PROLOGUE
I know this is a cliché but I have to say it, life is so unpredictable. One moment I was well and kicking, the next I was threatened to be cut up. And then I would say my recovery was fantastically fast, hindsight.
MAIN
Sun 4 Apr: Flew to Thailand for meeting in Sriracha Refinery. Thai food dinner at a restaurant with Mai, JJ, Mun Cheng, Kinno, Jimmy. Good food.
Mon 5 Apr: An apple for breakfast. Sandwich lunch in refinery. Flew to Malaysia. Green curry chicken with rice for dinner on the plane, good.
Tue 6 Apr: Breakfast in Admiral Cove hotel and lunch in Port Dickson Refinery. Flew to Singapore. Dinner with family at home, cabbage, fish, "water" egg.
Wed 7 Apr, 10pm: Had potato chips (wasabi flavor) with Ling, followed by chrysanthemum tea brewed by mother
Wed 7 Apr, rest of night till next morning: Stomach churning, thought it was gastric. Woke up several times due to this pain. Took a Veragel - DMS pill. No help.
Thu 8 Apr, 6am: Pain still bearable, brought Yeng to take school bus as usual. Mentioned to her about my stomach pain. Passed motion twice, first time normal to soft, second time soft with air. Bread with cheese and butter, and Milo for breakfast.
Thu 8 Apr, 7.30am: Saw Dr John Ng in PE clinic. Diagnosis: Food poisoning. Gave me 1 day MC and medication (Lomotil, Ultracarbon, Buscopan 10mg). Took 1x Buscopan and 2x Ultracarbon 1 hour later. Borrowed plastic bag from Farida before heading to meet Ling.
Thu 8 Apr, 9am: Waiting for Ling at Pioneer guide house and sweating with pain, guard also noted my condition. Vomited in car. Lucky had plastic bag.
Thu 8 Apr, rest of morning: Wriggled with pain on bed. Finally agreed with family advice to seek a second opinion.
Thu 8 Apr, 12noon: Nam San clinic last patient for the morning. Diagnosis stomach flu. Gave me an injection. Also, advised if my condition continued, will have to admit me to hospital. Can’t remember if I had lunch.
Thu 8 Apr, pm: Continued irregular vomiting and constant stomach pain. Vomited most of stomach content. Vomit starting to look greenish and tasted bitter. Can’t remember if I had dinner.
Thu 8 Apr, 8+pm: Decided need further medical help. Visit Nam San clinic again. Bypassed other patients. Doctor wrote letter for me to
Thu 8 Apr, 9pm: Got into AH A&E Observation Room within 5min of arrival. They did not give me anything except Potassium Chloride intravenous injection, and told Ling confidently I’ll walk out the next morning.
Fri 9 Apr, not sure time: Drifting between uneasy sleep and painful semi-consciousness. Vomited once into plastic bag I was holding. Nobody in Observation Room noticed or bothered to notice. A drunk or drugged Malay man came in, not sure what time. He kept making noise and struggled. His drama helped distracted my own pain but also reduced my sleeping or resting time.
Fri 9 Apr, 4am: Somehow managed to talk to the lady doctor who saw me earlier. Couldn’t see her face because she had a mask on all the time. Told her my condition had not changed and the vomit. She said I needed to be admitted.
Fri 9 Apr, 5am: Wheeled into Ward 4 Bed 11. Two young men/doctors went through a Q&A. Quite nice chaps. Never saw them again. Another young man/medic came asked if I would like to participate in HIV test. Somehow I did not get angry for his insensitiveness to my painful condition and the awful timing. This could have set my mood for the rest of the stay; patient, friendly, firm, etc. I answered him “no”. All these while, and for the whole of my stay in AH, the intravenous drip was my 24/7 companion.
Fri 9 Apr, rest of the day: Lost track of how many different groups of doctors came through and the Q&A repetitions. One Indian man/doctor did recommend I go for x-ray when he found out I was vomiting on a regular 2-hourly regime. By the time the second x-ray result came out around 5pm, it confirmed fluid was building in my mid section. It looked like the fluid could not find a downward outlet, it could only escape by going up, out through my mouth. He and other doctors suspected there could be some blockage in my system and they passed my case to GS (General Surgery).
Had an Indian man for a neighbor. Feisty old man. He seems only know a smattering of malay. His story: single, living alone, fell down and broke his arm.
