This has been on my mind for more than a week so I'm going to try pen them into a series of tweets with the hope that they'll serve as a grim reminder for myself not to take things for granted, no matter how small they are.
— (e+ho)ng (@talexeh) December 7, 2017
Back in Form 6, I had my first real brush with death when the car that was driven by my schoolmate went plunging down the cliff while we were on our way up to Air Itam dam. I came out unscathed but the car was totalled due to it coming to a stop upside-down on its roof.
— (e+ho)ng (@talexeh) December 7, 2017
Back then, my relationship with my gf (now wife) has not been made known to my family so the very first thing that came to my mind was "how's she going to know that I'm dead?" It was a split second thought but it was still vivid to this day.
— (e+ho)ng (@talexeh) December 7, 2017
That was the past & it has now become constant jokes when I met with fellow passenger who was in the same ill-fated car. I guess that's human; you tend to make jokes of things that you once thought were terrifying but survived. Hindsight is 20/20 after all.
— (e+ho)ng (@talexeh) December 7, 2017
Sunday November 26, I managed to complete my 4th full marathon (PBIM) in less than 6h. I completed last year at around 6h15m even though with better preparation so I was genuinely surprised that I performed better this time around.
— (e+ho)ng (@talexeh) December 7, 2017
Monday evening after late dinner, my stomach got badly bloated to the point that I couldn't sleep. At around 2am, I visited 24 hours doctor & was prescribed medication to relieve the air. Unfortunately, it got worse with pain radiating from my right lower hip.
— (e+ho)ng (@talexeh) December 7, 2017
Tuesday 2pm, I paid my office clinic a visit. After she identified the spot where the pain originated, the doctor gave me MC for the rest of the day & asked me to visit hospital if I started to vomit or have diarheaa. Not appendicitis, she said.
— (e+ho)ng (@talexeh) December 7, 2017
That night, I started to shiver badly in bed even with the air-conditioner off. My wife sent me to Gleneagles A&E & a school junior who I couldn't recognize diagnosed me with appendicitis. A CT scan confirmed this further & I was told to have the surgery on Wednesday morning.
— (e+ho)ng (@talexeh) December 7, 2017
This isn't my first surgery as I've had my varicocele surgery back in 2008 so I wasn't too worried. Appendicitis surgery has always been pictured as very minor & almost risk-free; at least that was what both me & my wife thought.
— (e+ho)ng (@talexeh) December 7, 2017
During the pre-surgery questioning, I told everything as honestly as I could except for asthma. I knew I was warded for breathing difficulty back when I was still in primary school but that was >20 years back.
— (e+ho)ng (@talexeh) December 7, 2017
I don't have any supporting documents that label me as asthmatic so I've always left the checkbox empty when I donated blood & also during my first surgery which all ended the way they were expected to.
— (e+ho)ng (@talexeh) December 7, 2017
The appendicitis surgery completed successfully but according to the anaesthesiologist, my lungs failed to kickstart by its own even after 2m. Normal person's lungs start at around 30s but mine was rock hard & not cooperating.
— (e+ho)ng (@talexeh) December 7, 2017
It was only when the oxygen level decreased to dangerous level that my chest started to soften up & he reinserted the intubator but all that came out was blood. My lungs were apparently filled with blood & in his 40 years as an anesthesiologist, he has never seen this case.
— (e+ho)ng (@talexeh) December 7, 2017
I was sent to ICU & boy, it was a total 180°of what I imagine an ICU would be. A nurse (not the right term since they're more qualified than a nurse but still below doctor; I stand corrected if I'm wrong) is stationed to each patient & cubicle.
— (e+ho)ng (@talexeh) December 7, 2017
When I came to, it was almost evening of the same day I had the surgery. Both my wrists were tied to the side bed posts, I had an intubator taped into my mouth, urine tube inserted into my dick & wearing adult diapers. Words can't describe the state of WTF I truly felt back then.
