Post Surgery

Some asked, why did you put up all those pain and suffering in a blog?

Others said, my so-called sufferings pale in comparison to others, like kidney infection, lung diseases etc.

First of all, I know I may have over-dramatized the pain, but so far, I had countless sprains, a mis-located thumb, and 6-ulcers in the throat, which all provided me with pain that I would never wish happened to others.

I used to go through entire sessions of my dad's uncle's "tui na" (urut or massage) without even a shout, and the most serious time was when my ankle was bruised like a pig's leg.

However, the current illness is the most unbearable of the lot.

I will describe more of it later.

For now, my intention of creating this blog is to let others, whom have experienced the same illness, to know what happened, is it similar to their pain, and to create a reference for me, in case I need some notes on this problem later on (who knows).

When I went back my hometown during Chinese New Year, a friend of mine from high school told me that he also had fistulae too, before he went to London for work, so we are like, "fistulae-mate". :

Anyway, for fistulae, the surgery wound cannot be sewn back, and have to be left open. This is so that the pus would not accumulate inside, and can go out through the wound.

I have read from wikipedia that there are other treatment options for fistulae and I will discuss this with Dr. Ravi later. The anal fistula plug looks like an attractive treatment.

"Anal Fistula Plug is a recently developed method known as AFP. This treatment requires placement and fixing of a plug in the anal fistula by a special technique. The plug is made of highly sophisticated absorbent material; it provides a scaffold over which body’s collagen gets deposited and closes the fistula. Comparative studies have shown this method to be very effective. One advantage of this method is that it involves no cutting, so there is no post operative wound and pain. AFP plugs can sometimes be inserted under local anesthesia. This method can be used successfully to treat high fistula without colostomy. It does not carry any risk of bowel incontinence. As opposed to the staged operations, which may require multiple hospitalizations, AFP requires hospitalization for only about 24 hours. The success rate of AFP is better than the other procedures. AFP was approved for clinical use by the FDA in May 2005 and hundreds of procedures have been done since then. "

Now, back to yesterday, when I first went back for dressing. I need to do dressings on the wound to clean the wound up.

I expected it to be painful, but since the last two days were largely painless, I don't think it will be as painful as the previous times.

Boy, am I wrong.

When the nurse first cleaned my wound with EUSOL, I let off a small scream. The dressing was terrible.

But that is not all, the nurse then had to insert a small gauze into my wound, so that it would soak up the blood and the pus. I didn't really see how the gauze is inserted, since I haven't attained the master level of yoga.

I think the most painful part is actually the tweezers, because she had to use a tweezer to push the gauze in, and the tip of tweezers will definitely touch the wound.

Surgery No. 3: Completion (Part 2)

Now, just after I managed to pee, I started having stomachache.

The stomache is terrible, and I shudder at the thought of having to pull up the gauze that was inserted into the wound of my anus.

However, the ache is too great, and I have to definitely go to the loo.

I pull off the gauze, which is longer than the previous time, filled with pus and blood.

Surprisingly, I did not feel much pain this time.

I hypothesized it is due to that this was the 3rd surgery, and that the previous wounds have already healed, while the current operation had cleared the inner part of the problematic region which had no pain sensors.

Anyway, I passed motion, and I asked the nurse to prepare a salt water bath for me to sit in, since this is one of the general recommendations for anal fistulae.

The nurse went to get some salt, and returned later with a bag of salt, and a huge pail, which is big enough to put 4 of my asses (my ass is already quite big).

Anyway, beggars can't choose, so I have to squat and soak my anus into the big pail, while balancing my body in order to avoid falling over, and avoid my anus touching the pail, because who knows what bacteria/micro-organisms are there (a recommendation from my uncle).

Now, when I am soaking in the salt water bath, I felt a pain in my stomach again.

Great, now I have to pass motion again, and the repeat the 15-minute salt water bath again!

That was just the start of the seemingly endless numbers of time I shitted, because once I finished my salt water bath, I would get stomachache once again, which lead to salt water bath again, and again the stomachache, repeat, repeat and repeat.

I tried eating some bread, drank hot milo, put some medicated balm, but none worked, I was still feeling the stomachache, even though all I shitted was just blood and some pus. (I borrowed the medicated balm from one of the nurses, but in the next morning, the balm was gone, and I assumed that the nurse has took it back. )

The thing is, since I was going to loo all the time, the nurses were unable to do my dressing on the wound, because if they did, I would need to pull out the dressing each time I go to the loo, and repeat the pain of doing that.

Anyway, I decided to bear with the stomachache in the end, and kept my mind busy instead by watching ESPN's college basketball, and sudoku.

Luckily, it worked, and I managed to get some sleep, albeit at around 4am.

Around 6-7am, I was woken up by the nurse, because it is time to do dressing.

I was expecting the worse, because I still remembered the first time I did dressing, the pain was excruciating.

However, once again, the pain of the dressing this time was bearable, compared to the previous dressings.

Dr. Ravi came over around 9am later, and basically approved me to go back home.

I asked him about the antibiotics since I was given antibiotics after the previous surgeries, and he told me that I shouldn't need any.

I assumed that he had actually forgotten about it, because when I checked out later, I was given antibiotics at the medicine counter.

Total bill for the surgery plus additional 3 weeks of dressings?

