Pain !

Posted by on Mar 26, 2015 | 0 comments

Chapter 1     Surgery

PAIN!  Unbelievable pain!

I yelled again, “It hurts, it hurts!”

What was going on?

I repeated my cries.  “It hurts, it hurts!”

A fleeting glimpse of a face beside me.  Was it my wife or the doctor?   My eyes closed quickly.  Opened again. My wife, Gail, trying to smile and reassure me.  Closed my eyes.  Darkness. Opened as slits again.  Doctor.  Was that a look of surprise?  Closed again.  Ah – peace arriving.  More morphine added to the line into my vein.   No more yells.  Bliss. Sleep.

A technician disconnecting me from monitors. Limited words of reassurance mixed with a language I couldn’t understand. Malay I was told later.  A teaspoon of ice for my parched throat.  Cool, satisfying.  More please.  Conscious of being wheeled to the elevator. Wife holding my hand, saying “It’s over.  You’ll be fine.”  A ride upward. 5 floors.  I could actually focus on the electronic numbers as we reached each stage.  Guess I was alive and OK. Still attached to a drip line.  Lifted into a bed, attached to more monitors.  Terribly, terribly tired.  Squeezed my wife’s hand, “Love you hon.”   Fell asleep.

Rudely woken up in the morning by a nurse asking how I felt.  “Lousy.  Sleepy. Aching. Sore.”  Forced to drink something and take a pill.   Back to sleep.  Woke to the physician’s assistant running stethoscope all over my abdomen.  Listens intently. Shakes head, leaves.  Says nothing.  Not a very encouraging indication.  Try to sit up.  Whoops – hold it buddy.  Not ready yet I’m afraid.  Why not, I ask nurse on her next visit?  “Because of the staples.”

“The what?” 

“Staples.  You have 22 of them in your abdomen.  Wanna see?”

She didn’t say ‘stitches’.  She said ‘staples.’  Sure enough, when I bent forward with her help I could see silver metal staples running parallel to each other crossways in a line down through my belly button, as many below as above.  Guess they really needed something stronger than nylon to pull the sides of my tummy skin together. 

“Your anesthetist is coming to see you shortly and the surgeon will be in in a little while after him. Would you like something soft and cold to eat?”

What better than ice-cream to perk up one’s spirits?  I was on the second last spoonful when Dr. Gordon Lam walked in. “Hi Warren.  Good do see you. How are you feeling?”

“A bit shitty doc.  Not up to a marathon yet.”  That’s me alright, smart ass, trying to be funny.

“You know Warren, I had to give you a lot of morphine afterwards – 27mg.”

“All I remember doc is hurting badly.  Thank you for looking after me.”

And that brought back some vivid recall.   I’d been prepped for surgery and had been waiting in a roll-in bed outside the operating rooms for perhaps 30 minutes when finally Gordon had turned up.  He told me timing was imminent and turned to the nurse and said “15mg”.  That’s all I understood at the time although I saw a questioning look pass across her face. She said nothing however, although she apparently knew 15mg wouldn’t be enough.  This was GlenEagles Hospital in Singapore. Over 95% of the patients here were slightly-built Asians. If 15mg worked for most of them, it was definitely going to take more for a much heavier Caucasian like me.   Clearly, whatever drug dosage Gordon gave me for the surgery was on track, but treatment of post-op pain needed reinforcement.

Back in my room after the surgery, no sooner had the anesthetist left than my surgeon turned up.  Susan Lim had earned some of her physician’s stripes at Duke University, so was familiar with Caucasian patients.  She also had a gentle, informative, and caring bedside manner.  She explained my surgery.

“We did a laparoscopic examination through a hole in your navel Warren and determined we needed to go in more deeply.  Hence the fairly good sized incision you have.  Inside we found a number of ‘adhesions’.  They are fibrous bands that had grown out of your appendectomy scar and choked around your upper colon stopping anything from passing through.  Pretty obvious why you weren’t feeling well.   We got to you just in time.  You were headed for a life-threatening experience.”

What? Something had grown out of my appendix scar?  I was flabbergasted. I’d had my appendix out at age 5 in Sydney Australia.  These things, ‘adhesions’, had been growing inside me for 50 years?  Unbelievable, but apparently true. The fibrous ribbons I had apparently cultivated over time had finally decided to let their presence be known on a business trip from Seattle to Singapore. I wondered why – couldn’t they have done it in some nicer way at a more convenient place and time please?

The next input from Dr. Lim seemed so cavalier that I couldn’t resist smiling.  “So we cut out the adhesions Warren, then put your intestines and other organs back in their proper place, washed out your insides, pulled over an apron of omentum so you’ll never have this trouble again, and used two sets of stiches internally and the staples to pull you back together again.”