— (e+ho)ng (@talexeh) December 7, 2017
My wife told me that she was at home expecting a message from me, informing her that surgery has completed. Instead, she received a call from hospital asking her to urgently head over to the ICU. Her heart sank & she feared for the worst.
— (e+ho)ng (@talexeh) December 7, 2017
In the ICU, I was on full panic mode. I was supposed to get some sleep but the intubator in my throat made it hard to do so. I felt hot all over my body even though thermometer reading showed normal temperature.
— (e+ho)ng (@talexeh) December 7, 2017
The nightmare started when the nurses perform "suction", a procedure where they insert tube into my throat/lung & vacuum out the bloody excretion. When they disconnected my intubator from the oxygen supply, I felt so breathless & came to realize my lungs were truly fucked.
— (e+ho)ng (@talexeh) December 7, 2017
So in between when my lungs were still filled with air, they re-insert the tube deep in & asked me to cough as many times as possible. With each cough I made, the less air I have so they would remove the pipe & re-pump air into my lungs. I could literally feel them expand.
— (e+ho)ng (@talexeh) December 7, 2017
Suction was the very thing that strike fear into me during my entire stay in ICU. Everytime a nurse came to my bedside, I dreaded the word "suction". It wasn't only painful, it was a procedure that required skill from the nurses.
— (e+ho)ng (@talexeh) December 7, 2017
So when some nurses did it ineffectively, I felt that the effort was both wasted & demoralizing for me since I paid in pain but received not the equivalent amount of secretions vacuumed out.
— (e+ho)ng (@talexeh) December 7, 2017
The fact that my trachea was pretty deep (I assumed that was what the term "peak 8" meant) forced some nurses who preferred the more-comfortable-but-less-effective closed suction to use open suction instead so that's another layer of fear for me since they might drop the tube in.
— (e+ho)ng (@talexeh) December 7, 2017
Wed night nurse was a new Chinese female.
— (e+ho)ng (@talexeh) December 7, 2017
When I wrote on the pad (the only way to communicate apart from nodding/shaking) that I was thirsty no thanks to the intubator forcing my mouth to remain open, she poured some drinking water into the tube that went into my esophagus.
That sensation was god sent. Even though I was still thirsty since the water didn't flow through my throat, I could "taste" it & this was the very moment I knew I've taken drinking water for granted. Replenishing thirst from running a marathon is nothing compared to this!
— (e+ho)ng (@talexeh) December 7, 2017
However, I guess there's a limit to this so sometimes she just wet her finger & applied it on my lips to quench my thirst.
— (e+ho)ng (@talexeh) December 7, 2017
Thursday morning nurse was an experienced senior Malay female. Her open suction skill was the best among all.
Thursday noon nurse was a Chinese female. She was sometimes assisted by a SYT Chinese female who has tendency of calling me "boy".
— (e+ho)ng (@talexeh) December 7, 2017
Thursday night nurse was a Malay female. While her suction skill was OK, she didn't perform it as frequently as the other which was both good & bad.
Friday morning nurse was an Indian female. When she realized that closed suction wasn't suitable for me, she tried asking for her senior (another Indian female) to perform open suction on me. Her senior said she would assist but she (my assigned nurse) needed to do it herself.
— (e+ho)ng (@talexeh) December 7, 2017
This was the very first time I feared for my life since I took it that open suction was harder due to the risk of dropping the tube into my trachea. Compared to the other, I believe she used a tube that was too thick because it didn't reach the level that could trigger my cough.
— (e+ho)ng (@talexeh) December 7, 2017
During suction sessions, after the nurses were done with the trachea, they usually clean my mouth & nostrils by inserting the same tube there. In most cases, they were a relief since they signal the end of suction agony.
— (e+ho)ng (@talexeh) December 7, 2017
This nurse though was the other way around.
She somehow always managed to get some secretions sucked out when she clean my mouth & nostrils so she kept extending the tube in.
