Sometimes the simplest remedy is a warm shower.

Breathing moist air from a shower can help loosen mucus and temporarily make a congested nose feel more comfortable. The CDC lists breathing in steam from a shower among measures that may help people manage cold symptoms.

A shower also has an advantage over leaning over a bowl of boiling water: there is less risk of accidentally spilling scalding water onto yourself.

4. Sip warm liquids

That familiar bowl of soup or cup of tea may provide more than comfort when you have a cold.

Warm liquids can soothe a sore throat and may help ease stuffiness by encouraging mucus flow. Water, clear broth, tea, and other nonalcoholic fluids can also help maintain hydration.

For someone feeling under the weather, this is one of the easiest remedies to incorporate into the day.

5. Give your body enough time to recover

It is tempting to continue with your normal schedule despite a cold, especially when work and household responsibilities do not stop.

But rest remains one of the simplest ways to support recovery.

The CDC recommends getting plenty of rest and drinking enough fluids while managing a common cold.

For adults in their 40s and beyond who may already be juggling work, family responsibilities, and other commitments, taking a slower day or two can be more productive than pushing through while feeling unwell.

Do nasal inhalers actually unclog your nose?

Products containing ingredients such as menthol or camphor can create a cooling sensation that makes breathing feel easier.

That sensation, however, should not be confused with actually opening swollen nasal passages.

A nasal inhaler may provide temporary subjective relief, but it does not treat the virus causing a cold. Products intended for use around the nose should also be used according to their labels.

In particular, topical products containing camphor should not be placed inside or around the nostrils unless the product specifically indicates that use. Mayo Clinic warns against putting VapoRub in or around the nostrils.

Is steam inhalation safe?

Steam can feel soothing, but the traditional method of placing your face over a bowl of boiling water carries a burn risk.

Current guidance from the CDC includes breathing steam from a shower or bowl of hot water as a possible way to ease symptoms. However, Mayo Clinic cautions that hot water and steam can cause burns, particularly around children.

For a safer everyday approach, consider a warm shower or a properly maintained humidifier rather than placing your face close to boiling water.

The goal is symptom relief, not creating a hotter or more intense source of steam.

What about spicy food?

Spicy soup may make your nose run, which can temporarily give the sensation that congestion is clearing.

Warm soup and broth can also be soothing when you have a cold. However, spicy food is not a cure for the infection.

If spicy food irritates your stomach, throat, or causes heartburn, there is no need to force yourself to eat it. A warm, nourishing meal and adequate fluids are more important.

Should you take a decongestant?

Natural measures are not always enough, especially when congestion is interfering with sleep or daily activities.

Over-the-counter decongestants can provide temporary relief by reducing swelling in the nasal passages. However, they are not appropriate for everyone and can have side effects or interact with other medications.

If you take prescription medicines or have underlying health conditions, it is worth asking your doctor or pharmacist before using a decongestant.

The CDC recommends using over-the-counter medicines according to their directions and discussing them with a healthcare provider or pharmacist when appropriate.

It is also important to remember that symptom-relief medicines do not cure the common cold.

When should you see a doctor for a stuffy nose?

A stuffy nose associated with a mild cold usually improves with time. But persistent or worsening symptoms should not simply be ignored.

According to the CDC, adults should seek medical care when respiratory symptoms include difficulty breathing, dehydration, a fever lasting more than four days, symptoms lasting more than 10 days without improvement, or symptoms that improve and then return or worsen.

It is also worth contacting your healthcare provider if you have a significant underlying medical condition that becomes worse while you are sick.

Seek medical advice if you experience:

• Difficulty breathing
• Persistent or worsening symptoms
• Fever lasting more than four days
• Symptoms lasting more than 10 days without improvement
• Symptoms that improve and then become worse again
• Signs of dehydration
• Worsening of an existing chronic condition

A cold-like illness can sometimes be caused by other respiratory viruses, including COVID-19 or influenza. If you are at higher risk for severe illness, the CDC recommends contacting a healthcare provider promptly because antiviral treatment for some infections works best when started early.

