“Why me?”
Yes, many things in our lives do make us ask God
this question. But being one of the
three out of a hundred people who will get surgical site infection (SSI) got me
searching for deeper answers. Where
could those bacteria have been lurking and then struck after nearly two months
of healing? Being scrupulously careful with wound hygiene, it just seemed
impossible that we had done something wrong.
Who or what was to blame? It would have been easy to make a case for
complaint. But the mystery of life is
that too many things happen randomly without easy explanations. How could a healthy kiasu patient like me have succumbed? Yet it did happen
despite care and caution. Just
shows that healing is not something doctors have that much control over as we
would like to believe. Somehow I can’t
even be bothered to rant and rave. I can
accept that even with a benevolent God, there will be things that can go wrong
in my life. I may not even understand
why they happen, as has been the case for many things past, but I can still be
at peace taking the bad, together with the many good things that life has
proffered.
Monday, 28 April 2014
8 April: Infection and 2nd op
While on the road to NNI for my 8 am MRI appointment, I felt some
wetness on the wound. Dabbed it with a tissue and it was yellowish. Sent Dr N a picture of the tissue and in just 10 minutes he confirmed that infection was
probable and that meant I had to be admitted immediately for another op.
I went for the MRI as scheduled. Even though the hour-long wait was less agonising this second time round (especially since I have memorised Psalm 23 down pat by now), the injection of the contrast dye was more painful. Then it was off to call on Dr A again for the results. He confirmed that the scan showed an infection at the wound site but that the brain was clean. Dr N had also been in contact with him with instructions for my readmission. Sent to Room 16 again to settle the costing. The estimate was $10K for a 3-day stay. While waiting there for a bed, Dr N came around 11 am after his op duties to see me. He examined the wound and then explained the details of the wound cleaning and removal of the original bone flap.
Checked into the room at Ward 13B at around 1 pm. A group of 3 doctors including one who was present at my first op came by to take a sample of the pus. The one doing it really did a mean job squeezing and pressing my head. Ouch! What was worse was when one of them came by to insert a needle into a vein near my wrist. He really botched it, spilling much blood and not succeeding after numerous tries. Double ouch! It irked me so much I fell back in a faint. The nurse who came by later managed to do it effortlessly.
I went for the MRI as scheduled. Even though the hour-long wait was less agonising this second time round (especially since I have memorised Psalm 23 down pat by now), the injection of the contrast dye was more painful. Then it was off to call on Dr A again for the results. He confirmed that the scan showed an infection at the wound site but that the brain was clean. Dr N had also been in contact with him with instructions for my readmission. Sent to Room 16 again to settle the costing. The estimate was $10K for a 3-day stay. While waiting there for a bed, Dr N came around 11 am after his op duties to see me. He examined the wound and then explained the details of the wound cleaning and removal of the original bone flap.
Checked into the room at Ward 13B at around 1 pm. A group of 3 doctors including one who was present at my first op came by to take a sample of the pus. The one doing it really did a mean job squeezing and pressing my head. Ouch! What was worse was when one of them came by to insert a needle into a vein near my wrist. He really botched it, spilling much blood and not succeeding after numerous tries. Double ouch! It irked me so much I fell back in a faint. The nurse who came by later managed to do it effortlessly.
6-7 April: Suspicious swelling
It was past midnight on a Sunday when there was a worrying swelling
on the wound, together with what looked like pus buildup. Gosh, how
can there be infection after nearly 2 months of healing progress?
Feelings of dread washed over me. Emailed some pictures to the doctor
despite feeling bad that I was disturbing him at such a late hour. He
replied 5 minutes later (bless his heart!) and though the picture wasn't clear, he wanted me to get checked in
the morning. He would
arrange for somebody else to see me as he was operating,. That gave a smidgen of comfort.
Reported at 9.30 am the next morning but had to wait a while before getting seen by Dr A, a rather young doctor. He didn't think it was serious but scheduled me for an MRI the next morning at 8 am, to be on the safe side. It would cost a whopping $1,200!
Reported at 9.30 am the next morning but had to wait a while before getting seen by Dr A, a rather young doctor. He didn't think it was serious but scheduled me for an MRI the next morning at 8 am, to be on the safe side. It would cost a whopping $1,200!