— (e+ho)ng (@talexeh) December 7, 2017
This resulted in very painful gag reflex. I almost wanted to write a note asking for no more suction by her or to have someone do it instead.
Somehow or rather, during the second suction session, my intubator popped out a bit & the ventilator air leaked out directly in my throat. Both nurses tried to resume the suction but when they realized that they couldn't shove the intubator back into position, they all panicked.
— (e+ho)ng (@talexeh) December 7, 2017
Judging from their repeated phone calls to the anesthesiologist, I took it that only he has the right skill to reinstall the intubator. The few nurses, including some from other patients all moved their chair outside my cubicle monitoring me from afar. I felt like a specimen.
— (e+ho)ng (@talexeh) December 8, 2017
My Thursday morning nurse (the experienced senior Malay female) happened to pass by & she managed to have the intubator locked into position again. I was very cooperative when she was nursing me so she told my current nurse to untie my wrists.
— (e+ho)ng (@talexeh) December 8, 2017
When the anesthesiologist came in, he recommended for ventilator (or the oxygen machine; I'm not very well versed with the terms) to be disconnected from my intubator so that I can try to breathe by my own. Nurse was told to monitor my O² level.
— (e+ho)ng (@talexeh) December 8, 2017
I knew that the anesthesiologist has been decreasing my O² supply progressively to get my lungs to work again but I was still quite surprised that I could breathe this well without the ventilator.
— (e+ho)ng (@talexeh) December 8, 2017
When the ventilator was connected, it periodically click & send O² into my lungs. So even if I wasn't breathing, the ventilator will make sure I don't run out of breath. Now that it was disconnected, I became wary of the danger of falling asleep.
— (e+ho)ng (@talexeh) December 8, 2017
After all, it has been 2 days of relying on it now so has my lungs got used to being assisted? After a while, I started to get tired. I wrote the nurse that was getting sleepy but deep down, I was terrified. Is this tiredness a sign that I was losing consciousness?
— (e+ho)ng (@talexeh) December 8, 2017
Or perhaps my lungs were not ready yet & I'll have to stay more nights in ICU which equate to more suction sessions? The anesthesiologist came back & my body O² reading wasn't up to his expectation but I guess it was good enough to extubate me. I was ecstatic for sure.
— (e+ho)ng (@talexeh) December 8, 2017
With the intubator removed, I found it easier to breath now. I guess being able to control my jaw instead of having it taped open allowed me better breathing technique. On the other hand, my lips, tongue & teeth were now hard & crooked like a rock.
— (e+ho)ng (@talexeh) December 8, 2017
Since my O² reading wasn't satisfactory, the anesthesiologist got the nurse to put on an O² mask with reduced supply. Bummed but still better than having an intubator in my throat. The nurse didn't tell me but I assumed that no intubator = no more suction.
— (e+ho)ng (@talexeh) December 8, 2017
The few times the nurse walked to my side, I was so scared that she was going to utter the word "suction".
— (e+ho)ng (@talexeh) December 10, 2017
Friday noon nurse was surprisingly the SYT Chinese female. Compared to the other, this one communicated, advised & assisted me the most.
She replaced my mask with a nasal cannula which wasn't only simpler but helped me practise breathing using nose instead of mouth. I was assisted to sit up & she even initiated a few calls to my surgeon asking if it was OK for me to start taking very soft diet.
— (e+ho)ng (@talexeh) December 10, 2017
She advised my wife on the kind of porridge that she could cook & bring over for my dinner. For the first time, I was allowed to sit on a chair for my meal instead of having milk solution poured into my esophagus. Did I say she brought me a TV to watch Titanic too?
— (e+ho)ng (@talexeh) December 10, 2017
She was such a dedicated nurse that I've to admit I was infatuated. Still, back in my mind, I guess this was a classic case of Stockholm Syndrome so I wasn't going to delve too much into it.