A stuffy nose does not have to derail your day

Nasal congestion can make a minor illness feel much more disruptive than it needs to be. Fortunately, relief does not always require a complicated routine.

A saline nasal spray, warm shower, clean humidifier, warm drink, plenty of fluids, and adequate rest can all have a place in a sensible cold-care routine.

Most importantly, give your body time to recover and pay attention to symptoms that fall outside the usual pattern of a simple cold.

Sometimes the healthiest thing you can do is slow down, stay hydrated, get some sleep, and let your body do its work.

For more information, please contact MakatiMed On-Call at +632.88888 999, email mmc@makatimed.net.ph, or visit www.makatimed.net.ph. Follow @IamMakatiMed on Facebook and Twitter.

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Heart Health Should Start Earlier, Not When You’re Old

Heart Health Should Start Earlier, Not When You’re Old

September 08, 2026

Heart health is not something Filipinos should put off until their 50s or 60s. In fact, the habits and health markers that influence cardiovascular health can matter decades before a person experiences a heart attack or stroke.

The numbers make the issue difficult to ignore. Ischaemic heart disease was the leading cause of death in the Philippines in 2025, accounting for 19.7% of registered deaths nationwide, according to the Philippine Statistics Authority. Hypertension is also widespread, affecting about one in three adults in the country, according to the World Health Organization.

That makes heart health relevant not only to older adults, but also to people in their 30s and 40s who may still feel perfectly healthy.

Why should you think about heart health before you feel a problem?

One of the biggest misconceptions about cardiovascular health is that it becomes important only when symptoms appear.

The problem is that some cardiovascular risk factors can remain unnoticed for years. High blood pressure, for example, often has no obvious symptoms. The same can be true of high cholesterol.

By the time someone experiences chest pain, shortness of breath or another warning sign, underlying problems may already have developed.

Cardiovascular disease refers to disorders affecting the heart and blood vessels. Its major risk factors include high blood pressure, high cholesterol, high blood sugar, tobacco use, physical inactivity, unhealthy diets and harmful alcohol use.

For people approaching midlife, that is an important distinction. Heart care is not simply about reacting to illness. It is also about knowing your numbers and understanding which everyday habits may increase your risk.

What should you keep track of?

A practical heart-health check involves more than stepping on a weighing scale.

Depending on your age, health history and doctor's advice, it is worth paying attention to:

Blood pressure: High blood pressure can damage blood vessels and increase the risk of heart attack and stroke.

Cholesterol: Certain types of cholesterol can contribute to plaque buildup in arteries.

Blood sugar: Elevated blood glucose is associated with cardiovascular risk.

Weight and waist circumference: Excess body fat, particularly around the abdomen, can be associated with higher cardiovascular risk.

Physical activity: Regular movement helps support cardiovascular fitness and can improve several risk factors.

Smoking and alcohol use: Both can affect cardiovascular health.

These are not simply numbers to collect during an annual checkup. They provide a clearer picture of your health than relying on how you feel on a particular day.

Why cholesterol deserves more attention in midlife

Cholesterol often gets a bad reputation, but the body actually needs it. It plays roles in making hormones and supporting other essential functions.

The concern is having unhealthy levels of certain blood lipids. Over time, excess cholesterol can contribute to plaque accumulation in arteries, potentially restricting blood flow.

The tricky part is that high cholesterol usually does not announce itself with obvious symptoms. A person can feel energetic, work full-time, exercise occasionally and still have an unhealthy cholesterol level.

That is why testing matters.

For people in their 40s and beyond, cholesterol is particularly worth discussing with a healthcare professional because cardiovascular risk can change with age, family history, lifestyle and other health conditions.

And cholesterol should not be considered in isolation. Blood pressure, blood sugar, weight, smoking status, physical activity and family history can all form part of the bigger cardiovascular picture.

Heart health is also about the habits you repeat

There is no single food, supplement or lifestyle trick that protects the heart on its own.

Instead, cardiovascular health is influenced by patterns repeated over years.

