customer not patient

when you sign the release form you become a patient ie a slab of meat that can be punitively handled. However patients should be regarded as customers as their power to complain carries weight and will affect the 'business'.

When in this context all customer facing profession suffer from complacency. Not just hospital staff. They sometime require a refresher course on customer handling, perception and empathy.

Sometimes some staff are use to their work that they forget to ask the patient whether they have experienced what they are about to do ie wash the throat. Sometimes they seem to be in a hurry, I'm not going anywhere, I'm a captive audience. Sometimes I feel like a piece in a factory, I get worked on as fast as can be by the operators and then the next procedure.

The nurses on practical are good as they are less experienced so they listen more.

Oh well the best that I can say is to be prepared when going to hospital. Reading other peoples account or talking to someone who has hospital experience will help prepare for ones time in hospital and reduce the surprises.

It's uplifting to have friends

My first non relative visitor was Mr O my former boss. He always has a story to tell and is never short of anything to say. He's a little like Santa but with a black beard. It was good to joke around with him.

Then came M and L my former workmates. We joked around I said that they took out the tumor but left the brain :). They tried to get me to do soduku I said that that's going to destroy my brain. I have never been able to complete even once soduku but I'll give it a try. Unfortunately the cleaners took the paper, sorry guys :).

Then tengku N came. I couldn't believe he managed to come and visit as I didn't know him that well. But this guy is always uplifting even in hectic times so it was good to get some encouragement from him. He said get well soon we need you. That was good to know because at this point I was about 4 months out of service ie no income. And it would be good to have something lined up when I get out. I should mention that I am a freelance IT consultant so my income is never guaranteed and definitely never on time.

Finally Mr and wife E came to visit also. He's also my former boss. Being in the IT industry does not provide income security as IT companies come and go overnight. I have been in 3 companies that has money problems. Not my fault. Oh well they came and we talked about the tumor and this and that.

My visitors brought fruits, cookies and biscuits. As I was still on a soft food diet The fruits were eaten first then later the others. So If you are visiting a friend in hospital and you don't know their dietary status, fruits would be the best choice. My preference grapes (comes in bite size pieces no waste), mango (nice sweet but need a knife), watermelon or any melon (but require a knife also), oranges (have high citrous acid content, so get sweet ones), etc. Then anything else.

Never bring live plants ie flowers. You don't know whether they are asthmatic. I was a little worried that someone would bring live flowers as I would've started coughing if the pollen count was high.

I have to say I'm blessed to have some friends who are the nicest people you'll ever meet. Imagine they drove @270km plus toll plus petrol plus time just to see me. Thanks guys.

home sweet home

Back at the ward, No neck IV, no leg IV nothing in the mouth. Just the brain drain and the wee-wee tube.

After 3 days the tip of my tongue was numb and with all the tubes in my mouth my vocals was such that I can't speak at a low volume. It only kicked in after a certain volume. I was allowed to eat but only 'soft' foods like jelly, fruits, things that is easily digestible. The nurse said that this is because after the long absence of eating I might vomit. OK. I see what looks like candy with my relative and I ask the wife for a pinch of it just to sweeten the mouth. Then my brother in law S comes across and say he can't eat that, relatively loud. Wonder how many heard it. "HE should eat soft food like jelly, I'll go see downstairs" he says. Ok go I thought jelly is better than nothing. So he goes and comes back with what, nuts and candy! I'm thinking you loudly say no solids so everyone can hear and what did you bring back? Man please let me out of this damn bed so I can get it myself. But the lumbar drain's bag and the urine bag was more than I want to carry around.

Each day I get 4 lollies from the nurses, straight into the IV line. 2 big needles and 2 small. The small is usually painless but the 2 big ones represent a lot more volume into the veins. What I didn't know was that each IV line has a limited life. 3 days is standard but with the 2 big needles wear the veins out faster so 2 days is the best life you get out of 1 IV. The IV on my right hand was 4 days old. On the third day it was already hell on the 4th it was unbearable. The pain was like having someone cut your veins with a knife and your whole forearm was also aching like you wouldn't believe. I couldn't take it I just said I wanted oral tablets and that's it. By this time my lollies had been switched to oral but was told that the antibiotic still had to be injected.Woohoo relief at last, I thought the antibiotic was the small needle but when the nurse came for the injection it was the big one. Let me die... god get me outta here! She didn't even manage to put much in.