— (e+ho)ng (@talexeh) December 10, 2017
Hopefully one day, her passion & effort will earn her some recognition or awards.
For someone who almost lost his life, my head was definitely in chaos with wild thoughts running amok.
— (e+ho)ng (@talexeh) December 10, 2017
Friday night nurse was a partnership between an expecting Chinese female & a very new Malay male.
Apparently, the expecting nurse recognized me, telling me that she was my wife's schoolmate, even though she has forgotten both my wife & her twin sister's names.
— (e+ho)ng (@talexeh) December 10, 2017
The world is a small place after all.
I slept the most this night. Even though the cannula has no capability to automate my lungs like the ventilator do, I guess I felt secure & comfortable enough to doze off.
— (e+ho)ng (@talexeh) December 10, 2017
He only woke me up a few times for the nebulizer session, which has now replaced the suction session.
Nurses, especially those in night shifts have always remarked that I was always wide awake throughout their shift when they briefed my replacement shift nurses.
— (e+ho)ng (@talexeh) December 10, 2017
Truth was, I was way too panicked & scared to sleep.
Even if I did fall asleep, I kept having tripping psychedelic comic superhero themed dreams or how sometimes the whole glass wall in front of me transformed into giant TV screens. Not nightmare but certainly nothing pleasant the same; all they did were to add to my confusion.
— (e+ho)ng (@talexeh) December 10, 2017
And the group of night shift nurses happened to be the loudest & most happening of all.
— (e+ho)ng (@talexeh) December 10, 2017
I was without my glasses so things looked blurry but I could hear them making silly jokes, placing orders for McDonald's delivery & how one of the patients there was giving them a hard time.
This patient called "uncle" was most probably an Alzheimer since I could always hear the nurses asking him to cough (most probably for suction) & open his eyes. I guess each patient present the nurses a different set of challenges & this must be why our wrists need to be tied up.
— (e+ho)ng (@talexeh) December 10, 2017
Nurses are human too & at the end of the day, all these procedures like suction are things that the patients actually need, whether we like it or not.
— (e+ho)ng (@talexeh) December 10, 2017
Saturday morning nurse was the same nurse who assisted my nurse when my intubator popped out.
By now, I was able to speak though with a hoarse voice. I was supposedly to be moved out of ICU today so I asked for my urine tube to be removed. She got another senior Malay male nurse to perform the removal & surprisingly it wasn't as painful as it was back in my first surgery.
— (e+ho)ng (@talexeh) December 10, 2017
The drama this time around centered on my left arm IV catheter which has reached it's 3-days lifecycle & now causing red inflammation marks on the skin along the vein stretching half my arm.
— (e+ho)ng (@talexeh) December 10, 2017
My nurse wrote a report that somehow point to the previous shift nurse for missing this.
To be fair, I didn't feel any pain or itchiness which was supposed to come along with this inflammation. Still, I had a few "nurses" (of officials, I don't know how the roles work here) coming over to take a look & interview me.
— (e+ho)ng (@talexeh) December 10, 2017
I was prescribed another cream to soothe the spot.
Nothing eventful took place after that..
— (e+ho)ng (@talexeh) December 10, 2017
For Saturday noon, I received the same nurse as I did when my ventilator popped out (the Indian female who preferred closed suction). It was during her shift that I was moved out to normal ward.
Looking back, as much as I dread her suction session, it was during her previous shift that I broke free of the intubator & things have progressed very well ever since that.
— (e+ho)ng (@talexeh) December 10, 2017
I might have vilified her in earlier tweets so here's a big thank you to her for all her help!
Why did I bother listing out all the nurses that have been assigned to me? To be frank, I don't know. When I was on the ICU bed, a part of me wanted to etch down all these details like some kind of revenge plot.
— (e+ho)ng (@talexeh) December 10, 2017
Maybe it was the medication messing with my head but this is one of the reasons why I contemplated so long before tweeting these down.