The WHO identifies unhealthy diet, physical inactivity, tobacco use and harmful alcohol consumption as major behavioral risk factors for cardiovascular disease. These can contribute to high blood pressure, abnormal blood lipids, elevated blood sugar and overweight or obesity.

For Filipinos, heart-friendly habits do not have to mean abandoning familiar food or adopting an extreme routine.

Simple changes can include:

• Move more throughout the week. Walking, dancing, gardening, household chores and other activities can contribute to regular physical activity.
• Pay attention to salt and highly processed foods. Many familiar Filipino dishes and condiments can be high in sodium.
• Eat more vegetables, fruits and whole foods. These can replace some highly processed and heavily sweetened choices.
• Avoid tobacco. Smoking is a major cardiovascular risk factor.
• Keep alcohol consumption in check. Less is better for cardiovascular health.
• Have your health markers checked. Blood pressure, cholesterol and blood sugar are easier to address when you know where you stand.

WHO Philippines has similarly emphasized regular physical activity, healthier food choices and routine checks of blood pressure and blood sugar as practical components of heart care.

Where do heart-health supplements fit?

The growing interest in preventive health has also created a market for dietary supplements marketed around cholesterol, circulation and cardiovascular wellness.

LAC Philippines is using World Heart Day to highlight two of its products: LAC Activated Heart Protect and LAC Activated Cholesterex.

According to the company, Heart Protect contains nattokinase, lecithin and hawthorn and is positioned around circulation and cardiovascular support. Cholesterex contains red yeast rice, plant sterols, lecithin, policosanol and beta-glucan and is positioned around cholesterol and blood-vessel support.

These are dietary supplements, not substitutes for medical diagnosis or prescribed treatment. Anyone taking medication for hypertension, high cholesterol, diabetes, blood clotting or other cardiovascular conditions should discuss supplements with a healthcare professional before using them.

This distinction matters because "natural" does not automatically mean risk-free, and supplements can interact with medicines or may not be appropriate for everyone.

For someone concerned about cholesterol or cardiovascular risk, the more useful first step is to know their health numbers and discuss them with a qualified healthcare professional.

What does World Heart Day have to do with this?

World Heart Day is observed every September 29. In 2026, the World Heart Federation is focusing on the message that heart disease can remain hidden and encourages people not to overlook cardiovascular risk.

The timing is particularly relevant for Filipinos.

The latest PSA data show that ischaemic heart disease remained the country's leading cause of death in 2025, with 122,339 registered deaths.

Meanwhile, WHO says cardiovascular diseases are the world's leading cause of death and that many cardiovascular conditions can be prevented or managed by addressing modifiable risk factors and detecting problems early.

For people in midlife, that message is less about becoming obsessed with health numbers and more about refusing to wait for a health scare before paying attention.

A better approach to heart health after 40

Turning 40, 50 or beyond does not automatically mean heart problems are around the corner.

It does, however, provide a good reason to become more intentional about preventive health.

Instead of asking, "Do I feel healthy?" ask more useful questions:

• When was my last blood pressure check?
• Do I know my cholesterol levels?
• When was my last blood sugar test?
• Am I getting enough physical activity?
• How much salt, sugar and highly processed food do I regularly eat?
• Do I smoke or regularly drink alcohol?
• Do I have a family history of heart disease, diabetes or hypertension?
• Am I taking medications or supplements that I should review with my doctor?

These questions can turn heart health from an abstract concern into something practical.

And perhaps that is the bigger lesson of World Heart Day: you do not have to wait until you are old to start taking care of a heart that has been working for you all along.

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The Psychology Behind the Confidence Economy: Why Feeling Like Yourself Again Matters More Than Looking Like Someone Else

The Psychology Behind the Confidence Economy: Why Feeling Like Yourself Again Matters More Than Looking Like Someone Else

September 03, 2026

More Filipinos are redefining what it means to invest in themselves. According to multi-awarded aesthetic physician Dr. James Co, Architect of Aesthetic Confidence and founder of Cosma Institute, confidence has quietly become one of the most overlooked forms of self-investment, influencing how people communicate, pursue opportunities, and experience everyday life.

