Living With Interstitial Cystitis In Malaysia.

Continue from Health And Farming 3, Endonmetristis And More.

Alice had been diagnosed with Interstitial Cystitis (Painful Bladder Syndrome). I did a search and there seems to be lots of support groups, all overseas, none in Malaysia.

After reading most of the sites, we found that diet plays an important role for IC patients. There are lots of variation, individual patient can tolerate certain / amount of food. The lists are mostly classified into IC friendly, Could Try and Food to avoid.

In Alice's case we found that chocolate (with alcohol) and white cooking wine cause immediate flare up . As she is still having phobia to the pain, we dare not even try. She sticks with the IC friendly list religiously.

Alice is only armed with

Elmiron, approved as a treatment for the relief of pain and discomfort associated with interstitial cystitis (IC), a chronic, progressive and debilitating urinary bladder disease afflicting primarily women. IC is characterized by severe bladder and pelvic pain and urinary frequency.

Xanax, used to treat anxiety disorders, panic disorders, and anxiety caused by depression. Addictive, and could cause withdrawal symptom. Comes in various dosage. To wean off later.

Laxapro, an antidepressant

Apo-Amitriptyline, an anti-depressant. It is also used to treat chronic pain and bed wetting.

Breathing exercise to relax.

Alice's condition improved and we got adventurous. We went for our first outing to Sunway Pyramid.
We went for tea at FullHouse Cafe. Alice bought a coupon via Living Social for only $7.00 per person. Had a fun and relax day at Sunway Pyramid.

As Alice is on the road to recovery, I took some time off and went to our farm in Sabah on the 19th til 24th June. She is cooping with some side effects on the above medication. A major one is constipation.She is eating a bunch of bananas daily. It didn't help much. Alice love to eat it raw. We later found out that eating raw bananas make constipation worse. Only ripe bananas helps.

While at home, I'm with Alice most of the time, to cheer her up and help her to normalize her life. She gets a good night's sleep most of the time as those medication kind of 'knock' her off nightly.We don't want her to fall back into a nervous breakdown. Help her with some daily chores, I'll try to finish before she wakes. We kind of like set things to be a routine.

Had a second outing (other than going to medical centers) to Renoma Cafe Gallery , also via Living Social. $47, afternoon tea for 2 with free flow of beverage. Alice had grew fond of shopping through these group purchase and she find it relaxing. Things are moving great and I find time to rest without having to worry about Alice. Me too is sleeping well at night.

There was just a major incident, while cooking as she accidentally dropped too much white cooking wine. This caused a flare up and took about 5 days to recover. This got us worried again. Also Elmiron had ran out as Dr. Loh only prescribed  it for a month's dosage.

Other minor flare up was due to Pepermint tea (too much I guess) and Chamomile Tea. Alice had been taking Chamomile & Pepermint tea to wean off her love for coffee. At one time we changed the Chamomile tea. Since the minor flare up and after a research on the internet, we realized that we had changed to Chamomile FLAVORED tea. So now we stick back with Twining's Pure Chamomile Tea.
Made with 100% pure camomile, naturally caffeine-free herbal tea.

A review with Dr. Loh is in early August. I then left for a short farm visit, 6th till 18th July, thinking that Alice is progressing smoothly.

While I was away, her condition deteriorated, she feels that the symptom is coming back. It got bad on the 14th. This send chills down her spine. Due to this Alice increased the dosage of  Apo-Amitriptyline to 4 tablets a day (still less than half the permissible maximum dosage) to keep her calm and sleep it off, it caused a side effect of major constipation, clumsiness and forgetfulness. Since I'm coming back on the 18th, Alice decided to wait. I didn't realize her condition was that bad even though I spoke with her over the phone constantly. She didn't communicate to me, I only realized when I reached home.