— (e+ho)ng (@talexeh) December 10, 2017
On the 2nd or 3rd day in ICU, my wife told me that she was asked to swipe RM21,000 since my company insurance hasn't responded.
I guess this is the price to pay since I had a few doctors consulted by then. Apart from the appendicitis surgeon, there was heart doctor (result: my heart was very healthy) & a chest doctor who concluded that the lung issue was an infection from the perforated appendix.
— (e+ho)ng (@talexeh) December 10, 2017
Based on what I heard (like I said, I didn't sleep much), the surgeon & anesthesiologist remarked that while the appendicitis was perforated, it was still sealed & if there was an infection, the abdomen would have been the first victim.
— (e+ho)ng (@talexeh) December 10, 2017
All these differing opinions certainly didn't help in giving me a peace of mind.
— (e+ho)ng (@talexeh) December 10, 2017
The anesthesiologist will write me a letter that I'll have to pass to the anesthesiologist if I were to have surgery in the future.
Heart doctor said it's mostly sepsis but nothing conclusive.
Chest doctor showed me the high reading of procalcitonin in my blood test (was 23 during my ICU admittance) which was supposed to be <0.5.
— (e+ho)ng (@talexeh) December 10, 2017
One thing for sure is that I'm not running marathon anymore. Both my brother & sister truly believe marathon to be the culprit.
While my wife didn't say so, I know I should stop proving to myself that I'm capable of anything & everything. Time to put a stop to the almighty & yes-can-do attitude of mine & start focusing on fulfilling my role as a husband & father. I owe them a lot now.
— (e+ho)ng (@talexeh) December 10, 2017
It also certainly didn't help when my son was admitted into the same hospital for Influenza A while I was 3rd day in ICU. Even when I was released into normal ward, I still couldn't visit him due to my weak lungs so everything was shouldered by my wife herself.
— (e+ho)ng (@talexeh) December 10, 2017
She has always exuded an aura of weakness due to her stress at work & constant fatigue but this time around, she has indeed came out the strongest. This is definitely a wake up call for me to stop making her into a clone of mine. Everyone has their own strengths & weaknesses.
— (e+ho)ng (@talexeh) December 10, 2017
My son's babysitter (my sister) ended up in hospital on the same night I went into A&E while her husband was admitted too just 2 days ago. The former was respiratory issue while the latter was work stress.
— (e+ho)ng (@talexeh) December 10, 2017
Both of them are now back home healthy & fine.
I guess I'm the new Black Kid King now though I certainly don't look forward to holding it for long.
— (e+ho)ng (@talexeh) December 10, 2017
It's been a crazy roller-coaster ride for me & I still fear bed time for I have no idea when my lungs are going to give up on me again.
Every morning when I wake up now, I have to pinch myself hard. I know it's silly but it gives me reassurance; that I'm still alive for another day.
— (e+ho)ng (@talexeh) December 10, 2017
I've walked a line thin enough that sleeping is not going to come easy for me for a very long time to come.
Growing up, I've been placed hope & a certain level of expectation by my mom. Even after she passed away, I think I shifted & yearned for approval from my brother instead, hopeful to be someone that they can be proud of.
— (e+ho)ng (@talexeh) December 10, 2017
"That guy is my lil' brother."
I don't know if my wife ever realize this still, I myself has been fighting to put off this facade of mine. Guess now is the best time to finally take off the mask so that I left no unfinished business behind.
— (e+ho)ng (@talexeh) December 10, 2017
I think that will come around when we get ourselves our own home.
Apart from the family members, doctors & nurses, here's a big thank you to the following for paying me a visit: KP (wife's boss), Wei Hong, Ee Liing, Kok Tat, Soo Mei, Manfred & Soon Siong.
— (e+ho)ng (@talexeh) December 10, 2017
I really appreciate you spending your time listening to my story while I was in ward.
