Part 12: PCMC My Second Home

By now, I have already been more than three weeks in PCMC for my second round of stay here. At the point of writing, I have been in hospital for a cumulative of 52 days in three different hospitals! This is indeed the longest ever in my life that I have been in hospital and out of work. It is quite an irony to think that I have not even taken a sick day leave for the past many many years. I supposed this should make up for it all somehow. All this now is just down to an emotional endurance test to live through the day, every single day.

And these have been my most trusted companion these days... I have graduated from walking frame to double crutches and finally down to single crutch. 

As far as being a patient; I supposed I'm what the nurses must have called a model patient, really. I'm obedient. I take my medicine whenever I was told to do so. I ate my meals. I'm more or less highly independent by now hence need almost no help from them in whatever I have to do.

My daily routine begins as early as 6:30 am after Subuh prayer when they had to give me my first dose of antibiotic. The IV procedure goes for about 2 hours at a time with them having to switch the infusion solution bottles 3 times and then to flush the IV line. Then breakfast and shortly after they would send me down to the physiotherapy gym downstairs for a one and a half to two hours session. They now had allowed me to join the crowd in the gym as my infection is more or less under control. It's quite a nice change to see other people's faces. And by being in PCMC, we get a fair share of celebrities and VVIP there too! I believe the physio therapy sessions stories deserve a post by itself after this considering how it was a highlight to my daily routine and how many interesting people I met there everyday. The routine repeats for one more physiotherapy session in the afternoon and then another round of antibiotic in the evening.

This monotonous routine would have killed me with boredom if not of the few surprises I get everyday. One is waiting for Zarina to come after she sends Afiq to school. She would hang out with me until it's time for her to pick up Afiq again from school. I enjoy those moments. We chat, we watched TV, we read and we just enjoy spending the time in the company of each other. She most of the time would turn up with some surprise comfort food, magazines or whatever she can do to cheer me up. The other thing that I look forward to are the visitors. I'm proud to say that up till today we still maintain the amazing record of - not a single day without a visitor!

I would like to take this opportunity to thank each and every visitor who came and paid me a visit. It meant a lot to me and it does contribute tremendously to my recovery. I lost count of the gifts people brought me but I treasure deeply each and every one of them - (not in any particular order) the flowers, fruit baskets, chocolates, comfort food, teddy bears, 'pati ikan haruan', probiotics, super berry juice, books, magazines, 'air zam-zam' and all sorts of other gifts that I loved so much! 

Anyway, talking about visitors reminded me of an incident, an unpleasant one, during the first few days I was in the hospital this time round. I always had plenty of visitors even on weekdays but more so on weekends. On the first Saturday, the stream of visitors kept coming and coming from morning until in the evening. I of course loved it so much but unfortunately my next door neighbor doesn't. She (as I only found out later) kept complaining to the nurses about the noises made by my visitors. Okay, I have to admit, most, if not all of my visitors were on the jovial side (you guys know who you are!) and hence there were plenty of laughter around. Unfortunately my neighbor does not appreciate this so she kept complaining to the nurses to tell me to tell my visitors to shut it up.

For the record, I do apologize for the fact that she can hear my visitors' from her room. The wall is too thin and to make it worse, they have an interconnecting door in between the two rooms. But then again, I also have to defend my visitors on the fact that they were there during the designated visiting hours. I also noticed that all other rooms have visitors as well and some were probably even louder than us and some even had their door wide open! Whenever I don't have any visitors I could hear them too and sometimes can even gather what they were saying but it doesn't really bother me. When she kept complaining, I had to caution my visitors to lower down their voice but then again that lasted for only a few minutes before they had to laugh again - quite uncontrollably sometimes. I can't help it - I am not terminally ill. Other than the back pain and the weak legs I had, I was totally healthy and in sound happy mind.

It bothered me after a while so I asked the nurse if I could be moved to a room far away from her, and preferably at the end of a corridor. Luck was on my side as the next day, a room at the far end of the ward was vacated and I of course get the first right-of-refusal to move into it. In one of the conversations I had later with one of the nurses, I referred to what was happened and said how I was feeling sorry for putting the nurses in such a difficult situation. But the nurse's reply shocked me. As it turned out, my neighbour complained about everything! She complained to the doctors that the nurses do not know how to do their job, not friendly to her and not helping her. She even complained that some of them did not smile! I was made to understand that her condition was not that bad but every time the doctor wanted to discharge her, she always seemed to develop some new symptoms that requires her to stay there longer. Anyway, come to think of it; I did not know her personally so it would be unfair for me to judge her and furthermore to a certain extent, we were at fault too! The lesson from this is probably how we should tolerate one another - which is something I find quite lacking in the community these days, myself included.

It struck me that my sequel of dramas is probably finally over. If what happened above was already an event worth thinking and writing about - then the worst is definitely over! No more pain, no more needles, no more bad news from doctors. I believe it is all going to be a nice and gentle glide from this point onwards.

I have a neat arrangement with Dr. Jag now. I'm allowed to leave whenever I want! Yes, the only reason why I had to be in the hospital is for my antibiotics IV and my physio therapy sessions. Other than that, I'm free to go wherever and whenever I want. You won't believe how that simple arrangement made a big difference in bracing through weeks of otherwise what would have been like a long imprisonment. 

It is called "home leave", a term I was not very familiar with before. All I need to do was get my arm bandaged so that the IV line would not be dangling all over the place or expose me to external infection, and then sign a consent form and then off I go. I look forward to the time when Zarina will come to take me out. My first destination - to work! Please, do not roll your eyes or sigh disgustingly on this statement. And please don't make me feel bad about it. Don't get me wrong; I AM NOT a workaholic. I just happen to have a wonderful job and I love it so much. I'm a member of a great team working on this one and all I wanted to do was just to join in the fun with them. Don't get me wrong on this one too - the team is fully capable to handle absolutely everything in my absence. Again, I just don't want to miss the fun they were having. 

