When Things Go Wrong

On Sunday, whilst waiting for WY and WF's classes to be over, R and I took a break at McDonald's (because all seats at school had been taken up - many by snoozing parents).

It had been an exhausting week. I felt so mentally drained and tired. Generally tired.

I told R, "I think it is very scary when things go wrong with our body. Really very scary, hor. One Wrong can lead to another Wrong, which in turn can lead on to so many other Wrongs. It's really frightening."

Nodding his head, R agreed, "Yah. That's why in today's context, it's either be healthy and able or die quickly; cannot be sick."

Sigh, so depressing.

***************

Last week, I suddenly received a call from the GP whilst I was in the office (toilet). She said, "Hey, LP! Your F is sick, you know or not?! He is here at my clinic with very high fever of 39+ degrees. He says he has stomach ache and he complains of giddiness. He's having diarrhoea, too. Are you aware?"

Caught unaware, I could only utter an embarrassing "No, I didn't know. He hasn't told me anything."

The GP continued, "I have examined him, his pain seems to be localised over the gall-bladder. The part of his stomach where the liver is located seems to be a little swollen. Has the other doctors he is consulting done any liver screening for him before?"

"The one at NSC did when I accompanied him there some time ago. Everything was cleared, all ok," I told the GP.

The GP then said, "Ok, then this is what I want you to do. Monitor your F for the next 3 days to see if he develops any jaundice. If he does, bring him to seek medical attention at once. Check his eyes rather than skin because by the time jaundice shows up on skin, it would have been too late. You know how to check for jaundice, right?"

I was quite stunned. Ha?! Jaundice = liver problem, correct?!

The GP then went on to explain that for some patients, a localised pain over the liver/gall-ballder accompanied by some swelling over the area and high fever may suggest a gallstones attack. If jaundice sets in, then there could be reason to suspect blockage of the gall-bladder. If any blockage is not attended to, the gall-bladder may burst and that would lead to a potentially fatal condition. She added, "Of course, this is only a suspicion only, lah. I hope he is merely having a common flu only. But it is good to exercise more caution."

"Ok, I'll take a look at him this evening," I told the GP.

"So now, how? He complains of giddiness. I have given him medicine for his fever, diarrhoea and stomach pain. He told me that he has come by taxi because he cannot walk," the GP said. "So, should I ask him to take a taxi home now?" she asked.

"Erm, I guess so. I cannot run there now....." I was at a loss as to what to say. I know this sounded so bad, but I really couldn't just drop all and just run off. In any case, it was less than half an hour to the clinic's usual closing time.

So after the GP hung up, I called R on the phone and told him what the GP had just said. I asked R to see if he could make a quick trip home to check on F during his lunch hour.

(R later updated me that he had contacted F at home, and F had reassured R that he was alright. Just needed to take his medicine and rest. So R didn't go back home.)

By the time I returned to my work station after talking to R, my head was spinning. For the rest of the afternoon, I didn't do any real work.

But I managed to google a little on gallstones attacks etc. Everything I read added to the fear and tension in me. It was quite scary thinking how a person's abdominal cavity could become septic if the gall-bladder should burst, how the pain associated with a gallstones attack can sometimes even mask a heart attack etc.

***************************

When I visited F that evening, he didn't look very good. In fact, he looked quite pale and sounded quite weak. He said his diarrhoea had been very bad although after taking the GP's medicine, the fever had subsided and the stomach ache had gone.

As instructed by the GP, I checked briefly on the whites of his eyes (so that I can compare if there is any change in colour in the next few days, mah). Then I reminded him to take sips of water to make sure he didn't get dehydrated.

He pointed to the half-drunk can of 100-Plus standing on the dining table and said feebly, “医生叫我要喝这个。我买了一罐，喝了一半了。不错，现在喝了比较好，口没有这么渴了。”

Aiyah, just one can?!! “我楼上有好几罐。迟一点我拿给你。你拉肚子，应该喝这个来补充水分。可是别一下子喝太多。”

I went home after reminding him again to call me if he should feel unwell again in the night.

