May Bato sa Apdo ang Mamay P

Kapag nagkakaidad ang isang tao ay maraming nababago sa kanyang katawan: humihina na ang kanyang resistensya; lumalabo ang paningin; humihina ang pandinig; tumataas ang presyon; sumasakit ang mga kasu-kasuan at mga buto-buto; at kung anu-ano pang karamdaman na sanhi ng pagtanda. Kung minsan, nasa isip na lang natin ang mga gawaing easy-easy lang nating nagagawa noong tayo ay bata-bata pa.

Dahil sa ating pagtanda, bigla-bigla na lamang lumilitaw ang iba’t ibang sakit na hindi natin alam na meron tayo. Tulad sa kaso ko, hindi ko alam na ang simpleng pagsakit ng tiyan ay may malalim palang dahilan. Gabi nang biglang sumakit ang aking tiyan. Akala ko ay hyperacidic lang ako dahil pareho ang sintomas. Agad akong uminom ng maligamgam na gatas na aking ginagawa kapag nakararamdam ako noon. Bahagyang nawala ang sakit subali’t nang ako’y matutulog na ay umulit ang sakit ng aking tiyan. Hindi ko malaman kung saan parte ito nagmumula. Parang hinahalukay ang aking sikmura, may pumipintig sa loob, at medyo kumukulo. Tagos hanggang likod ang sakit kung kaya’t hindi ko alam kung saan ko ibabaling ang aking paghiga. Halos hindi ako nakatulog nang gabing iyon. Pagising-gising ako.

Kinabukasan, medyo pawala ang sakit ng aking tiyan. Minabuti kong kumunsulta na sa isang manggagamot nang hindi pa rin ito tuluyang naalis. Mabait at maasikaso ang Nigerian na doktor na si Dr. Olumide Omawaye na umasikaso sa akin. Pinapunta ako sa laboratoryo upang kuhanan ng sample ng dugo upang masuri kung ano talaga ang dahilan ng pagsakit ng aking tiyan. Gayunman, niresetahan niya ako ng SOMAC, isang gamot sa hyperacidity o GERD (Gastroesophageal Reflux Disease (GERD). Sinabihan din niya kong magbawas ng timbang dahil overweight ako base sa aking BMI (body mass index).

                                                CT Scan Machine

Nawala ang pagsakit ng aking tiyan ng araw na iyon. Nang bumalik ako kinabukasan para sa resulta ng aking blood test, nakita ni Dr. Omowaye na masyadong mataas ang aking ferritin – isang protina ng dugo na nagtataglay ng  “iron”. Ang normal na level ng ferritin ay nasa 30 – 300 ug/L lang subali’t ang ferritin ko ay 3,079 ug/L – sampung beses ang taas! Maraming indikasyon kung bakit nataas ang ferritin ng isang tao. Maaaring sanhi ito ng sakit sa atay, rayuma, pamamaga, o maaari rin namang isang uri ng kanser.

Ang unang sapantaha ni Dr. Omawaye ay pancreatitis ang aking nararamdaman kaya binigyan niya ako ng referral upang magpa-CT scan (computerized tomography scan). Hindi ako kumain ng hapunan ng araw  na iyon at almusal kinabukasan para sa test. Isang basong kulay tsaa ang pinainom sa akin bago ako sumalang sa CT machine. Tinurukan din ako ng heringgilya upang pasukan ng dye ang akin katawan. Hinga at pigil-hininga ang aking ginawa habang nakasalang sa makina.

Hindi pancreatitis o tumor ang dahilan ng pagsakit na aking tiyan. Ang nakita sa aking CT scan ay maliliit na “bato” sa aking apdo o tinatawag na “cholelithiasis”. Upang masuring mabuti ay inirekomenda ni Dr. Omawaye ang “abdominal ultrasound” upang makitang mabuti ang kalagayan ng mga “batong” ito. Madali lamang ang procedure ng ultrasound. Walang ineksyon at walang pinaiinom. Papahiran lamang ng parang “gel” ang iyong tiyan at may ilalapat na instrumento rito. Tulad ng dati, hinga at pigil-hininga lang ang iyong gagawin.

Ultrasound machine

Ayon sa resulta ng aking ultrasound, ang aking apdo ay naglalaman ng maraming gumagalaw na mga “bato” o “calculli” na ang pinakamalaki ay 9 mm. Normal naman ang wall o kalamnan ng aking apdo. Ang common bile duct o CBD ay “dilated” na may sukat na 9.3mm subali’t walang nakitang mga “bato” rito.  Ang aking lapay at bato (kidney) ay normal naman.

Pinahinto ni Dr. Omawaye ang pag-inom ko ng Atorvastatin – isang gamot sa high cholesterol level – dahil baka sanhi rin ito ng pagtaas ng aking ferritin. Sa pag-inom ko ng Somac at paghinto sa pag-inom ng Atorvastatin, ay unti-unting bumaba ang aking ferritin. Gayunman, nirekomenda ako ng doktor sa isang surgeon, si Dr. Frank Wang, dahi baka mauwi sa “choledocholithiasis” o pagbaba ng mga “bato” sa CBD na maaaring maging sanhi ng pagbabara nito.

