Tuesday, June 18, 2013

Ursula vs the Ovaries: An Epic Battle for My Womanhood and the Human Race

I was walking downtown with Amanda when a mob of crazy donut fans overran the streets for a doughnut rally on what allegedly was Donut Day. I should have taken this as a sign that Ursula would soon be coming back...


Ursula made her first appearance a few weeks back. After returning for a second term,  I returned to the hi-so  hospital for a new drug treatment. The next day I had a light breakfast of 1 piece of lightly buttered toast. Five hours later I began excessively vomiting up water and bile, but no toast.  Needing to go to the hospital I attempted and failed. Getting less that 50 ft before reaching a particular soi stench that immediately induced vomiting in of my neighbor's gutter. I returned to my bed where I stayed overcome by incredible stomach pains that resulted in an 8 hour period of immobility. I knew this wasn't going to get better by the morning so I finally stood up, went downstairs and asked the security guard to call me a cab. He, of course, pretended not to know what I was talking about. When I pointed to the cab service number on the wall he smiled and pointed back to me. Through some angry charades and me ordering him (in Thai) to call a taxi to the nearest hospital he eventually did.
    The nearest hospital is Bang Po and it's the same one I'd been to the first time I had this stomach problem, however, when I went back for my follow-up the one English speaking nurse wasn't there and eventually I left.

When I arrived at the ER I told them I had a lot of stomach pain. It took about thirty minutes before I saw the one doctor working in the ER. They took an X-Ray and found lots of what's called " free- floating fluid" in my abdomen. The doctor said she didn't know how it got there, but that it was bad.  They would need a CT scan to figure it out. Then a surgeon comes in and tells me the CT scan is 2,000 baht which then quickly changes to  20,000 baht. At which point I'm thinking maybe we skip that then. Then the same surgeon says "we need to monitor you over night and do a CT scan in the morning, but in the meantime we want to monitor your urine, at which point two nurses walk over with tubes. We want to do a catheter for your stay" "Mmm, I think not sir." "Are you denying our recommended treatment?" "Yes" "Okay, then you have to sign this saying you're going against our recommended treatment." "Okay, give me a pen."
 
They put me in the room, I'd end up spending the next week in. They took my blood every 3 hours to check my hemocrit levels. I don't know what those are, but mine dropped 10% and by the morning I looked like a heroine addict with all the holes in my arms. None of the nurses could form complete English sentences and one nurse in particular was extremely difficult to understand. Like many Americans probably would, she repeated herself extremely loudly when I responded that I didn't understand. It wasn't helpful and eventually made me quite stressed out, like on the fourth day when she came in and yelled HIV test, then a man shot me with a needle prick in the ear, that's a good example. The following day, they took me down for the CT scan that I couldn't afford. They handed me a bottle of some green water and told me to drink as much as I could. Then they told me they were gunna put some intravenous fluid through my veins while also putting some tube up my ass. I was pretty lethargic the entire time I stayed there, but a few highlights perked me back into life and my 'personality' definitely came through. This was one of those times. First, I was listening to him drone on about all this abuse they were gunna put me through but when he said they were gunna put some tube up my ass, for the first time, I flew upright, and responded "You want to do what?!?!"  " Your anus" was his response. "Ya, I don't want that." At this point the doctors obviously hadn't received this type of reaction before. Another doctor came out and said we're going to try something less invasive, we'll give you an ultra sound instead. "Yeah, you do that," I responded and went back to my lethargic state of being.

They wheeled me into where they do the ultra sound at which point they found the free floating fluid was almost exclusively blood. There seemed to be a large amount of it surrounding my uterus as well as floating in the abdomen. This is when I got handed over to the gynecologist. My first assigned fluent English speaking doctor, who stuck with me as my consulting doctor and later became my surgeon.  She gave me two more ultra sounds, one being the kind the US was trying to demand for abortion patients. Totally invasive and unnecessary. People should refuse doctors more, cause there's nearly always more than one kind of treatment option, hence the word option. Anyways, she said the blood looked like it was coming from an ovary as there may have been a cyst that burst.

So here's Red Flag # 1: I've been swallowing hormones since I was 15 with birth control, which  is supposed to prevent cysts. Red Flag #2: Cysts normally do not bleed. Red Flag #3 They don't bleed all the way up to your chest cavity.