All said in a matter-of-fact tone; it was as if she’d been describing what she’d had for lunch that day. Susan then spent twenty minutes passing the stethoscope backwards and forwards over my abdomen, until eventually she said.  “Yes!  Those PA’s said they couldn’t hear anything. I’ll have to teach them what a colon sounds like when it’s waking up from surgery.  You will be fine Warren. Another day of bed rest then we’ll start some light walking around.”

In the middle of the night I was woken by the phone ringing beside my bed.   “Hi Dad, it’s Arlene (my eldest daughter, who is an MD).  I’m calling from Saudi Arabia where I’m working with Doctors without Borders.  Haven’t had access to email for a couple of days and just heard from Gail about your surgery. How are you doing?”

I told her about the information gleaned from my surgeon’s visit that afternoon, and she told me that the body can go partially paralytic when you abuse it with such drastic surgery, and that indeed some components shut down as part of the natural defensive healing process. She mentioned when she was in training that they once had a girl whose organs took five days to respond.  The fact that mine were giving out signals in 24 hours was very positive news.

That one phone call made me feel so much better.  Next day I even had color back in my cheeks according to Gail, who came loaded with email wishes from workers and family around the world.

Gail. What would I have done without her beside me?  I don’t know and I don’t want to know.  She was the greatest comfort around, before and after surgery.  Florence Nightingale out of uniform. Not a physical staff nurse at the hospital, but a just-as-important emotional support nurse.  She’d flown thousands of miles at a moment’s notice to be with hubbie because he was in serious medical trouble.  Dropped everything and got the last seat, which happened to be a Business Class one, on the first available flight. More expensive than expected, but waiting another twelve hours wasn’t an option she considered.

On the day that I had left home I had driven to Vancouver, Canada where I was to catch my Cathay Pacific flight to Hong Kong.  Along the way I’d called and told her I had a bit of a stomach ache.  I hoped things would calm down while I waited in the lounge at the airport, and would let her know.  While things did in fact ease off in the lounge, it was just the lull before the storm. 

I had no way of anticipating what was in store up ahead.



Chapter 2     The Flight to Hospital

I had my favorite window seat near the front of Business Class.  I always chose the right hand side because I could watch the coastline of the Canadian mainland as we took off to the west, and hours later my view would take in the coast and snow-topped mountains of Alaska. Then I could watch Japan slide beneath us on the final part of the journey. I always liked to make sure our pilot was going in the right direction!

I know, you think that sounds funny.  But I refused to fly Korean Air into Asia, because years earlier one of their commercial planes strayed into Soviet airspace and was shot down.  Bet if I’d been on board I would have checked to make sure the pilot changed his route.  J   

I liked the Cathay flight to Hong Kong for lots of reasons.  First, it started in Vancouver as a turn-around so it was fresh and clean inside and well prepared. The staff on board were smiling and attentive, happy to be heading in the right direction homeward.   Second, the plane left in the afternoon, unlike Cathay’s other flight to Hong Kong which departed at 2am in the early morning after coming in from New York.  Third, the flight arrived in the middle of the day with a range of possible connections to other Asian cities.  And I liked flying through sunshine rather than overnight flights.  I had the ability to sleep easily on all long distance international flights, no matter what time of day or direction they flew or whether they were overnight or daytime flights.   But I preferred ten hours of sunshine than ten hours of darkness. I flew a lot those days.  I was a 5 million miler with all the attendant privileges.

Like all air warriors I had my own personal quirks of travel.  I drank a lot of water to keep hydrated and I got out of my seat frequently and walked up and down the length of the plane for exercise. I slept after the meal service, waking a few hours before landing.  On this particular trip dinner didn’t sit well, and the stomach ache came back.  My only intake after that was 7UP in an attempt to settle things again.  I did not have a good sleep and by the time we arrived in Hong Kong I was even more uncomfortable.

I managed to get through the wait for my connection to Singapore, but once again refused any more food on the flight.  I arrived in greater pain, and remember in the taxi that I was sweating with discomfort. As I checked in to the Marriott I asked to have a doctor sent to my room.  I was hurting big time by then.

Dr. Geoffry Seah gave me some pain killers and sleeping pills and promised to come by in the morning to check on me.  Whatever thoughts he had about what my problem might be he kept to himself.   But in the morning when he came back he was clearly concerned and actually drove me in his own car to a Gastroenterologist, Dr. Roland Eng, who diagnosed gallstones and ordered me into hospital, refusing my request to let me fly home.   I called Gail who was fretting and wondering why she hadn’t heard from me, and gave her the bad news.  