Made an appointment to see Dr. Loh on the 19th July. He prescribed 2 more months of Elmiron. Dr. Loh said that Elmiron may not be suitable for all patients and it's a very costly medication. Should be good after 2 month's usage. Told us that no need for review after 2 months if Alice is okay. Dr. Loh's clinic no longer have stock for Elmiron, gave us a prescription to buy at the Gleneagle's pharmacy. It cause Alice some anxiety as while at the pharmacy, our que number was skipped. Oh god, no Elmiron. After a few more numbers, we saw the pharmacist took out 2 bottles of Elmiron, Alice was so relived. Immediately took a tablet when we received it. Elmiron is sold at about USD $216 to USD $265 (RM $680 - RM $840) for a bottle of 100 capsule in the internet. Here in Kuala Lumpur, it's RM$ 1,200. I had tried our regular pharmacy near our house and found that it required special permit and prescription. Can't order for us. Requested help from our family physician, says it requires a specialist's prescription. Can't order for us.

Alice felt better after a short moment, so we guess it's partial psychological and partially chronic. Anyway as long as Alice is getting better it doesn't matter. The symptom is residing. Let's hope that Alice is getting better. For the next few days, the symptom started to subside.

 

Our adopted plant. We found it more than a month ago, abandoned at the stair way in a broken pot. The previous owner must had shifted. As Alice was feeling well that day we decided to adopt it. Had it pottered in a used pot, courtesy of my mum. Separated the cluster. After a month of care, there are new growth and it's starting to flower. No idea what plant it is. It also bring us hope and fulfillment.

27th July, we went to Gleneagles, no not for clinic visit, but to send a Thank you card to both Datuk Dr. Azis Yayha and Dr. Loh Chit Sin. Unfortunately both were not in.
 
Time for me to go off to our farm. Hopefully everything shall be well. Shall be back with Alice next month. Stay tune for her progress.

Amitriptyline belongs to a group of drugs called tricyclic antidepressants. Although they’re still used to treat anxiety and depression, they’re also now widely used at lower doses to help block the chronic (long-term) pain of some rheumatic conditions. The main aim of lower-dose amitriptyline is to relieve pain, relax muscles and improve sleep, but it may also help reduce any anxiety or depression resulting from the pain. Low-dose amitriptyline alone won’t be enough to treat severe depression. - See more at: http://www.arthritisresearchuk.org/arthritis-information/drugs/amitriptyline/what-it-is.aspx#sthash.ORXqW5ZB.dpuf

Amitriptyline belongs to a group of drugs called tricyclic antidepressants. Although they’re still used to treat anxiety and depression, they’re also now widely used at lower doses to help block the chronic (long-term) pain of some rheumatic conditions. The main aim of lower-dose amitriptyline is to relieve pain, relax muscles and improve sleep, but it may also help reduce any anxiety or depression resulting from the pain. Low-dose amitriptyline alone won’t be enough to treat severe depression. - See more at: http://www.arthritisresearchuk.org/arthritis-information/drugs/amitriptyline/what-it-is.aspx#sthash.ORXqW5ZB.dpuf

Health And Farming 3, Endonmetristis And More.

Continue from Health And Farming 2, Endometritis.

Did a search on the recommended O&G specialist and Gleneagles Hospital KL via the internet. Decided to see another specialist, which I feel is more appropriate. Datuk Dr Abd. Aziz Yahya, he has a clinic in Prince Court Medical Center as well as Gleneagles Hospital (KL).

Manage to get an appointment on 18th May at his clinic in Gleneagles. As it's a Saturday, his clinic close at 1.00 pm. We went early in the morning as Alice's condition had turned very bad. The pain was so unbearable that she is loosing the will to fight on, she is hallucinating at night when the pain was too great. She sees her departed mum. We arrived in the morning and requested a wheel chair. His clinic is at second floor. I find it a bit difficult to send in a patient as I need to park the car which is quite far a way, the lift is extremely slow and too heavy traffic. As we enter his clinic, it has a very soothing effect, but unfortunately Alice was in too much pain also it got worst as there are some discharge at her Virginal. She was all in tears. The receptionist tried to keep us comfortable.