I then tried to get my hands on a doctor to change the antibiotic to oral. Alas the doctor said the top 5 antibiotics were only available as injectibles. I said that it hurt like you wouldn't believe. He then tried to flush the line ie inject water or something and I said that yep it hurts bad. Then he said that its time for another line. Damn I hate that thing but it would hurt much less than the traumatised vein that I have now.

Next morning around 6:30 am the nurse came with my lolly. I said let's give it a go on the new line, it should be ok. And it was, just felt the coolness of the liquid pour in, as room temperature was colder than body temperature. Thank almighty god.

departures are delayed

I guess I stayed another night. The feeder tube which was in my mouth magically got swallowed. So more staring and sleeping. Man the boredom is agony, sleep time.

The nurse say that if I can swallow I can get the tube removed. I took my time but then I think the sooner I do this the sooner I can go. So I say ok give it to me. She gave me a straw but my lips were so dry I couldn't suck anything and my tongue was dry preventing me from wetting my lips. Eventually I managed to get a bit in, allowing me to wet my lips. After that I managed to swallow more, it was sweet, milo she says. Didn't taste like milo but who cares. She says good.

She says first you have to swallow some water and then milk. Ok better than nothing. Up to this point I had nothing to eat since thursday night's mandatory fast. But through the tube. So I won't taste anything it'll just appear in the gut. I'm lactose intolerant and I'm thinking this will finally cause me to poo in those diapers down there. God please no. I ask if the milk is lactose free. She says yes then say soya. Good. So in it went. The tube felt cold so it must be going in. It felt like the tube was just at th end of the throat abd might gall out. Tried to keep it in so I don't get a mouthfull of pumped milk. I forgot that I should also burp. This caused some gas to get stuck. Man it was gastric agony. But they have another magic injection for that too. Man These people in ICU are injection crazy, once you have an IV line they sure make use of it. So I can swallow and my reward was the removal of the tube. Will this be real freedom? She says just relax and let the tube make its way out. OK. She then pulls it out. It was long! Sure didn't have to worry about it falling out.

An ENT doctor was there this morning and she came over and said I had a nasal plug and had to get it removed on Tuesday. She showed me this plastic popsickle thing, saying this was pressing against the wound to stop the bleeding. I thought I had a hole in the bridge of my nose and the string was protruding. Man the plastic was big and I thought it had to go through this hole because there was a bandage there, Man its gotta hurt. Will they cut to reopen the hole? I'm thinking why can't they just give me surgey and then let me out. Why these extra things. Now this thing is giving me nightmares.

Later in the day they must've gotten sick of me and sent me back to the ward. At last freedom. I thought since there was no doctor I would still be in ICU but I was going back. What a relief because this represented a bit more degrees of freedom. My advice to anyone who can choose the operation date, NEVER have an operation on friday. Doctors don't work on weekends although they are on call. So they can't check up on you unless they come in for the sake of it. And this weekend was a long weekend! 3 days no doctor. However on Monday Mr Cheang did come in to check up on me. That was good.

please take me back to the ward

I am still in ICU and with this tube in my mouth. My tongue has been dry for ages.

All I do is stare at the ceiling and sleep. There is nothing. Should've bought a dilbert book.

I'm thinking when will I ever get back to the ward. I can't remember if I stayed another night (Monday) or I was to go back today (Sunday).

I remember getting the neck cleaning treatment. I can hear them do this from one patient to another all day long, initially I thought it was a massage but that would be too good. Now it was my turn again and my lip was still getting caught. I try to make hand signals but I was not getting through. She was more concerned about her sterile hands "don't touch the hands it's sterile". But at last I get the pen and paper and show what I was trying to say. Finally they understand and agreed to check my lip before lifting. I was relieved for our next encounter. But it was not be because I was to have the tube removed.