Everytime Zarina allowed me to visit my work I felt alive again. I can almost feel the blood pumping and the adrenalin gushing and a couple of hours with the guys can feed my craving and will fuel my brain for a few days after. Once it wears down I just have to be super nice to Zarina and beg her to send me to one of those visits again. Okay, it was not all work. I do spend more considerable amount of time and number of trips out with my kids to have lunch or dinner, to go to the mall, watch movies or do some shopping. Zarina even took me out to see my koi at the koi dealer's pond yesterday! Anyway, I just have to keep reminding myself to do it sparingly and only for a sensible length of time for every outing or otherwise I would have a difficult day in the physio session the next day due to my sore back. 

This is one example of the difficulty I was willing to go through just for a taste of good food. Imagine having to struggle even to get in with my crutches in one of the cramped nasi kandar restaurant in Jalan TAR. But it was all worth it!

One thing I noticed whenever we go out is, whenever people see me on a wheelchair they couldn't help but gave me a certain kind of look. Maybe it was just me being ultra-conscious of my condition or maybe it was true that our society still find it awkward and uncomfortable to deal with people with disabilities. I don't mean this in a bad way - it just appeared that they were just not so sure on how to behave and interact with a disabled person. Do they hold the elevator door for me? Do they walk pass and overtake me or do they follow my pace from behind? Do they make eye contact or do they just pretend that I'm not there? Do they greet me and smile at me or just try to make me feel at ease by accepting me as one of the normal person i.e. one of them? I came across this simple article on the internet that might help you on how you need to interact with someone in that condition.  

Link: How to Interact with a Person Who Uses a Wheelchair

The other highlight of my day is definitely my physiotherapy sessions. PCMC clearly has the best Physical & Rehabilitation Medicine Department I have come across so far. A well equipped rehab gym and large number of highly experienced therapists are not just it - it also has a very conducive environment for recovery for patients like me - the have plenty of smiling faces and laughter! 

This is Shaheerman, my physiotherapist or more fondly known as Man by all of them there. He is THE "Che Man" mentioned by Johan, the recent winner of 'Maharaja Lawak Mega 2012' - a fact he proudly and repeatedly mentioned on daily basis. Anyway, with Man and his colleagues' help I have improved tremendously. But I still secretly believe that physiotherapists in their nature - like to torture people! Here we are all these less-abled patients being put through series of daunting tasks, made to endure pain and suffering throughout all those exercises. But then again, it works! And in Man's own words - when I mentioned to him that I feel like I was improving - he said, "That's my business. If you don't get well, then what's the point of me doing this anyway..." So true.

So, here's my endorsement. If you  need any kind of physiotherapy or rehabilitation treatment, PCMC is the place! Mention my name and I'm sure they will have stories to tell about me but don't believe them!

By now, as you already know, the only reason why I am still here is just because of my internal infection. They conduct weekly blood tests on me. The two "markers" to measure the level of infection in me are the CRP (C-reactive protein) and ESR (Erythrocyte Sedimentation Rate) which basically measure the internal inflammation. The target is to get two consecutive zeros of CRP and a reading of below 20 for ESR. I don't quite know how it works or how do they actually measure all those readings but all I know is that those are the KPI's that I have to achieve so that I could go home. I did rather innocently asked Dr. Jag on what I can do in order to get those results quickly. He pointed to the infusion machine as said, "Never miss those and you'll be fine..."

At this point, this blog posting is finally current. And I am exceptionally happy to announce that Dr. Jag as of two hours ago had confirmed that I can go home tomorrow! They are removing my long line and I will be home free by tomorrow morning. I deliberately ignored the fact that my blood test results actually wasn't really showing the results as per the agreed KPI. What happened was the CRP has gone back up to +6 and the ESR is still above 20 but Dr. Jag believes that this time, it could be the long line that was causing the infection. So, they are going to remove it and switch me back to oral antibiotics. I will be home free but I would still have to come back here on weekly basis for my blood tests and will still have to achieve the set KPI. I am not going to argue with the decision and I was not going to entertain any negative thoughts either. I just want to go home...

Eventhough my drama was about to reach the end, this will certainly not be the last posting. With all that happened in the last nine weeks, I still have a lot of experience, thoughts and reflections to share. Of course after a short break to enjoy being at home again...

  

Part 11: PCMC Revisited

On Thursday, 3rd January, we went back to PCMC. I had my physio session lined up and Dr. Jag is also back from his holiday so I'm having a follow up check with him. The physio went first but sadly, due to my muscle spasm, I didn't get to do much. I could just conjure a few very light legs exercises and spent the most part of the session being treated under the pain management regime with ultrasound and ice packs. They did relieve the pain a bit but I know the spasm is still there; like a time bomb waiting to explode.

My physio therapist was poking around looking for the particular muscle or nerve that was causing the pain. As we found out, there is a 'trigger button' for it just two third of the length down from my bum on the outer side of my left leg. One push and it was like an electric shock sending high voltage current throughout my entire body at the pain scale of 10 for a whole 5 seconds. I saw blinking stars for a while after that. I warned him not to push that button again! The physio guru of PCMC also came around and her diagnosis was that it could be instability of joints. I didn't really know how to take that. I just hope instability of joint (or joints) is something that can be fixed from the outside.

Later I went to see Dr. Jag. He was happy to see me and for the fact that I was already discharged but quickly asked me why I was not on my feet but being pushed by Zarina on a wheelchair instead. I explained everything to him and he gave me his worrying look. I had a feeling that this was not going to be good. He asked me to lie down on his examination bed. He must have noticed that this time I was really afraid of his pulling-and-poking method and reassured me that he will not do anything. He even stood about a meter away just to prove it. But I knew he was asking me to do certain movements in order to trigger that excruciating spasm pain. And he was right, it hit me; twice! I was screaming in pain and almost fell off his examination bed. I was left with teary eyes after the two short episodes.

