On 6th June 2021, I went home feeling great! My church and close friends had sent over some "get well soon" fruit & snack baskets. My mother-in-law was at my place playing with my son and all seemed well.
Bleeding
We bedshare with my son so he always nurse and sleep. I got up to urinate at around 3am and was shocked to see blood on my underwear and urine. In addition, I was having the dull pain that I used to experience before the appendicitis surgery. I shared this information with Nat and he decided that we should proceed to the A&E for a checkup.
I could see his anxiousness as he had shared that he should've sent me to the hospital previously when I mentioned that I had recurring pain. I guess all of us go through life and learn things along the way. Sometimes we wished that we had done things differently and sometimes we blame and can't seem to forgive ourselves for the things we didn't do. I think the books that I have read brought me peace and I could accept things as they are. A good recent read is "The boy, the mole, the fox and the horse" by Charlie Mackesy. Don't miss out on the audiobook! The sound effect made the story come alive.
Back at the hospital
We arrived at the hospital 4-ish and the A&E doctor who attended to me looked slightly nonchalant. I wondered how does it feel to be working the graveyard shift and whether his critical thinking abilities was subpar due to the strange hour. Like other doctors, he applied pressure at different points of my abdomen and requested to have a look at my urine sample. He also withdrew some blood for blood test (this is the first doctor who could poke a needle in without the second attempt). Since we are on the topic of insertion of needle to draw blood, it was to my surprise that the probability of failing at the first attempt is high. Sometimes the doctors need the nurses' help. If you had read my previous entry, you would know that I spoke to other patients. Interestingly, my experience was not unique, a patient showed me bruises from failed attempts at drawing blood. Anyway, I was impressed with the doctor because of his ability to draw blood (haha) and became less doubtful.
How appendicitis feels like
While I waited to hear the update to my condition, I overheard a doctor saying to a young lady that they suspected her to have appendicitis. I asked Nat if I could be wheeled closer to this lady to share about my experience. The husband/boyfriend agreed and I spoke to her. She asked me a couple of questions including what kind of pain I felt and I said when it was dull, it felt like menstrual cramp kind of pain. She nodded in approval and by the end of my sharing, she looked appreciative. We bade farewell when the doctor wanted to speak to me again. The doctor shared that my urine contained a lot of blood and I should try to urinate again to see the output. I visited the toilet and my output was more or less clear with some puny blood particles floating. Doctor said that after discussing with the other doctors, he suggested that I go home. The reason for it was that they were uncertain whether I was menstruating soon and also I wasn't experiencing tremendous pain. I found the doctor's advice to be convincing. When we thanked him, he was finally smiling from his originally stoic look.
Readmission
Time passed and in the afternoon I was still having quite a lot of blood in my urine and the pain wasn't going away. Nat brought me back to A&E. This time, the doctor consulted a senior doctor who advised that I get warded. While I was waiting to be warded, the nurse informed me that I could skip the observation ward and go to a class C ward. As mentioned in my previous entry, the observation ward wasn't that crazy to me. I decided to go with what the nurse offered so that Nat could go home to rest.
Class C
When I reached the class C ward, the nurse handed over to me a set of hospital pajamas. The pants had an elastic band and I requested to change it to one with drawstring so that it would not tighten my navel. After I settled down onto the bed, she took my parameters and then she gave me a swab. She was very rough and made me feel uncomfortable. I took a quick glimpse at her name and noticed that she is from an ASEAN country. Having this information made me less upset. It could be the lack of language to describe what she was doing to me, or it could be that in their culture, the action was not rough. Anyway, after pumping out some milk, I tried to sleep despite the mumblings from other patients around me.
My supply was good throughout my stay in the hospital.
This made me glad.
The next morning I woke up and noted the difference between class C and B2 wards. The patients around me did not have the mental capacity to converse with me. In contrast to the class B2 ward patients that I encountered previously, most of the class C ward patients were very frail and showed little interest to engage. Though both class C and B2 wards did not have air-conditioner, the class C ward felt more humid.
NUS Nursing interns were learning alongside the experienced nurses and 1 of them changed my wound dressing. She was so nervous because it was the first time she was doing it and she was instructed by a senior nurse and observed by a clinical instructor. The familiar doctor came and he recounted briefly that he stayed in class C too while recovering from appendicitis. A part of me was astonished as I thought that doctors would get some privilege. Nevertheless, I also thought it is a valuable experience as the healthcare practitioner would be able to empathise more with the patient.
Staying in the class C ward honestly wasn't that bad. It was just humid. Throughout the day I wondered if I had menstruation back after the long absence of it due to pregnancy and exclusive breastfeeding. I was more certain that it was not around midafternoon when I looked at the distribution of the blood on the pad. The pain though dull was still existent. I had requested for class B1 or B2 wards several times to no avail and didn't want to bother the nurses any longer.