For decades, investing in yourself followed a familiar formula. People pursued higher education to advance their careers, exercised to improve their health, and invested in personal development to strengthen their skills. As conversations around wellness evolved, mental health, emotional resilience, and work-life balance also became essential parts of personal growth. According to Dr. James Co, another form of self-investment is quietly joining that conversation: confidence.

Unlike education or professional experience, confidence is rarely viewed as something people intentionally develop. Yet it influences everyday decisions, from speaking up during an important meeting and applying for a promotion to starting a business or reconnecting with old friends. Although difficult to measure, confidence often shapes how people participate in life.

After years of treating patients and training aesthetic practitioners across Southeast Asia and Europe, Co has witnessed this shift from an unexpected place: the consultation room.

“When I first started practicing, many patients came into the clinic wanting to look like someone else,” Co said. “Today, those conversations are very different. Patients are no longer asking how to copy another person’s face. They’re asking how they can feel more like themselves again. Many tell me, ‘Doctor, I used to look like this,’ or ‘I used to feel more confident.’ Life happens. We get older, careers become demanding, we raise families, or go through difficult experiences. More often than not, they’re not trying to become someone new. They’re trying to reconnect with the version of themselves they remember.”

For Co, this shift extends far beyond aesthetic medicine. Whether someone pursues higher education, works with a therapist, joins a fitness program, develops leadership skills, or seeks aesthetic treatment, the motivation is often the same: becoming more confident and more willing to participate fully in life.

Drawing from years of patient consultations, Co describes this emerging mindset as the Confidence Economy, a framework that explains why confidence has become one of today’s most valuable forms of self-investment.

“The phrase isn’t about beauty or aesthetics,” he explained. “It’s about understanding why people invest in themselves. At the heart of many of those decisions is the desire to become more confident, not because they want to become someone else, but because they want to become more comfortable being themselves.”

Modern life has made confidence more visible than ever. More than a personality trait, confidence has become a life skill that influences careers, relationships, and everyday interactions.

Professionals are expected to lead presentations, entrepreneurs build personal brands, and digital platforms have made people increasingly aware of how they present themselves. Confidence has evolved from being a personality trait into a life skill that influences careers, relationships, and everyday interactions.

This changing mindset also challenges one of the biggest misconceptions about aesthetic medicine. Cosmetic treatments are often associated with vanity, yet many of Co’s patients are preparing for something much bigger than changing their appearance. Some are returning to work, pursuing a promotion, starting a business, or entering a new chapter of life. For them, appearance is only one part of a much larger journey.

“In many consultations, the treatment itself is rarely the destination,” Co said. “Confidence is. People aren’t asking to become someone else. They’re asking for their appearance to reflect how they already feel inside.”

The Psychology Behind Confidence

Decades of psychological research support the relationship between self-perception and confidence. Psychologist Daryl Bem’s Self-Perception Theory suggests people develop beliefs about themselves through their own actions and experiences, while later studies on Enclothed Cognition found that self-perception influences behaviour and psychological well-being. Research examining aesthetic medicine has likewise reported improvements in patient-reported self-esteem, body image, and quality of life following appropriately selected treatments, while emphasizing the importance of ethical practice, realistic expectations, and careful patient selection.

For Co, these findings reinforce what years of listening to patients have already taught him.

“The greatest compliment I receive isn’t when someone tells me they look younger,” Co said. “One of the moments that stayed with me involved a patient who returned a few months after her facial harmony treatment,” Co said. “She told me she finally felt confident enough to audition as the lead singer of a band, and she even came back to the clinic and sang for us. That wasn’t about the treatment itself. It was about removing something that had been holding her back. Moments like that remind me the conversation has never been only about appearance.”

Confidence Cannot Be Injected

For Co, the research points to an important distinction. Confidence begins long before any treatment. It is shaped by a person’s experiences, relationships, achievements, and sense of self. Aesthetic medicine, when practiced responsibly, has the potential to address an insecurity that has occupied someone’s thoughts for years, but it should never be viewed as the source of confidence itself.