Dr. Jag agreed with the physio's diagnosis but he thinks it could also be caused by internal bacterial infection. He had the benefit of seeing the internal infection himself when he opened me up last time so only he knew how bad it was. I'm guessing it was pretty bad. If it was just instability of joints, he said it could be fixed by putting a body brace on me to hold the joint properly and over time it will heal. It doesn't sound that evasive but it doesn't sound too promising either. If it was due to infection; antibiotics are the only cure. But that would mean going back to Dr. Suresh, the bacteria warfare guy, and most probably using the antibiotics on IV which means another round of hospital stay. I was still shaking and too tired from the previous attacks to disagree with him.

"I'm going to admit you back in. We are going to do a blood test, an X-ray and an MRI again to find out what it is." I looked at Zarina and then we both looked at him. I can't remember what our actual reply was but in unison we agreed - do whatever it takes to fix this.

After he made a few calls to book all the tests for me and send his nurse out to arrange for my admission, I suddenly remembered to ask him. "What if the infection can't be cured with antibiotics?". I was merely putting together the facts he presented to me earlier - if the bacteria is on the spine itself, rather than the muscles; then it will be hard for the medication to reach there.

"Then we'd have to go in again..."

I can almost felt another spasm coming. This time not triggered by my movement but by the words he uttered.

He added, "I'll have to go in and give it a good clean. It will be a fairly simple and short procedure. Not to worry." Rather unconvincingly this time...

I can't even think on how to react. I think I will just have to cross the bridge when (and if) I come to it.

For the second time in PCMC, the routine repeats again. The only difference this time is I'm going into the medical ward instead of the surgery ward. And sadly also, I didn't get the Twin Towers view from my window this time... I just hoped and pray for the best. Just like last time, Zarina had to rush home and get my necessities and then came back to accompany me at the hospital. The X-ray and the MRI should have been a simple routine procedure for a regular like me but this time it was a bit constrained due to the spasm. I kept having to apologize to the imaging crew because I really had to take my time in getting myself into position. I was moving like a sloth in order to avoid triggering the spasm. The X-ray went quite well but I had two spasm attacks during the MRI and it wasn't fun at all.

Zarina spent the night at the hospital that night just to accompany me on my first night back at the hospital. I was in a way glad that I am back into good professional care but I can't help playing the scenarios in my mind on what was going to happen next. I pray hard that night so that I would not require another surgery...

Dr. Jag came early the next morning bearing somewhat a good news. It was confirmed that the infection was the one causing my spasm pain (well, this is not the good news). The good news is that he thinks the infection could be cured by antibiotics. They are going to pump me up with two strong antibiotics; Vancomycin and Fusidin. I googled them later and found out that Vancomycin used to be considered as the "last resort" medication to treat serious infections. I was comforted for the fact that they are using a super-drug to treat me but on the other hand, I was also not so comforted by the fact that, if this is indeed the last resort - what would happen if the last resort doesn't work?

Vancomycin would have to be given intravenously so I would definitely have to stay in the hospital. It is also so 'corrosive' that it were given via normal IV line like the picture on the left (for the purpose of those non-medically inclined people like me) it will only last for a few days before the veins will get 'burnt'. It happened to me during my previous stay when they had to remove the IV line when it starting to hurt the vein. This time they had to do it in such a way that will sustain weeks of delivery of this antibiotic.

So, I was introduced to this one cool procedure. It was actually quite scary when it had to be done on your own body but it was definitely worth it when you see how people cringed when you told them how it was done. The procedure is called PICC that stands for Peripherally Inserted Central Catheter line. In this procedure, a line was placed in a large vein in the arm near the inside of the bend in your elbow. It is then threaded through the vein all the way up your arm until the tip sits in the large vein just above the heart and sometimes extended right into the heart. As I was telling people how it was done, I drew a line with my finger on my arm all the way to my heart - that's when they cringed.

They had to wheel me into the OT for this and it had to be conducted by an anesthetist. It has a very low risk of infection and will last a long time but the best part for a patient like me is the IV delivery now doesn't feel a thing. In laymen's term, they basically run the line through the narrow trunk road and made a bypass straight to the highway - hence no traffic congestion. 

Anyway, I can sensed that Dr. Jag was being ultra-conservative this time when he was estimating that I would need at least 4 to 6 weeks of antibiotics in order to get rid of the bacteria totally. I'm an engineer so how can I argue with my doctor... He was stressing again and again on the 4 weeks stay and was asking if was I okay with the arrangement - not that he was going to give any choice anyway...

As he was about to leave, I said to him, "I only have one request". He turned back toward me and said, "What is it?".

"I want the Twin Towers' view", which he replied with a grin, "Considered done!". I guess if I was going to do it, why not do it in comfort. Somehow the Twin Towers had always have a therapeutic effect on me...

They got me a new room on the other side that very same evening. Last time I was in the surgery ward but now I'm in the medical ward. Same good service but with a different crew. I'm going to make a new set of friends for the next 4 to 6 weeks... My advice to everyone is - "Be nice to your nurses. They are the one holding the needles..."

Part 10: Home, but not for long...

This is me after few days at home. 

I posted this on my Facebook wall and immediately received tons of comments from my friends on how thin I looked. Yeah, the last time I was in this shape was probably more than 12 years ago! I'm happy with the weight I lost, but I was actually hoping that it was not this way. I lost a total of 7.5 kg so far within a month. My doctor said that what I lost was a lot of muscles mass and a bit of fat so when I'm back to normal and worked out all my muscles again, I would definitely gained back the muscle weight. Just try not to gain back the fat as well, she said... Another downside is, I probably have to go out and buy some new pants. Some of the ones I have are getting a bit too loose... (Sorry, I just don't know how to say this without sounding like I'm bragging... haha!)

I also have a very dedicated nurse at home. Zarina was running a tight ship when it comes to my medications, diet, supplements and other daily routines. She was a professional accountant before so you should expect this level of organization. I failed my compliance audit a few times though...

Despite having to make some adjustments and having to take a few backwards steps in recovering at home, I can almost feel that the recovery process is now on the positive side again. More family time, more laughter, more good food, more tender loving care. It so happened that my kids are still on their school holiday so they have been a great help in me adapting to the living condition at home.