After a quick shower and dinner, I packed the cans of 100-Plus we had at home into a carrier. Then I asked M if she could help to cook some plain porridge for F the next day for his lunch. And to buy during her morning marketing, a can of preserved 菜心 to go along with the totally bland porridge. M agreed. She also agreed to bring the 100-Plus to F at the same time.

***************************

The next day, I went to the office and managed to complete a fair bit of work in the morning.

At about 1pm, M called me to tell me that F was looking for me. When I called F, this was what he told me in a very worried voice, “LP 啊，你帮我打个电话问一问医生，我从昨天晚上到现在，很想小便，可是去了厕所好几趟，都小不出来。为什么会这样？”

I was quite shocked to hear this 'new problem', and told him, “现在诊所已经关了。医生傍晚才会回来。你现在还有没有发烧？肚子还痛骂？”

F said, “烧已经退了。肚子只有一点点痛，没什么。只是小便小不出来，肚子有点胀胀的感觉，很辛苦。医生不在，那好啦。不要紧啦。”

I felt so helpless when F hung up the phone on that note. I mean, what could I do? What should I do? Should I return home immediately to check on him? My head began to feel a little light again, like the day before.

And also like the day before, I couldn't do any real work after that. My heart just went heavier and heavier thinking how F was coping alone at home. And I kept wondering if his fever had been 'artificially suppressed' only because of the fever medicine prescribed by the GP. What if the GP's suspicion about the gall-bladder problem came true? And if jaundice really set in? How? What was I to do??

It was really very disturbing and confusing with all these "how's" and "what if's" going over and over again in my mind. It didn't help that there was no one with whom I could share this load.

Finally, at about 5pm, I called F, “F，怎么样了？有好一些吗？”

F said, “尿还是小不出啊！我站了半小时，还是放不出来！！”

I asked, “你有喝水吗？”

“哎呀，我喝了好多水，可是，怎么小都小不出！我站半个小时，尿还是没出来，我能怎么办？！”F replied in a rather exasperated voice.

But because the GP's clinic would be open only at 6pm, I told him that unless he wanted me to accompany him to the A&E, there was nothing that I could do except wait till 6pm when the clinic opened, then we would be able to check with the GP.

F said, “哎呀，那没关系啦。不要紧啦，不要紧啦。” Then he abruptly hung up the phone.

After about 5 minutes, an idea suddenly struck me. I called F again.

“F， 你现在去准备冲个凉。然后，把你所有正在吃的药准备好，放在一个袋子。医生的诊所六点开门，你把药带去那里。我在那里跟你会合，我下班后，竟快赶到。如果医生建议我们到紧急部门去，我们直接从那里出发。”

Although F was at first reluctant (especially when I mentioned A&E), he agreed to the plan.

And so, once the clock struck 5:30pm (my official knock-off time on Fridays), I dashed off and in under 15 minutes, I was on the MRT train. By 6:10pm, I had arrived at the clinic. After waiting about 10 minutes, F came on foot (he said he couldn't get a cab during the peak hour then).

We saw the GP and told her F's problem. In summary, the GP's advice was this:

a) amongst F's medicines, there were possibly 2 medicines which sometimes could cause the patient to have a urine retention problem - the antihistamines prescribed by TTSH for sensitive nose and the tablets prescribed by the GP for the stomach pain;

b) given that F no longer had stomach ache, he could stop taking the stomach pain tablets. For the next 2 days, F should also stop taking the antihistamines. The effect of these medicines would generally ease off in about 6 hours or so;

c) based on F's confirmation that he had last taken the stomach pain tablets at 4:30pm, the urine retention problem should therefore ease off by about 11pm and so, if F was able to 'hold it' till that time, then the bladder should 'automatically' empty itself;

d) if, however, the discomfort of a full bladder was unbearable, then F could consider the catheter treatment to relieve the discomfort. Basically, this involved the doctor inserting a tube into the urinary tract to drain off the urine. For this, a trip to the A&E would be necessary.