MRI Machine

Gumawa ng referral si Dr. Wang sa isang laboratoryo upang sumalang ako sa isang MRI (Magnetic resonance imaging). Isinagawa ang MRI noong May 19, 2020.  Hinga at pigil-hininga lang aking ginawa habang kinukunan ng larawan ang loob ng aking tiyan. Inabot nang higit sa isang oras ang pagsalang ko sa MRI machine dahil inulit ang malalabong kuha.

Nirekomenda ako ni Dr. Wang kay Dr. Passan para sa isang ERCP (Endoscopic retrograde cholangiopancreatography), isa itong procedure kung saan may ipapasok na instrumento sa iyong katawan mula sa bibig hanggang sa doudenum at CBD upang suriin at/o alisin ang anumang nakabara roon. Sa isang pampublikong ospital ginawa ang aking ERCP. Tinurukan ako ng Anaesthesiologist ng sedative o anaesthesia upang hindi ko maramdaman at mamalayan ang gagawin sa akin.

Habang nasa loob ng silid ay iniisip ko kung paano makakatulog at magkakaroon ng bisa ang initurok sa aking gamot. Nagising na lamang ako na nasa Recovery Room na kabilang ang mga pasyenteng dumaan din sa iba’t ibang procedure ng Endoscopy Department ng ospital, habang may IV fluid na nakalagay sa aking kanang kamay. Apat na oras na NBM (Nothing By Mouth) ang rekomendado ni Dr. Passan kaya 4 na oras din ang inilagi ko sa silid. Ibinalita ng doktor na nasa 30 ang inalis na “bato” sa akin na ang pinakamalaki ay 4mm.

Pagkatapos ng apat na oras ay pinakain ako ng jelly at pinainom ng tsaa at saka pinauwi rin nang araw na iyon. May ilang araw na masakit-sakit ang aking lalamunan dahil sa instrumentong ipinasok dito. Nawala rin naman ito pagkatapos. Nang muli akong bumalik kay Dr. Wang ay sinabing kailangan akong operahan at tanggalin ang aking apdo dahil meron pa itong mga “bato”. Nag-fill up siya ng Admission Request sa isang pampublikong ospital kung saan gaganapin ang operasyon. Pinilapan ko rin ang nasabing dokumento at ipinasa sa nasabing ospital. Maghihintay pa ako ng tatlo hanggang apat na buwan sa opeasyon na maaari ring matagalan dahil sa Covid-19.

Sa ngayon, hindi naman sumusumpong ang pananakit ng aking tiyan. Limitado lamang ang aking kinakain. Iniiwasan ko nga lamang ang pagkain ng mamantika kahit sinabi ni Dr. Wang na wala akong dapat iwasang kainin nang tanungin ko siya. Halos 10 kilo ang nawala sa aking timbang. Mula sa 77.7 kilo ay nasa 67.5 kilo na lang ito. Ang pagbaba ay dahil sa limitadong pagkain at paglakad-lakad ng 30 minuto sa araw-araw. Dahil nabawasan ng timbang, medyo tumanda ang itsura ng inyong Mamay P subali’t mas iwas naman ito sa iba pang sakit. 

For the video version, please watch below:

The Day Dr. Wang Sucked Out My Gallbladder

I knew it was coming…but I didn’t realize it would be that soon. Normally, it took about 3 months for that to happen. It might take longer because of the Covid-19 pandemic. Well, that’s what the hospital staff told me when I handed in my admission request. And then that phone call from the specialist’s clinic…3 weeks after I saw Dr. Frank Wang, my surgeon.

Honestly, I preferred that the procedure would be done sooner. Yet, I had to wait for there were hundreds before me in the queue. Being a public patient with no private health insurance, the hospital and the specialist will decide when your time is.

A month back, I had my ERCP (Endoscopic Retrograde CholangioPancreatography). According to sages.org, “ERCP is a procedure that allows your doctor to see the small tubes inside your body called the pancreatic and bile ducts. These tubes are near your stomach. They carry digestive juices from your liver and pancreas to the intestines.

For ERCP, your doctor uses a flexible lighted tube called an “endoscope.” The endoscope, or scope, is about as thick as your index finger. It goes through your mouth into your stomach and the first part of the small intestine called the “duodenum.” There are many reasons why the doctor uses ERCP. In my case, he has to remove gallstones in the common bile duct. My doctor said that he removed about 30 small calculi from the duct.”

With a history of gallstones, the common recommendation by doctors is to remove the gallbladder to prevent future gallstones formation that might result in inspection, blockage, and cancer. My doctor has the same view.

I was “lucky” to have the procedure earlier if lucky is the right word. At least, the agonizing wait will be finally over. On August 22, 2020, Dr. Frank Wang sucked out my gallbladder!

