As the title of my entry suggests, I am going to talk about my encounter with appendicitis.
The Beginning
On the morning of 28th May, I woke up with a bad (I won't use severe because I don't think that was what I experienced) episode of gastric pain. I wasn't actually sure that it was gastric but having experienced it, that was the closest that I felt. I woke my helper up to make a simple breakfast for me but she made a heavy breakfast that consisted of toasts, egg and milo. I remember having a hard time trying to consume the food that I resorted to using utensils (yeah, I usually eat bread of any kind, including pizza with my hands).
After eating, I literally vomited everything that I consumed. For some people, vomiting is uncommon, for me though, it is quite common. I am unfortunately prone to feelings of nausea while having my menstruation, almost throughout my pregnancy and sometimes episodes of mild food poisoning. Hence, I was not overly concerned. I also defecated a lot. Following that, Nat brought me to one of the nearest clinics to see the GP. I have never visited this GP but Nat claimed that the GP (notice that I did not use the pronoun because I didn't know whether doctor was a male or female) was good.
I shared with the GP what I thought I had and in this case, gastric. She checked me by applying some pressure on my abdomen in which I responded that there was pain but not excruciating. She told me that I was quite bloated and that I should be fine after consuming some probiotics that she prescribed. However, I should see her if I had blood in my stools.
The next few days, I did not fully recover from the pain and I was mostly hunched when I walked around. Furthermore, pain can be felt if I walked fast. I thought I just needed more time to recover from whatever bacteria that was irritating my bowels and I would be alright. I continued living normally with reduced activities.
Escalation
At the 1 week mark, the following Friday, 4th June, at 3am, I was in acute pain. I could not sit down after getting up from the bed. It was so agonizing that I had to pace for about 20 minutes. I asked Nat to call the ambulance as I felt it was rather unusual. When the paramedics arrived, my pain had subsided and I almost regretted troubling the emergency team. I signed to confirm that I would not like to go to the hospital. After that, I attempted to sleep and the pain went dull and I slept till 8am.
When I woke up at 8am, it was dull pain transiting to acute pain. So, reluctantly, I had Nat accompanied me to the same GP. This time, the GP thought I might be experiencing pain at my perineum area. I thought the diagnosis was nonsensical (as I gave birth to my son via Caesarean) so I asked follow-up questions.
Outside, Nat whispered to me saying, "Let's go to our regular GP (that is located further away) for a second opinion." Nat booked the cab and we consulted our regular GP. Our GP listened to the symptoms and had suspicion that it was colitis (inflammation of the large intestine/colon). He wrote a referral letter to CGH and we went straight after.
Upon reaching CGH, the staff/volunteer at the entrance counter immediately offered a wheelchair. We registered and to my shock, I was having a low grade fever with my temperature at 37.6 degree celsius. Though I was quite worried, I decided not to overthink. The wait to see a healthcare professional at the A&E was surprisingly fast. Seen the first doctor who tapped on various points on my abdomen, drew blood and she would subsequently advise if I needed a CT scan (she hoped not to put me through a machine that exposed me to radiation 100 times more than a regular x-ray). When she first attempted to draw blood, she failed. I was feeling alright about it as I knew that my veins appeared fine and it can be hard to feel and poke through. When she managed to get blood, she mentioned, you are quite dehydrated as your blood is so dark. I wanted to drink water but for reasons I could not remember, I was asked not to. By the time I see her again, she told me that I needed a CT scan as my blood test results were showing signs of infection and that I need to be warded. I've not been warded so a small part of me was like, yeah, I get to clear this off my bucket list.
I went to a few other stations, got the intravenous drip and fever started to kick in. I was about 38.3 degree celsius and feeling cold and shivering without the ability to control. A part of me was worried that I had to be swabbed if my fever did not go down. Thank God, the panadol tablets given brought my fever down (but I later learned that I still need to be swabbed!). While I waited for the CT scan, I was lethargic and nodding off. I hardly used my phone. The applications that could help me relax were the reading applications and I could not focus. The nurse at the counter was diligent and took my parameters every now and then. She was so kind that she eventually queued up with me outside the radiology room so that I could be forced in. (While waiting, she told me that she thought Nat was my brother. I shared with her that I have an 8 month old son, to which she was even more surprised. She inquired if I went through a Caesarean birth and I replied yes. Subsequently, she shared with me that in Philippines, mothers can opt to remove their appendix while having a Caesarean birth. I was briefly astonished and thought it was a good idea till I thought about the birth process could be one performed under general anaesthesia. I wouldn't want to be unconscious at the birth of my child.)
Discovery
After the CT scan, I waited. The female doctor that I encountered came back to see me. She told me, "you have appendicitis and you need a surgery." (You can read more about what's appendicitis here and the function of your appendix here) I heard her saying something about the "pouch of Douglas (click to read more)" without explaining much to me but she told me that the surgery team would come to me. Feeling scared at that point, I don't know why I didn't start googling. I think I was simply too tired.
All I could remember after that was that 2 general surgery team doctors came to see me. I think at that point I was afraid because I had not undergo any surgery other than Caesarean section (I had wanted to experience natural birth but I couldn't). Also the word "rupture" did sound frightening too. 1 of the doctors told me that he had the same keyhole surgery and that I shouldn't be too fearful. I asked what caused me to have appendicitis and the same doctor told me, "just pure bad luck." So if a doctor can say that, I thought it was what it was. I've been keeping myself healthy; playing sports intensively at least once weekly, healthy diet and lifestyle etc. Momentarily, I thought about my recent transition to a stay at home mom. I used to be stressed on most days at work but I was healthy. On the contrary, now that my body is at rest, I had been falling sick (yes, I had bad flu previously). Funnily, this thought crossed Nat's mind too.
