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.