It took a while to get used to everything. I have to admit that before this, I never really appreciate how my mother-in-law struggles to move about in the house. She's a bit elderly and also suffering from Parkinson's Disease. She's also been having problems with her knees and back. I now had an opportunity to have a first-hand experience on how it is a challenge for her to live day by day and going about doing what otherwise would have been a normal and simple routine. I even had to borrow her walking frame and wheelchair. I also realized that in my case, no matter how bad my condition is at the moment, I can still hope that I would be better in the foreseeable future - but not in her case.

We many times 'scolded' her for wanting to do everything herself and not asking for help from others but in the end she ended up making a mess and created more work for others. A few times when she refused to use her walking frame she ended up falling and hurting herself. Even when she insisted on carrying her own plate to the kitchen, she ended up dropping the plate and making a mess on the kitchen floor. Little that I realized that she just wanted to be independent. All her life she was the one providing for the family and dedicating her life in 'serving' others. She's never used to being dependent on others let alone feeling like she's a burden on them. Why she insisted on doing everything is in her nature. In my case, I might enjoy the extra bit of attention and assistance from others because I know that I will only need that for this short period of time during my recovery but in her case it's different. For every single thing that she used to do herself, but now having had to depend on others; she might never ever get that independence back. Once she let go it will be gone forever. I understood that now. She was just clinging to the very last hope and opportunity to be herself, to attend to herself and not be a burden to others.

I remembered the PETRONAS' Hari Raya commercial in 2006 and may this be a quick reminder to us all who still have our parents under our care. I lost both my parents quite a while ago. How I wish that I could still do every bit I can to repay their kindness, dedication and hardwork in bringing me up and making me the person I am today. Now that they're gone, I can only give them the gift of doa and Al-fatihah and at the same time strive to be the best human being so that they would be rewarded in the hereafter, insya'allah...

Another humbling experience was when I had to go to the Pejabat Pendaftaran in Putrajaya to apply for my replacement IC. We had done the application online via "MyEG" and we were only supposed to go there for me to pickup the IC in person. One of my nephews volunteered to drive us there which was quite a relieve as Zarina would have had difficulty handling me all by herself. This will also be my first experience going out to a public place as a "less-abled" person (or in the Bahasa Malaysia term, OKU i.e. Orang Kurang Upaya). I would have imagined that a new and modern buildings like the ones in Putrajaya would have had incorporated the latest architectural design and would certainly be disabled-friendly but unfortunately and sadly, not so.

Our first impression was actually good as we found out that they have a wheelchair ramp access at the main entrance of the building. But that day was also the day when the cleaners decided to wet-clean the carpets and guess what? They used the railing of the wheelchair ramp as a place to hang the carpet to dry! Somehow they managed to turn the facade of a multi-million ringgit building into a low cost flat.

There was no sign for disabled access anywhere so we had to look around and then asked one of the staffs who pointed us to the direction of a lift - which later we found out, was not the right one as we ended up having to walk a long way round to the other side to take yet another lift after that one. I also found a design flaw in the floor level where there must have been a mismatch spotted only after the civil and structural work has been completed. The difference in finishing level between the floor and the lift area caused the lift to have its own raised "platform" and hence a 2 inches kerb to get onto the platform. It's a challenge for Zarina to push me up and I'm sure no less-abled person can do it if they are by themselves on a wheelchair.

There seems like more to be done for the building to really be disabled-friendly. Perhaps whoever who was supposed to accept the building handover from Contractor should have put him/herself in a wheelchair and see whether he/she can actually get around the building without significant help from others and then make the necessary adjustment accordingly.

Anyway, as far as the recovery is concern, having been at home everything seems to be going on so well in all aspects. But then again, the drama continues...

It was my 5th day at home after returning from the hospital when it started. Another peculiar pain but this one was even more peculiar than the previous ones. I can only define it as muscle spasm. And quite a severe one too.

Every time I made some movement, at some unpredictable position in the middle of the movement, it will just hit me. I'm well trained by now by the doctors and nurses to give a pain scale of 1 to 10 for every time they want to assess my condition. Generally, '0' is no pain. 1 to 3 is mild pain; somewhat nagging or annoying and interferes a little with your daily routine. 4 to 6 would be moderate and defined as significantly affecting your daily lives. 7-10 would be severe, disabling and stopping you from your daily routines. My sciatica pain would be a 3, my recovery pain would be a 5 but my '5 am' pain was a 9. But they gradually move up and down the scale throughout the day and is very much dependent on the level and type of activities I had. Meaning to say, I can control them and bring them to below 2, by adjusting my position or movement or by using some pain relieving methods. By now I'm quite a 'Subject Matter Expert' on pain management techniques.

However, this one is a definite 10.

Picture this; I would be lying on my back and trying to get out of bed. Just like my physio taught me, first fold both of my knees, then rotate the entire body to lie on my side, then lower my feet to the floor. Next I will simultaneously push my body up with my elbow or hands so that I would be seated at the edge of the bed. At half way through this movement when I was leaning at 45 degrees, the pain would just shoot in - ZAAPPPP!!! Literally from 0 to 10 in half a second! A strong pull on my lumbar muscles and sometimes on my lower back and it kept on like that for a whole 5 seconds! I would be screaming in pain and then after 5 seconds it will just stopped. Just like that, and left me breathless and panting. The pain did subside but the memory of it lingered on for a while. Within the 5 seconds, I would be stunned, not knowing whether to lie down again or keep trying to get up - whichever way, I would still be in the '10' region. That happens a few times a day and always at the unexpected moment.

I was now scared to even move. I would be awaken at night screaming in pain when I must have moved my legs about in my sleep. Coughing or sneezing would just throw me into a fit! It was getting worse and worse by the day and my recovery progress was rapidly making a 'U' Turn. Due to my constrained movement, I was also developing pain on my elbows and shoulders because I was putting too much weight on my hands with the elbow crutches instead of my legs. Everything the physio taught me went down the drain and I was at best, just getting by in moving around. I was really looking forward to see Dr. Jag when he gets back from his holiday. I'm sure he will be able to fix this, as always. Only with some simple medication, I hope...