He saw us as soon as he could, as appointment was rather full that day. His first question after we started telling him Alice's problem was, who refer him to us and why him. I said that I did a search via the internet and feel that he could help us. He then made us calm down and ask us what happened. He then started to write down dates and events. He says that he knows the O&G  as he is a visiting consultant at Gleneagles. We showed him all the documents, images, reports and even medication. He requested a confirmation that the laparoscope was done before or after the MRI, we confirmed that it's after. He says usually they shall try to diagnose and find the problem, if can't then shall try to "rule out" method. After ruling out all possible medical condition, then only shall check the psychological factor.

Datuk Dr. Abd. Aziz then examined Alice. Found that the discharge is caused by vaginosis. This create an itch (very bad) and aggravated her condition. He went through the medications again and instructed us to stop the medication, except 1. He identified 2 antibiotic that is suppose to treat the same thing and said that Alice is already overloaded with antibiotics, which caused the vaginosis. Shall treat this over the weekend and we discussed our options. He sees a lot of things on the photographs and the MRI image (the same ones). He also made a remark that the imaging should be done before the laparosope and we might had been better off if we had made the decision to had a full hysterectomy rather than just removal of 2 of the Endometriotis. Alice then said that there were no discussion on this and no options were offered.

Datuk Dr. Abd. Aziz suggested us to do a full hysterectomy basing on the image, image report and photographs, as he can still see some growth from those image. Alice has no intention of giving birth anymore and she is close to menopause hence fertility is not an issue. His operating day is Tuesday and Thurday. For the hysterectomy, we have the option doing it the conventional way, bikini line (open), laparoscope or a robotic assisted one. The cost, the benefits are highlighted to us. Told us to think it over the weekend. Asked for permission to photocopy the imaging report and requested us to leave the imaging for him to study.

 His prescription is Diflucan and Lactacyd virginal wash. Come back on Monday, 20th May, the vaginosis should clear and shall proceed to the next problem.

19th night, 20th dawn, pain was too great, started to hallucinate again, have to do a emergency admitting. Had pain killer to stabilize Alice. During our stay at Gleneagles, IV and injections was done without much drama. I spoke with the nurses and was told that there are sizes on the IV needles. Also Alice's veins tends to "move". Datuk Dr. Abd. Aziz came in the morning, we confirmed that we do the robotic full hysterectomy. The vaginosis had cleared. One problem solved.

The Da Vinci Robot is available in Prince Court Medical Center. So off we move to Prince Court Medical Center. Had been to Prince Court before a few years ago as an outpatient. I like the environment at Prince Court, parking, space and not as crowded. We checked into a room and I guess all room has a Petronas Twin Tower view on 20th May.

Surgery was done on the 21st, afternoon and it lasted for about 1 1/2 hours. There were some feeling of pain when the anesthesia worn off, which is quite normal. Datuk informed that the precedure went smoothly. Alice was instructed to move a bit and have hot shower twice a day. As she is still in pain, she didn't move much, also we are not used to taking a early bath. Due to this, I think it created some problem as her tummy got bloated, due to the difference in pressure. Her stomach was pressurized while doing the surgery. A hot bath actually helped equalizing the pressure. So started taking 2 bath a day. Alice also develop constipation and it was quite serious and it irritates the bladder. A strong laxative took care of that. Alice was discharged on the 24th May as instructed to recuperate further at home. To be back in a week for a review and the laboratory report.

25th May mid night, the pain is back an is unbearable. Hallucinated again. Rushed Alice to Prince Court emergency department. Stabilized her with pain management. Rested for a few hours at the emergency department and was discharged when she felt better. To see Datuk Dr. Abd. Aziz in his clinic during office hours in the morning.

Alice managed to rest for a short while. I used these time to search the internet with the symtoms. I managed to zoom into a condition called Interstitial cystitis (IC). It is a chronic condition characterized by a combination of uncomfortable bladder pressure, bladder pain and sometimes pain in your pelvis, which can range from mild burning or discomfort to severe pain. Pain level is also amplified due to the infected neurons. This is also called painful bladder syndrome and can affect children and men but most of those affected are women. I made a print-out so that I can bring it along tomorrow.

