Kansai revisited, pretrip

It was a planned trip, I defined it as a celebration trip for Xian graduation. During Xian childhood, it was a dream seeing him going to school as a normal child. However we did it, Xian had graduated from junior high. It was an amazing journey seeing him growing up. Well, he made it.

The last trip to Osaka was a short and a surprised one and we did not visit the Universal Studio Japan. Xian had been a fan of Resident Evil and he had tried most of the version/generation during the last few years. He was actually attracted by the live show of Resident Evil organized by USJ for the past few years. We were looking forward to its rerun this year during summer holiday unfortunately it didn’t. However, we had still proceeded with our plan. I had decided to visit Kyoto and later ending the trip in the USJ during the trip. It was a 6d5n trip (vs the 4d3n few years back)…The planning was a complicated one.

The choice of lodging had disturbed me for a few weeks as I need to find a spot near traffic facility during our stay in Kyoto. Our last stay in an apartment around nipponbashi was an excellent experience. I had sought out to seek similar apartment style lodging but most of it was at a distance from the Kyoto bus station. After week of seeking, I finally got a apartment which was 1.2km from the Kyoto station. A short walk with would passed by 2 convenient shop along the way; it was a must so that we could collect some food/supplement along the way back. The great thing about apartment was the facility to cook and prepare breakfast/supper. Unlike Malaysian and Taiwanese, the Japanese seldom have the breakfast in a food shop; you can only found western type breakfast shop. The Japanese would have simple breakfast such as rice ball or rice with soup.

The choice of staying in Osaka for the USJ trip was more challenging. There was no apartment located around the USJ. The only choice was hotel and all of them cost a hand and a leg for any room for 4. I had chosen the cheapest one to facilitate the visit. However   the most stunning part about the visit was the ticket [plus the fast pass of course]. Nothing to shout as it was full peak season during the summer holiday.

It was a walk till you drop trip as we planned to use bus and train as our choice of transport. Detail of dinning in which food shop was one of the challenging part. So many detail to work on and I could only relay on google……

Everything was seemed to be set 2+ months before the journey, however another challenge was waiting for me after the trip and I took the bite….

foreigner with no relative....

It was a boring Sunday shift…everything was slow until I got a call from a hospital down south. It was a referral; the local ED down south wanted to refer a case of intracranial hemorrhage. A usual referral with an unusual patient…The patient was a foreigner. That means there would be a pain in the axx should he required any invasive procedure that require consent…. I did not hesitate to accept the referral as we are the nearest hospital with neurosurgeon oncall. I did however asked them to faxed over his passport page so that I could called up the relevant department for help.

5 minutes later I got the fax and noted that he was Canadian. His birth place was however Ipoh…

The patient arrived 1 hr later; he was intubated and the imaging revealed subarachnoid hemorrhage which suggest aneurysm rupture. Appropriate management was rendered and nothing more that I could do except to ask for a neurosurgical consult.

I called up the Canadian representative office up north and the call was redirected to foreign ministry office in Canada. I provided the officer on call with the relevant information and asked them to help me to contact his family so that further management plan could be discussed.

The owner of the R&B lodge had accompanied him to our ED. He was also a Caucasian who run the lodge with his girl friend(Taiwanese of coz). The patient was a lone traveler who had visited mainland for over two weeks before he landed and joined a PADI diver course down south. He had ridden an electric bike roving around the town after breakfast and later found lying along the roadside unconscious….

We had glanced through his belongings and found an I-phone. A good news and most probably we could get contact number from it. However we had failed to assess the phone as he did not set up finger print lock….So that was why I sought help from the Canadian representative office.

While waiting for consult I had decided to call the immigration office as the patient would need to filled up an entry card during his entry and it might contain useful contact no. I called up the head office and the on call officer had referred me to the Taipei Airport immigration. I got a returned call later and the officer had told me that they would refer the matter to their colleague in Vancouver for further help.

The next 3 hours was a busy one and I had successfully got a referral  to a medical center in K city. 
Prior to the referral, I got a call from the on duty officer of immigration agency. The officer told me that their agent in Vancouver had successfully contacted the local police and found the relative. The relative had gotten my contact number and would call me soon. 
I got the call minutes later and informed the family about grave condition. They told me that there would be a closed friend staying in K city that would managed the whole event for them. I called up the given number and told the friend about the condition and suggest him to act accordingly.
The patient was transferred out later...
I had however run a check over the net and found that Malaysia did not provide any similiar service for its national during such emergency-> you are on your own, the embassy will not be there for you....

after D day...

The next day was also an off day for me….I woke up early and started to read whatever that had left out. It was a relief when I learnt that there was no curfew nor any bleeding event had taken place.

I saw the clip of Dr M in his residence preparing to head for the palace. It had been a harsh night for him, staying up late and managing the taking over. I prayed for him hoping that nothing would happen to him during the process. Everything had gone smoothly, I had witnessed the swearing in later over the net.

During my breakfast with Xian, I had updated what had happened and I could tell from his look that he was actually confused about why I was so excited about…

I lived in a hybrid community; my neighbors were Indian and Malay. The politicians had created an issue regarding difference of races. We were being taught that 3 major races should live in harmony however there was something regarding rights, economy inferiority that was being stressed from time to time. I belong to the group which has economical advantage; but in fact, my family was not doing well then; thence I was not eligible to any government aid….

I hate those racist remarks made by those political opportunists. As the opposition grew stronger since the last two GE, racist remarks were more harsh than ever and I feared that one of those days, we might be marginalized and eventually lost everything. After years of living abroad, I had never forgotten the land where my blood spilled and never have a single thought of giving up my nationality.