Not unexpectedly, F opted to 'wait it out'. Contrary to what he had told me earlier, he said that the discomfort was bearable. He insisted that there was no need to go to A&E.

We walked home, therefore, after getting a loaf of bread and a 1.5L of 100-Plus from the Econ Minimart next door.

On the way, F told me how his eyes have become quite sensitive to glares these days. The NSC doctor had suggested that he puts on sunglasses if he needs to go out during the day (he goes to buy his lunch). But since several days ago, he had stopped using his pair of sunglasses after the lenses cracked when he accidentally dropped them on the floor. His eyes get tired easily too, when he watches TV without the sunglasses, he has cut down on his TV time. F jokingly commented that perhaps because of this, the electricity bill for the past month had actually declined!

Then he also told me that ever since he started his L treatment, his hearing has deteriorated in his right ear (the 'problematic near-deaf' ear). I told him that he should then highlight this to the NSC doctor so that the problem could be sorted out early. Waving his hand and shaking his head, F said that it was no use because all that the doctor would do would be to refer him to yet another specialist. “看一个又一个的医生，吃他们一个又一个配的药，那么多，吃到我都怕了！没有用啦。” He went on to say that his plan was that after he had completed the L treatment, he would then consult the doctor (I think he meant the GP) for his hearing problem.

I also asked him if he would now like to get hearing aid. He said no, he still had the money that HA gave him for it, but he would use it to fix the hearing aid later if this was needed. F also said that given M's incessant 'scolding' each time she saw him nowadays, it was better that he does not get any hearing aid first. Sigh.

As we reached our block, F told me that he planned to retake the test for his vocational licence. I was quite shocked and told him to forget about driving the cab again even after he recovers. But he said, “没有事情做，很辛苦，时间很难过。等我好了，我可以再去驾一驾，时间比较容易打发。”

I didn't want to argue with him, so I said nothing more, lor. Then after helping him to adjust the brightness of the TV that BK had bought for him, I left for home. WY had to go for his piano lesson that evening.

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At about 8am the next morning, I called F to see if everything was alright. He said that since he had neither water nor food the night before (after our visit to the GP), he didn't make any trip to the toilet at all till 4:30am. Whilst at the 'big business', the bladder also emptied itself. So, he felt better already.

With that assurance, I proceeded with my own Saturday schedule of lessons for WY and WF. R had to go to work that morning.

Then, at about 12 noon, F called me. “LP 啊！我今天早上到现在，没什么能小便。只是一点点，现在肚子又有些胀胀的感觉，很不舒服。你帮我打个电话给医生，看看为什么我已经没吃那两种药了，还是不能顺畅的小便。整个早上，只是一点一点。”

This time, it was me who felt exasperated. I suggested to F to call the GP directly and asked for her advice first. Then if he needed to go to the A&E, I could bring him later in the afternoon. There was no way that I could leave WY and WF (who would be dismissed in about 45 minutes' time) in the school then and go home immediately to bring him to the doctor. R was at work in his office.

After about 20 minutes, I called the GP and spoke to her. She told me that F had just called her minutes ago and told her that despite having stopped taking the 2 medicines that had been highlighted by the GP, there was still quite a bit of discomfort because the bladder still could not be completely emptied. The GP said that this probably suggested that there were some other underlying conditions which were causing the urine retention problem. 2 common possibilities would be: 1) urinary tract infection and 2) enlarged prostate.

She suggested that to help relieve F's discomfort, he should go to the A&E to receive the catheter treatment. The GP explained that the doctor at A&E would then put F on oral antibiotics (since the insertion of the catheter would predispose F to infection) and also refer him to the urinology specialists for a proper assessment subsequently.

So, it became clear that a trip to the A&E would be inevitable afterall.

After picking WY and WF up, we all grabbed a quick bite and proceeded to the studio which we had booked at the music school where WY is scheduled to take his piano exam in about 2 weeks' time. WY spent the next hour practising on the 'exam' piano there whilst WF and I waited for him. (Credit must be given to WF's patience in waiting that one whole hour without 'disturbing' WY.)