At this point I'm laying in bed for hours at a time, strapped to an iv and generally unhappy. Nurses come in and out say "Pain" and hand me pills, or start giving me sponge baths without me having any idea what's happening.  I have no idea what I can actually afford, or what's happening. No idea whether these doctors know what they're doing or not, no confirmation of progress. One unlucky nurse came in to give me pain medication and I just broke down crying that I couldn't understand her and needed someone who can understand me to come in. She had enough English to say "Oh No" and that's when one of the two people who knew I was in the hospital walked in the door. My friend Tan, who's fluent in Thai came in to see me in all my glory. Sobbing in a hospital gown. He handled all my insurance claims with the staff and translated everything between the nurses and doctors and I.  He also restored my sanity for the next twenty-four hours.

So the mystery alludes but things becomes a smidge more clear as they are finding out more information. The gynecologist comes in and tells me she heard about me refusing the CT scan. She asks me to take it so they can check that it's the ovarian cyst rupture that's bleeding for sure because there's a chance it could be my pancreas or something wrong with my appendix.

Before I go on, I just want to say that there are certain things your body will never forgive you for. This blog post will only reveal most of them and remember this blog is a sacrifice for your own entertainment and the entertainment of others. Human decency does not live in hospitals.

As they wheeled me back down into the CT scanning room, I'd reached a new low. Depressed from being in the hospital alone for 3 days, lethargic from not having eaten solid food in 4 days, and looking like a piece of a dish rag that'd been forgotten under the dishwasher for 6 months. The only possible point you can be at before you throw your hands up and say "Fine, put the tube in my ass I don't even care anymore. Fuck all of you." The experience on the whole was extremely un-enjoyable. Of course they built up to the anus, first making me chug some fluid to highlight some organs. Then having run out of IV real estate, they put the IV in the side of my wrist which was uncomfortable to say the least. However, when they turned on the machine to pump the medicine into my veins I can't describe the feeling to you, but the noise that came out of me was the equivalent to the sound a dog makes when an old man kicks it in the ribs as hard as he can. I can't say what they did behind me, but I can tell you four different people were behind me watching it and when the scanning was over I told them to get me out immediately. The nurses, of course, started to panic and couldn't get the IV out so they ended up ripping the cap off, my blood spewed everywhere all over the floor and I grabbed my IV and booked it out of there to the bathroom. 

When I woke up that night, the gynecologist said the CT scan showed my organs weren't bleeding but they still weren't 100% sure if was an ovarian cyst rupture so they needed to do surgery to clean out all the blood that had gotten all up in my abdominal cavity and all the clots around my ovaries. She said if they couldn't clear the whole rupture and cyst then they would have to take out the ovary as well. I cried again, but this time more on principle. I felt like I was supposed to cry with the potential loss of an ovary. Then when I realized I wasn't crying cause I was going to actually miss it's presence I stopped crying and starting thinking maybe I really didn't want kids. Like 100%.

Although, I'd never spent a night in a hospital before or had surgery or even had an IV, I didn't feel scared or stressed anymore when she told me I was having surgery. The first few days in  the hospital where I couldn't communicate with most the staff in charge of my care was super stressful and as I said I had my breakdown. But after that it just became very different. There was no longer a sense of urgency or panic of not knowing. They were going in to stop the bleeding and that was pretty much it. There weren't other options, it's just what had to be done. I could finally sit back and let someone else deal with it.

This is the point in which the other side of the world became aware of my state. And my mother, true to form, went into panic, asking if she needed to fly me back or come out. When I was going into the ultra sound days before, I told the doctor if they couldn't find out what was wrong I was going back to America to figure it out. After the scan she told me if I left with whatever it was still bleeding that I could go into shock. This is when I realized my escape plan was squashed and I'd be committed to Bang Po Hospital until it everything was over. My mother coming out would have been expensive and useless as she speaks less Thai than I do and she's not well adapted to the whole sabai sabai attitude.

The 4th day, I went into surgery at 18:30. Earlier that day the anesthesiologist came to speak with me about 'the risks.' He said " It's a medium surgery, not minor or major, so the risks are medium, just the risks of doing surgery. But you are perfect candidate because you are healthy and young." That was it.  The financial team came in and handed me a note that read We take valuables in case of Finance this. Now reading this I'm interpreting it as we keep you rings if you can't pay. By the way This is what your Spanish teachers had to deal with in high school when you put shit into Google Translate. Some of this can kind of be understood, but when the nurse gave me a note reading You put a pot with my stool there was nothing I could do with that. These little treasure notes helped bring back my Thai attitude of just letting it go and laughing through it.

