Papa's Pneumonia Scare I: How it began



Today is 18th May 2014, 11.40 pm.

The past 10 days have been such a crazy and wild rollercoaster ride. What had happened was that my dad was hospitalized in a private hospital in Johor Bahru on the 8th, and not long after that, the doctors decided that he should be intubated and sedated for him to rest more and battle the disease.

This disease is called pneumonia, and apparently it's something that has been with him for a bit, and he has been resisting seeing the doctor, thinking that it's "just a cough", and he doesn't want to go on MC, as he's saving his working and annual leave for his golden handshake, end of this year.

I visited him almost daily in the hospital as he's sedated and intubated, and could only pray for him as much as I can, whilst watching the readings in the ICU room anxiously. There would be days where his readings would be good, and I'll be so glad, thinking that he'd be alright soon.

Then it'd be followed by days of worse coughs and choking, and his readings would go haywire, and I'll be worried and praying more and more.

He warded himself into this private hospital as his very good friend works there as the head of the medical department, and he trusts him very much. Apparently, with his life too.

My father was intubated on the 10th of May 2014, and I wasn't there when he was intubated. But what I heard from my mom was that he resisted the intubating quite strongly, and he didn't want to do so...but I think that it's more that he doesn't want to die yet.

He was afraid.

When I reached him on 10th May, he was already intubated, and I don't know how to start to describe the medley of feelings I had inside, as I saw him sleeping there on the bed, listless and unmoving. Perhaps in the beginning few days, I thought to myself that "it's a short term thing, he'll get well soon" and that's what that kept me going.

The specialists there kept telling us that they're doing their best already, and so I trust them, as my father trusted them.

Only after 8 days, did I think or paused to consider that something more needs to be done, this wasn't right. Something somewhere, there was a disconnect. I started to have this weird feeling in my gut, especially when I started noticing that my father's lips and eyes and stomach started to bloat a little more, and what that tipped it over was that the doctor said that they're already doing their best.

No doubt that they're doing their best...but is their best really the best available out there? I started to think that there must be more available out there that I need to look at.

Bearing in mind our limited finances, originally I was thinking of moving him to the general hospital in JB, but a few medical professionals told us not to, and instead to consider Singapore.

Again, thinking of our limited resources, all I thought about was how to limit the financial strain, and asked the specialist doctor to refer him to ICU in public hospitals in Singapore. He said he tried, but couldn't get any rooms in ICU. I thought that my dad couldn't wait any longer, so I decided to get an ambulance to send him to a public hospital A&E, wait a little and then get warded into ICU.

That was the general plan.

When the ambulance arrived together with the ambulance doctor, they tried to move my dad by his condition wasn't stable enough to move, and they decided against moving him, as they said if they moved him without a ready bed, he'll either end up with brain damage from loss of oxygen, or die. Both outcomes weren't favorable.

What worked in an interesting manner was that the ambulance doctor was actually a lung specialist, and after looking at my father's condition, he informed a doctor Su in Singapore, who called me on Sunday 18th May 2014 at 12.05 am to explain to me the direness of the situation.

In a nutshell, because my father's lungs had more and more water and inflammation, it was difficult for the lung to absorb oxygen, so they had opted to give him a strongly powered ventilation, which will blow more oxygen into the lungs. This gave him a constant level os 90+ % for his SpO2, which I recalled was good.

What isn't good is that the high velocity of the ventilator was constantly causing shearing tears and damage to his lungs, and this was what Dr Su was trying to tell me - sooner or later, these damage will cause build up of more and more toxic in the lungs, transferred to the kidneys and liver, causing them to fail and sooner or later, lead to multiple organ failure....and eventually death.

That was the key item that made me think seriously what to do next - public hospital was definitely out of the picture, as he wont be able to make it for the wait in A&E.

Dr Su told me to try for at least 5 days in ICU with him in Gleneagles; by the third day they will likely be able to tell me if we could "cut loss" and take my dad back to JB, or look for a way to raise funds if he had an opportunity to live.

Preparing for the ambulance ride was scary and crazy enough - I felt that they were so unprepared, but looking in hindsight, I think that was the best they could do given that my dad's plight was really quite bad. It took roughly 40 minutes to travel from hospital to hospital.

What really impressed me was that when I reached Gleneagles ICU at 6 am on 18th of May 2014, the doctor was already there waiting. Apparently he and the team had been waiting there since 3 am, and they quickly got me out of the room so that they could start my dad on the procedure to insert the ECMO, which will be his lung bypass. It does the job of the lungs, so that his lungs can rest.

After the operation, the doctors (there were 2) sat us down in family conferences and explain to us what they did, what they saw, what they are going to do, and what would happen in the next few days. Both gave grim chances: 10% and 20% chance of survival.

They told us to prepare for the worst, and they walked away.

This was 18th May 2014.



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