Saturday, July 12, 2008

PART II: GETTING THE BEST MEDICAL CARE

Singapore: Monday 23 June. Things started moving fast as soon as I arrived at Moon’s apartment at 3.00pm. Half an hour later, Moon and I were in the clinic of an old family friend, Dr Lim Kian Peng, a Consultant Gastroenterologist at the Mount Elizabeth Medical Centre. After viewing my scan results, he immediately made a few calls, and got me an appointment right away with Dato' Dr Tan Kai Chah at Gleneagles Singapore.


At the clinic, we found out that Dr Tan, Consultant Surgeon, Hepatobiliary / Transplant, heads the Asian Centre for Liver Diseases and Transplantation. He has been hailed as “The Liver Legend” by the local media for the pioneering work he has done on liver patients.

At the consultation, Dr Tan asked me a lot of questions, especially about my gall-bladder removal operation in 1989. Based on my answers and the scan report, he told us there was a high probability that my current predicament was related to the first operation done 20 years ago.

Dr Tan explained what the surgery would involve. I was struck by his confidence and assurance that the problem would be dealt with “once and for all”. These are words that all patients want to hear. They want to know that they can trust their doctor with their lives.

No time was wasted. I was admitted to the Liver Ward after seeing Dr Tan. That evening and for the next two days, I underwent a battery of tests, blood transfusions, albumin infusions, a chest X-ray, ECG and a second scan. The doctors had to make sure my condition was sufficiently stabilized for the surgery scheduled for Thursday 26 June.

Dr Tan’s core team consisted of Dr Lee Kang Hoe, Consultant Physician, Pulmonologist and Intensivist, and Dr Desmond Wai, Consultant Transplant, Hepatologist and Gastroenterologist. Dr Lee, who is also Director of Critical Care Services at the Centre, monitored my daily progress. He and Dr Wai made their rounds twice a day to see how I was doing. The ward nurses would accompany them on the morning round, but Dr Lee and Dr Wai would come on their own in the evening. Imagine my surprise when they dropped by early in the morning on Saturday and Sunday! Talk about walking the extra mile.

All the blood tests were done without any pain, and usually between 5.00am to 5.30am. The results were ready by the time the team made their morning round from 8.00am to 9.00am. The nurses who tended to me were truly my guardian angels during my hospitalization. They were there for me 24 hours a day. Their gentle touch, smiling faces and reassuring words helped me get through the initial post-surgery discomfort.

Just to give you an idea of how thorough the team was in preparing me for the surgery, besides Dr Lee and Dr Wai, several other doctors also attended to me before the surgery:
Dr Gong Ing San, consultant surgeon, who assisted Dr KC Tan
Dr Ranjodh Singh, anaesthetist
Dr Benjamin Mow, consultant hematologist
Dr Ng Kheng Siang, consultant cardiologist

In addition, I was assigned a physiotherapist, who taught me how to do deep breathing as well as simple exercises for post-surgery rehabilitation. I also had a pain management consultant who showed me how to use the morphine dispenser in case of need. Near the end of my stay, a pretty customer relations officer turned up in my room with a lovely basket of fresh fruits.

I’m not sure if this is standard practice at private hospitals, but I would be interested to know how the medical care I received at Gleneagles Singapore compares with that at private hospitals in Malaysia.

Thursday 26 June: Surgery was scheduled for 1.00pm. At 10.30am, the nurses prepared me for the surgery. The last thing I remembered was giving a thumbs-up sign as I was wheeled out to the operation theatre.


(Flashing a thumbs-up sign just before being wheeled to the operation theatre.)

Four and a half hours later, I heard a faraway voice saying, “Lily, it’s over. It’s 5.30pm.” In my semi-conscious state, I was vaguely aware of being transferred to a bed in the Intensive Care Unit. That night my sleep was filled with nightmares. I lay unable to move. My mouth was parched but I was not allowed to have water yet, not for the next few days. I could only have ice chips, just to wet my lips. For someone like me who always carried a bottle of water everywhere, it was torture.