25th May, Saturday, Datuk Dr. Abd. Aziz is having his clinic in Prince Court. We went there first thing in the morning. As Alice is still in pain, the staff let her use a bed at the laboratory room while we waited for Datuk. We had a discussion and before I can brougth up the interstitial cystitis issue, Datuk cut me off  by saying "please do not jump the gun". He said he had done his part, and that he had removed the diesese on his speciality so the next step is to have a urologist examnine Alice rule out all disease in that area, then a pychologist. Alice started to panic. Oh no, I remembered we had this sort of conversation during the initial specialist that asked us to go to the other one. I begged Datuk Dr. Abd. Aziz not to give up on Alice. He gave us a firm reassurance that he shall help us. At the moment, I can feel that his assurance came from his heart. As it was a Saturday, Alice got admitted and he made arrangement for us.

Later part of the day a urologist Dr.Loh Chit Sin, came to visit us. He is a visiting consultant at Prince Court Medical Center but he doesn't have a clinic there. He said that we'll have to go to Gleaneagle where he practice if we need his services. Alice was discharged on Sunday and we went home. We practically had sleepless night since this nightmare started.


27th May, Monday, again first thing in the morning we came to Dr. Loh's clinic. Datuk Dr. Abd. Aziz had already brief him on Alice's case. Again we told our experience again. He went through the imaging, imaging reports, blood test reports, urine test report, urine culture reports which I had file them in a file according to date. He had a frank discussion discussion with us, stating that Alice's case could be difficult, he can take it up on condition that we'll have to accept his decision on the diagnostic, of course he shall put in his best ability also everything shall be recorded and documented. He may not be able to cure Alice, but he's definitely sure that he can make Alice feel better. He shall also need to feedback to Datuk Dr. Abd. Aziz. We find that his frankness is unlike the initial 2 specialist that we had seen. We accepted. Dr. Loh then asked for the CD recording of the cystoscopy that was done by the initial specialist.We told him none was given, also the patient's card and records were pull back. We only have the official receipt. According to Dr. Loh, we must be given the recording. Since we don't have it and if we were to retrieve it, shall cost us some time, suggested that maybe he can re-do it if needed. He brief us on the procedure & treatment that he shall do with Alice. He shall do some diagnostic, pressurize the bladder check / inflate, enlarge the urinary tract, flush / clean the bladder. We confirmed and he started to organize. As Alice is still in pain, Dr. Loh was very helpful and booked the OT under emergency.

Procedure went smoothly and the OT personnel kept Alice comfortable, even with her phobia. There was no drama like in the first medical center where they can't successfully do an IV.As it was done under anesthesia, she don't feel anything. Procmisc procedure, Procendoscopic, Hydrostatic Distention of the bladder and Procdiagnostic Endoscopic examnination of the bladder was done.She was returned to the ward in the afternoon with 2 big bags of saline to flush her bladder. The day passed without much drama as Alice is a bit sedated and drowsy. 28th May, a bladder installation was done in the ward, and this was rather dramatic for Alice. Her bladder was filled with medication and she is suppose to hold the solution in her bladder, turning around over four quadrant and every quadrant is suppose to hold for a minimum of 15 minutes. This is to soak the bladder and create a coating. A recap, Alice feels pain in her bladder even with a residue of 60 cc of urine. This was the longest hour of our life. This elevated her anxiety and phobia. She feels very frighten as the thought of no cure and have to endure these pain for the rest of her life is unthinkable. Alice was discharged in the afternoon and Dr. Loh reemphasize that these shall make her better, but give it some time. He confirmed that Alice has a non-bacteria Interstitial cystitis. She was prescript with the medication Elmiron.

29th May, time to visit  Datuk Dr. Abd. Aziz for a review. The report is out and Datuk gave us a copy. He put a stamp and signature on it, unlike those 2 initial specialist, told us to keep it and emphasis the the disease is remove. Gave a pat on Alice. Remove the suture check the wounds. Ask her to rest. He said that we can see him if we have anymore problem. He note on the report, under diagnostic, Adenomyosis and leiomyoma. Alice had broken down and we requested his help to refer us to a psychiatrist for help. He help us make arrangement and sign us off.