Fri 9 Apr, late afternoon: Two young men/doctors (one Chinese, one Indian) from GS came to interview me. Repeated same diagnosis. Added they would refrain from sending me for further scanning like CT scan, on concern that I already had 2 x-rays. One time, YL showed the Indian doctor, Dr Ganesh, a photo of my vomit and I timed a vomit right there and then. Dr Ganesh immediately ordered a CT scan for my and I was rolled into a room with a big donut and a table through its center around 8pm.
Fri 9 Apr, 9-10pm: Dr Ganesh and the Chinese doctor visited again. He confirm bowel blockage and suggested possible solutions: 1. Surgery, 2. Put a tube through my nose into my stomach to drain the fluid in my abdomen, then wait and see (lets call this the drain-wait method), or 3. Just wait and see. They suggested option 1, surgery. The Chinese doctor went through what seemed like standard prep statements and shoved a stack of papers for me to sign. I thought for a moment and asked him again if there is any other alternatively. He answered there is no alternative. I signed on the dotted line. Called Ling to come.
Fri 9 Apr, before Ling joined me: Dr Ganesh came again. He suggested the drain-wait method. I agreed. He got a tube through my nose. Asked me to swallow. I did. I vomited slightly. He continued to shove the tube into my nose. My throat kept telling me to vomit but I kept telling it to relax. Soon it stopped. Dr Ganesh took a syringe and drew out about 700-800ml of dark green fluid from my stomach. He was very surprised. I tried to tell him this was what I vomited every 2 hours. But it was lost in the “throaty” translation. He was complaining there was no nurse around to help, cause it was getting messy on him. Hey, I didn’t get any help either. Though, he being a doctor would expect better treatment. He told me to keep the tube in as it will help to relieve the fluid pressure on my intestine and it will self drain, before he left.
Fri 9 Apr, near midnight: Ling and some family members were here to see me. My stomach was getting bloated again. The tube is not draining. I asked the nurse to call for Dr Ganesh but was told he was in surgery. I could not vomit with the tube. Things became so bad I lost it. I yanked out the tube. It was much longer than I had expected, I pulled and pulled. The next thing after getting it out was to vomit. Ah. Relieved. The family members left. Shocked at my display of uncoveness.
Sat 10 Apr, after midnight: Dr Ganesh came. He was furious that I took out the tube. I tried to explain to him my reason. He tried to explain to me the importance of having the tube. I can see he was very upset, nearly to the point of telling me to do what I like, he didn’t care if I died. I was convinced he believed in it. I agreed for him to put the tube in again. I agreed to behave myself this time though not knowing what will I do if the same thing happened again. This time I did not vomit when the tube went down my nose and throat. Dr Ganesh was amazed saying I’m the only patient he say able to swallow the tube so calmly. I tried to tell him experience in such short time span helped. But again, it was lost in the throat.
Sat 10 Apr, till dawn: Drifted in and out of sleep. Saw Ling tried to rest beside me. Asked her to combine 2 chairs. She shook her head. When I opened my eyes again, saw she was trying out my advice. I’m not sure how she could have any rest for the night.
Sat 10 Apr, 7am: Went to the toilet, one hand holding a rack with my water bag dangling , another hand holding a bag of fluid connected by a tube to my stomach through my nose. While sitting on the toilet bowl, thought I give the old backside a try. I gave a squeezed in the abdomen and to my surprise, green fluid flowed out of my nose tube, into the collection bag. Aha! I’ve finally found a way to clear the fluid from my stomach. Why didn’t the doctors or nurses tell me about this method? Come to think of it, this should be obvious, isn’t it? Shared this wonderful discovery with Ling. Went to the toilet to pee and pass motion (99% green coloured fluid) another six times for the rest of the day. Got to report to the nurse each time for recording.
Sat 10 Apr, 8am: Went for a shower. Here’s method 1 for handling my water bag during shower. The nurse disconnected the bag for the period I was showering. Over the next 2 days, there were another 2 other methods used. Wonder if they have a best practice.
