On October 18, 2008 I had a cholecystectomy to have my inflamed gall bladder removed. The following is a chronicle of what took place from October 15 when the pain first started to today, four days post-op.
Keith and Z had gone to camp on Monday and came back on Wednesday, October 15. I was extremely glad to have them back, and they were very happy to be home. At dinner, we just heated up some leftovers. I had pork rib and daikon radish soup with some rice. I had cooked it Sunday night and started eating it Monday. Since Keith wasn't here to help, the soup lasted quite a few days. After dinner, we were watching TV and I asked Keith to make some caramel apples. He had fed me a bite of it before dinner, and it tasted very good. So I had quite a few wedges of caramel apple. Almost in no time, I started to experience acute pain in an area right below the rib cage and a bit to the right. My back also ached a great deal. I laid there regretting eating the caramel apple, wondering if the pain is from overeating. I also felt a bit nauseated, and wanted to vomit, with no success.
Finally, I decided to go to bed. It was getting late enough and I could lay in bed in pain more comfortably than I could on the couch. While getting ready for bed, I did vomit a little but not a whole lot came up, to my dismay. I thought if I just got rid of the excess food then I would feel much better. All night the pain persisted, and at times the pain was in my shoulders too. Sometimes the back pain was worse than the pain in my stomach. There was a lot of pressure and my stomach felt distended. For fear of disturbing Keith, I finally got up and tried to sleep on the couches in the living room and then the family room. I thought of Glenn Mitchell at KERA, who died of a heart attack alone on a living room couch. I thought my heart fluttered occasionally too, but it could have been my imagination.
Daylight didn't bring any relief, but slowly the ibuprofen and naproxen sodium started to work, and I was able to get some sleep. Before drifting off I managed to call my assistant Linda and left a voice mail to let her know I won't be coming into the office. She later told me that I sounded really horrible. After a bit of sleep I felt better and the painkillers helped to take the edge off the pain, but it was still there, a constant pain in the area below the rib cage, in the center and to the right. I ate a piece of toast that day and tried to drink as much water as I could. I didn't go to the doctor that day because I still thought it would go away on its own. That night in bed I asked Keith to look up what might be the problem (I know, should have done it earlier). In a physiology book we have, we were able to identify the pancreas and the gall bladder as the organs that were situated where the pain seemed to come from - immediately below the rib cage. On the web, Keith identified pancreas attack and gall bladder stone as possible problems with the symptoms I was having. We thought we better get to the doctor the next day.
On Friday, October 17, we had planned to go to the Texas State Fair. Both kids had the day off and I had planned taking off that day so we could go. Alas, this would be the first time in many years that we missed the state fair. We went to see Dr. David Lee at PrimaCare. I liked the convenience of PrimaCare - no appointment necessary, just pop in when you have a health problem. But now I know that they are good at taking care of minor health problems but not major ones. Dr. Lee listened to my symptoms and we asked him about pancreas and gall bladder stones. He ordered a blood test and an X-ray. The blood test showed that my white blood cell count was twice that of normal, at about 20,000 count. This showed that I have a raging infection. The abdominal X-ray didn't show "perforation." Dr. Lee didn't explain what perforation meant, but I guessed some kind of tear or opening in my intestines. From all of this, Dr. Lee's diagnosis was - food poisoning. Keith and I were skeptical. Food poisoning? You've got to be kidding. But he was insistent and ordered an antibiotics shot, put me on antibiotics, Cipro, and prescribed an anti-queasiness medicine and an anti-cramping medicine. We didn't even fill those two prescription as I really didn't have those problems. I still ate very little, I think a piece of toast that day.
The next morning, as we were getting ready to go back to PrimaCare for a follow-up check-up, Keith called Dr. Ron Skufca, our neighbor down the street. He told us to come over right away. After listening to the symptoms, and listening to and palpating different areas of my stomach, Dr. Skufca thought it was the gall bladder that was causing the problem. He wanted us to go to his clinic, but after finding out that his ultrasound technician wasn't in for the day, he directed us to go to the hospital emergency room right away. He explained that the doctor should order an ultrasound and have my liver and pancreas enzyme levels tested. He also took the time to explain the laproscopic surgical procedure and I would need an overnight stay. I will always be grateful to Dr. Skufca for taking such good care of us at a time when we really needed it. I am also grateful to Keith for sticking by me the whole time, but more ordeal to come later.