We went down to 2nd floor to look for the psychiatrist department, there was none. Then a lady asked us if we need assistance, we said that we are looking for Dr. Zainal. Abdul Rahman, we were directed to Life Style Modification Center. Dr. Zainal couldn't do much as Alice is too frighten at the though of going to a medical center, that she is in a state of trembling. We had a short chat, Dr. Zainal pull out an orange color pill for Alice to calm her down. He was rather surprised when we told him that we requested for a psychiatrist. We went through our story again, but he kind of gave me 'the glance' that he wanted Alice to tell it. The pill worked and Alice had started to calm down. After hearing our story and checking with Datuk, he then did a prescription and ask us to go home. He gave us lots of reading material, some forms /questionnaire to fill up. Not to take the medication first, call him in the evening. In the evening he guided us on how to take the medication and another dosage before sleeping. Call him tomorrow morning. We had time that night to go through the reading materials and questionnaire as Alice was very much better. That night Alice had the best sleep since this episode started.

Called Dr. Zainal in the morning, feedback to him. He requested us to pop over as Alice is calm now. Made an appointment in the afternoon and we went over. Had a long chat, he went through the questionnaire. He also requested Alice to define Nervous breakdown. His opinion is that Alice is too traumatized with this episode due to the bad experience during the initial 2 specialist. We also talked about Alice halucination that her departed mum came and Alice requesting her departed mum to take her 'away'. He explained to us why and all that is in our mind. He then proceed to advise Alice on how to take and modify the dosage of Xanax, Lexapro and Apo amitriptyline. He feels that it shouldn't be too long for Alice to recover and suggested activities like Yoga, Tai-Chi and even Caligraphy. Taught Alice a breathing procedure to keep calm.

We were so relieved and we hope that we can quickly put this episode behind us. Finally, we could see a light at the end of the tunnel. Stay tune for Alice's progress, recovering, re-flare?

Short Farm Working Tour

 Working Tour.

Just finished a short working tour and shall make my way home tomorrow morning to keep my family company. Even though it's a short tour, I injured my right hand, sprained my right wrist and had plenty ant bites (even at my buttock). It's too challenging as I had been idle for quite a while, now my whole body is aching. Most of the time, it's mind willing, but body unable. Almost all my target fell short as I was too tired half way through. Must be getting old.

Thanks to my partner, whom had kept things going during my absence. There were too many challenges for us to handle. We had some pretty dry, then pretty wet days, which hinder our access. Left with only 1 helper. Luckily my partner managed to recruit some part timers to tie us through. Had to fine tune our strategy to fit.

The most well kept is Parcel 1 due to it's location. Managed to control the weeds here and even did partial fertilization. We are reverting back to organic fertilizer this time, hope to supplement back some Trace Elements (TE) and Calcium Carbonate.

Had 2 fallen trees, due to termites infestation. We had these treated a few months back, but seems that the woody part had been eaten and with strong wind. Had these replace with Jackfruit trees.

Wild bees are abundant here, still harboring the plan to go into Bees Farming once the rubber tress can be tapped. We brought in lots of rejects papayas to feed the chicken and it attract lots of bees. They also loves over ripen bananas. Shall research more to find out if these are suitable for Bees Farming. I notice there are 2 types and I'm sure the big black ones are not suitable.

The initial Avocado (seeds, not grafted) are doing well. We'll see when can these flowers or I might graft onto these later. Did a check on the grafted Avocados, most of them are doing well, 1 missing, 1 died. Checked on the Soursop that were planted next to the access road. A couple died and some were covered up by land slides. Managed to replaced some of these.

Our Free Range Kampung Chicken is about 60 chicken strong now. We are targeting it to reach 200 before we decide if we want to take it to a bigger scale. These are some of the 2 days old chicks.

Parcel 5, our little farm, had culled some papaya trees. Our market does not accept the yellow flesh and doesn't like the round fruit types. As we still have lots of seedlings, we manage to replace some. It'll take a while before we can replace all. Seeds selection and multiple planting can minimize this. I had failed to emulate the papaya farm into our rubber plantation as the rubber trees canopy is getting large and blocking off the sunlight. We can only do it on new planting / land when the rubber trees are small. Harvesting is also a problem in hilly conditions / difficult access as papaya can be harvested twice weekly. Still Papaya has certain advantage over Banana as a cash crops in Rubber Plantation.

