the destiny road....D1

Xian was complaining of abdomen distension and easy satiety since early this year. I had given him some antacid but did not seem to work….I was a little bit worried but did not come out with any definite diagnosis until that day…..

I was finishing my night shift and Ving had called me up and told me that Xian is having fever and abdominal pain. I asked about diarrhea and vomiting and Ving had given me a negative answer. I asked Ving to pass the phone to Xian and asked him to do a deep palpitation over his rt and left lower abdomen. Xian knew how to do it as months ago, he had an episode of abd pain with fever and I did a physical examination over him. He given me an answer that I did not want to hear…..

I told Ving to grab some clothing and send him over to the hospital after dropping Yun at school.

I was praying while waiting for their arrival, hoping for a non-surgery miracle but I knew that the great one had made his decision. Xian had arrived in a bitter melon face; he had kept asking me what would happen to him….I told him we would proceed with the CT scan and see that how would the event progress….

Xian had told me during the process that the pain had started around 3am and he was hoping it become better in the morning after he gone to toilet. The pain was initially over the epigastric region….Well, typical appendicitis story, but CT is currently the key to definite diagnosis.

I pulled some string for an urgent CT and informed my general surgeon colleague about a possible case of appendicitis.

The CT had confirmed the great one decision and I broke the news to Ving. Xian was still in his denial stage and kept telling me that he would be doomed. The next decision was to do a laparoscopic or traditional appendectomy. The decision was actually simple as Xian appendix was retrocecal and very long; its end almost in contact with the liver tip. I told my colleague that I would opt for a traditional appendectomy. Again, I told my anesthetist that I would like to join the team for the anesthesia period as Xian would be very anxiety facing the ops. After a short wait, Xian was send to the theatre and I entered to aid the process. The anesthetist and his team were friendly enough to joke around and tried to pacify Xian anxiety. Xian had fallen into sleep after diprivan was given….I left the room and joined Ving at the waiting room for an agony  wait. 45 mins after the ops start, the OT nurse who came out and picked up their lunch box had told me that they were closing the wound and asked me to the joined team . I finally sighed and feeling of fatigue had swarmed over my body; no rest was noted after last night stressful shift….

I entered the OT and saw the culprit; the appendix was swollen and it was the biggest one I had seen for decade. Extubation was done and I had chat with the anesthetist while waiting for Xian recovery from anesthesia. He told me the traditional method was a good choice; once there was a gynecologist who opted for laparoscopic appendectomy and ended up with a rupture of appendix while being removed from the peritoneal cavity. The consequence was a one month open dressing of wound.

Well, everything was smooth until now, but I knew that the worst was waiting for me….