Sunday, 27 April 2014
Doctor just a click away
What a privilege it has been to have my very own doctor just a click away. I was so surprised that his email reply came so quickly the first time. Now, I know for sure that he will bother to reply to every one of my concerns, big or small, like his life depended on it. He was patient in explaining things and genuinely caring despite the minutest of anxieties that beset me during this vulnerable time. And he did all this even at 2 am. Neurosurgeons must be needing less sleep than other humans! Though he must be a very busy person being as important as he is in his department, Dr N took pains to attend to me over virtual space when there were no extra rewards to be gained in terms of fame or fortune. Quite a few times, it has led to follow up visits to the clinic. It would not have been remiss of him to ignore such extraneous demands on his time and attention, yet it seems like his duty to do so.
My smartphone has been a real boon through this communication channel. I have sent over pictures of the surgical wound and other dramatic developments for his assessment. His immediate responses have helped avert many a problem, especially when the wound suddenly developed an infection after 2 months of healing. During this crisis, his concern was palpable as he frequently emailed to check on me.
Pity him if he has more patients like me jamming his inbox!
My smartphone has been a real boon through this communication channel. I have sent over pictures of the surgical wound and other dramatic developments for his assessment. His immediate responses have helped avert many a problem, especially when the wound suddenly developed an infection after 2 months of healing. During this crisis, his concern was palpable as he frequently emailed to check on me.
Pity him if he has more patients like me jamming his inbox!
The blessing of family and friends
Throughout this period, there has never been a moment for me to feel lonely in my pain or recuperation. My family's love and attention have been overflowing, especially from L. They took turns to be with me for every visit to NNI to ensure that I was safe and supported. While I was at TTSH, they came every day (and more than once a day for L). Just being with me helped me feel so cherished as wife and mum.
The same is true of my friends. Even though we had indicated that I would rather not have visitors during my hospitalisation, many still came as they were above 'visitor' status (like my brother, Julie and David, Ah Pheng, and Yiling) or considered themselves so (like Daniel Tan, Norman, Liz and Ai Choo, Alan and Stacey, and Tim and Patsy).
The rest of the ex-Glasgow gang also rallied around after I returned home: Beng Hong and Ros, and James, Monica and Connie. The home-brewed ginseng chicken from Monica was a real treat. Liz and Ai Choo dropped in for a repeat visit too. My colleagues William and Shakila came separately. I was quite touched when my ex-ETD colleagues Nat, Lynde and Mano took the trouble to see me. So too Janet Ling, Elaine, and Alan Goei together with Wen and Jennifer.
Sis-in-law Ah Tai also came by many times with nutritious snakehead fish and double-boiled chicken soups. I received so much chicken essence that I could set up shop. Fruit and floral gifts were also sent by TPMC, PLMC, PLMGS, ELIS, and Kheng Hock and Irene. What was most precious were the many prayers from the many PLMC members like those from our cell, and Alice and Wendy.
The same is true of my friends. Even though we had indicated that I would rather not have visitors during my hospitalisation, many still came as they were above 'visitor' status (like my brother, Julie and David, Ah Pheng, and Yiling) or considered themselves so (like Daniel Tan, Norman, Liz and Ai Choo, Alan and Stacey, and Tim and Patsy).
The rest of the ex-Glasgow gang also rallied around after I returned home: Beng Hong and Ros, and James, Monica and Connie. The home-brewed ginseng chicken from Monica was a real treat. Liz and Ai Choo dropped in for a repeat visit too. My colleagues William and Shakila came separately. I was quite touched when my ex-ETD colleagues Nat, Lynde and Mano took the trouble to see me. So too Janet Ling, Elaine, and Alan Goei together with Wen and Jennifer.
Sis-in-law Ah Tai also came by many times with nutritious snakehead fish and double-boiled chicken soups. I received so much chicken essence that I could set up shop. Fruit and floral gifts were also sent by TPMC, PLMC, PLMGS, ELIS, and Kheng Hock and Irene. What was most precious were the many prayers from the many PLMC members like those from our cell, and Alice and Wendy.
Saturday, 26 April 2014
12-16 Feb: Ward stay
One thing that impressed me was how much nicer the nurses and amahs were. The nurses from the Philippines stood out. Most of them were genuinely attentive and eager to please. There was a world of difference in service standards compared to the last time I was hospitalised in 1987, 17 years ago. My own surgeon, Dr N turned up nearly every morning including Sunday, to check on me. What a real gem this dedicated doctor was in his kind and reassuring ways.