At the time we were living on an island halfway between Seattle and Vancouver. I’m the travel agent in our family and so I gave her the Cathay Pacific phone number and flight options, contact numbers for the hotel and hospital and left arrangements up to her.  Friendly neighbors drove her to Vancouver airport in the middle of the night (we didn’t need two cars parked there for our return), and next I knew she was calling me from Hong Kong.  Blessed relief.  She was on her way.  What a horribly anxious experience she was going through.

I think it was nearly as hard for Gail as it was for me for the next few days as the Surgeon at the hospital put me through a conservative investigative process aimed at finding out my problem.  Had my colon simply twisted on itself – apparently a condition known to affect harried businessmen – or was it something else?   Gail made the manager at the hotel aware of my plight and that she didn’t know how long the room would be needed.  The staff there were very empathic, arranging special meals, access to the Internet, and cars to drive her to the hospital. But it was a lonely, sad existence, full of worry and feelings of helplessness. Email communication with friends back home was poor solace.

The hospital setting was quite unique.  GlenEagles is a top institution in the city, and I was fortunate to have been admitted there.  The fifth floor was different from all the others in that it was reserved for ‘elite’ customers.  Apparently as a Caucasian visitor in serious condition I was afforded that appellation.  There were apparently many unique capabilities and arrangements made on that floor that didn’t occur on others.  There was one that especially intrigued us.

In one corner of the wing there was a large, elaborate suite, always dark.   It had its own lobby and several rooms spreading along two walls of the building.  Ornate statues of Buddha among luxurious fake palm trees decorated the entrance.  Mahogany woodwork indicated expensive tastefulness.  Clearly, this was a special place.

I was in hospital nearly 4 weeks.  Never in that period did the corner suite get used. So we just had to ask about it.

The Princess of Brunei did all her important shopping in Singapore where she could buy wonderful high quality western-type goods.  Clothes, electronics, leather products, furniture, fabrics were among her acquisitions.  The lady would fly into town with an entourage of relatives and security guards. And if milady suffered a headache while she was shopping she could always pop into her suite at GlenEagles with her entourage and rest there until she was ready to hit the streets again. And of course if anyone in the royal family was ill that was where they would stay and be looked after.

Perhaps the Sultan was a contributor to the hospital. We didn’t ask. In Singapore itself there are three main ethnic groups – Malay, Chinese, and Indian. While there are distinct localized homogeneous communities, the country is a true melting pot with many inter-group marriages. My business friend there is Indian, but he married a Chinese girl.  They had two distinct elaborate marriage ceremonies – one for each culture.  But the families got on well together.  You’ll hear both pros and cons about Singapore.  Lots of social support systems, some a bit confining for us westerners.  But clean, and orderly, with the city well maintained. A bit sterile in some folks’ views, too planful, too organized. No real hustle, bustle, and excitement that characterizes Hong Kong.  Crime well contained, communication technologically advanced.  And of course Singapore Airlines is one of the best airlines in the world, epitomizing a sincere, gentle, caring approach of Asian personal service in the skies.

After just over two weeks of various tests, some far less pleasant than others, Gail and I were asked to visit the Surgeon’s office.  She told us there were no more tests they could apply but it was clear there was an obstruction of the bowel and it would be necessary for surgery to find the problem and correct it.  She used a phrase we hadn’t faced before by suggesting a three-phase approach to my life-threatening condition. First a laparoscopic look, ‘with a view’ to incision if deemed necessary, ‘with a view’ to removal of part of the colon if required.  That last part shook us both up. Very scary indeed. 

Here we were 13,000 miles from home via airplane routes.   Hadn’t talked to any of our doctors back home. Felt good because of the western-trained doctors looking after us.  But re-sectioning of the bowel?  That was pretty drastic stuff with a long recovery period. How likely was it?  What were the chances of success?  If it happened how long would we have to stay?  No definitive answers forthcoming to those questions. 

We were introduced to the anesthetist who’d be assisting Dr. Lim. Gordon was full of empathy, asking a few more questions about current medications, allergies etc etc.  Oh boy, this was all too real. Scheduled for the next afternoon, neither Gail nor I slept well that night.  It was probably the toughest, loneliest evening of the whole visit for Gail. 

