Friday, October 12, 2018

I thought it would be over by now: Part 4

After reading those last three blog posts one expects a semblance of a happy ending. Then I got better and we lived happily ever after.

I didn't.

I was home, struggling with everything. At the time I was running fevers daily but I didn't know because checking didn't matter to me. Feeding my new baby was tough because of my tender abdomen and nipples although not cracked were very painful for some reason. Also my milk supply was not the most inspiring. After the uneventful gynae check up I had lost hope. Basically he said you should be better, but I wasn't. I was sick and didnt know why. Didn't care why, I just wanted to get better. It had been 3 weeks and something still wasn't right.

Just to recap, I had had a cesarean section where a very angry appendicitis was found and removed during the same surgery. By a surgeon. This meant I had two doctors to review me. And this is what the gynae did. He sent me off to the general surgeon just to make sure there wasn't anything else missed after 3 weeks post surgery.

We realised how popular this surgeon was when we waited in a queue for half an afternoon. Even with my colleague privileges we had to wait for what seemed like a lifetime. Everytime you called him someone else would pick up the call and let you know he is in theatre somewhere out of town but will be there shortly. What was the point of appointments then, we wondered. Anyway, be grateful he is coming today.

As soon as he saw me he knew something was wrong. My heart was beating too fast and too hard (bounding ) , my abdomen was too tender and I was pale. I had been on all the antibiotics favoured by trigger happy doctors so it didn't make sense why I still had an infection. He ordered ultrasound scan and a Ct scan. I was secretly happy but deep down I felt it was overkill. I was thinking yeah, at least they can find any other things of 'interest'

Fast forward. It took about a week to get all these tests and results done because our glorious Zimbabwean system is so efficient. I wondered what women in the public sector go through. Actually I didn't have to wonder, I knew. The CT scan had a waiting period of 3 working days for a report. But what if it was an emergency? Apparently there was no such thing. When I finally got my results my whole world was shook from inside out. It was worse than I thought. Why would this happen to me? Well, it could be answered medically, but emotionally I was finished.

I had developed a pelvic abscess. In simple terms, the infected appendix that had been removed had infected free fluid in my abdomen and I eventually developed a big pocket of pus in my pelvis. This was what was causing fevers. This was why I wasn't getting better. Memories came flooding back of my internship days of women with pelvic abscesses dying in the ward because they came in when it was too late. I was gripped with fear. The treatment for this needed me to be readmitted to hospital. There was a high chance I needed yet another surgery. What was I going to do with my baby?

Why me? Why me? Why me?!?!

There's something about knowing your diagnosis. You start feeling as sick as it is. What I had been able to soldier through before was now too difficult. I had to take the shameful step of starting my baby on supplementary formula. It was so ironic as I thought back of all the times I reprimanded mums about breast is best for 6 months. All that went out the window. Rather, fed is best.

My surgeon didn't want to reopen me. He suggested we go see an interventional radiologist who could possibly drain the abscess using ultrasound scan as a guide and do the whole procedure laparoscopically. I would still have to be in a hospital set up. It would still involve needles, which by this time I was weary of. I would be on antibiotics and monitored afterwards. This was still a better option than surgery.

Organising the whole thing was a torrid affair. Involving medical aid companies who said everything is impossible, people's secretaries who said their boss is in theatre (forever) , hospitals that wanted their cheques from extensive previous stays. Superman hubby took over and up to now they know him. I'm proud but I'm also scared for the recipients.

I was readmitted to an HDU ward... Not because of my condition but because of limited bed space. My baby was not allowed here. He was was to go home with his gran and dad with some of my expressed milk and visit me twice a day for feeds. The condition of the other patients in that ward made me grateful but sad at the same time. It was then that I realised health is Not A Given. It's all grace. The whole thing. Our lives. Everything.

Fast forward again. They drained about 350mls of terrible looking pus for my pelvis. They left a drain for 24hrs and the stuff was still coming out. I was those people who walk around with a catheter bag, trying to hide its contents. I sympathised with all those prostate patients. Albeit them being elderly men I really understood now.

This time round I did not make friends with anyone in the ward. They eventually moved me to maternity ward with mothers who had just delivered. Congratulations I would say and that's the end of this friendliness. I just wanted to get better and get out of here. I was no longer shy to make my needs very clear to the nurses. I did not care how demanding they thought I was. This was Operation Get Home.

Meanwhile the real world was going on. Apparently as I lay in hospital Zimbabwe was going up in economic flames. I couldn't make sense of most of it. Fuel queues, panic buying. Something about 2%? My world was about getting out of here and getting better. Friends and family did not understand why I wasn't answering some calls. When could they come see the baby? It all didn't make sense to them. It had been four long weeks. And there were big events like my graduation for my masters degree. I was sadly going to miss that.