I hear someone say I get the tube removed today. I was ecstatic. It was time. They remove the connector to the machine. Woohoo. Then the nurse say don't fight it. Hey I aint gonna do that, I want it gone so I can speak, complain. When she pulled it out you can't help but fight, it was like vomitting and choking. But who cares keep going damn it. It was a long sucker. At last I was free! but as soon as one tube got removed she throws this other tube like throwing a fishing line over the side of a boat! What the ... I just got my freedom and this other thing comes in. I point to the tube and the nurse say no no no it aint gonna go yet. Huh? I ask what it was she says a feeder tube. My tongue is gonna be dry for a bit longer. Man I can't believe this.

My back was getting itchy. Itchy as hell but there was bandaging there. The nurse noticed and asked if it itches. I said sure do. The she says I have magic liquid for that and proceeded to inject me with it. Still itched though but later not so much.

welome to the house of pain la la la la la ...

This is me after surgery in ICU. Wonder what that other tube in the mouth is? There should also be a tube to my head. I'm holding a notebook to write my memoirs :) no but to write what I want to say.

All this while my concerns were with the surgery when in reality I should have also thought about post surgery. Being a virgin warder placed me at a severe disadvantage. I really was not prepared for it and I will pay for it.

I woke up with an IV tube on my left leg, right hand and neck. I still hate those things. The one in the neck was so psychologically sensitive after all it's in you neck. Every time it gets tugged it feels like someone might pull at it. I also had a tube from my forehead to a little bag and a lumbar drain which is another tube into the spine in my lower back to suck the juice out of my brain, literally. I also had a breathing tube connected to a breathing machine and of course the mandatory CBT ie urine tube.

Can't remember which came first the neck cleaner or the bath. Let's go with the neck cleaner. So I have this breathing machine in my mouth which means I could not talk ... complain. So when they clean the mucus from your throat they start pounding your chest.That wasn't anything bad. Then they pull the breathing tube up making you cough like crazy. The mucus flies out of the tube and onto my face. When you cough your throat closes up and you cannot breath, I was about to panic. Then I tried through the nose, thank god that still worked. So I concentrated on breathing through the nose. However when the nurse pulled at the tube my lip was wedged between my teeth and the tube. Hurts like crazy! Thanks to the tube I couldn't complain. Dang! I was screwed. It was over when I didn't cough anymore signalling the lack of mucus in the throat. Ah it's over.

Next the bath. The nurse starts by wiping the face then pours the water over the body. It was COLD. She even wash the privates. Since I can't move about I have to wear diapers. What the. Glad I don't have anything to eat I don't have to do it in the diaper. Man no way I was going to do it there, it's like doing a number 2 in your underpants on purpose. Then the teeth. She uses a vacuum brush like one of those wet vacuum cleaners that pours water and suck it back at the same time. She brushes my teeth that's fine then she start to brush the roof of my down to the throat, it was not comfortable, how many people wash their throats!

I also needed to do a CT scan to check whether the doctors left anything behind like their watch :). Not really they just wanted to see hows things in there. I had to change beds and man it was cumbersome. All the tubes and wires, the one in my neck was the most sensitive. They cart me along the corridors and lifts, through the crowds. Reminds me of when I was at the other side watching the people on the beds being carted in but now I was the one on the bed. Then once there I had to move again onto the CT bed. Once done move back but this time I was too high and needed to be put lower on the bed. This assistant/nurse/dumbass grabbed me by the ankles and move me down. It was frickin agony. Where ever there is an IV (intravenous) and where there was an IV the veins are very SENSITIVE. This is because it get traumatised when stuff is directly injected (depending on the chemicals being injected) and also the veins can get stressed like a balloon depending on how fast you inject. Man I wanted to scream but the breathing tube was not gonna make that happen. I thought about about all the hands jestures just to say 'hey dumbo that frickin hurts like hell' but in the end I just had to accept it as I go back to ICU.

