Abdominal Pain: Why You Should Not Take it For-granted

It was one of the darkest days of my life.


Tuesday morning, April 22 I woke up not feeling well. Despite the mild abdominal pain I still managed to do household chores right after husband left for blogging work. The pain scale went up from 2 to 5 until it reached 7 (pain scale 0-10) at 6pm. I could no longer stand. Initially, I thought it was just the usual symptoms of hyperacidity so I took Kremil S and had sky flakes without relief.




That evening, the pain started to become more severe so hubby brought me at the nearest hospital, Chinese General Hospital. They let me stay at the ER room and rest but they did not even perform physical assessment, no blood tests done. The nurse gave me Omeprazole and Plasil through the vein which provided immediate but temporary relief. I asked hubby if we can go home after an hour.




The next morning, I feel weak and lost appetite. I started crying due to severe abdominal pain near the navel growing sharper down the right and left abdomen. I cannot describe and tell where exactly the pain was. I was brought to the ER of UERM in Sta. Mesa. Upon arrival, I was already vomiting, breathing faster or hyperventilating, and with fever.

UERM-Review

It was the right decision to go to the hospital and I am very thankful for the staff, they immediately they attended to my needs. They even checked if I was pregnant so they know what meds to give. Immediately, they provided IV fluid. Blood tests, pregnancy test, urine test were done. Medical, Surgical and even OB-Gyne doctors came to see me.

They were suspecting for appendicitis so they sent me for abdominal X-ray. Blood tests reveals increase in WBC, an indication of infection. Blood pressure started to rise, from the usual 100/70 it went to 130/90 due to severe abdominal pain.

Ultrasound-Procedure
Pale, thirsty, hungry while having Ultrasound.
I was admitted in the afternoon and was advised not to eat or drink. I know the doctors were preparing for possible surgery. That afternoon though, pain decreased from 10 to 2. Later that evening fever persists and I started to have diarrhea every hour.

AeroMed to another hospital for abdominal CT Scan
AeroMed to another hospital for abdominal CT Scan
Thursday was spent on other medical examinations. Through ultrasound, they found out dilated small intestines. TransV ultrasound was also performed and found a cyst-like on the left ovary. I haven't eaten or taken any liquid for the past 48 hours so visualization of the bladder was a bit difficult. The findings lead to other diagnosis apart from appendicitis when they suspected ectopic pregnancy but later on was cleared because of the negative pregnancy test. The OB-Gyne further explained about the findings on my left ovary which is normal during ovulation.

Medic of AeroMed
Friendly Medic of AeroMed on our way to De Los Santos Hospital
Loving and ever supportive husband on her side
Later that afternoon, a repeat abdominal ultrasound was ordered. The examination revealed fluid on right lower abdomen. I heard the words "surgical abdomen". The doctors advised to do an emergency abdominal CT Scan which is unfortunately not available at the hosp so they brought me to De Los Santos Hospital via Aeromed ambulance. We had to wait the next day though for the official result but my surgeon Dr. Agustin wanted to see the plates so they requested a copy early Friday morning. My surgeon and radiologist at UERM read the CT scan and confirmed enlarged appendix and inflamed bowel. It was one of the darkest days of my life, as if everything stopped.

My family was anxious about the dilated intestines while I'm afraid of the surgery. Dr. Agustin explained two possible surgical procedures, first is the laparoscopic appendectomy which uses a camera, patient is under general anesthesia and it's more expensive than traditional appendectomy. Second is open appendectomy, a larger cut (infraumbilical midline incision) to see the intestines and other internal organs such as the ovary and uterus.

CT Scan Room of De Los Santos Hospital
Inside the CT Scan, DLS Hospital
CT Scan Room of De Los Santos Hospital
Abdominal CT Scan reveals enlarged appendix and inflamed intestines
CT Scan Room of De Los Santos Hospital

De Los Santos Hospital

Friday 3pm, I'm inside the operating room. The last thing I remembered when they put me on my right side for the spinal anesthesia. I woke up after 6 hour at the recovery room, not feeling any pain but anxious with the NGT (nasogastric tube).

At the Operating Room before the operation
Inside my hospital room, I heard the anesthesiologist giving instructions to mom to report if I will  urinate. The anesthesiologist said I had to in three hours because I had very little urine output in the RR. I heard about it so I immediately asked for a bedpan, requested to open the faucet enough for me to hear water flowing and requested to pour a little water over my pubic area not touching my abdomen. It was effective, I was able to urinate.

Post-op, the most irritating, painful and tough was having an NGT (nasogastric tube). It serves as decompression, drainage and feeding but it's very painful and irritating especially when swallowing. I was afraid when they fed me through the tube with 210 cc Nutren. I also feel bloated. Now I understand why patients are so irritated after surgery.


Third day after surgery, they removed the NGT and I started to drink water. I can also do self-care, washing my face and brushing teeth while on bed. Nurse Aid Sarah rendering a morning care. 


I was discharged in the hospital on the 4th day, post-operative. The experience was an eye-opening. It gave me a life lesson I will never forget. Best of all, I learned to appreciate the people around me especially my family and my husband.


Thank you Kristine Cocos for this book!
At the height of feeling bloated, irritable, I met a medical intern who prayed for me, even gave me this book but I never saw her again. My friends from Grace Christian Church and CAFE (Pastor Seb's church) went to visit me.


Left my gwapong husband, Right my gwapong Surgeon Dr. Gerard Agustin
Left her good-looking husband, Jonel / Right her good-looking 
and awesome Surgeon Dr. Gerard Agustin
Dra Angela Layusa, Anesthesiologist
Dra Angela Layusa, Anesthesiologist
Dr. Romulo Ramos and the Medical Intern and Residents
(Team Medicine) Dr. Romulo Ramos and the Medical Intern and Residents
Team Surgery
(left: Nurse RJ / right: a young medicine student)

I decided to share my story to raise awareness on the complications of Ruptured Appendix. I had Peritonitis as a complication. The surgery went well and I'm back to my regular daily activities including blogging. Thank you to all who visited and offered prayers of healing.


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