My original plan of capturing the New Year's firework display with my new camera and lens did not materialize this year. Instead I was just watching TV at home in bed as the fireworks were lighting up the bright sky of Putrajaya. I made a mental note of a few new year resolutions and one of it is to take care of myself more than before. I didn't regret what happened. In fact, I was rather contented. I strongly held on to my believe that everything happened for a reason and what happened to me was due to a few reasons. I promise myself to fix what I can fix and at the same time, sincerely accept what I cannot fix. All in all, I know this experience have made me somewhat a better person.

Part 9: Home Again

Despite having a fairly restful period in the hospital, I can't help but craving to get back to my normal routine as soon as I can. The hospital room, no matter how luxurious, is still not home. I miss my family especially my kids, my kois, my bikes (in that order)... I miss the action at work too! My doctor had hinted that even if I could go home, it will still take months before I'd be allowed to go back to active duty at work, and more importantly; no travelling! That's a bit scary considering that there is no non-active part or role that I could play in my work. And travelling is a big chunk of the work! I can't help but to entertain the paranoia that if I were absent for too long, they might decide that I'm not fit for my work, or any work at all... Anyway, it was bit comforting when I thought of what my Boss' Boss' Boss said when he visited me at the hospital the other day. He told me not to worry about work; get myself properly fixed first and then only think about coming back to work...

Other than the hordes of visitors, there were many other things - good things - that made life in hospital bearable. I have plenty of time to read and write and to reflect  The bathroom is just 5 steps away from my bed. The reclining bed. The friendly nurses who are available just at a push of a button. The Coffee Bean downstairs that sometimes Zarina wheeled me to. And a few others as well. But then again; the ultimate aim is still to go home. To be able to sleep in my own bed, eat what I want to eat instead of what's available in the menu-of-the-day and not having any needles chasing me.

Talking about needles, I was already running out of veins on my hands for them to poke. Both my hands, through the three surgeries, have taken quite a beating. One time, one of the IV line was inserted wrongly in the ICU and I ended up with a swollen hand for 4 days! They are now using the only available spot on my arms for the IV line. But with the corrosive antibiotics, it doesn't take long before I started feeling the burning sensation. One evening I just had to ask them to take it off before it became swollen again. My 'bacteria warfare' doctor was brought in immediately the next morning and luckily he sympathized and asked for me to be given oral antibiotics only - by a concoction of four antibiotics. The bad news is that I now have more to swallow many more times in a day but finally, I should be home free!

From the beginning I had asked my doctor when he thinks I would be able to go home. His first estimation was two weeks but it entirely depends on how the infection reacted to the antibiotics. If we can stop the IV antibiotic and just have to rely on oral type of antibiotics - then I can go home. It was actually quite frustrating for the fact that, no matter hard I work, like all the effort I put in into my physio training, the actual determining factor of whether I could go home is actually not under my control. I'm not a control freak but I do prefer to be in control... most of the time...

Luckily, after two rounds of blood tests, my body was beginning to show positive reaction to the antibiotics. The 'markers' are showing lowering trend and by projection will clear all the infections very soon. Finally, on the 13th day I was in PCMC, my doctor came and delivered the good news - as far as the surgery and infection point of view, he feels that I was fit enough to go home! All I had to do was to have an assessment with the Rehab Specialist and get her opinion on my physical abilities and mobility.

This was the final moment. I aced it and I am now home free...!

I did ask her after the assessment on how long does she think until I will be totally crutch-free. My doctor gave me a three months medical leave which seems a bit too long for me judging by my rapid progression now but she said there is no guarantee that I would be able to walk independently even after three months. It seemed to me that she was being ultra conservative in her estimation. With all due respect to her in-depth knowledge and experience in her field of expertise, I would gladly prove her wrong. I'm giving myself one month top to be crutch-free and at the same time will be back on active duty. I take their advice on not travelling but I will not hold back on anything else.

I quickly called Zarina to come and pick me up and she quickly rushed there the moment she sorted out the kids. I had mixed feelings. On the one hand was obviously the happiness and excitement to go home but on the other, how is it going to be - recovering at home. Will I not be a burden to my family? Will I adjust well to the conditions at home? Is this really the final hospital stay for me? I really hope it is...

Just when I thought that everything is going on exactly as planned and how nothing else could go wrong at this point - as Zarina was packing my belongings I then realized that my wallet was nowhere to be found! I remember I had it when I first got in two weeks ago. Zarina also remembered taking it from the drawer when I had to check out from my room before going to the operation theater but somehow, there was a memory blank between the time I returned from the ICU and stayed in the new room until now. Zarina practically turned the hospital upside down and inside out looking for it and traced back all our footsteps in the hospital but we still couldn't find it. What ought to have been a sweet and triumphant moment of returning home turned to an unpleasant episode of worrying. Probably the only minor comfort was that there has been no attempt of use on any of my credit cards but still, I can't even bear the thought of having to replace my IC, driving license, ATM cards, credit cards, corporate cards, medical cards and many others. I don't mind the money, really, but was really upset for the fact that whoever who took it didn't have the decency to at least returned all the other important documents. It wasn't a pleasant drive home but at least I was going home. Quite a test this has been...

After a reasonably restful first night at home, we spent the whole day next day calling banks, registering for the new IC and settling many other official stuffs. Eventhough we have moved on and did all the necessaries, I still couldn't get over the fact that whoever took it was really heartless - taking opportunity of other people's low point in their life for his/her evil intention. The only way I could channel my anger and frustrations away is to hold on to an assumption, although quite unlikely, that I could have been the one who misplaced it or we could have dropped it during the shifting of the room and it must now be lying somewhere where no one thought of looking. In any case, I have also decided that I was not going to allow this mishap to ruin what should have been a very good start on my journey to full recovery. 