So the day ends but the story is not over. I am a shallow breather and when I sleep I sometimes skip or delay a breath. Unfortunately when this happens the machine pumps air into me and sound the alarm. I have to take a deep breath on the next breath to reset the alarm. Frickin pain in the neck just to satisfy this machine and get a night sleep. I'm thinking this is gonna make me look bad, the machine will say I needed lots of assist and I will never have this thing removed. Dang.

During the day I had relatives come and visit. It was good. I was not in the mood due to boredom, pain, whatever and a few people got a cranky me to visit. Apologies. One of my relatives T came early on the day, he says hi, I lift my hands to acknowledge. I then do the paper and pen signal. So he looks for scrap paper and pen but then begins writing! I make the gesture to give it to me don't write anything but he gave the signal no no no and kept writing. And then he shows me the paper. It had some greeting as I remember, actually I can't remember. I wrote " I am not deaf, just blind". Then he got the picture.

for those about to rock...

This is it. The big day.

7:30am the 'bed' comes for me. This is it. I ask the nurse if I can wear underwear, she says no, I ask why, she says so we can do stuff down there. Confirm! They do feel you, not really, she says that it's easier to probe you :) ie put tubes there like maybe an enema or CBT (urine tube). So off I go to the slab. When I got there they say this piece of meat is too early to be cooked come back later. So back I go.

I get another hour of life. But at 8:30ish they came back for me. Gulp. This time it's for real. I get carted to the OT (operating theatre). It was at the end of the hall. There is no escape. I ask the nurse if I can still make a run for it. She said yeah there was still time :) . I hopped on to the slab, get a little juice via the IV then the gas. The gas was a little stuffy. I close my eyes trying not to fight the process, which was the last thing this coward wanted to do. I was trembling due to the cold. I can overhear (probably) a trainees saying 'poor thing'. I had 2 layers of trembling a low amplitude high frequency tremble and a low frequency high amplitude tremble. One of the trainees say 'peganglah' (I wasn't thinking underwear thing here :) and the other touched my shoulder. Probably wanted to see what a trembling splashing fish felt like. I was now a writhing fish about to be cooked. Then I hear someone say hello doctor and he proceeded to touch my head. Another person say that I as not sedated. Dang when will I get sedated.

Hurry up and sedate me damn it. He's gonna open my brain soon. I can hear T's voice and a nurse saying that there was no one waiting for me and that they contacted the wife and she was on the way. It didn't register in my mind, all I can think of was not being sedated although there was a tightness on the top of my head, I guess they magically shaved me. I think I can open my eyes. "Can he open his eyes?". So I open them. "He can open his eyes? Good. Sir where are you?". My wife says that I am in ICU, "I-C-U". So I look around and yes no surgical lights I guess I am in ICU. "ICU" I reply. "Good". A thought did cross my mind to jokingly say something else but I feared that they may send me back to the OR and remove something else :D. Dang what happened. One minute I'm in OT then in ICU. Didn't dream or skipped a thought. Amazing then it's back to lala land.

It's as if the surgery never happened.

Live to die another day

So i escape the knife for today.

Again i go to d canteen and then to d neuro klinik. I wanted to know how much d screws cost. So d guy takes us to see an MO. He says the string is $20 a piece but u wont be charged for it. The screws are $200 a set (2 screws and a small connecting plate). Depending on the size of d skull removal will require 3-4 sets. I ask if the string dissolves over time. He says no. He also added no airplanes for 2 years. Also it can get knocked about if not careful and will require surgery to fix it. Then i say i'll take the screws. They say we wil happily bill u. Thanks.

Again i get a cal to return to d wad cos d eye doc wants to see me. Man I'm getting a little phobia about leaving d wad. Everytime i leave someone is looking for me. When i get there they say mr cheang also wanted to see me. Man this makes me look bad.

Then d eye doc says 'follow me'. She wants to check my eye status before op to compare after op. Then proceeded saying i need to dilate your eye blood veins. Great how u going to do dat. I'm going to use some irritating eye solution. It'll sting, thanks. And it did. It also made me loose focus in my vision n sensitive to bright lights ie sunlight. She then did some tests n say that my right eye is slightly swollen. Then out i went with my new very blurred vision.