Managed to recover quite a numbers of seedlings / plant-lets. We have about 50 Soursops, 200 Agarwood, 150 Jackfruits, 100 Avocados and 50 Mangoes, a couple of Limes and a Durian. Some of the Jackfruits plant-lets are too large for rootstock. No sure if it can wait as I bought 4 Honey Jackfuits, which I had just planted for scion. Maybe have to plant these first, then do a field grafting. Managed to graft about 50 Avocados plant-lets. Hope that the successful rate is acceptable.

The pruning scissor gave way and I injured my right hand. Had been using this scissor for a couple of months. May had used it to cut too thick a scion. This is the dis-advantage of using forged / cast iron type. Bought a new one of MS steel to replace. MS steel shall bend, but not snap. The old scissor spring (straight wound) always falls off, and the hold (shut) broke off not long after used. The new one compare much better (maybe it's new & sharp).

 One afternoon, dark clouds looming and it rained heavily not long after. Well, had a productive week and I did all that I could, given the circumstances as I'm still worry about my wife. Have a few hours of rest and shall start my journey home, first light tomorrow. Stay tuned.

Traveling To Farm Using Malindo Air.

Traveling to my farm.

This is the first time that I am traveling to my farm in Sabah using Malindo Air. I had been using AirAsia all this while, with the exception of a couple of times using FireFly.

FireFly had stopped flying to Kota Kinabalu from Kuala Lumpur a couple of months ago.

Malindo Air is a new comer. They operate from Kuala Lumpur International Airport and lands at Kota Kinabalu International Airport.

My flight OD 1002 takes off at 7.45 am. Took the 5.00 am bus from Sentral to KLIA. I reached KLIA at 6.40 am. Walk up to level 5, Row F to check in. Find that the ques are pretty long. Then it occurred to me that their web check in is not ready and I find that most of the passenger has luggage to check in as Malindo Air allows 20 kg of check in luggage. Lucky me, as I went early as is the first time flying via Malindo Air.

Check in gate had been changed from Gate A10 to A11, hmm,  okay, just next door. As I already had my breakfast, I'll just wait at the boarding gate. Found Gate A11, it's at the far end (last) and it's a VERY LONG walk. Luckily I came early.

Flight is on time and boarding were done very efficiently via an aerobridge. Business Class, Senior citizens, passenger with children, passenger sitting behind, then the front passengers.

As I was checking in, I was asked if I had any seat preference. Since I was traveling alone, I said none. As I was looking for my seat 17E, I realized that it's on the emergency exit. I was thinking, oh my, from my experience on AirAsia these seats can not be reclined. It is different in Malindo Air. The leg space is definitely bigger than AirAsia (normal as well as emergency exit), those seats at the emergency exit CAN be reclined. There is also an individual entertainment system with a touch screen that provide you with movies, music, games & etc. Since I had my ear plug with me, I did not request for one. There are a ear plug port, a USB port which can charge our phones and a game controller port (I guess). A rather annoying problem is whenever there is an announcement, the volume is at a much higher level, and I had to pull off my plugs. We were served sandwich and mineral water.

My flight was very pleasant and we touched down according to schedule. As I travel frequently, cost is still my number 1 priority. I guess to me it's still cheaper if AirAsia is on sale, and if I book way in advance. I could be an exception as I do not have luggage.

Would suggest you people to do a comparison before purchasing your flight. I would give positive points to Malindo Air on 1) Luggage 20 kg (when / if required), 2) Boarding via aerobridge (no heat/rain), 3) bigger leg room, 4) Meals, 5) No convenient fees. It could be cheaper if you are flying at a short notice, like this flight which is not in my regular schedule.

My last comment is that it lands at Kota Kinabalu International Airport and there are more food outlets there :-)

Health And Farming 2, Endometritis.