We stopped by home to tell the kids that we were off to the hospital and to pick up anything we may need for an overnight hospital stay. I just made sure my prescription drugs were with me and was anxious to go. When in a pinch, we really don't need a lot of external things, do we? I really wanted to get to the bottom of it and get rid of the culprit as soon as possible. We first went to Baylor at Preston and George Bush. I walked up to the emergency registration window. There was no one behind the glass window, but there were signs with instructions to fill out a form and a slot to put the completed forms. I did so and Keith came in from parking the car and joined me in the waiting room. A woman showed up behind the glass window and called people in once in a while. There were quite a few people in the waiting room, probably about 6 or 7 patients waiting to be seen. We noticed what looked like a mission statement for the hospital - "We want to provide you very good care." Very good care? Keith and I thought that wasn't very inspiring. I demand excellent care! After about half an hour, I was called into the little room where the woman sat. She took my symptoms and took my blood pressure. She also put a paper band with my name and birthdate around my wrist. As she opened the door to let me out of the room, I asked her what the situation was in the emergency room. She answered that the emergency room beds were full and she couldn't tell me when my turn would come. That wasn't what I wanted to hear!
We left Baylor and sped off to Plano Presby. It's also an emergency room, but the side-by-side comparison was enlightening. At Plano Presby, where I gave birth to both kids, there were two receptionists who sat behind a desk, not isolated by panes of glass, and they greeted us with smiles. Although the emergency beds were also full, they assured us that since we were second in line, we would be seen fairly quickly. Although we know that still doesn't mean right away, we were at least hopeful that sometime today we will be seen. I reminded Keith of the man who waited 19 hours in the emergency room who finally died of a heart attack in the emergency waiting room. A TV monitor in the waiting room promised "the best care possible." I thought that was much better! Keith also thought the decor was much warmer and more pleasant. We arrive at Plano Presby at 11am, got my symptoms and initial temperature and blood pressure taken at around 11:30am. We sat around until noon when I was ushered in to see the emergency doctor. Dr. Robert Holland was fairly young and attractive. He had very good bedside manners and put us at ease right away as he ordered an ultrasound to check out the gall bladder. He agreed with us and with Dr. Skufca! He also ordered blood tests done and we informed him to be sure to check the liver and pancreas enzyme levels! Kita, the hospital money lady, came to get our insurance and payment information to make sure we will pay up for the service (we still don't know how much we owe). She told us the emergency room visit is $1800, and that didn't include the ultrasound and blood test. At about 1pm a nurse, Judy, put an IV in my arm. I guess they figured I am here to stay. Her first try, on a vein on my right hand, brought tears to my eyes that it hurt so bad. She mumbled something about being dehydrated and finally settled on a vein in my left arm. Using the IV they gave me some pain meds to ease the pain.
The ultrasound technician, Carol, arrived when Nurse Judy was poking me. Tech. Carol looked thoroughly at the area right below the rib cage. She had me change positions and hold my breath so she can have clear views to show the doctor. We asked her what she saw and she delivered a prepared spiel: the doctor, together with lab results and the ultrasound results, will give us the diagnosis. At around 2pm, Dr. Holland came back to deliver the news: a gall bladder stone was obstructing the duct leading to the common bile duct to the stomach and the gall bladder has to come out. There were no alternatives. He informed us that he will check to see if a surgeon is available for surgery in the afternoon and the surgeon would come see us.
All this time Keith had been calling home to see if A has a ride to her band competition. Uncle David and Aunt Daphne were ready to step in if she didn't find one. When we found out we needed surgery, David and Daphne went to check on Z and brought him something to eat. They also took him shopping, we later found out. We also called my parents to let them know what was going on. My mom was shocked to learn that I was having surgery as the last thing she knew, I had food poisoning. I wanted Keith to get something to eat himself as he had not had a proper breakfast and lunch. He found the vending machine and ate some chips and a Payday. Not really the type of food I had in mind.
Dr. Kantor, a distinguished looking surgeon, came to see us around 2:30pm. He explained that the procedure is laproscopic, meaning that I would not be cut open but rather four small openings would be made to allow instruments to go in to view and remove the gall bladder. I asked Dr. Kantor how many of these procedures he had performed, and he indicated that he has stopped counting that there had been so many. I was good with that. I just wanted it done. I had stopped drinking and eating at around 11am, since I thought if I had a surgical procedure I would need to do that. Good thing! Dr. Kantor scheduled the procedure for 4:30pm.
David and Daphne told us that they would take the kids home with them and they would have a movie pizza night. It sounded like fun and I am grateful to them for taking such good care of the kids. I think I emailed several people then to let them know that I would be having surgery, and for my assistant Linda to cancel my meetings for the next week.