Now its the ENT's turn to see me. He says 'Ah yes this case, surgery tomorrow'. 'Come sit'. Then straight with the nasal spray. Are all ENT like this? This must be their signature greeting. Basically he says he will do endoscopically. Ok. I just voice my concern about losing my smell. He said he'l take it into consideration. But later I learn its not his choice to make.

I go back to the ward and later Mr Cheang visits. Says that there is 3-5% chance of stroke and uncontrollable bleeding ie death. That sort of worries me but 50% chance of fluid leakage. This is too high. I ask about gamma knife. He said experimental and <3cm.

No turning back

So I'm on my way to Ipoh n my friend M calls. So we joke around. Got to the topic of hospital garbs. I think it was designed by mahatma gandhi. We got to whether u can wear underwear at hospital. We concluded no n that doctors r gay n wanted to see our willy. But there's male nurses too.

Somehow we got to the topic of removing the virus in my Windows head and that I will soon be rebooted with linux. NERDS.

This is it. D (hopefully not death)day. I go to d ward.

Ask about d wad class and d girl says 'go see lah'. Ok so we go. Class 3 is d battery chicken section, while class 2 is in the same room but at d opposite end with less people (16). The difference is the food n i will be charged at 2nd class rates for anything n everything.

My first visitor is d HO (house officer ie postgrad). She wants to put d iv needle into me. Man that thing sucks. Its so discomforting. Then she pulls d plug out. I'm tinking, wouldn't d blood spew out? Dang sure did all over d place. She then rushed to suck it up with a syringe. Then she goes but later comes back wanting more blood. Vampire this one.

Next comes doctor Shan. Comes to explain something but i was still in oz. He did mention something about a risk from stroke. That i will have muscle weakness. But to exercise. Huh? This doesn't sound like stroke. Oh wel this is post op i'm stil concerned about op day. Then he talked about patching my skull back with string. String! Plus I cant travel by plane for two years (actually this point was raised later by another MO). But d alternative is titanium screws n i plates at $200 a set. I need 3 to 4. Oh well imagine those guys who sujud very hard just to get d marks on d forehead? Well it would be death for me to do that with string holding my forehead.

But his real intentions is for me to sign my life away. That's right I gave permission to do anything they want. Anything. And by anyone. As for as i know they can get hannibal lecter to operate and eat my tumor. But it's a no brainer, i had to sign.

The other form was for a blood transfusion. Basically they can give me anything they want even mud. No, not really it's a waiver against anything wrong with the blöod its not their fault. Wonder if flesh eating virus can live in d blood bank?

I go to d canteen then they call to say d aneasthatist (bius man) wanted to see me. So i guzzle d bihun sup n back i go.

The bius man explained that they will inject me with some happy fluid to help sleep then the happy happy gas then the muscle relaxant so that i won't be able to tel them I am awake. I have heard cases where people become concious mid op n this is my greatest fear n anxiety. Man i shouldn't have watch d movie awake. But never thought i would have to face d music so soon. He tries to reassure me that it will be ok n d bius man (which won't be him) wil have equipment to monitor me. Again i have no choice really. Sign or resign. So i sign.

Later someone walks straight to me n say my name. I say yeah. He didn't intro himself. I'm thinking 'are u d angel of death Izrael?'. He proceeds saying 'kami mengisytiharkan bahawa operasi anda pospone ke jumaat.'. So i live in fear for another day.

the moving target

Today I planned to see Dr Cheang. The Man who is going to scoop my brain.

When I call the clinic they say that he is busy in the afternoon and is doing the rounds at the ward. Man that sucks. I just wanted to get some info from him regarding the operation and 'after sales service'.

Now I will have to wait till warded before I get to ask the questions. Maybe I may run in fear before the operation.

I was hoping to get some free pimple lotion rather than pay at the chemist. The steroids are giving me annoying pimple growth.