Health play a very important role in farming. I had been away from my farm since early April and now it's early July. My wife had develop some health issue and I went back to take care of her. We went through this very difficult (most) period of our lives. Am writing about this so that it may be of help just in case someone is in this or similar situation.

My wife, Alice, felt burning sensation while urinating. These comes and goes and is quite normal for her. She usually buys some medication from the local pharmacy, urinary alkalizer. It's use to treat Urinary Tract Infection. Drink it with lots of water and it's suppose to flush your urinary system. At times if if does not work, add an antibiotic and that shall takes care of the problem.

Back in December, these episode are re-occurring more frequently. She went to visit our family physician, Dr. Desilva in March and a blood, urine test and a urine culture were done, results shows that it's clean. Our family physician suggested she visit a Urologist specialist.

Alice picked a well know medical center close to our home in Cheras and there was only one Urologist there. She compliant about her urge, frequency and pelvic pain like the bladder is full all the time. He examined her, did an ultrasound and prescribed some medication and sent her home. Was told that it's mostly in your head. By this time what we though as a UTI ( Urinary Tract Infection) had got worst. Her pain while urinating, the urge and frequency is escalating. The lower pelvic pain is as she is feeling that her bladder is overly full 24 hours non-stop. Back to the Urologist again, did another ultrasound and confirmed the residue urine is insignificant. This time made an appointment to do a diagnostic cystoscopy. 

After the cystoscope, Alice was told that there is a growth and is obstructing the bladder, it need immediate attention. She was immediately referred to the Obstetric and Gynecologist specialist. Now the funny things begin. She was made to settle her bills and her appointment card were pulled back then ask to go over to the O&G.

Alice was told that she has a growth outside the bladder that needs to be removed. The O&G got her admitted on the same day, 12th April. A laparoscopy was done on the night itself. The next day she was told 2 growth were removed ( Endometritis), shown two samples and these were send to the laboratory for test. These Endometritis are obstructing the bladder. Alice was discharged on the 15th April with the assurance that her problem were solved and pain shall subside in a couple of days. Made an appointment to be back on the 18th for the test report and an injection. On the 18th she was given 8 photographs and a laboratory report. The photographs show some before, during and after the surgical procedure. The laboratory report is labelled as Histopathology Report. The report described the 2 samples as Endometriotic cyst from the right and left ovarian wall. The injection of Lupron was given and it's suppose to put Alice into menopause. Alice was told that the Endometritis strive on the hormone and putting her into menopause shall starve off and prevent these from growing. Need to go for a 6 session course. Prescribed some medicine with some pain killers and were told that the pain shall ease. Rest assure, your problem has been solved.

Alice went back on the 22nd April as the pain not only did not ease, it got worst and is no longer bearable. We were told that the O&G specialist was on leave for a week. In case of emergency we could see his associate, also an O&G specialist in the same hospital. This is an emergency and we saw his associate. Again a blood, urine test and a urine culture were done. By this time we already know that it shall come out as clean and we told the specialist so. An ultrasound was done and base on calculation there is about 120 cc of urine in the bladder and according to the O&G is normal residue. I suggested we drain out the urine with a urine bag to see if the pain subside and the O&G obliged. The volume is 160 cc measured at the urinary bag. A pain killer injection and some medicine was prescribed with plenty of oral pain killer to be taken home. Was told that it's mostly psychological.

We went back on the 24th April and the above was repeated. This time the specialist insisted that it's psychological and I should take Alice to visit a Psychologist. Was also told that the O&G that did the surgery shall be back on the 26th. This made me feel that this O&G is not treating Alice as a patient and is just acting like a stand-in until his associate is back. Requested for a referral with Urology and O&G, he mentioned  Dr. Seri Suniza Sufian,but the waiting list is about 3 months.

Dr. Seri Suniza has a clinic in Prince Court Medical Center. Made some calls and were told that to leave our contact and her personal assistance shall get back to us. Yes the waiting list is extremely long. So this is of no use to us as Alice's condition needs intervention now.