What wasn't nice was the nausea and my pounding head. All the nice meals were wasted as my appetite had left me. The only things that went down well were warm sugarless Milo and cool barley drinks. Sleep was fitful as the nurses had to check on my vitals every hour or so. Not being able to rest on the right side of my head didn't help too. I stayed an extra day and only left the hospital on Sunday 16 Feb, after a total of 6 days.
What wasn't nice was the nausea and my pounding head. All the nice meals were wasted as my appetite had left me. The only things that went down well were warm sugarless Milo and cool barley drinks. Sleep was fitful as the nurses had to check on my vitals every hour or so. Not being able to rest on the right side of my head didn't help too. I stayed an extra day and only left the hospital on Sunday 16 Feb, after a total of 6 days.
11 Feb: A day at the ICU
After being wheeled to the ICU a doctor came by to ask weird questions. Asked where I thought I was, I uttered unhesitantly, "SGH". Now why did I say such a ridiculous thing? Next question: What time was it? Now, how would I know, right? But then she directed me to the clock that was hanging on the left wall. Must be an amusing game for these doctors hearing the nonsensical things from patients fresh from their GA stupor.
The most memorable thing about this small space was being very 'connected'. Tubes and wires were all over me to pump in glucose and medication, measure my heart and blood pressure and drain my urine. Tight support leggings were also yanked up my legs for circulation. Really felt like being trapped in a straightjacket as panic screamed voicelessly deep within me.
The family came. Was pleasantly surprised to have Daphne drop by too. I spent one night there and by Wednesday, the next afternoon, I was liberated and sent to the normal ward at 13B, Room 20.
The most memorable thing about this small space was being very 'connected'. Tubes and wires were all over me to pump in glucose and medication, measure my heart and blood pressure and drain my urine. Tight support leggings were also yanked up my legs for circulation. Really felt like being trapped in a straightjacket as panic screamed voicelessly deep within me.
The family came. Was pleasantly surprised to have Daphne drop by too. I spent one night there and by Wednesday, the next afternoon, I was liberated and sent to the normal ward at 13B, Room 20.
Wednesday, 23 April 2014
11 Feb: Post op daze
I can't even remember whether I was roused by anyone when I emerged from GA. The MVD had taken four hours. Now, I
was in a recovery area bustling with other patients in their beds and their surgeons and medical staff tending to us. The first thing that hit me was a bludgeoning headache, a busted upper lip and bruised cheeks. Tried to catch somebody's attention but it was really like trying to lock eyes with evasive waiters in a restaurant. Eventually some vaseline was put on my lip and cheeks.
Won't be able to forget the big commotion when an elderly Indian lady (she sounded like one) kept on shouting at the staff that she wanted to go home and didn't want to have her op. Somebody had irked her somehow and caused her outburst. There was also urgent arrangement around another patient who was to be transported back to NUH after the op. Wondered why he/she didn't have it at NUH. Was it a good reflection of the surgical team or facilities at TTSH? At one juncture, a doctor stopped by my bed to remark to a nurse that patients having had my type of procedure would be into major vomitting. Well, it hadn't hit me yet but soon enough, I had to call for a puke bag. In my GA-laden daze, I wasn't sure whether my own surgeon did come by to talk to me or I had dreamt it. He told me that the surgery went well despite finding more arteries that compressed against my nerve than the one they saw on the MRI. Later, I found out that what I thought I heard was actually the case.
After an intolerable wait, a doctor was assigned to move me to the ICU. But she was suddenly summoned away by a surgeon to do some errands for another patient. The nurses who took over made much of the fact that she'd failed to do the necessary paperwork for my moving. Looks like inexperienced doctors do come in for bullying by more experienced nursing staff too.
Won't be able to forget the big commotion when an elderly Indian lady (she sounded like one) kept on shouting at the staff that she wanted to go home and didn't want to have her op. Somebody had irked her somehow and caused her outburst. There was also urgent arrangement around another patient who was to be transported back to NUH after the op. Wondered why he/she didn't have it at NUH. Was it a good reflection of the surgical team or facilities at TTSH? At one juncture, a doctor stopped by my bed to remark to a nurse that patients having had my type of procedure would be into major vomitting. Well, it hadn't hit me yet but soon enough, I had to call for a puke bag. In my GA-laden daze, I wasn't sure whether my own surgeon did come by to talk to me or I had dreamt it. He told me that the surgery went well despite finding more arteries that compressed against my nerve than the one they saw on the MRI. Later, I found out that what I thought I heard was actually the case.