“Confidence cannot be injected,” Co said. “No treatment changes who someone is or defines their worth. Our responsibility is to understand why a patient is seeking treatment before recommending anything. Sometimes treatment is appropriate, and sometimes it isn’t. Listening will always come before the procedure.”

That philosophy has defined Co’s approach throughout his career and earned him recognition as the Architect of Aesthetic Confidence. His approach to aesthetic medicine has also earned industry recognition, most recently at the Merz Aesthetics Tala Awards, where he received two awards at the recently held ceremony.

Rather than focusing solely on technical outcomes, he advocates consultation-led aesthetic medicine that begins with understanding a patient’s goals, lifestyle, and motivations before discussing treatment options. Every recommendation, he believes, should support long-term well-being rather than respond to trends.

This philosophy also reshapes how aesthetic medicine is often understood.

“When people think about aesthetics, they often think about looking younger or changing the way they look,” Co said. “What I see every day is something much more personal. I see people preparing for a new chapter in their lives. They want to walk into an interview with confidence, deliver a presentation without worrying about an insecurity, celebrate milestones with family, or simply feel more comfortable being seen. Those are very human motivations.”

For Co, this is where the idea of the Confidence Economy becomes most relevant. It is not limited to aesthetic medicine. Whether people invest through education, therapy, fitness, leadership development, communication training, or aesthetic care, they are often pursuing the same outcome: becoming more confident and more willing to engage fully with life.

Confidence, he believes, deserves a place alongside conversations about physical and mental well-being. Although it will never appear on a medical chart, it influences how people apply their skills, build relationships, embrace opportunities, and navigate change. In many ways, confidence bridges the gap between potential and action.

“As physicians, we naturally focus on improving health,” Co said. “But confidence also shapes quality of life in ways we don’t always recognize. When someone is no longer distracted by an insecurity they’ve carried for years, they often become more present, more engaged, and more willing to participate in opportunities they once avoided. That’s why these conversations matter.”

The Future of the Confidence Economy

Looking ahead, Co believes the future of aesthetic medicine will be defined less by changing beauty ideals and more by understanding the people behind every consultation. As expectations continue to evolve, he believes the profession’s greatest responsibility will remain helping patients make thoughtful, informed decisions that align with their own goals rather than external pressures or passing trends.

“The future of aesthetic medicine isn’t about changing faces,” Co said. “It’s about understanding people. Every patient has a story, and every consultation begins by listening to that story. Our role isn’t to feed insecurities or convince people they need to change. It’s to help patients develop a healthier perception of themselves and make informed decisions that align with their own goals. If we can help someone become more comfortable with who they already are, we’ve done our job.”

For Co, the Confidence Economy is ultimately about participation, not appearance. Whether people invest through education, healthcare, leadership development, therapy, fitness, or aesthetic medicine, the goal is often the same: removing barriers that prevent them from showing up fully in their own lives.

Confidence will never replace talent, experience, or hard work. But it often determines whether people choose to use them. It influences whether someone raises a hand in a meeting, accepts a leadership opportunity, starts a business, or steps into unfamiliar situations despite uncertainty. In that sense, confidence is more than an emotion. It is the bridge between potential and action.

As more Filipinos continue investing in their personal growth, conversations around self-investment are also changing. Success is no longer measured only by educational achievements, professional milestones, or financial security. Increasingly, it is also measured by how confidently people engage with the opportunities, relationships, and experiences that give life meaning.

For Co, that shift represents the real significance of the Confidence Economy. It reframes confidence not as a luxury or a personality trait, but as an essential part of overall well-being and personal growth. It is also the philosophy that guides every consultation at Cosma Institute, where understanding the person always comes before discussing the procedure.

“Looking better was never the goal,” Co said. “Feeling better was.” Because in the end, the greatest investment people make is not in changing who they are. It is in becoming comfortable enough with themselves to fully participate in the life they want to live.