When WY was done with the practice, we met up with R. Then we drove to Kallang to buy the herbs that M needed in order to make some soup for WY (and WF). After R's lunch at the food court there, we all went home.

The boys had their showers and finished the work which I had assigned them. CP had something to attend to that day and so could not give WY his Saturday tuition. The plan then was that R would bring M and the boys to YP's place for dinner (the arrangement had already been confirmed the week earlier) whilst I would bring F to the A&E before joining them again.

And so, I left R and M to deal with WY and WF. They only had to make sure that they remembered to bring my fresh clothes with them so that when I joined them at YP's place later in the evening, I would be able to take a shower there.

******************

F and I took a taxi to the A&E. After a brief and superficial Triage screening, we were ushered to the 'Fever Zone'. Almost all the 20+ seats were taken up at the waiting area. F, who had already put on the face mask which the staff had handed to him, also urged me to grab a mask for myself. I did so.

After a while, a young doctor came and I went through the story of what F's problem was, what medication he was taking etc (showed him the box of medicine which I had asked F to bring along). And then, they proceeded with the catheter treatment.

From then on, it was a long and frustrating wait for me. I shuttled between the open doorway (furthest from the 'Fever Zone' and with the only access to 'fresh' air), the enclosed waiting area (with patients waiting to be seen by the doctors or to be admitted to their wards, several coughing away) and the 'Fever Zone' (where F was lying on a bed and being attended to). I was concerned that F might need me to translate something to the doctor/nurses or might need my help to get the nurses (who kept walking around all the time) etc.

Each time I peered in at F and saw him lying down on the bed with the bag of urine being drained off into hanging by the side of the bed, I felt very sad. No words can describe my feelings then.

I remember that when F had his heart attack some years back, it was also me (and R) who had brought him to the A&E. At that time, there wasn't much of this sadness although the sudden-ness of the situation then was a bit shocking. I felt mainly fear and anxiety then. Not sadness, like now.

F's urine looked a rather shocking and weird shade of brown/red. I was at first shocked to see the colour of the urine but F gestured to me and muttered to me that he had taken a particular type of medicine prescribed by the NSC doctor. This medicine was to be taken only once a month and it was expected to colour the urine and stools. F asked me to explain this to the doctor, which I did.

The A&E doctor said the colour was ok, but as a sort of SOP, they would do some blood tests and urine tests for F anyway. I think they were trying to see if they could rule out any urinary tract infection etc.

Whatever the doctor said to me, I had to go near to F to translate it to him. That way, I think he felt more assured.

After a long and tiring wait standing around (I had avoided sitting at any of the seats and leaning against any part of the walls/handrails), the clock finally struck 8pm. I began to feel a little impatient and very uncomfortable in that odd-smelling face mask. I sent several sms to R to try to pass time. Through sms, YP also asked if I would prefer her to go and join me at the A&E. I told her there was no need.

Eventually, as the doctor signed off the discharge form and the prescription etc, he explained that the catheter would have to stay inside F till his appointment with the urologist in about a week's time. This was because the bladder's muscles would usually need time to 'get back to work' and if the catheter was removed immediately, chances were that the urine retention would recur almost immediately the very next day. The urine bag (which hangs externally - the A&E does not carry the urine bags whose design allows it to be secured inside the clothes) attached to the catheter will therefore act as F's 'temporary bladder' in the meantime.

The doctor went on to explain that the urologist would be the one to remove the catheter and assess F's condition. And as explained earlier by the GP, the doctor prescribed some antibiotics for F (I requested the doctor to specifically check through F's box of medicines to ensure that there was no other antibiotics or other medicines which should not be taken together with the one he was precribing).