After an intolerable wait, a doctor was assigned to move me to the ICU. But she was suddenly summoned away by a surgeon to do some errands for another patient. The nurses who took over made much of the fact that she'd failed to do the necessary paperwork for my moving. Looks like inexperienced doctors do come in for bullying by more experienced nursing staff too.
Tuesday, 22 April 2014
11 Feb: The microvascular decompression (MVD) procedure
It sounds like some wind will be taken out of me. If only that was
all. The decompression involved going into my brain stem to reach all
the naughty (or 'offending' in medical parlance) arteries and what-nots
that were pressing on my trigeminal nerve which had caused me 8 years of
pain. Teflon felt pads were used to separate these offending vessels
in 3-4 places. This was to fix the trouble spots of compression that
was causing the trigeminal neuralgia (TN). See one MVD website for more information. If you have the stomach to watch a video of the MVD procedure, just google it.
After 4 hours of manipulation, there was numbness which the doctor said would take weeks to months to disappear. He did have to add that 15% of patients may have to live with it the rest of their lives. Well, for most MVD patients, it won't be that unacceptable as numbness was way way better than blinding pain. It just takes getting used to, like having a permanent effect of the dentist's painkilling jab on one side of the face, together with half the tongue and teeth. Even my right eye is more wet than my left because there is less control over tear production.
After 4 hours of manipulation, there was numbness which the doctor said would take weeks to months to disappear. He did have to add that 15% of patients may have to live with it the rest of their lives. Well, for most MVD patients, it won't be that unacceptable as numbness was way way better than blinding pain. It just takes getting used to, like having a permanent effect of the dentist's painkilling jab on one side of the face, together with half the tongue and teeth. Even my right eye is more wet than my left because there is less control over tear production.
11 Feb 2014: Op Day
This was Day 12 of the Chinese New Year instead of the original date, December 17 last year. So I got to enjoy Christmas
2013 and usher in the Year of the Horse before undergoing
neurosurgery, thanks to a bad
two-week bout of
flu before the previous date. The delay was also better as L was
delayed in returning from Kunming on December 16 due to unexpected snow
that closed down the airport.
So after the Chinese New Year break, L and Daniel accompanied me to report at Tan Tock Seng's Day Surgery Centre at 7.30 am that Tuesday. Registration was smooth and soon I was summoned to enter the dreaded doorway. At least they allowed family to be around at the first stop where I changed into my op garments, which was just a back-to-front piece of fabric with sleeves. After hopping onto the bed and getting a warm kiss and cuddles, I was wheeled to the holding bay. There I was unsleeved, with laid bare except for the flimsy garment as cover. No room for any dignity here. They also put in an IV line and attached wires to my chest to measure my heartbeat. Doors slid open frequently for masked people to move in and out. Now and then one of them came to prod and poke, or else made me repeat my name and IC number. After an interminable wait, I was pushed into the OT. At least three doctors hovered around some scans, discussing in a low murmur. Dr N, my neurosurgeon was nowhere to be seen. Well, looks like everybody was hanging around waiting like an orchestra tuning up before the conductor showed up. Meanwhile, I was moved to the narrow operating table. After telling them that I was getting frozen, they wrapped me up in some inflatable warm cocoon. A gas mask was put over me and I thought this was it. Then I learnt that it was oxygen. Soon somebody mentioned that I should pass out, and I went out like a light.
So after the Chinese New Year break, L and Daniel accompanied me to report at Tan Tock Seng's Day Surgery Centre at 7.30 am that Tuesday. Registration was smooth and soon I was summoned to enter the dreaded doorway. At least they allowed family to be around at the first stop where I changed into my op garments, which was just a back-to-front piece of fabric with sleeves. After hopping onto the bed and getting a warm kiss and cuddles, I was wheeled to the holding bay. There I was unsleeved, with laid bare except for the flimsy garment as cover. No room for any dignity here. They also put in an IV line and attached wires to my chest to measure my heartbeat. Doors slid open frequently for masked people to move in and out. Now and then one of them came to prod and poke, or else made me repeat my name and IC number. After an interminable wait, I was pushed into the OT. At least three doctors hovered around some scans, discussing in a low murmur. Dr N, my neurosurgeon was nowhere to be seen. Well, looks like everybody was hanging around waiting like an orchestra tuning up before the conductor showed up. Meanwhile, I was moved to the narrow operating table. After telling them that I was getting frozen, they wrapped me up in some inflatable warm cocoon. A gas mask was put over me and I thought this was it. Then I learnt that it was oxygen. Soon somebody mentioned that I should pass out, and I went out like a light.
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