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Suicide Warning Signs: What We Need to Notice When Someone Is Struggling

Suicide Warning Signs: What We Need to Notice When Someone Is Struggling

August 27, 2026

Sometimes the people who need help the most are the ones who appear to be doing fine. A person can continue working, attending family gatherings, socializing and even making plans while privately struggling with overwhelming emotional pain.

Recognizing suicide warning signs therefore requires more than looking for obvious signs of depression. According to psychiatrist Carmina Charmaine G. Bernardo, MD, people may experience suicidal thoughts following mental health conditions, traumatic experiences, financial or relationship difficulties, serious illness, or intense feelings of worthlessness and loneliness.

For adults in their 40s and beyond, this is an important reminder. We may be in a position where friends, siblings, spouses, colleagues or adult children turn to us during difficult periods. Sometimes, noticing a change in someone's behavior and taking the time to ask a direct question can make an important difference.

What can trigger suicidal thoughts?

Suicidal thoughts do not have one single cause.

Dr. Bernardo, a psychiatrist and head of the Mood and Anxiety Resource and Referral Center at Makati Medical Center, explains that mental illness or personality disorders can affect judgment. However, a significant life event can also become a trigger, particularly when someone already feels overwhelmed.

Possible stressors include:

• Death of a loved one
• Relationship breakdown
• Physical or emotional abuse
• Serious financial problems
• Career setbacks
• Painful or terminal illness
• Feelings of worthlessness
• Loneliness
• Feeling like a burden to others

A difficult event does not automatically mean someone will become suicidal. Rather, the concern is when distress becomes overwhelming and the person begins to see death as a way to escape what feels like unbearable pain.

That distinction matters because it prevents us from making assumptions about who is or is not at risk.

What are the warning signs of suicide?

Some warning signs can be visible, while others are subtle.

Common changes may include losing interest in activities that once brought enjoyment, withdrawing from family and friends, significant changes in sleep, or expressing hopelessness.

However, not everyone follows the same pattern.

1. Sudden withdrawal or loss of interest

Someone who normally enjoys spending time with family or friends may begin avoiding social contact.

They may also lose interest in hobbies, activities or routines that previously mattered to them.

One isolated change does not necessarily indicate suicidal thinking. A pattern of significant behavioral changes deserves greater attention, particularly when accompanied by expressions of hopelessness or despair.

2. Reckless or self-neglecting behavior

A person who suddenly stops taking care of their safety or health may need support.

Dr. Bernardo identifies behaviors such as excessive drinking, dangerous driving, skipping medical appointments or failing to take prescribed medication as potential warning signs.

For someone managing chronic health concerns, this can be particularly important to notice. Changes in medication adherence or medical appointments should not automatically be interpreted as suicidal behavior, but they may warrant a compassionate conversation about how the person is coping.

3. Unexpected goodbyes

One of the more difficult signs to recognize is unusual activity involving friends and family.

Someone may suddenly seek out particular people, resolve old conflicts, ask for forgiveness or give away possessions that are important to them.

These actions can have many explanations, so they should not be treated as proof that someone intends to die. But when they occur alongside other warning signs, they should be taken seriously.

4. A sudden change after severe depression

Perhaps one of the most confusing situations is when someone who has appeared deeply depressed suddenly seems calm or unusually happy.

Dr. Bernardo cautions that this does not necessarily mean the underlying problem has disappeared. In some circumstances, a sudden change may occur after a person has made a decision about suicide.

For loved ones, that is a reason to remain attentive rather than assuming everything has returned to normal.

Why birthdays and holidays can be difficult for some people

Certain dates can intensify difficult emotions.

Birthdays, anniversaries and holidays may remind people of loss, loneliness, relationship difficulties, aging or major changes in their lives.

This can be especially relevant for adults entering midlife and later years, when significant transitions may occur. Children may leave home, parents may become ill, careers may change, relationships may end, and retirement may alter daily routines.

The important point is not to assume that a particular date will be difficult for someone. Instead, pay attention when a loved one has previously struggled around an anniversary or other meaningful occasion.

A simple call or invitation can be meaningful.

Should you ask someone if they are thinking about suicide?

