On The Brink....

NOTICE: THIS POST CONTAINS GRAPHIC IMAGES OF SURGICAL WOUNDS THAT SOME MAY FIND DISTURBING. VIEWER DISCRETION IS ADVISED

It was a relatively simple surgical procedure – a cholecystectomy – surgical removal of the gall bladder due to stone in the bladder. The procedure was done laparoscopically and I was discharged after 2 days. By the fifth day, I felt fine enough to drive. However, the seventh day (May 7, 2009) brought on acute stomach pain accompanied by vomiting. The pain grew progressively worse, spreading to my back and shoulders.

At about 1.30 p.m., I was admitted into the Emergency room of the same hospital where the surgery was carried out. An injection was given to help me deal with the pain. However, inspite of that, the pain continued and I requested, and was given, a second injection an hour later.

Although I was in acute pain and repeatedly requested for the surgeon, I was told that he was busy attending to patients in his clinic and I had to wait. Given my condition, it would have been comforting if the surgeon had dropped by and checked on me, even if for a while…his presence would not immediately cure my condition but would be a demonstration of a caring attitude…but maybe that was too much to expect? Sick patients do not just need medical care; they also need empathy and emotional support. I would not be surprised at such indifference if I were in a government hospital – but this was one of the well-patronized private hospitals in the Kelang Valley.

The accommodation I requested was not immediately available so I continued to wait in Emergency. Finally, at about 4.30 p.m., I was temporarily admitted into a suite and until then, there was still no sign of the surgeon. He finally appeared at 6.30 p.m. (5 hours from the time I was admitted into Emergency) and announced that it might be gastritis. Gastritis? I have never had that condition in the entire 5 plus decades of my existence; but since he is a doctor, I believed him. Medication for gastritis was administered.

In the meantime, more tests were carried out and on May 10, an MRI (x-ray) was conducted to confirm what the problem was. The x-ray showed that there was fluid in my abdomen, suspected to be caused by a leakage of bile into my system. The leakage was suspected to have occurred at the site where the bladder was clamped after removal. I was told that the condition could be managed in one of two ways – performing an endoscopy or administration of antibiotics. The surgeon advised that the former was an invasive procedure considering that I just had surgery and recommended the latter since the leakage was slight; judging from the time lapse from the date of surgery and the condition at hand.

Unable to endure the pain and placing my complete trust in the surgeon's professional opinion, I agreed to be treated with antibiotics for the next four days. By that time, I had developed fever and signs of jaundice (the whites of my eyes turned yellowish), my abdomen was bloated, my urine was the color of dark tea and my stool was greyish in color. My protein level had also fallen and I was given liquid protein intravenously for three days.

On the eighth day, the surgeon advised me that the leakage could not be fixed at the hospital and recommended that I be transferred to a teaching hospital of a local university where specialized services are available. I was transferred to that hospital in an ambulance on Friday, May 15.  At this hospital, I was assigned under the care of a surgeon specializing in hepatobiliary and pancreatic conditions.

The surgeon examined me later that evening and told me that he had scheduled for endoscopy the following day (a Saturday) when he would insert a stent to stop the leakage. After this procedure, he told me that he had to go out of town for the weekend and would check on me the following Monday.

In the meantime, my fever continued and at about 9 p.m. on Sunday, May 17, the surgeon showed up and told me that he had to return from his trip as I required immediate surgery. A laparotomy (abdominal surgery) was done at about 11 p.m. and when I woke up at about 3.30 a.m. the following day, I found myself in the High Dependency Surgical Ward of the hospital.

My condition had been life-threatening - the surgeon had drained about two litres of pus from my abdomen (I was suffereing from septicemia) but the worst was over. He confirmed that the leakage was caused by an injury to the common bile duct; which occurred during cholecystectomy.

On learning this, I freaked out; angry that I had to suffer physically and emotionally for the apparent negligence of a medical professional at an exhorbitant cost (total ~RM27K). I was still on dribs, I could not walk to the toilet for bodily functions and had to wear diapers, and I hated the tubes that stuck out from my abdomen, draining bile into a pouch that I had to carry. I had bouts of asthma due to stress and from there on, I went downhill emotionally to the extent that I required psychiatric help to cope with my condition. Although the worst was over, those were the darkest days of my life!

Bile Flowing out Post Surgery

Infection at surgical site

During the month-long hospital stay, I had to undergo physiotherapy to rehabilitate - not only due to the surgery but also other conditions caused by immobility as I was bed-ridden for three weeks. I also had to deal with an infection at the surgical site.

My condition requires long-term care and today, I still have a stent in my bile duct. This experience drove home the reality that life is fragile, temporary and fleeting. Since then, I have learnt to live for today and be thankful for what I have. I turned to prayers to give me the strength to go on and I wake up every day thankful that I have my health again. The laparotomy was my thirteenth surgery in the last 20 years, three of which were botched jobs that required follow-up surgeries, and these were all performed at private hospitals with supposedly specialist expertise.

Someone once said, "life is not about waiting for storms to pass - it is about learning to dance in the rain", and I am indeed learning to dance in the rain!