 Tan came in about ten minutes before the surgery and walked along side as they wheeled me to the OR.  They had me on a stretcher and made me transfer to the surgery 'bed'. Now in America I know they put you to sleep before they put you in the OR, but not in Thailand. I'm lying in the OR,  as they strap down my arms and cover me in a forest green sheet. The room itself is freezing and there's nothing in the center of the room but me. The lights above are the same ones you stare into at the dentist's office, but from 1976, browned and yellowed. There's about six people in the room, only two of whom are wearing gloves. The woman who I assume is the supervising surgeon is standing with her back to me collecting sharp objects and tools that she's going to be using to cut me open. The clinking of the tools and seeing them gather them up like an episode of Dexter definitely got to me and I tried to stare at the 70's lights and think of something else. Thankfully at this time they put the oxygen mask on me and I sucked that shit down as fast as I could.

What seemed like years later I woke up to see Hilary and Tan in what seemed like a silent film. The again later I opened my eyes to see a bunch of the staff from work sitting on the couch with flowers and cards. I remember holding A-ya's hand and then fading out again until about 5am when I fully woke up, but no one was there by then. The next day I laid in bed all day, but for the first time they offered me food. This was the menu...

A lovely selection of Oval Latinos and Boiled Cameras

But I couldn't eat. I had no appetite and the boiled camera wasn't like they promised. The day after surgery they injected morphine straight into my IV every three hours. Not my IV drip, but straight into my hand. Needless to say I wasn't incredibly useful that day, not like I had been anyways, but less than normal.
 The next few days were slow as I walked for the first time in 5 days. Trying to eat enough Boiled Cameras for them to release me. My friend Hilary was kind enough to let me stay with her the whole week to recover. Walking felt like... gravity.  Like every molecule in the ground was pulling at my uterus and like I needed to hold it in with every step so it didn't slip out my giant wound and fall on the floor. It took a few days before being able to walk upright, as the first few days I was walking like a 95 year old woman who'd been pregnant for the last decade.

My self portrait

   
If you're paying attention you may be wondering, uh didn't you go in for a stomach ulcer. Why Yes I did, which is why I'll be seeing the gastrointestinal specialist today, who happens to dress like a plumber, which I find very ironic. Turns out I'd just been doubling up on the fun the past two weeks, but Ursula definitely subsided as a result of being starved out by Bang Po hospital. Eating isn't the wholesome experience it was before, but hopefully that can be restored in the future.

You might think that spending so much time in a hospital I'd have time to reflect on some things. Well, Morphine isn't a very reflective drug, but since they went from giving me that to Tylenol my thoughts are a lot more clear now and I learned A LOT from being in that hospital:

I'm not exactly someone who people would describe as serene or peaceful, but I have however become an incredibly patient person in the last few years. At least in my opinion. Thailand definitely helps with patience in that you can be as rushed as you like, but it doesn't change the pace of anyone else, so you might as well just relax and mai pen rai ( not worry). A lot of things in this country work for me just by having a little faith. If you can't rush it and you can't make sure things go the way you want at some point you sit back, accept there is nothing to be done on your part and take a leap of faith to hope for the best. Now I've adapted well to this culture, but these past two weeks were a true test. Putting your health and care in the hands of someone else, crossing your fingers and hoping they know what they're doing is not something I was prepared for. However, it's what I ended up doing. I couldn't communicate well enough, I couldn't get informed and I really just had to take the back seat and hope everything was going to work out. I think for me that was the final frontier of the whole sabai sabai culture. Because to me that's the pinnacle of letting go, when you do it with basically your life and well being. I'm not saying it's a good idea or a bad one, I just think it's a challenge for a person to be able to do butI feel like a bigger person for getting there.

However, this wasn't the only thing that was put in perspective for me during my stay. All my life I've been a really scared person. Even though it may not seem like it travelling and moving to Thailand by myself. I never thought I'd live alone when I left Colorado because I was too scared and I've always been one to let my mind wonder in bad directions. But it occurred to me after I got out of the hospital that the person I came here as, never could have gotten through what I'd just went through.  I would have been terrified to stay in a hospital room alone, though I had a roommate in the hospital who was slowly coughing up each individual organ. Bless her soul. I would have probably cried the whole week, left the hospital and went back to the US anyways, as well as have been terrified the whole time.  But being in the moment it never actually occurred to me to be scared. I never thought to be afraid when they said they were going to do surgery  or when I was sleeping next to the hacking woman on the other side of the curtain. A lot of friends have commended me for strength or bravery, but this isn't Game of Thrones, I just had blood suctioned out of me. It's more gross than noble for sure.

On the other hand it's shown me a lot of really awesome sides of people. My coworkers, who came to visit and were so supportive, my friends near and far that sent me well wishes and were a comfort whenever I've needed them as well as the entire staff at Bang Po who found other ways to communicate and didn't need to speak English to show that they cared. By the time they left every nurse knew my name, they all checked on me, and all told me to smile (all the time).  It was no walk in the park, but I ended that week feeling incredibly blessed for the friends, family, and strangers who've helped me get here today.