Sat 10 Apr, 10am: A man came to see me. He looked like in his 50s. Small built, thin and dark complexion. The front of his hair was combed high and up towards the back but not gelled. He could well be a contractor foreman if he was wearing a hard hat and overall. He carried a small brief case, wore short sleeve shirt and tight business trousers (not the type worn by young men these days, the type worn by my father when he was younger) without belt. I noticed a hole along one of the belt ring. He talked briefly to me and left. The other young doctors told me my case will now be handled by Mr. Daniel Tan.
Sat 10 Apr, 12-1pm: The hospital started to feed me liquid diet. Apple juice, clear soup (salty) and green clear jelly. Finished the apple juice, 20% of clear soup and 2 mouth of jelly (tasted awful). The Indian old man started shouting. Seems like he was not happy everyone got their lunch except him. After a while, he drew up the curtain around his bed. When he emerged again, he was changed out of the hospital clothes into his own. He was preparing to leave. The nurses looked panicked. Several of the nurse quickly came to him. A loud malay nurse who seemed to the lead nurse talked him backed to his bed and one other brought his lunch. After the nurses left, the Indian man looked at my father and I and smiled as if telling us he had won this round. Something came back to my mind. My father was helping the Indian man earlier getting water. My father said, in this kind of places, we have to help each other. He was right. There was no race, language, age differences. We, the patients, must stick together. Now, for world peace!
Sat 10 Apr, 2pm: After lunch, transferred from Medical to GS ward, Ward 12 Bed 8. But requested bed change as Bed 8 has a scaffold over it that blocks my access. Changed to Bed 13. Was feeling quite cheery to joke with people. The nurse found a rolling stand for my water bag. In addition, the infusion pump, the one that controls the intravenous drip flow rate has a chargeable battery. The other bag holding fluid flowing out of my stomach can be hooked onto the pocket on the hospital shirt. Now, I can move around pushing the rolling stand and with a bag of green fluid dangling on my shirt. Things are looking up. I was able to clear my body content through the usual paths and I got my mobility back, sort of.
Sat 10 Apr, evening: Something was wrong. I started to feel gastric pain after liquid diet dinner. Beads of sweat were flowing down my forehead and back of the neck. Asked the nurse for gastric medicine. She said the doctor did not prescribe for me but she would check. She came back with Famotidine. Not much help. I asked again for the white liquid gastric medicine, it helped the last time. No, it did not work this time. The doctor ordered a onetime phosphate drip for me after looking at the last blood test result. This one was a killer. The moment the nurse switched from my regular to this special drip, the back of my left hand felt a burning sensation. It grew and grew and became unbearable. I told the nurse it was painful. She said, yeah, this phosphate drip was expected to be painful. Why nobody warned me? The nurse tuned down the drip from 180ml/hr to 120ml/hr. The pain reduced. I told her it was still painful, I could not more my left hand. She further tuned down to 60ml/hr saying that was the minimum she could go. I was hoping for less pain but looked like I had to put up with it.
Sat 10 Apr, night: Tried to sleep off the gastric pain, couldn’t sleep. Tried different sleep positions, still pain, only slight difference in intensity. Tried going to toilet to relieve bladder, it worked. The pain went down significantly. Managed to drift off to sleep around 10pm. Awoke around midnight by the pain again. Tried same process again, cleared bladder. It worked again. Repeated the same process in 1 to 2 hour interval throughout the night.
Sun 11 Apr, morning: I thought I was going to be very exhausted having gone to the toilet at least 7 times throughout the night. Surprisingly, I felt refreshed. Breakfast was sandwich with cheese and Milo. The gastric pain came back. This time, despite peeing and passing motion eight times throughout the day, the gastric pain intensity did not reduce much.
Sun 11 Apr, 8am: Showered. This time, the nurse did not disconnect my water bag buddy. I took off my shirt through the tube in my left hand and used the shirt to cover the infusion pump while I showered. Half way through the shower, the infusion pump began to beep. My water bag was running out. The nurse stepped into the shower to change the water bag. There was soap in my eyes, I closed my eyes and tried to rub it. The nurse thought I was feeling faint. I explained. After the shower, she helped to disconnect my water bag for a few seconds so that I can change into a new hospital shirt.