The Wait
After some time, I was wheeled to the observation ward. This is the ward where patients wait before they are warded. I am not sure why people would say that it can be quite crazy over here because my experience was different. I saw my surgeon for the first time here. If my memory did not fail me, I believe he told me that he might have to do a small abdominal incision if the situation called for it. In my case, I understood that some pus had leaked out so it was foreseeable that my surgery might be slightly more complex.
Despite the busyness at the observation ward, I was attended to every now and then and the nurses were great. After more time passed, I informed my mother, pastor and close friends about my admission and surgery. They were mostly concerned but my pastor was really good at asking me logical questions challenging me the way I felt. He asked what was I really scared of? To which I answered, "general anaesthesia". So the thing is, I know that it would feel like I am sleeping but I sometimes had this nagging feeling that the anaesthetist might somehow give me too much anaesthesia that I could not wake up. (The anaesthetist who I met later and during my Caesarean section are the friendliest. They appeared really reassuring and trustworthy too!) Nat had left to get breastmilk donated by a mommy I met online (I have gotten breastmilk from her when I had to suddenly report on-site for work). A close friend was reminding me, "remember to pump out the breastmilk in your breasts", it was then that I asked Nat to bring along my pump. I have been exclusively breastfeeding through latching that I had totally forgotten about it.
I could not remember what time at night it was when I was wheeled to the Operating Theatre. I told the first nurse I met that my breastmilk was oozing out from my breasts and she took some kind of high-absorbency gauze and taped them on me. A huge part of me was thinking if there would be complications when I wake up from the surgery with serious engorgement. The same nurse told me not to nurse my baby for 3 days post-operation but my gut told me that I should check in with the surgeon or someone else. I appreciated her calming demeanor despite her advice that I was unsure about. After some time, a nurse told me that there were only 2 Operating Theatres available at night and there were also fewer staff working. She apologised for the long wait. When I finally entered the Operating Theatre, one of the nurses asked if I had urinated and I said I couldn't. I could hear the nurses discussing amongst themselves about the fussiness of the surgeon as he refused to put a catheter on me (I later learned that it may complicate things if I had a catheter attached). I was being transported to another area to attempt to urinate on a recyclable bedpan. I had a tough time and I could not urine. When I came out of that area, I was notified that there was a road traffic accident and a surgeon was going to conduct an operation on this person. I could already hear the helpless cries from this person, begging to be saved in Mandarin. Some time later, nurses informed me that my surgery had to be postponed. All I could think of at that time was to pump out my breastmilk as I was afraid that I would get mastitis. I got the attention of a male nurse and he was quick to get Nat to me.
It was strange but in my agony, I could listen attentively and analyse what was going on. The nurses did not know which ward to send me to and they were taking a long time to confirm. From what I understood, the nurses at the B2 ward was supposed to pick up the call that the nurses from the Operating Theatre made but it seemed that nobody was answering. I thought this scene reminded me a lot about my work previously and how I enjoyed problem-solving to improve service quality.
Eventually, I arrived at a class B2 ward. My mom came and cared for me and left. Nat came and cared for me and left too. Intermittently, nurses and doctor disturbed me from my sleep.
The Surgery
Suddenly, at around 3.20am, a nurse informed me about my surgery. The thought of whether my surgeon was still competent at this hour did cross my mind. I went up to the Operating Theatre at around 4am and all the nurses asked me if I had urinated because surgeon did not want to insert catheter. I did and when I was on the operating table, I focused on the image of Jesus carrying me like in Psalm 23. My eyes were wide open and glued to the spotlights. I wondered if the lights would dim as I go to sleep. Seeing that I wasn't drifting to sleep, the surgeon asked me to relax and the next thing I knew, I was at another area in the Operating Theatre. My acute perforated appendicitis s/p (this means status post) lap appendectomy was successfully completed without any issues up to the point of my first discharge.
Photo taken when I was wide awake after the surgery
on 5th June 2021.
Post-Surgery
I woke up later on not by choice at the same class B2 ward. The surgeon and the party of general surgery team of doctors came to visit me to have a look at my wound that were amazingly well concealed at my Caesarean scar. I asked if I would have blood when I urinate or defecate. The answer was no. I thought I would ask this question because I thought it would be something natural. I also didn't think what I asked was important till I saw the surgeon instructing the note-taking doctor to input into the notes. The healthcare professionals left and I continue to feel groggy and nauseous from the anaesthesia. I puked green fluids and couldn't eat much till dinner. The patients around me somehow looked friendly but we did not exchange any words. My extroverted self wondered how to create appropriate conversations. In my recent memory, a few of my supposedly extroverted friends came out as introverts. They would share articles of how to thrive as an introvert. People who are not close to me would not describe me as an extrovert but I am an extrovert at heart. I thrive when I have great conversations and I enjoy social gatherings without a break in between. At some point, a patient spoke to me and then I spoke to all of them except for 1 who could not.
End of Part 1
On the 6th June, the surgeon said that I was clinically well to go home. However, he gave me an option to stay for 1 more night for observation and to have "a break from caring for my baby". I would follow whatever the surgeon said but since I was clinically well, I decided to go home. Being away from my baby was tough. My baby is my source of strength. His smiles and touch are therapeutic. In general, my stay in the hospital was very pleasant. To a certain extent, I miss my fellow patients too. I had hoped to know the final diagnosis to their condition.
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