Around RM3500. (Previous bill was only RM2700, but is without 3 weeks of dressings.)

Surgery No. 3: Completion

Yesterday morning, I went to get my GL from the HR at 8.30am, and went to Pantai straight away after that.

The journey was took with a heavy heart, as the last surgery had caused severe amount of pain and discomfort.

I registered for admittance at 9am, but was made to wait until 3pm before I went in the operation theatre.

The operation was actually a brief and minor one, but the most painful part is the anesthetic, administered by Dr. Tan Kim Hock.

I just noticed that he has the same name as the famous Tan Kim Hock when Maureen told me so. "No wonder we didn't see him in the shop last time."

Anyway, the thing is, I am to have half-body anesthetic, which means the anesthetic is to be administered into the spine.

The pain was terrible the previous time, but somehow this time, it is still ok.

The operation took around 10 minutes, and I was sent to the heater before being sent back to the ward.

I was originally given a single ward, since there is no available twin-sharing room at that time.

Since the half-body anesthetic would last for around 6 hours, I couldn't move my lower body at all.

Then came the agony for the night.

Around 3 hours after my operation, two nurses came and told me to shift to a twin-sharing room, else I would be charged for the single room.

However, they did not have the strength to carry me from one bed to the other, and they did not have a slider for the shifting purpose.

Thus, they asked me to shift by myself, which is impossible because I can't move my legs at all!

So, I shifted my upper body, while they dragged my legs over to the other bed, which was a cause of concern for me, because I was instructed not to raise my head, or bend my spine due to that there is a small risk that it may cause problem to my spine.

Luckily, nothing came out of it.

The next agony was with pee-ing.

Since my lower body was paralyzed, I was, um... unable to use my 'thing' for pee-ing.

In fact, when I grabbed it, I could not feel that it is attached to my body, it felt more like some otherworldly thing.

Believe me, it almost lead to a nervous breakdown.

Now, at the same time, my urine kept accumulating in my bladder, and I could feel severe pain inside it, but I am unable to pee, causing the accumulation to get worse.

In the end, I had to bear with it for 3 hours more before I could finally pee.

By the time the anesthetic effect went away, I was feeling an urge to pass motion.

This proved to be a major problem...

Surgery No. 3

I got the letter from Dr. Vasanthy yesterday for the recommendation to be inspected by Dr. Ravikumar of Pantai Hospital.

Previously, I have used my medical card from Prudential for the claims, which is faster compared to claiming from MMU.

However, this time, I have decided to claim from MMU instead, since medical benefit is part of the employment benefits.

Before I can go to see the specialists, I would need to obtain a GL (guarantee letter) from MMU's HR department.

So I sent in my request at 10am, but I was told that I need to wait 3 days for it to be processed.

I explained that it is an emergency, since Dr. Vasanthy had suspected that I had a recurrence of fistula.

The clerk thus helped me to process the application which would be ready after 2pm.

I waited in the office until 2pm, but when I went over, the GL is still pending approval.

I only obtained the letter around 3pm, and I rushed over to Pantai Hospital with Maureen.

As usual, Pantai Hospital's frontside parking was full, and I had to park at the back.

Arriving at Dr. Ravi's clinic, I was made to wait once again, since he is supposedly busy.

When it's finally my turn, I went in and told him that there is pain near my anus, and that I could feel a 'boil' on the left cheek of my anus.

Customarily, I then took off my pants, and lied at the bed, waiting for him to inspect the wound.

At that time, all I could think of is the utter terror of having to undergo the surgery ordeal once again.

I do not feel ashamed at all now of having my asshole being examined, it's already been exposed to various kind of 'viewing situations'.

Dr. Ravi then broke my train of thought by poking at my wound, asking if it is painful.

"OOWWWWW!!!" is my answer.

He was as puzzled as me, because the wound has already healed, but there is a small blister near the wound, which is the cause of my pain.

"It's only a small blister, which maybe caused by the wound healing and closing prematurely, so I would open the wound up, and see where it leads to." Dr. Ravi said.

For the previous two operations, my uncle, Dr. Goh, told me to get the surgeons to talk to him before the surgery, but both times, the doctors MIA before I can get him to talk.

This time, I was determined not to make the same mistake, and phoned Uncle, passing the phone over to Dr. Ravi.

After their brief conversation, Uncle told me to proceed with the surgery, and to get Dr. Ravi to call him again after the operation.

As such, I was scheduled for surgery tomorrow, at 9am.

I was famished at that time, which was around 4pm, because I did not eat anything since breakfast as I thought that I would be operated on in the evening.

......

Anyway, wish me luck.

I shall get through this anus hell by tomorrow.

......

Hopefully.

Anal Abscess 2

I just went to see Dr. Vasanthy, whom I frequented very often to do my dressings after my fistula surgery.

There is still pus coming out from wound, even after almost 3 months from the day I did my first incision and drainage procedure at Damai Medical Center in Kota Kinabalu, Sabah.

Dr. Vasanthy told me that it could be a recurrence of the fistula, and wrote me a letter to see Dr. Ravikumar of Pantai Hospital once more.

I came back home after that, and checked my anus.

Shitty, there's another soft and tender 'boil' on the left side of my anus!

This means most likely, I will need another surgery.

I shudder at the thought of going through all the hell of surgery once more..