That day was the coldest day in Sydney during the year. Chilly winds kissed my face as we stepped out of the car. You felt as if you were inside a refrigerator. As my wife and son entered the hospital lobby of Campbelltown Private Hospital, an usherette-nurse scanned our forehead for fever, handed out face masks, and asked questions because of Covid-19:

“Do you have itchy and sore throat, and/or difficulty in breathing?”

“Have you gone to Melbourne in the last week?

“Have you been in the identified “hot spots” in New South Wales?

Etc.,,, etc.

Then I proceeded to the reception to check-in. The nurses there are accommodating and kind. After answering some questions and signing some documents, my companions and I proceeded to the lobby. After roughly 20 minutes, a nurse approached me and led me to another reception area. There, she weighed me, took my height, and led me back to the lobby. Another 30 minutes and I was back in the same room for documentation. My wife and son left me after that. I was alone in the waiting room with other patients who were also scheduled to have a procedure.

Another 30 minutes and the nurse accompanied me to the third floor of the hospital via the elevator. There, she led me to the dressing room to change. All your clothes had to be removed and replaced with a hospital gown, bathrobe, and disposable shoes and underwear. Again, I need to wait with the other patients until a nurse called you again.

After 30 minutes, a nurse called me and entered a small cubicle. By her voice, I knew that she was a Filipina from the Philippines. I lay down on a small bed where Marissa injected nitrite in my stomach to prevent blood clotting. I thought I will be in the operating theater next but I wouldn’t. I was back again in the waiting room while the drug was “tingling” in my vein.

My admission time was 10.45 AM but after 4 hours later, I was still waiting for the procedure. There were about 7 patients waiting when I first arrived and there were only two when the Filipina nurse called me to sit on a more comfortable chair where she also gave me a heated blanket.

It was about 3:45 PM when a male nurse put me on a bed. Another Filipina nurse approached and asked personal questions to make sure that I am who I am and the procedure that will be taken place. After that, the male nurse, Chang, grabbed the railing of the bed where I was lying down and pulled it through the hospital corridors while I was looking at the lights on the ceiling.

The bed stopped in a small room where I saw some hospital materials and equipment. “This is it,” that’s what I thought. A nurse from the back door suddenly appeared and asked me the usual questions to verify my identity. Afterward, she slipped on compression socks to aid blood circulation on my feet and knees, and other materials were wrapped around my shoulders for the same purpose. Then she attached some adhesives on my chest and forehead and left.

After 10 minutes, the anesthesiologist came and administered anesthesia on my left hand while asking identity questions. After she left, I thought the drug will take effect immediately just like what happened when I had my ERCP. I began counting but when it reached 1000, I stopped. I guessed, 2o minutes had passed, and yet I was still awake.

The female nurse appeared again and asked me if I could walk with her in the operating theater. I said “yes” and we walked in the back door where the theater was connected. There Dr. Wang and the rest of the operating team were waiting. I lay on a narrow operating table and after a minute, I did not know what happened.

What I know was that Dr. Frank Wang will be performing a laparoscopic cholecystectomy on me. According to myclevelandclinic.org, “A laparoscopic cholecystectomy is a surgery during which the doctor removes your gallbladder. This procedure uses several small cuts instead of one large one. A laparoscope, a narrow tube with a camera, is inserted through one incision. This allows your doctor to see your gallbladder on a screen. Your gallbladder is then removed through another small incision.”

I woke up when someone’s hand was touching my face. I opened my eyes and then realized that I was in a recovery room with the surgeon. There was an IVF attached to my wrist and I was breathing in with oxygen. Dr. Wang told me that I will be spending the night in the hospital because it was already evening. I didn’t know how much time I spent in the operating room and what time it was.

After the doctor left, a male nurse came. By his intonation, I knew he was also a Filipino although he was speaking like an Aussie and I was right! It really helped when you could relate to someone when you were alone and unwell.

The nurse gave me a pain killer when I told him I felt some pain. He also administered antibiotics via IVF. Afterward, he brought me something to eat – tea, water, and a sandwich. After eating, I slept.

I woke up again and took another pain killer. I didn’t have any idea of the time. The nurse asked me to take a pee because it would be inconvenient if he needed to put a catheter on me. Luckily, I was able to pass out my urine in the toilet bowl without any problem except that I had to walk inside the toilet by myself.

Morning came and a female nurse came by for my breakfast – tea, and Weet-bit. She also injected me with nitrite my leg. I also took a pain killer. It was about 9:30 AM when she told me that I will be discharged from the hospital and my son had been informed. She also asked me if I want to take a bath or do it at home. I was a little bit shocked since I just had my operation.

My son fetched me at around 10:30 AM and drove me home. At last, the agonizing wait was finally over. Dr. Wang was successful in sucking out my gallbladder. Immediate recovery is the next goal!

At home, I took the pain killer “Endone” twice a day for 3 days. The nurse cautioned that constipation was a side effect and it did. On the fourth day, I took Panadol instead.  On August 28, 2020, my wife removed all the gauges and plaster from my wounds to dry. Right now, I am on the recovery period knowing that it will take at least 6 weeks for a full recovery.