After that, the nurse motioned to me. She said, "I will teach you how to drain off the urine and clean the bag." I was shocked into silence momentarily. "Erm, I think you have to show my F. I don't stay with him, so he will need to do this by himself. It's more important that you show him how to deal with the bag etc," I explained with mixed feelings of shock and embarrasment. 'Shock' because I hadn't expected the nurse to assume that I would be helping F to drain off the urine etc. 'Embarrassment' because the nurse was not wrong to assume that F's daughter should be around to care for and help him etc.

Anyway, the soft-spoken lady proceeded to demonstrate to F how the catch on the tap could be released to drain off the urine and then how it should be locked again. At each of these steps, the relevant part of the tap had to be cleaned with either alcohol swaps or warm water. (I told F that I would get alcohol swaps for him since then he wouldn't need to worry about boiling water for this purpose.)

As I stood by F's side watching the whole process, I suddenly wanted to cry. My eyes reddened and I could feel tears welling up. I quickly looked away because I didn't want F to see me this way. F appeared very positive about the bag (like a little child watching earnestly his teacher show him how to work a special apparatus during class) although he did complain that the catheter inside him was causing him some pain. The nurse reassured him that some pain would be expected since he was 'new' to this. I felt even sadder on hearing this.

After the nurse was done with the 'lesson', I settled payment and collected the medicines for F. F said he felt much better now that the bladder was no longer full. In fact, he no longer felt the giddy-ness or nausea he had when we first arrived at the A&E. I helped F to scribble on the medication packaging the pharmacist's instructions on how and when to take the medicines etc, in Chinese.

I asked F if he was ok to go home himself as I was planning to join R and the rest at YP's place. He said yes, he would be alright. After seeing him off in the taxi that came along, I hopped onto another to proceed to YP's place. On the way, I tried not to think further if I should have gone home with F instead.

When I arrived at YP's place some 30 minutes later, I took a good shower and then had the dinner which YP had kept for me. Then I updated M and YP on F's condition.

All the boys were happily engaged with the TV, XBox and the computer. The post-dinner Saturday evening is always their 'Happy Hours'. WY and WF always look forward to this.

We went home only at 10:30pm after the Channel 8 News was over. By the time we reached home and got to bed, I was so exhausted I couldn't do anything but sleep.

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On Sunday morning, F said he was alright when I called him in the morning. I reminded him to take the medicines prescribed by the A&E doctor and to avoid dairy products because that would contradict the antibiotics. Then I also reminded him about cleaning the tap with the alcohol swaps etc.

“知道了啦。我懂得消毒啦。我会记得把手消毒好啦。” F said.

I was a little shocked to hear this - what sanitize the hands with the swaps?! The swaps are for the tap!! So I reminded him on how to do the cleaning as shown by the nurse. “护士是叫你把那个袋子的开关消毒，不是叫你用消毒巾擦手！你用了开关，把开关擦好了，再到洗脸盆，用水龙头的水洗手！手，不需要用消毒巾消毒，可是要洗得干净！要记得啊！”

F replied rather impatiently, “好啦好啦。我知道了啦。”

Sigh. That day, when R and I brought to F his lunch and dinner respectively, he looked alright. Not so weak-looking anymore although still rather tired.

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M voluntarily offered to buy lunch for F on Tuesday after getting to know that F had gone out on Monday to get lunch for himself, with the catheter inside him and the bag hanging by the pocket of his bermudas! F appreciated that, and when I asked him this morning whether he prefers M to get for him rice or porridge, F said the lunch M had bought for him was good.

So, I conveyed this 'feedback' to M, who will buy lunch for F today, too. F had said that he prefers rice to porridge. (I think this is indication that he is feeling much better now - on Sunday, he had asked for porridge.)

F's appointment with the urologist is this Thursday morning. I will be on course that day, so cannot accompany him there. Instead, R will run out of his office to meet up with F at the Urology Centre at about the appointed time. Hopefully, the session will end before noon, because R will need to run back to his office for an important meeting from noon onwards.

I really hope that everything will be ok and the catheter need not be depended on from Thursday onwards. I pray that this Wrong will be Righted soon.