Strange Suspicion
After all the inputs that I had given to the team of general surgery doctors, the recommendation was for an urologist to see me. The urologist came at 4-ish in the afternoon, asked me a couple of questions and examined me. He told me that there were 2 possibilities, (i) urinary tract infection - UTI (ii) syphilis? My suspicion for syphilis is a -1,000... He shared that I could do a scope to find out more about my condition but I wasn't keen. I thought his questioning and thought process was not rigorous enough for me to take his suggestion.
Possibilities
Nat, at the advice of our financial consultant, decided to transfer me to a private hospital. I was more open to the recommendation at this point as I still did not have a very clear idea of what's happening to me and what's next. I thought from the surgeon and doctors' point of view and to a certain extent I could understand the delay in making any conclusions. There were several possibilities: (i) resumption of menstruation (ii) blood flow from the uterus triggered by the touch of the endoscope (iii) intraabdominal infection (iv) UTI or syphilis.
Satisfactory Explanation
By the time Nat came to visit me, I wanted a transfer to another hospital too because I would likely be attended to more quickly and get to the root of the problem. After attempting to reach out to the nurses several times to let them know about my intentions, I got slightly restless. Out of desperation, Nat reached out to the surgeon via a social media platform. It worked and the surgeon replied him soon after. When the surgeon finally came to us, he asked specific questions and I answered accordingly. Based on my answers, the most likely explanation was that the endoscope touched my uterus and it triggered the blood lining to flow downwards. Nat and I listened to this explanation and found it most convincing. The surgeon also shared that it would be a lot of trouble for us to transfer as the other hospital would need time to go through the lab and operation reports, CT scan and discharge summary before deciding on what to do. He advised me to go through another blood test tomorrow so we can have some insights to my health status. Another round of CT scan would not be recommended due to the high amount of radiation that I would be exposed to.
Generally, I felt comforted hearing from the surgeon himself that I should not be overly concerned about anything serious happening to me. However, that would also mean staying 1 more night for observation before blood test.
Discharge & Observations
The next morning, the familiar doctor came to extract blood for blood test. I was told soon after by the surgeon that I was well enough to go home or I could stay 1 more night just in case. Relieved that my blood test results was unremarkable and that I felt well, I decided to go home. The surgeon also mentioned that Nat loves and cares for me so deeply and he hope I would not be readmitted to the hospital. After confirming that I would like to be discharged, the surgeon called Nat immediately.
The day of my discharge was 9th June 2021. In some sort of chronological order, these were my observations while people-watching:
(1) At around 7-ish, the Ah-Ma in front of me was trying to get the nurses' attention. She was asking in Hokkien whether she could have a change of clothes. That went on for a long time and the nurses were generally nonchalant about her request. I thought for a moment whether this Ah-Ma had dementia. After some time, maybe an hour later, a doctor came to inform her that she would be going to the Integrated Building. I've volunteered at the building a long time ago for a short while to assist with the activities conducted by the nurses for persons living with dementia. Hence, I knew I was right about my assessment. After all, I have worked with seniors for some time and it isn't too hard for me to tell.
(2) The son of the patient on my left came to visit again. He looked somber and I was surprised that he approached me to ask a question. He inquired, "did my mother wake up?" I replied, "no" with a slight smile and realised that my expression was not quite right. He walked away with a forlorn look in which I sympathise with.
(3) The relative of the patient on my right came to feed her lunch as usual. The patient had down syndrome and did not appear to speak at all. The interactions were mostly one-sided but you could tell that the relative loved her through the tone of her voice. As I was already dressed in home clothes by lunch time, the relative spoke to me for the first time and asked if I was heading home. I asked when would the patient be discharged but the relative was unsure as she shared with me that patient had fever after the COVID-19 vaccination. She also told me that the family was not sure about what to do with patient if she was discharged. I thought momentarily about the challenges families with a special needs member to care for. The persons with special needs may not be able to articulate how they are feeling and hence, do not get attended to timely and appropriately.
(4) A patient who was diagonally facing me had requested to visit the toilet every 5 minutes. I saw the nurse at the nurse station almost losing it but kept her cool. That nurse asked me to complete a feedback form and I gladly did.
When I looked at my discharge summary, the diagnosis for this second admission was acute cystitis, which means infection of the urinary bladder. Though I am not sure if that was an accurate diagnosis, I believe what the surgeon informed me. I guess it can be quite difficult to write a diagnosis when nobody is perfectly sure. At the end of the day, I was well so I was alright with what was written.
Conclusion
I left the public hospital learning quite a number of things about it. The most prevalent thought is my appreciation for healthcare professionals, including counter staff, healthcare attendant, janitors and other blue collar workers who choose to work in a public health setting. I could see that the work is demanding. During my stay, I witnessed several healthcare attendants or janitors helping the nurses to translate Mandarin to dialect. I thought it was admirable and great teamwork.
As I recalled the sequence of events, I asked Nat if he knew the accurate diagnosis to my condition, would he have sent me to a public hospital. His response was no. I thought from this experience, he would not admit me to a public hospital again due to the longer waiting time. As for me, I am just thankful for this unique experience and I really have a lot to appreciate if I do get admitted to a hospital in the future.
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