It took quite a bit of effort to adjust to the situation at home. The bed has no side railings to hold on to, the mattress is different, the shower is not less-abled friendly and the climbing of stairs was really killing me but emotionally, I was at my all time high and I believe, that alone can speed up the process. The New Year came by and I was adjusting even more to home and beginning to really get used to the routine of having a long holiday. The only one setback was I was yet to be able to find a good position to write hence the blog got held up for a while. Until we could solve on the sitting position, I could not even bear 15 minutes on a chair working on my notebook! But the best part is probably having the opportunity to spend more time with my kids. In between my long working hours and travelling I know that I have been neglecting them somehow. I subscribed to the idea that it's not the quantity of time but the quality of it that matters hence had always make a point of spending 'quality time' with my kids. But now I'm beginning to realize - quantity is just as important.

One night I was having a long chat with my daughter in her bedroom. We talked about all kinds of things - her life, her school, her friends, her pet rats, her problems, her fears, her dreams and all sorts of other things. She was really pouring out. At one point she said, "Babah, please don't get me wrong but I'm happy that you're sick." I was taken aback but before I could say anything, she added, "I'm just happy that you're sick so you get to spend more time with us at home. I'm glad that I get to talk to you like this. I know Mama is always here for us but she's also busy with the boys and Tok and everything else. You are a good Dad and I know you worked so hard to provide for your family but I just want more of you..."

I felt a nail driven through my heart...

I always believe that everything happened for a reason. God puts us on a certain path, or He puts something in our path in order for us to learn something from it. Our knowledge, experience, wisdom and faith will guide us in determining the lessons that we were supposed to learn from everything that happened to us and around us. I learnt a lesson from all this and I hope you all do too...

By the way, this is not yet the end of the story...

Part 8: Recuperating in luxury

Prince Court Medical Centre (PCMC) is definitely the best hospital that I have ever been in. It's more like a hotel than a hospital. The nurses walking around in their uniforms and patients on wheelchairs are probably the first giveaways but you could have easily been fooled when you entered the grand lobby that resembles more of a 5-Star hotel. They don't even have that peculiar 'hospital smell' anywhere! And if you think the doctors and specialists are good; the nurses are even better! Okay, enough promo on PCMC. By the way, I'm not promoting them just because my company owns it but it is truly a good hospital. They should really have a tagline like, "The place to be when you're sick", or "PCMC - The only thing to feel good about even when you're feeling down...", or maybe even  "Want to be treated like a prince? Then get sick and come enjoy a stay with us!"

And with a view like this from my hospital room; how can I not recover fast... But on the other hand, I may never want to leave...!

Anyway, back to the story...

Dr. Jag came to see me in the ICU very early the next morning. I was still half awake but I could figure out that it was a Sunday. "Do you ever have a rest day?" I asked him and he returned a sheepish smile.

"It was a success", he started. A good start indeed. "But we found a lot of internal infection... It was indeed a right decision not to put in the titanium screws." The spine fusion surgery he proposed earlier requires removal of the damaged discs and replacing it with bone graft. Then, in order to lock the two vertebrae in place, titanium screws and implants will be used. As cool as "titanium" sounds to an engineer like me, I would prefer that those metal stays on my wrist, finger or golf clubs - but not in my body. The third surgery would have multiplied the risk of infection and if there was any infection and the bacteria stick themselves on the metal implant, then they cannot be eliminated with antibiotics. In that situation, the only solution is to go back in to remove and replace the metal.

"But don't worry", he added. "I gave it a good clean and we'll start you with a course of antibiotics immediately". Then he started poking me here and there, lifting my legs and asking me to push his hands with my legs etc. and every time with the same question, "Is this painful? Is this painful?" I couldn't really distinguish whether it was a real pain or more of me being too scared about him roughly handling me. But the truth is; finally, the sciatica pain is no longer there...!

"Don't worry. No need to ask..." I said to him. "If I'm in pain, you'll hear me screaming".

In which he replied, "Ahaa... I see you got your sense of humor back already. That's progress..."

The physio training starts the very same day, in the ICU. As I expected, and feared, I had to start all over again. All I managed to do was to get up and sit at the edge of the bed. That's it. Not a very encouraging start. It really feels like playing "snake and ladder" where after a few good roles of the dice and having climbed a few ladders; then one wrong move and you're being swallowed by a snake and had to start over all the way from the bottom.

I kept telling myself that now the worst is really over but still I couldn't help it but fear the unknown. What if the disc decides to prolapse again? What if I take a tumble and hurt my back again? What if for whatever reason, some other parts of my body decide to give way and will cause another bout of incidents similar to this? But I also know that if I kept entertaining these negative thoughts, I will get nowhere. So every morning I will have to wake up, put on a smile and stick on my 'positivity patch' and try to look at the day in the brightest possible way. The truth of the matter is, it wasn't that hard. With all the support I'm getting from friends, colleagues and families, it feels like all these combined strengths are supporting me from behind. The record continues from the very first day that I was admitted - there has not been a single day where I have not had any visitors!

I was about to shift into third gear in the recovery process when on the fifth day after the operation, Dr. Deepak (who is the replacement to Dr. Jag while he goes for his year end holiday - so he's human after all) came and informed me that the bacteria strain in my infection is not the one that they had assumed earlier on. It was a different one (it was two strains actually) and they are also not very commonly found here. It quickly occurred to me; of course, they're from London! Because of that, the antibiotics they have been giving me from Day 1 is actually not working. They had to bring in an Infectious Disease Specialist (or more fondly known among them as the 'Bacteria Warfare' guy) who will devise a plan on how to tackle these bacteria. It turns out that I would have to take 4 different types of antibiotics and one of them via IV. And just because of that, me leaving the hospital is no longer determined by how I improved my mobility and my physical abilities but by the effectiveness of the course of antibiotics.