Will there be any changes, I doubt it, however deeply in my heart , I knew if the PH had lost, we would be in deep sxxt but fortunately…. 

2 days later, when I met my fellow Malaysian colleague at work, we did not have any deep chat regarding the changes but yet an exchange of smile was something good enough to celebrate the victory.....

D day.....

Finall, the day had come… it was off day for me and I woke up early as usual. I tuned into Astroawani website and started to view the morning live show.

It was an exciting day for me, after weeks of googling and gathering information. I concluded that there was still a slim chance. The survey from Merdaka center was an interesting one which shown a further down sloping of BN vote to 37.3% in the Peninsular but still won the election.

I sent both the kid to school settled back to the screen after breakfast with Ving. Everything was calm but the voting rate was alarming. In the past, the opposition won more if the voting rate was high. However the voting rate was still low at 2pm. I called up my dad and my bro-in law. They have told me the same story, the voting process was very slow. They had waited a long time to cast their vote. The process of staining finger was time consuming and they had waited a long time to finish the casting.

I took a nap and by 6pm after our dinner. I was sitting in front of the monitor;  anxiously switching from webpage to webpage, podcast to podcast trying to get the latest update of the final result.

The BN had the lead but the seat came mostly from the east side. By 9+pm, the opposition had retained Selangor and Penang. However the Parliament result was still sluggish, the possibility of change was higher as the clock tick. Everything went stagnant by 11pm. No new update was noted for the Parliament; BN had taken a lead which was mostly contributed from the east. Perak, NS, Malacca had fallen to the opposition I was pretty sure that a change would be happening but yet I was very worried about a curfew or other tactics being use to prevent the transition.

At 1am, no update was noted and opposition had accused that the SPR was responsible withholding the result. Even the palace had issued a statement requesting the SPR to speed up the announcement. At that time BN had only retained Pahang. Kedah and Sabah were at stalemate. The Hope Alliance had won the election apparently. BN had cancelled its press conference and indirectly admitting their defeat. I took my last sip of red wine from my glass and gone to sleep at 1:30am, praying that no hanky panky staff will interfere with the transition……

D-day...D-1....

Day by day passed and I was hoping get my ballot paper on time. As the day draw closer, my anxiety rises; my option had changed from EMS to courier services that offer same day or next day services. I had read through the net and found that there is fellow Malaysian who was willing to deliver the ballot paper to relevant office…. My options had run out as the countdown tick; mailing option had faded out and my final option was to fly back and delivered it personally. If I could receive my ballot paper on 5/7, I would take a flight back on 5/8 and delivered it to the office on 5/9 as the flight from TPE or KHH arrived in KUL late in the afternoon. So receiving the paper after 5/7 was hopeless…..

Well, at the 5/7 evening, I had given up hope and thought that the ballot papers should have been swallowed by someone. At the noon of 5/8, a courier van came and I got 2 DHL envelopes…. The date of posting was 5/5….4 days before the ballot day, apparently the SPR does not want us to vote. I grinned and told Ving about the news. I was not worried as my voting area was stronghold of PH…but yet, I despised the act of SPR of playing dirty.

Nomination day = 4/28, local postal voting date = 5/4, to be fair, we should have received my ballot paper before 5/4. However the ballot papers were sent out on 5/5, 1 days after the local postal voting. There was only a 4 days window for the ballot paper to reach the respective voter. Unless the courier service could be done on a next day arrival basis it was a mission impossible, furthermore, 5/4 was Friday, the delay over Weekend would be obviously another obstacle….

Well, nothing could be done…

Over those few days, the ruling party had stressed over the media that there would not be any tsunami. However the Merdeka Survey Center had published a very queer survey stating that the BN vote would be down to 30+% but would still retained control over the parliament. Weird indeed, but I felt that the result was actually being manipulate before it was published.

post ops....

Ving left us by 2pm and I took over the job of nursing aid. Xian woke up and he was troubled by wound pain. Xian sensory perception was outstanding he had good eye sight, good hearing and also very sensitive to pain. He had no problem of tolerating the pain while laying still, but the pain was torturing when he attempted to get down from bed.

Urine output was an important index for post ops care…5 hours past the surgery and Xian had tried very hard and no urine output was noted. He felt uneasy to do it on the bed and we had tried a lot of method; sitting over the bedside, sitting on the toilet. Every single way led involved getting out from bed and both of us were exhausted. After 9 hrs of struggle, he had finally emptied his bladder. He was indeed dehydrated, over 2000cc was infused/drunk and only 300cc of urine noted. I felt comfortable but did not enjoy a good night sleep. I had awakened on hourly basis to check on the drip and Xian condition.

The pain was better on D2 but was still disturbing. Ving visited us on twice a day bringing us food and supply. On D3, the bed next to us was discharged and I had chartered the room. Nowadays, single occupancy room in the hospital had become very difficult to get as many patients had insurance and afforded to stay in a single occupancy room. When the single room is not available one could still chartered a double room and turn it into a single room (the pay was of course more expensive). When Xian got admitted there was no single room nor any double room to charter. I had to squeeze myself on the foldable chair for first 2 nights.

Taking care of patient with post abdominal surgery was not a simple task. The mission of going to toilet is a great challenge. Every steps was pain and it took forever to complete the few meter walk.

I had day shift on D3 and Ving had come to look after Xian but he was way better and the pain was much tolerable…

Xian was discharged on D5 but it was not the end of the story…..

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….