Thursday, February 05, 2009

Return of the Stones

KH fell ill two weeks before CNY. One morning while sending the kids to school, he suddenly had really bad abdominal pain. We managed to get to the A&E in Mt A. X-rays and a CT scan revealed a 6mm stone lodged in his ureter. Just like a microscopic dam, it was causing a major jam up in the upper ureter and in the kidney. The whole thing had swollen up and he was passing blood in the urine. The doctor arrested the pain with two injections to the butt (which he said hurt more than the stones!). But the best part was that insurance would not cover us if we decided to be admitted and the hospital called its own urologist. Thanks to the limitations of KH's company's medical plan, we were told to visit our own GP to get a referral to a urologist who could do something to get the stone out! It was an insurance snafu that left us fuming and later resulted in a letter to the Straits Times which was just published two days ago.

To cut the story short, we went to the GP who referred us to the SGH Urology Centre that same day in the afternoon. The specialist there immediately ordered an ESWL - a non-invasive procedure that uses shockwave therapy to blast the stone into fragments. The machine looked super high-tech and KH was made to lie down in a shallow bowl of water - the waves would pass through this medium. The x-ray pinpointed the exact location for the shockwaves to flow. He had to be sedated of course, but not fully asleep.

He's okay so far. A return visit to the doctor showed that there was only a smaller 3mm fragment left that had passed to his bladder and was floating about waiting to be peed out.

This was not the first time he'd had stones.

In 2000, we were in Cadaques, northern Spain. A pretty, whitewashed town that faced the Mediterranean with Salvador Dali's house nearby. Picture this. We'd just enjoyed an early dinner, a stroll on the waterfront and the lights were just coming on in the houses on the hills, the sun was setting and the ambience was so romantic when my dear husband decided to liven things up. He complained about agonising pain in his back. We managed to get back to the hotel.

The hotel proprietor called a doctor who promptly gave him a jab in the butt. And gosh, when I say jab, I mean JAB. She took the hypodermic needle, stabbed him once in the butt to the hilt, then screwed on the vial and pressed the plunger!! I was in awe. The ambulance came, we abandoned our rental car, I hustled two ginormous backpacks and sat in the ambulance with him. It was night. The road over the hills to the nearest hospital in Figueres was windy. I was disorientated. Prone to motion sickness. Add all that up and you've got one sick puppy. I managed to hold it in until the ambulance pulled up in the hospital. The minute the doors opened, I lost it. Bleah!! Spent the night puking, guarding the bags, trying to sit on hard plastic chairs while watching KH snooze on the gurney. Bah! It wasn't all fun for him of course. The Spanish medics had a hard time locating a vein and popped him 5 times before the IV went in. Remind me never to fall sick anywhere else in the world but Singapore.

Barely had he recovered from this episode then the next struck. Just last Saturday night, while at his friend's home to celebrate the lunar new year, he suddenly felt giddy and nauseous, throwing up in the bathroom. It got so bad that we had to call dad and Paul over, one to drive the kids home and the other to drive us to the hospital. Shades of Cadaques all over again as I tried to get some shut-eye in the waiting room, KH getting a shot (yes in the butt again!!) to stabilise the vertigo. The doctor could not say why he suddenly had this attack. The BP was normal. He hadn't had a stroke. Most likely it was some infection or imbalance in the hindbrain.

It was so sudden. One minute he was fine and the next, he was throwing up. This episode, plus the kidney stones episode just left me pensive and wondering. What's the plan B if something happened to KH, who is right now, pretty much the sole breadwinner in our house?

I think first of all, morbidly, lets talk about dying. I guess I would be extremely devastated. Even though the boy can be a real pain in MY butt sometimes. But when you've known each other for years and gone through so much, there are naturally bonds there. Mushily, I guess this is called love. I think I would also feel incredibly helpless since I really depend a great deal on him - too much actually. I need to be more independent!

Financially, I think we would not be too badly off. The house is covered by insurance that would cover the housing loan. His own personal insurance (yes, I made him insure himself generously because we have so many kids!) should tide us over for a bit but we'd definitely have to cut back and be prudent. I'd have to go back to full-time work. I'd certainly have to learn how to drive! In a practical sense, I'll be okay. But in an emotional sense, I think I'd be really... afraid. Yes, devastated and all... but largely, afraid. And my biggest fear? Being alone, being lonely for the rest of my life. But I suppose given time, we do adjust and move on.

But as I pondered further, I realised my biggest fear was not about if or when death would come, but what if death WOULD NOT come? What if I had to care for him for the rest of his life, my life? Could I stomach it? Could I be physically strong enough? Do I have the courage? I'm not talking about the emotional part of caring for someone bedridden, but the physical part - inserting feeding tubes, changing soiled diapers, clearing vomit, washing/bathing, carrying, bringing him to endless medical appointments etc. Am I unselfish enough to do so? Honestly, its not PC to say this but the thought leaves me feeling squeamish.

At what point does love degenerate into resentment? When does selflessness fade with fatigue? What is the breaking point? In sickness and in health. Till death. Can I do it?

I think I would. I might resent the hell out of it, but I would. I would feel like running away everyday but I would stay. I would fantasise about a better day but still live out this day. I would wish this all away every second of every day but I would do what I had to do. No pretty answer - just honesty.

On my end, I went out to mail the AMD I'd done. Finally. At least I know that if I am ever in the same limbo situation, no one is going to work too hard to save me. And if ever I am in a situation where death is likely or imminent, please, someone pull the plug. If I can't stomach the thought of being a permanent vegetable, dependent on someone else for the rest of my life, a burdensome figure, shadow of a memory of what he once loved, then I'd better do something while I still can. The AMD is my first step. Now to talk to KH about his AMD...

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