This is my typical early morning dose which in a day, includes four antibiotics plus many other medications and painkillers. One of the antibiotics was so cruel to my stomach that one time I had a terrible acid reflux after taking it with an empty stomach. With all those chemicals in my body, my mouth was constantly dry and tasted bitter. I don't feel like eating (for those who know me personally, would know how impossible this may sound but yes, I don't feel like eating!). I lost a few more kilos and can feel my muscles shrinking. And all the times both my legs and also my bum are still numb.

Another thing I hate is needles. I believe I have a reasonable level of tolerance to pain but somehow not when it comes to needles. I just hate them and can't stand even the smallest prick with those syringes. And by having to have 3 surgeries and many rounds of blood tests, IV medications etc., I had almost run out of places on my arms for them to prick me with. So sometimes they had to go back to the veins they have used before while they are still sore from the last use! To make it worse, the antibiotic IV is so corrosive that it burns the vein after a few days of use. Anyway, I shouldn't be complaining but should actually be thankful that I am now in good hands of the experts.

I'm a believer that laughter is the best medicine. And indeed my visitors brought plenty of that! Other than the pain I get at the stitches when I laughed too hard, the laughs I get with every visitors had really gave me the strength and willpower to get back on my feet as soon as I can. I lost count of the number of people who came but judging from other patients' visitors, I believe no one can beat our record. The scores of visitors were a mixed of friends, colleagues (and my Boss, my Boss' Boss and my Boss' Boss' Boss!), families, relatives, koi friends, long lost friends (one of my friends I last met was 30 years ago!), newly found friends, friends of friends and many others. Sadly, I totally forgotten the routine of taking pictures with visitors like I did in London. Perhaps subconsciously I feel that I'm already home and will easily meet these people again that made me forget to take their pictures. The only ritual that we never forget here is to take pictures of daily progress of my wound. Don't worry, I don't intend to post those gruesome pictures here. They were just taken by either Zarina or the nurses or sometimes even the doctors themselves so that I could see what's happening behind my back, literally. And that was healing nicely too.

This is the period of time when I actually started writing this blog. Other than the suggestions I received from some friends, there was also another story behind it. One day, one of the visitors said, "Do you know that every time you go under a GA, it will kill a lot of your brain cells? That is why doctors normally would space out the gap between surgeries so as not to do too much harm on your brain." Zarina panicked. If one GA can do significant damage, then what about three! She quickly asked me to start doing something creative other than surfing the internet reading the Koi Forum and of course writing comes to mind. It was such a great feeling looking at the tremendous support to the blog. Within a few days, the number of hits had easily beaten what my old blog "To The Red Centre and Back" did in half a year!

I was doing well with my physio therapy (just when I thought my therapist in London was bubbly, the one in PCMC is even bubblier!). I progressed from a single step to three steps, then five steps, then half way through the ward and finally all the way to the next ward. I also graduated from the walking frame back to the crutches and the next aim is to go a single crutch. I also regained my balance. I felt so pathetic when I first tried to stand up unassisted and have both my hands on my side, instead of the walking frame. I could only managed 5 seconds before I was swaying vigorously and had to quickly grab the walking frame again. But then again, with the hard work  I progressed from 5 seconds to 10, 30, 60 and the best record at that time was 2 1/2 minutes! Anna the physio lady was very encouraging and motivating but sometimes the way she cheered me up I feel like I'm a kindergarten kid and she's the kindergarten teacher... but as long as the method works - can't complain. I also learnt to appreciate the simple things we do even more like standing up. I bet you all can stand still, raise your hands all the way above your head, and then close your eyes. At some point, I could only do one of those at a time. Not even two, and obviously not all three.

Two weeks flew by effortlessly. I told Zarina not to spend the night in the hospital anymore as I don't want to rob her from the kids. I am much more independent now and with all the nurses around me, I will be able to manage anything and everything. The kids are on school holiday now and even at their age, they still need supervision from her. But then again, she still insisted on visiting me every day, without fail, so she's been driving back and forth everyday from home to hospital on top of running errands and managing the household.

...I love my Superwoman...!

Part 7: Third Time's a Charm?

Zarina, Iman and I went to the Prince Court Medical Centre (PCMC) that Thursday, 13th December. Dr. Jag, my neurosurgeon was the same doctor I met some 2 months ago about my severe sciatica problem and he was the one who suggested the Spine Fusion Surgery that I opt not to do. I was, in a way, prepared to get a long 'I-told-you-so' speech from him that day.

Zarina dropped Iman and I in the front lobby and Iman then pushed me in a wheelchair to Dr. Jag's office. Eventhough we frequently visited PCMC for Afiq's Occupational Therapy and Speech Therapy sessions (Afiq is my 8 year old son who is autistic), I noticed that everything feels different from the perspective of someone sitting on wheelchair. I anticipate that I might need to make more frequent visits here for my physio therapy sessions, if that was what going to be suggested by Dr. Jag.

As I finally entered his room, he was attentively reading my file containing my medical record that must been sent by the insurance company prior to my visit. Before I get to tell him what happened, he said, "I know about everything that happened" and then he added in very concerned look, "I just want to know how are you feeling now...". It was quite a relief that I did not get any of the scolding like I was worried about. I told him that I'm feeling much better now. I proudly told him at length about the progress I made in terms of mobility, being able to climb stairs with my crutches, being able to sit down at the dinner table and so on. On the not so positive side I also mentioned about the slight lumbar pain if I were to sit down for too long in which his reply was, as expected, "You had two major spine surgeries just a week ago - you should really take it easy..." but he finally frowned when I told him about my "5:00 am" pain.

He told me to lie down on his examination bed and started doing his routine lifting leg, pushing up, pushing down stuffs. I can't help but cringed in pain at certain positions. He sat me down again and this time asked again what they did to me in the last two surgeries and I explained again to him. By now, I must have repeated the story 50 times already that I'm beginning to sound like a newscaster. After a long pause, his reply stunned me. He said, "You shouldn't be having some of those pain if they had taken out all the protrusion on your disc. I tell you what, let me set an MRI for you...", the word 'MRI' felt like a sharp tug on my gut, "...today and let's also do a nerve test as well. For that I would have to admit you now into the hospital." My heart skipped a beat at the two words 'MRI' and 'admit' and I didn't quite hear the rest. He must have noticed my reaction hence he added, "It's just a test. Just to be sure..."

