Friday, December 21, 2018

To operate or not to operate?


First night in the hospital...

The door to our room burst open around 2:30 a.m., but it wasn't for me. We were getting our fifth roommate. Zina had gone home for the weekend, but her bed was still reserved as she wasn't officially discharged yet. And now a new patient would occupy the remaining bed.

Lights were turned on and the new roommate squealed a little bit as the nurse tried to place an IV. I eventually learned that evening/weekend nurses were not the best at this type of procedure. And began to pray a silent prayer of thanks that I had an IV port in my wrist and didn't need a needle poke each time.




Saturday

Daily schedule

Around 6 a.m., the nurse came in and beeped our foreheads with the thermometer and left. There were still a few hours until wake-up time and I had snapped a photo of the daily schedule on my phone. If you've read about my experience when David was hospitalized, it was a lot like that. In fact, this hospital ward was quite similar, except with adult patients, of course.

I still wasn't allowed to eat, and was given IV meds in the morning. I was struggling with nausea and a heightened sense of smell, as is often the case with me. I had to hold my breath when using the bathroom and when entering our room. I could never really figure out what smelled in our room, maybe just the scent of unwashed bodies (no shower)/bed linens/old mattresses? But even when Andrei arrived with his fresh toothpaste/soapy smell, it still made me gag.

Although I've read that there can be nausea/vomiting with appendicitis, I don't think that was the case with me. I'd mainly just had a bloated feeling for several days and a tenderness on the right side that wouldn't go away. Doctors kept asking why I'd "toughed it out" for 2 weeks, but I'd been able to keep up with normal activities during that time, even walking the mile to the clinic. I just tossed and turned at night with the ache in my side. Everyone said I'd "know" if I had appendicitis and my next step in diagnostics was going to be a colonoscopy. I was told to call an ambulance if I got sharp pains, but the sharp pains never came. So it was actually 6 days after my first visit to the clinic that I ended up at the hospital.

In between procedures, my roommates and I got to know each other. On the other side of the room next to the little sink/mirror, there were two beds. In the first bed was Marianna, a woman in her 70s. Whatever flare-up she'd been having seemed to be subsiding. She was quite friendly/talkative and would go down and buy a newspaper, then rustle it around all day and sometimes read excerpts to us out loud. When there was a lull in the conversation and the rest of us were napping, she would get on her phone and start making calls.

On Marianna's other side next to the window was Young Olga, who had arrived during the night. She was a little dramatic but also had a mischievous side. In the morning, she woke up flailing her arms and legs which had gotten stuck in the multiple holes of her blanket cover. We all had a good laugh over that.

The bed on our side next to the window belonged to Zina, the missing roommate.

Next to me there was Olga, who was in her 50s. She taught at a local university, so she and Andrei had a lot in common career-wise. Olga was a really good conversationalist and was also good at keeping Marianna's stories in check.

When we were getting our IV drips, we would all watch each other's in order to turn them off in time. We would also press the call button for each other. Sometimes we would have informal "competitions" to see who had the bigger bottle of solution, who had the slower/faster drip, etc.

I did eventually get some news from the doctor. Apparently my burst appendix was closed off by surrounding organs. They were going to treat the inflammation with antibiotics, and then later (in a month or so) go in and get the remaining piece.

"You got off easy, Lizochka," said my roommates (who had heard the whole conversation). "It could have been worse."

When my brother called from Congo, 3 time zones away, I gave him the report also. No operation for now.




Sunday

On Sunday morning, a nurse came in right away and told me not to eat or drink (I hadn't been allowed to eat anyway), because I was going to have an ultrasound. She came by for me a few minutes later and escorted me downstairs.

The ultrasound technician seemed really excited about the picture she was getting. I couldn't tell if that was good or bad. "Here's the perforation, and here's the fluid. It's been walled off by the other organs. And the stump went off in the other direction." I guess it had been hard to detect because of its positioning. The technician couldn't tell me what this all meant, but she did bring up another interesting topic. She had to repeat the question a few times. Apparently I was on a list with a chief surgeon, or something to that effect. Had I made a phone call to Management (AKA pulled some strings)? No, I hadn't. I'm still not sure what happened. Whether by divine intervention or the private clinic's effort to right their wrong, my name was flagged for additional observation.

The ultrasound technician took several minutes to write up her report for my chart and give it back to the nurse.

Shortly after I arrived back upstairs, a hulking man in scrubs came into the room and headed straight for me.

"Here's what we're going to do," he said. "Your infection is not responding to antibiotics. We need to go in from your side and make a large incision in order to operate, under general anesthesia. The recovery will be long and painful. You'll have a drainage tube for the first several days, and the wound will be packed with fillers of gradually decreasing size. Recovery could take a month or longer. Or we could keep treating with antibiotics. So, what's your decision?"

"What happens if we keep treating with antibiotics?" I asked.

"Sepsis could set in. And you don't want sepsis in our country."

I said I wanted to consult with Andrei. The surgeon left me with two sheets of paper: a consent form, and a denial form.

"Of course you need the surgery," my roommates murmured. "If you need the operation, you should get the operation," said Andrei, who was just leaving to come to the hospital.

I signed the consent form.




To Be Continued.

2 comments:

  1. I sure don't know why this doesn't sound like "the way they'd do it here", but somehow it doesn't. My goodness. What an adventure, is all I can say. I guess since you were in Russia (and in a major city, to boot) it wasn't going to help to consult an American physician, but I would have been tempted! Funny - I think there must be a natural sense that healthcare in "MY" country is preferable. One of the ladies in my Bible Study is from Slovakia, and she will not have anything done here without consulting the experts she knows from there. In fact, recently she flew there with her husband's x-rays for a consultation! Meanwhile, my friend's Belgian husband went to Belgium for eye surgery. But - there you were and it was an emergency. I'm glad I know how this turned out!!!!

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  2. I'll update soon! You know, in Russia sometimes the best physicians really are in the public hospitals. It's confusing. There's so much that can go wrong and yet you may get the best care...maybe. I suppose I could have just walked out of there, but being that the private clinic had SENT me there, I'm not sure where else I could have gone! And obviously once they'd already cut me open, I wasn't going anywhere...I had to be careful about Googling when it came to surgery. I don't think I wanted to know how different it was here. It's not like I could pick and choose.

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