Apprehensive?   That was a highly euphemistic description of how I felt next morning.  Terrified? That was closer. In a strange city, no friends around us, unknown doctors and nurses of different races with varying degrees of English proficiency. An Indian nurse on our floor had taken Gail under her wing, for which I was incredibly grateful.  She dispensed anti-anxiety pills and arranged special western food.  She accompanied the pair of us in the elevator to the basement operating theaters.   She checked in on Gail during my surgery time relaying whatever information she could glean about what was going on, mainly when the anesthetist arrived,  when I was wheeled in to the OR, when the surgeon arrived and when she knew I was headed for recovery. One of the longest 120 minute periods in Gail’s life for sure.

Dr. Lim approached Gail in the lobby of the recovery area where she shared brief details of the operation, providing immediate relief by indicating that she’d had to go no further than phase two of her plan.  So that when I was wheeled into the recovery it was much easier than otherwise for Gail to tolerate my screams of pain.  The screams were both good and bad news.  I’d obviously survived surgery that was far less drastic than it could have been, but it was clear that I was hurting.

Sometimes, some days work out better than expected. This was one of them.

Chapter 3     Recovery  & Homeward Bound

There came a day when Dr. Lim came by and said, “I hear you are doing well Warren, increasing in strength each day with your walking exercises.  Would you like to walk outside in the garden tomorrow?”

“Yes ma’am. You bet.” 

I think Gail especially was getting tired of our repetitive tours of the corridors of our floor.  Round and round. Clockwise, then anti-clockwise.  Round and round again.  Monotonous. There weren’t many patients at all on the floor, but we knew all about them. Gail had been confined for 4 weeks in the hotel or the hospital.  A breath of fresh air would be very welcome.

And then the next positive input.  “Come by my office around noon tomorrow and we’ll remove some stiches.”

Wow, I really must be on the mend.   Definitely good news.

Have you ever had metal staples removed? Believe me it’s not something you want to pursue voluntarily. I grimaced as every second one was pulled out.  Ouch! 

“Good job Warren, we’ll take the rest out tomorrow.”  I wasn’t sure I wanted to come back for that procedure, although I knew I had no option, so to offset my hesitation I asked, “How soon before I can go home doc?”

“The day after tomorrow would work.  My receptionist can help with making bookings if you like.”

I didn’t quite sprint to the waiting room where Gail was, but I sure moved faster than I had in weeks. “We’re going home hon.  Two days time.”  We hugged in an unabashed display of affection which made the onlookers smile.  Joy, oh joy!

We had open Business Class tickets, and next day we had the receptionist call Cathay Pacific with tickets in hand to arrange eastward bound flights. No problem. She gave us the details and then told us about a wonderful embellishment.   Apparently Dr. Lim had already dictated a letter to the Officer in Charge, Cathay Pacific, Singapore.  It basically said that I had undergone prolonged major abdominal surgery and due to the nature of my pathology it would be best if I could fly with my feet up most of the journey back to North America.  Also, due to my surgical scar Mrs. Dent would be required to be next to me for nursing assistance.  Finally she ended with a request to please kindly assist with an upgrade to First Class if possible. 

The letter was faxed to Cathay immediately the bookings were confirmed.  No guarantees of course, but what a nice gesture on the part of the doctor.

It’s just under 4 hours flight time between Singapore and Hong Kong. Cathay Pacific’s schedule didn’t offer First Class on that route at the time of day we needed to travel but we were waited on attentively once on board as if we were somewhat special. It was at Hong Kong that the earth moved.  As we walked off the jetway a big sign with our names drew us to the side where about 6 uniformed employees waited for us. There was a large electric cart waiting and we were whisked away through unused corridors to a separate immigration checkpoint and on to a semi-secluded corner of the First Class lounge where we were offered a meal if we wanted.

The attention was almost overwhelming but very nice as manager after manager asked if there was anything they could do for us.  Talk about care, concern, and commitment. These folks really turned it on. We felt flattered.  I was handed a First Class boarding pass, although Gail only had a Business Class pass.  We hoped that might change but nothing transpired before we were taken by electric cart again to the gate area.

First Class and Business Class passengers were called to board and when Gail’s pass was scanned she was pulled aside and handed a First Class seat assignment instead.   We couldn’t fault Cathay in any way. Their service was outstanding.  Believe it or not things got even better. Our plane was a 747 – my favorite – and I had the single left front seat in the nose area. Gail was a few rows back on the other side.  But when people saw us chatting they switched around for us and she ended up directly opposite.  We were totally spoilt. And we enjoyed it.

It was still 13 hours to Vancouver with a two hour drive after that, but we were very happy to be heading home, in First Class no less, just drained from the whole episode.

Gail and I of course had done some real bonding. Her love was unconditional and I sincerely appreciated it.

These days she often wears a beautiful tanzanite and diamond ring.  It is my thank you to the most wonderful Florence Nightingale around.



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