When I was discharged there were no celebrations. I just didn't know what other curveballs awaited me. Was this journey finally reaching its destination to good health? Surely this was the end right?


Sunday, September 23, 2018

Part 3 of 3.

I don't know if it's a good idea to write the third instalment of an ongoing ordeal. I was hoping that by now that I would be among the "bounced back" mommas.
Well it has been two solid weeks today. There should be some progress right?
Baby looks like a two month old and eats the share of one too  He is quiet and calm unless you are delaying with his good good. He sleeps quite well and is peaceful when awake and full.

Cracked nipples make you anxious everytime it's feeding time. And that's a lot of anxiety. Objectively speaking, no one cares. My cracked nipples were not healing with nipple cream or the ebm trick. Gynae and paed had outlandish suggestions ranging from method of detaching baby to laser treatment. Insert WhatsApp emoji. You know the one.

Review at the doctors gave answers to questions that we had. It turns out according the pathologists histopathology report that I had "an acute suppurative appendicitis with sections showing oedema, hypermedia, and an exuberant necrosuppurative inflammatory exudate". In English I had appendicitis. Only by miracle had this been seen and removed during surgery except at the time all three doctors were not sure what it was. It looked nothing like an appendix. Removing it was the best thing they could have done.

I also developed an upper respiratory tract infection. Tonsillitis. Not so bad yeah? But it turned out it was the reason I was weak and dizzy and hot. Viral meaning no antibiotics would be effective. Just shingirira.

Tummy was a constant one. Sore.

I expected too much from my doctors review. Hoping for a magical potion which would heal all these things  But there's was nothing. Just fickle words of reassurance. And being told again how interesting my case was.

I decided to blog. Publish or perish. Therapy was going to be important..everything I went through was a risk factor for post partum depression. It got me thinking about mothers in similar situations. Maybe they were fine but babies were born with problems like prematurity or congenital anomalies. What were those mommas going through? And you didn't really have to go through complications to get depressed. Some were just predisposed. And yet none of my health team enquired on my mental health. And if they did, all it got was a shame, how awful.

I am done with the writing therapy now. Working on healing day by day. Apologising to friends and family for not bouncing back to their expectations. Taking care of my baby with the help of great support structure. Setting daily goals to return to normal function. Taking care of myself by saying no to some things. Eating right. Exercising when I can. One day at a time, is all I need.

Saturday, September 22, 2018

Praying in vernacular: Part 2 of 3

The fever I developed on Day 5 made me pray in vernacular. All politeness with the nurses had gone out the window. Unleash the dragon-lady. I ordered one nurse aide to bring me a personal thermometer. Another to bring me a blanket. It was 32 degrees Celsius. They both looked confused with these requests and neither of those two ever returned. My teeth were chattering and body shaking like a leaf. So this is what they mean by chills and rigors. You would be surprised at some of the concepts a medic never really understands until it happens to them.

Differential diagnosis time. What could I have developed? An infection from the hospital? A urinary tract infection? Peritonitis? Peuperal sepsis? Any other sepsis? Throat infection? Cholera??? My mind would not shut down. These were all possible. Why were the nurses moving so slowly? Had they called the doctor? Where was my blanket? Why was I developing a fever now? I could hear murmurings of concern that the doctor patient in 5b is crying, what do we do?

Most mothers at this stage were at home now, romantically nursing their babies whilst sipping a cold glass of water as Gina Ford had advised. Maybe their bodies were already back to normal. How long are we given to "bounce back" again?

Instructions over the phone were to increase my IV medications. More painful infusions. Battery of investigations done. Meanwhile tummy still like a drum. An angelic 5 day old still wants his juice every 2 hours. And the routine of the hospital unapologetically continued.

My husband became my nurse, doctor and counsellor that day and somehow by the time the real doctor came, I was feeling better. Hubby's tactics included force feeding and demolition of pity parties. Health workers have a lot to learn from real people. A little TLC goes a long way.

I had finally calmed down. Fever had broken. Some movement in the bowels were cause for mini celebration. There was hope again. The doctor said if there's no fever tomorrow morning, I can go home.


I did not have a fever that night. And was discharged the next day but over the next 2 weeks that fever would rear its ugly head again not less than 5 times.

The day I was discharged, my meds were stopped too early. Administration took hours to process my papers. By the time I arrived home there were razors in my belly and I felt weak and fragile. Not at all how I imagined homecoming. Still it was good to be home with our latest addition. His older sister took to her brother almost immediately. She offered him her favourite blanket. It was in that moment I knew that no matter what, all this was worth it.