We rushed over first thing in the morning, 26th April. Again a blood, urine test and a urine culture were done and we again told the specialist that it'll come out as clean. Ultrasound was done and again shows an insignificant residue of urine in the bladder. The bladder bag is still attached. He insisted that the Endometritis were removed and reffered back to the photographs and Histopathology report. Spoke with his associate. The specialist says that since it's bladder, this is a urologist problem and referred us back to the Urologist. The Urologist then says that this is Endometritis, it's outside the bladder and he doesn't knows how to cure Endometritis also the O&G was the one who did the laparoscope and ask us to go back to the O&G.

Now we are in a fix, and just don't know what to do or where to go.  Decided to go back to the O&G and we demand that Alice is in pain (extreme) and both of the specialist should do something about it. Also if this is an overlapped area, then both of them should come out with a solution. Should they do now have a cure, then they should at least minimize her pain. It's the same hospital.

The O&G finally agreed after a telephone conversation with the Urologist and had Alice admitted under his care. Pain killer was injected to subside her pain. The O&G finally managed to get the Urologist and he came to review Alice. Both of them agreed to do an imaging and an MRI was order. By this time Alice was very traumatized by the whole episode. It was made worst as both her arms where already full of injection marks as these nurses keep on saying that it's very difficult to get to her veins to set up the IV line. There was one time that only after 2 nurses and 2 MO, it was only 1/2 successful, can inject, but can't draw blood. MRI was done twice as that evening. The first time, the area wasn't correct. This is also the only time that an injection was done without too much pain. Was sent back to the ward. During the night was given a very high dosage of antibiotic, 4 tablets at one go. At 5.30 am the next morning, the nurses came and instructed Alice not to urinate as the Urologist want to expand the bladder and do another MRI. Went down to the imaging department, waited for it to open, 27th April. With the bladder expanded, the pain is unbearable so lots of pain killer were given. She was given medicine and injection for pain when we requested. Alice was discharged on the 30th April as condition improved and was told to recuperate at home.

On the discharge date, the Urologist said the antibiotic has taken care of the problem and asked if we want him to prescribe medication or let the O&G do it. We answer  we wouldn't know. He then suggested let the O&G do it since he is treating the Endometristis.

Now the O&G says it's getting better, shall continue with the treatment. Come back latter for the Lupron injection.

The pain started to reoccur and we when back on the 6th May as it was unbearable (ran out of pain killer). Again all tests and ultrasound is good. Gave more pain killer both oral & injection and was assured that the pain shall improve. Discussed with the O&G if we have other alternative but was told that surgery could be risky and a long procedure. There are many vascular tissue at that area and complication like incontinence, rectum and etc. Suggested that we take the medication route, takes longer but less complication.

The pain was getting worst and we went back on the 17th May. The above was repeated and an additional Lupron was administered. Was assured that once the Lupron kick in, then things shall get better. My research on the internet shows that it does not take that long for Lupron to kick in. We had lost confident in the O&G. We ask him to refer us to a specialist that can cure Alice since her condition is getting worst. The pain is so unbearable especially at night. So much so that she is on the verge of breaking down. Our request was ignored and were send home with the assurance that condition shall improve, it's mostly psychological. The O&G is suggesting strongly that Alice is seeking attention as I am working outstation. Also we may have other marital problem since I'm always away from home.

Alice is a very independent lady with strong character. We had been together for more 3 decades and I am pretty sure that it's not the case.

This started me off on a research on the internet. The more I research, the more I loose confident on the present O&G. Decided to have a chat with our family physician Dr. Desilva. Showed him all the documents and spoke on our experience. He noted that the imaging report shows that there are more problems still in existence. He feels that the surgery should not had been performed without further diagnostic and discussion with the patient like alternative or other options. He suggested we go to Gleneagles Hospital (KL). According to him the doctors and specialist there can work together. He even gave me a O&G specialist, suggested we see him with all the records and tell him we need a second opinion.

Alice's condition is getting worst. Sleepless nights for the past 2 months, pain, traumatized,  anxiety, phobia, false hope. Her will to fight is no longer there. She feel that she'll rather die than to endure this type of pain for long term. Her greatest fear now is that this can't be cured.

To be continue.