Friday 27 June - I was moved back to my 2-bed room in the Liver Ward after only one night in the ICU. I was lucky to have the room all to myself during the entire post-surgery period. My daily progress was closely monitored by Dr Lee and his team.

The first day after the surgery was probably the toughest for me. I had developed a bad cough two days before the surgery. So each time I coughed, I had to hold a pillow to my abdomen to lessen the pressure on the stitches. I had all sorts of tubes attached to various parts of my body, and three drainage pouches dangling from the side of my bed.

Unable to move much in bed, I suffered agonizing lower back pain. This, together with the no-water-allowed rule, was my biggest gripe. To the credit of the doctors and nurses, I experienced no post-surgery pain.

Saturday 28 June – the second day after the surgery was also my 60th birthday. I received hand-drawn cards from my granddaughters, Allie 5, and Hana 4. Sister Vivienne gave me a balloon poodle that she did herself. Later that evening, Moon, Ansgar and their two little girls visited. That really cheered me up, as did all the text messages from family members and friends.

(Spending my 60th birthday in the Liver Ward.)

Sunday 29 June – my best day since the surgery. Some of the tubes were removed and I could enjoy more mobility. Over the next few days I continued to improve. Soon I was able to take short walks in the ward, and have regular meals. I spent most of my time reading, watching TV and writing in my diary. Moon continued to visit twice a day.

The doctors had to be sure that my bile duct was functioning properly before they could discharge me. Every day Dr Lee would ask me, “Have you passed gas?” or “Have you passed motion yet?” My stock answer was “Not yet.” It soon became a running joke, with Ansgar saying we were all waiting for shit to happen, and Moon asking if I had made any deposit that day. To my relief, I finally did both on Tuesday 1 July.

Wednesday 2 July – After spending a total of 10 days in the Liver Ward, Gleneagles Singapore, I was discharged. I was given six weeks of antibiotics, some painkillers which I have yet to take, and a bottle of Duphalac. Full recovery would take at least two months. In the meantime, I was advised not to do anything strenuous. That effectively ruled out my trip to Sarawak for the World Rainforest Music Festival in mid-July and to the Beijing Olympics in August. Well, there're always other trips to look forward to once I'm back on my feet :-)

(Some of my guardian angels of the Liver Ward, Gleneagles Singapore.)


At this moment of writing, I am recuperating at Moon’s place in Singapore. I plan to be back in KL on 22 July.

What I’ve learned from this experience:
Listen to your body. Do not dismiss persistent symptoms, no matter how minor, as something that will go away with a few days’ rest. See a doctor, preferably a specialist, and find out for certain what’s wrong.

Ignorance may not be bliss when it comes to health. Skipping blood tests and regular medical check ups merely delays early detection of a health problem till it’s too late. If you are in doubt about your doctor’s diagnosis, seek a second or third opinion. Look for an experienced doctor who is confident about his ability to solve your health problem, and whom you can trust with your life.

If you have no clue which doctor to see, or how good he is in his field, ask for recommendations from friends. Then do an Internet search on his medical qualifications, years of experience, professional achievements and publications.

Insist on getting your blood test and scan results the same day. My beloved sister, Molly, had to wait one week to collect her blood test results. She passed away a day before the collection date.

Share your health problems with your family members. Just knowing that they are there for you helps you get through the ordeal. And very important, remain positive at all times.

2 comments:

Antares said...

Great to see you back in action, my dear. And your firsthand report on what you just went through is a wonderful way for us to to share your medical episode vicariously (which is the best way to experience these things :-) Heal fast and completely!

Yong Hon Chong said...

Hi Lily,
HOPE YOU WILL GET WELL SOON!
YES, I AGREE WITH YOU THAT WE MUST ALWAYS KEEP POSITIVE.

GOD BLESS YOU.