Sun 11 Apr, 12noon: Plain porridge (finished 50%), tofu (finished 90%) and broccoli (finished 10%). Gastric pain started to build despite given Famotidine. By dinner time, it was unbearable. Ate <5%>
Mon 12 Apr, 8am: Kept my fingers crossed, hope to shower at home. Doctor (no name) came to check on me. She said one of my temperature point taken yesterday was 37.8degC. She would keep me till around 5-6pm for further observations before deciding whether to discharge me. She was the tall and slim one. Her mannerism portrayed a “chop chop” attitude, one who would come in to tell you and tell you, all business, one who would dominate her peers. She wore A-line dresses on the few occasions I saw her. She seems to have a sidekick, a stout and slightly meaty lady. I was also told I would have to come back on 28 Apr for a colonoscopy to ensure there was no growth or something that could have caused the blockage.
Mon 12 Apr, 9am: Daniel Tan came and repeated the “peer dominator” doctor line of thoughts. But he spoke to me like I was a person, not an answering machine. Since I was not going home soon, I decide to shower. This time I did not tell any nurse as I was getting the hang of it already. After the shower, I found a young male nurse in the shower room and asked him to help me change out of the old shirt because I still had the water bag linked to one hand. This time method 3 was used. He took the tube out of the infusion pump so that I don’t even have to disconnect the water bag at all. This was where trouble started. He could not put the tube back. He seeked help. Both he and another nurse could not get the infusion pump to work again. I had to push it back to my bed and asked the nurse who was responsible for my section to help. This nurse remarked that the IV was not required anymore. If not for the clumsy male nurse, I would have had the IV for longer. Thanks, clumsy male nurse. While the nurse was going to remove the IV, an older nurse came to talk to me able volunteering for HIV testing again. I rejected again. She then asked my reason for not doing it. My mind went blank for half a second. I almost asked her why I should do it. If I had agreed to do it, particularly in front of Ling, I could be misunderstood as admitting I could have done something that warrant a HIV test. No way. Then my mind caught up. I just said I didn’t want to do it because I am not in the high risk group. The older nurse turned threatening, saying if I don’t do it now, it will cost money to do it in the future or the government might make it mandatory if there wasn’t sufficient statistics. I stood my ground. While all these conversation was going on, the other nurse had removed the IV from my hand. She asked was it painful. I replied no because the older nurse had distracted me. But now that she mentioned it, it felt like a hammer just landed on the back of my hand. The nurse then noticed the back of my left hand was swollen. She said the IV must have come out of my vein for some time so that the drip was actually accumulating under my skin. No wonder my hand was so painful for the last 2 days. Ouch! (retarded reaction) The nurse was very nice, she took a bandage and wrapped it around the hand saying the swell should subside in a few days. I knew what she was doing. The bandage applied pressure on the swelling thereby pressing the liquid into the blood stream. Called Joyce to find out if I could claim hospital expenses. She gave me AIA contact. AIA was very helpful, just asked for my particulars to confirm my coverage plan. The Letter of Guarantee was faxed over to Alexandra Hospital in a short time. I signed of the LOG at Ward 12 admin counter around lunch time. Hope this will cover all my hospital expense and not touch my Medisave.
Mon 12 Apr, 11am: The “sidekick” doctor came around again, could not remember most of the conversation except I asked her to give me a few days of MC to recover. Her reply shocked Ling and me. She said she was giving me two weeks of MC, and asked if it was too long. Excellent, more is better than less in this case.
Mon 12 Apr, 1pm: A young larger built young doctor (man) came to see me while my temperature was taken. 37.5degC. I tried to explain it was the hot afternoon and the hot Milo in front of me. He looked at me and then said I can go home. Woo hoo! We waited for the medicine before I discharge, and waited, and waited.
Mon 12 Apr, 2-3pm: The medicine finally arrived. Besides the Famotidine, there were several that I had to take the day before the colonoscopy, these help to clear my stomach for a better view. Don’t want to think about having something up my backside for now. Changed into the T-shirt and basketball shorts Ling bought for me during lunch time from Queensway. Totally fits. We took a taxi home. I still walked like an old man because I the pain gnawing in my stomach.
EPILOGUE
The gastric pain gradually reduced over the next few days. It was almost unnoticeable on Fri 16 Apr. I was also burping and passing gas fairly frequently while having the gastric pain. It must be due to the digestive system still trying to find the right balance after stopping work for a few days. These also gradually subsided with the reduced gastric pain.
In the mean time, my diet has been restricted to soft small frequent meals. The food is also low retention type.
Whenever I told people I went to Alexandra Hospital, inevitably, I get the question “why”.