"What if we find something?" I asked him anxiously.

"Then we would have to go in again..." he replied. "But don't worry. Let us do the MRI first. Just to check..."

Now, when is it that a specialist just ordered an expensive test, 'just to check'...???

After the paperwork was done I was immediately sent to the ward. Zarina had to rush home to get my stuffs - no, not clothes and toiletries - but more importantly; iPad, iPod, Kindle, notebook, and all their respective chargers... That time it was already in the afternoon and my nerve test is scheduled at 4:00 pm and MRI at 7:00 pm (somehow '7' has not been my lucky number since the last few weeks - both my ops started at 7:00 pm!). I waited impatiently. I filled my time mostly with my postings on Facebook...

The nerve test at 4:00 pm was indeed a 'nerve-wrecking' procedure. It involved "shooting" electrical impulse on certain part of your nerve and then measuring how fast the signal travels through that particular nerve. There was about 5 shots on every spot and every time with increasing intensity. Imagine that I was already in pain and then they hit me with more pain. I jerked at the first shot and hurt my back. After the 5 gruelling shots were done I asked the lady who operates the machine, "Is that it?". She said, "No, that's only for the first spot. We have to do the same, 5 times on each spot for 5 different locations on each leg". I almost fainted... Okay, I was exaggerating but really, it was a torture... I asked the lady, "Do you like torturing people...?". She smiled a devilish smile... No, I exaggerated again. They (actually two of them) were actually very kind, pleasant and gentle. But still, I believe they took up the job just because they like to torture people...

The MRI was done at 7:00 pm as planned. By the time we finished with the MRI, Zarina is already back from sending Iman home and with all my stuffs and she wanted to spend the night at the hospital with me. Pity her too... only one night in her own bed and now she had to endure the hospital's sofa bed - which by the look of it, would be many times less comfy then our own bed at home. But she still insisted to accompany me that night. How can I say no. No matter how luxury, well-equipped and well-staffed with highly trained professionals the hospital is; nothing can beat the tender loving care of my own wife. The emotional support is what I needed more at that time compared to the professional physical care.

We had a fairly restful night that night. Maybe we were both still exhausted from the long travel home. Zarina was still jet-lagged but I slept like a log.

Dr. Jag came to my room very early the next morning. By the look on his face; I knew. It wasn't going to be a good news.

"I'm sorry..." he said, "We have to go in again..."

I was speechless... His following few sentences went quickly in a blur. It was something about what they found in the MRI. Then the additional risks of a third operation, the even bigger risks of not doing it. Something about higher risks of infection and a few others. He ended it with telling me that if I want a second opinion, he can get a colleague of his to come and see me or I should feel free to seek a second opinion from another doctor of my choice from any other hospitals. I told him my other doctor is a spinal surgeon in HUKM and I choose to seek for his opinion on this before we move forward. Dr. Jag concurred and told his nurse to pass all the relevant data to Zarina for her to bring it to the other doctor.

I didn't, and still couldn't say much after Dr. Jag left. There was too much to process. The was already too much to think about in terms of what he had said but there was even more to think about when it comes to what could happen next! This is the same feeling just like before the second surgery but multiplied a few times more in depth and intensity.

I did ask Dr Jag all these in the conversation just now but I find it hard to process the answers;

"This is exactly the same like what they told me before the second surgery!"
"What had actually happened in between the second surgery and now?"
"Is it because they had not done a good job in the second surgery?"
"If this is how it's gonna be; what is our chance that there won't be a need for a fourth surgery?"

He of course answered them all professionally and with his best ability but nothing could really satisfy me, and worse; nothing could make him backpedal and reverse his decision as I had hoped.

Zarina had to take a while to comfort me. I was in a mess. For a brief moment; the typical men and women roles were reversed for a while. She had to leave after a while to rush to the other hospital. I was again waiting impatiently. Some part of me wanted Dr. Jag to be wrong but as much as we agree that numbers don't lie; we have to agree that MRI doesn't lie too...

The call finally came after what seemed like a very long time and Zarina said my other doctor wanted to talk to me personally on this and she then passed the phone to him. I half expected what he was going to say next - " If it was me, I would have recommended the same thing too" he said and I replied; "Thanks. You don't know how comforting it is just to hear that directly from you..." I put down the phone and then buzzed the nurse in and told her, "Please tell Dr. Jag; I'm in..."

Everything else after was so much a routine that I could really do without the nurses, anesthetists, even my surgeon and everyone else involved telling me about the procedure and what was going to happen. The only differences are maybe that this surgery was on a Saturday morning and it only took 4 hours. Oh, and also an unpleasant difference - due to my sleep apnea, the anesthetists here prefer that I be wheeled in into the OT before they put all the GA lines on me instead of putting me on sedative first then only to go in. Bad idea for me. Being wide awake in the OT and seeing all the commotion of the crew members getting ready is certainly not calming. Even the sight of the huge overhead spotlights (or whatever they call it) was scary! And to top it all up, when the GA came in without you being sedated first, just like my surgeon described; felt like your veins are burning - literally! My 'last 10 seconds' this time was filled up with my screams instead...

I woke up "shortly" after and was expecting the normal tiring-but-relieving feeling but instead quickly noticed the burning sensation on my back, where the surgery was done. Zarina was there next to me holding my hand but the first word I uttered to her was, "Why is it painful? Why is it painful???" again and again and later, (I don't remember this but she said) I kept saying, "Flatten the bed... flatten the bed"... until they had to knock me down again...

Next time I woke up it was the familiar tiring-but-relieving  feeling again. The first few seconds I saw Zarina, then my eyes shut. Then next time open, was my elder sister, then shut, then open again and my other elder sister. Then a long restful sleep... I was told that quite a few other friends and relatives showed up at the ICU that day but they all let me sleep through... The recuperating process has begun... for the third and final time... I hope...