After a bit more waiting, which was easier since I had painkiller in my veins and I was laying down, I was wheeled to the operating area by Ruben. Ruben was very pleasant and chatted with us as we navigated the hallways, doorways and elevator. Dr. Segal and Dr. Kantor were standing in the hallway when we went through a doorway that indicated surgery. Dr. Segal was to be my anesthesiologist. He explained what I will feel or not feel. He explained that he will be monitoring my brain waves to make sure I am indeed under and not feeling any pain. That helped as I have heard stories where the patient was immobilized but could feel and hear everything. He put something in my IV and I immediately felt like a light veil was put over my whole body that dulled my sensations. I kissed Keith goodbye, hoped that I would see him again, and the next thing I know I was waking up and feeling nauseated. I vomited into a little plastic pan three times and heard a nurse say to someone that she's never seen anyone vomit so much. I thought I didn't vomit that much! Hardly anything came up. I didn't get a good look at where I was, and the next thing I know I was in my private room and Keith and my parents were there. Keith later told me that I looked really bad, like I was dying or something. I think it was around 7pm then and I remember thinking then that it took longer than I thought. I could tell that Keith was relieved. He later told me that it was very hard to say goodbye to me.
I think I was in and out of consciousness, still groggy from the anesthesia. Keith showed me some pictures that were taken during surgery but it didn't really register with me as I was still a bit groggy. I had a compression gadget wrapped around both of my legs to prevent blood clot. They were hooked up to an air pump that alternately pumped air into the wrap over each leg, which would tighten and squeeze the legs. After a few times, there would be some kind of resetting clicking sounds repeated for each side. That went on all night. Nurse Paula and Tech. Eva checked on me throughout the night to take the blood pressure and temperature. Keith tried to get some sleep on the built-in seating in the room which had a cushion that caved in in one spot. Nurse Paula kept asking me if I wanted some painkillers. I didn't need any until the next day but then just a couple of times. During the night and the next day, I got up to go to the bathroom about three times, each time into a little pan that fits in the toilet. Tech. Eva and then the new Nurse (forgot her name) the next day took down the volume of the urine. I didn't have any trouble walking or have pain when I walked, just a bit sore. A lab technician came in around 6am to take more blood. He was good, it didn't really hurt. I asked Keith what did the doctor tell him after the operation. Keith said that there were no other stones found (because I had pain in the shoulders they suspected stones in the common bile duct) and no complications. I was allowed to order some clear liquid food for breakfast. I asked for chicken broth and jello. The broth was extremely salty but the jello was good. The nurse gave me a couple of potassium pills to take with the food as the blood test showed that I was low on potassium for some reason.
My parents came at around 9am. To help calm my parents down I showed them the lap entry wounds, which were small and neatly and nicely sealed off by some transparent film over them. The biggest one was in my belly button, but pretty much hidden. The other three were situated along a straight line from center diagonally down to the right side. Dr. Kantor seemed like a very neat guy as he left me very neat wounds. The wounds were not bandaged at all and just a little sore.
At around 11am Dr. Kantor showed up. When asked, he delighted in telling us that my gall bladder had swelled to fist-sized and was pink when it was supposed to be robin eggs-blue. It had been so diseased that the paper-thin walls had thickened considerably. The stone itself was also sizable at 3/4 inch. Dr. Kantor said that a patient of his a long time ago had made a necklace out of her gall stones. I wanted my stone but they don't give those to the patients anymore. Dr. Kantor gave me a clean bill of health, scheduled a follow-up visit, and cleared me to leave the hospital.
That afternoon I walked around the yard as much as I could and basically stayed outside enjoying the birds, butterflies, and our animals all afternoon. Life is good! Dr. Skufca stopped by on his afternoon walk and checked on me.
Post-op care has been minimal. The wounds are sealed so they didn't need to be taken care of. I was able to shower right away and was glad to after so many days spent in agony. I started to eat a little soupy food that night. Mom cooked some good Chinese food for me. She was worried about my nutrition as I had not eaten much for several days. I am extremely grateful for Keith as he stood by me during the entire ordeal, always vigilant and always acted as my advocate. He has been a saint. I had told him before when I gave birth to the kids that I didn't trust doctors and nurses to always do everything correctly, so that we have to question and watch carefully. Today, four days post-op I can say I feel almost 100%. I must say that this hospital visit was as smooth as can be. Everyone we met at Plano Presby was nice and made our visit very pleasant, if a hospital visit and surgery can be pleasant. I thank God for watching over us and the blessings He gives us. I am also thankful to all the family and friends who have prayed for my recovery. Life is good!
Lessons learned are that we should trust our own intuition more. I knew Wednesday night when the pain started that these were unusual. But I ignored it and instead tried to wish it away. Had I gone to the right doctor on Thursday, I would have saved myself three days of agonizing pain and gotten the problem taken care of promptly. Second, PrimaCare is good for the flu and sprains, but for the serious stuff, go see the right doctor. Third, insist that the medical personnel take your input into consideration and not ignore it. We knew that the symptoms didn't fit those of food poisoning and we were right!
God Bless America
Copyright 2008 Wei Wei Jeang. All Rights Reserved.