Yes. A direct, compassionate question can open a conversation that might otherwise never happen.

Asking someone whether they are thinking about suicide does not mean putting the idea into their head. The more important considerations are how the question is asked and what happens afterward.

Choose a private moment and speak calmly.

You might say:

"I've noticed that you've been struggling lately. Are you thinking about hurting yourself or ending your life?"

Then listen.

Do not immediately argue, lecture, criticize or tell the person that their problems are not serious. Give them an opportunity to explain what they are experiencing.

Listening does not mean agreeing with suicidal thoughts. It means allowing the person to talk while you assess whether they may be in immediate danger.

What should you do if someone may be in immediate danger?

The level of risk matters.

According to Dr. Bernardo, the greatest concern is when someone has a specific suicide plan, access to the means to carry it out, a planned time and an intention to act.

If you believe an attempt may be imminent:

• Stay with the person. Do not leave them alone.
• Seek emergency professional help immediately.
• If it can be done safely, reduce access to potentially lethal means, including medications or weapons.
• Bring the person to the nearest hospital or emergency facility when appropriate.
• Contact local emergency services if immediate intervention is needed.

Do not attempt to manage an imminent suicide crisis by yourself.

Professional mental health and emergency services are there for situations that exceed what family and friends can safely handle.

What can family members do before a crisis happens?

Suicide prevention does not begin only when someone is already in immediate danger.

It can begin with ordinary conversations.

For families, particularly those supporting older parents, siblings, spouses or adult children, maintaining regular contact can make changes easier to notice.

Instead of waiting for someone to say, "I need help," ask how they are actually doing.

Questions such as these can open the door:

• "How have you really been feeling lately?"
• "You don't seem like yourself. Is something bothering you?"
• "What has been the hardest part of the past few weeks?"
• "Do you want to talk about it?"
• "How can I support you?"

The goal is not to become a therapist. It is to make it easier for someone to admit that they are struggling.

Why this matters as we get older

Mental health conversations do not become less important with age.

Adults in their 40s, 50s and beyond may be navigating several major changes at the same time. Career uncertainty, financial pressure, caregiving responsibilities, bereavement, relationship changes, physical illness and concerns about aging can all affect emotional well-being.

There can also be a tendency among adults to minimize distress because they believe they should already know how to handle life's problems.

But emotional pain is not a sign of failure.

Someone can have a successful career, a loving family and financial stability and still experience depression or suicidal thoughts. Conversely, a person experiencing financial or personal difficulties may not necessarily be suicidal.

This is why observation and conversation are more useful than assumptions.

What not to do when someone opens up

When someone says they are thinking about suicide, avoid responses that dismiss or minimize their experience.

Statements such as "You have so much to be thankful for," "Think about your family," or "Others have it worse" may be intended to help but can make a distressed person feel misunderstood.

Instead:

• Listen without judgment.
• Take what they say seriously.
• Ask directly about their safety.
• Encourage professional help.
• Stay connected.
• Act quickly if there is an immediate risk.

Most importantly, do not promise to keep suicidal intentions secret if doing so could put the person's life at risk.

Suicide prevention begins with noticing

There is no single appearance or personality associated with suicide risk.

Some people withdraw. Others continue with their daily routines. Some show obvious distress, while others conceal it. A sudden change in behavior can sometimes be more important than how a person appears on any given day.

That is why paying attention matters.

A phone call, an invitation to have coffee, or simply asking, "How are you really doing?" may not solve someone's problems. But it can remind them that they are not facing those problems completely alone.

Recognizing suicide warning signs is not about becoming an expert at diagnosing another person's mental health. It is about noticing significant changes, taking expressions of hopelessness seriously and knowing when professional help is needed.

For those of us who are supporting aging parents, spouses, siblings, friends or adult children, staying connected can be one of the most practical forms of care.

And when someone may be in immediate danger, the responsibility is not ours to handle alone. Professional and emergency help should be sought without delay.

If you or someone you know is in immediate danger of suicide or self-harm, contact your local emergency service or go to the nearest emergency department.

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