November 29, 2011 A Cameroonian Appendectomy: play by play
Last week I got appendicitis. Yes, the kind where your stupid non- working organ decides to act up and make your life miserable. Growing up with a nurse for a mother, you tend to over look real pain and think ‘what can I do to make this go away so I can get back to real life?’.
3am Friday morning: I had started having stomach pain, but went back to sleep when it felt reasonable.I got up in the morning and dressed for work thinking I ate something weird the day before and made a conscious choice of Tea instead of coffee in the teachers lounge, and sitting while prepping for my class instead of standing. The pain increased by time I had to teach so I walked down to the kindergarten to ask them to wait untill I got back from the nurse. I felt light headed. After the nurse gave me Tylenol and Tums I went to take a nap on cushions that I sprawled out on the floor of my classroom. 5 mins later I realized this was a bad choice. I wouldn’t be able to stand up to teach the 4th grade either. I decided to go home and wait out the pain till it stopped. haha. I drove home and realized lying down made the pain worse. I started to panic and woke up my mother in the states to ask what I should do. (asking her medical opinion has become a reflex)
I explained the pain I felt through out my abdomen and explained a strange sharper pain in the lower right hand side.
“Mom, is that where my appendix is?”
“Its on the other side?”
“ Um yes”
“Its probably just a gastric intestinal virus”
“Should I take any Cipro?” (I brought a portable pharmacy with me when I came in August, Cipro (and antibiotic) was one of those prescriptions.)
“No, don’t take anything. Why haven’t you gone to the doctors?”
“I don’t know I thought I would feel better…”
“Well go to the doctors! Don’t wait.”
Later I found out that she thought I had appendicitis but didn’t want to freak me out. And I would have. I wouldn’t have handled the rest of the day quite as well.
The Nigerian school nurse and my savior, Comfort (yes her real name) came with a driver to start me on my tour to finding the truth.
11:30: We entered the doctor’s office at the French Clinic. A simple room with a desk and a medical table (the kind with a cushion for laying down). The doctor didn’t speak English so Comfort translated. Up on the table he felt around my entire abdominal area.
“Does this hurt?”
“Does this hurt?”
“Does this hurt?”
Then pushing on the lower right hand side,
“Does this hurt?”
“Voila!” …. Then non-discernable French and shaking yes of the head to Comfort.
Pushing again… in the same lower right hand side.
“owwwww…..owwww… ok…. (pathetically) …. Ha-ha um ok yes it hurts.”
“viola!” then the same not non-discernable French with gesticulations towards Comfort.
“Ok Comfort, what is going on?”
Well the French Dr. thought it was my appendix… um duh. But like any good doctor wanted to make sure.
Around 12:00pm we arrived at a clinic where they do blood work. My hand vain is so small so they use a pediatric needle to get blood.
At 12:30 we arrive at clinic where they have ultrasounds. Everything is brown, the floors walls, and ceilings. The benches and even the flowers are made of dried strategically cut open chestnuts surrounded by wheat. I got to spend an hour watching pregnant ladies walk in and out of a room before I got to go in. The Cameroonian ultrasound technician was very nice, all smiles, I think if I was getting this ultrasound for a pregnancy I would have felt right at home. After using 4 different handles and angles to see the home of the culprit causing all the stress, we found out my appendix was 13 cm instead of the normal 6, and it would have to be taken out.
The technician informed us that the only doctor in Cameroon, yes the whole country, that could perform the surgery using laparoscopy was leaving for vacation the next day and I would have to rush to see him today to see if he should or could take it out.
2:30 We finally enter Hopital D’Esse where my Cameroonian doctor is located. Its next to the train station, about 8 mins from my apartment in Bastos. The hospital’s aesthetics is of small concern to me. I had heard about African hospitals but had no idea what to expect. My friend Sarah called to see what was going on while I was walking in.
“Is it clean?”
“I don’t know, I mean it’s pretty shabby, but I don’t know what standards I’m supposed to refer to.”
Later I would learn that for African standards it was pretty good. Everything was on computers instead of notepads; the cockroach were small and few and far between, and there was a comfy chair, although falling apart, with a cushion in my hospital room… a room all to myself where I didn’t have to share it with 4 other room mates.
My Doctor, Dr. Oumarou, knew little more english than the French dr. so he tried very hard to be clear with me when he could. He looked at the ultra sound pictures and my blood work that said my white blood cell count was high and explained that I could be in surgery in an hour. The ‘Theater’ was already prepped. He showed me a picture of what my appendix looked like at this time, and what would happen during surgery on his Ipad. He would even have a copy of the surgery on tape so I could watch!
So, basically I had just enough time to call my parents calmly and tell them I was getting surgery and would call them as soon as I got out.
So at that point, Nurse Comfort was given a list of the things I needed during surgery and sent out to get them so I could go under. Yes she had to go pick up the surgical items that pertained particularly to stereoscopic appendectomy, and the medications and saline I needed afterwards for shots and IVs.
4:00-5:00: Many things happened leading up to the surgery…first a man (male nurse, but didn’t really know at the time) walking into my hospital room with a box cutter asking me in French to take my pants off, in which I replied “um.. no.” 10 minutes later I was in a room full of nurses having a fun conversation while shaving my stomach. While, the male nurse kept telling everyone in my room that I was afraid of men.
5:30 the assistant director and his wife came to stay with me and bring money for the surgery. They were awesome and very comforting.
6:00: Tearing up a little before surgery, the anesthesiologist asked me why I was afraid and proceeded to tell me that “if you didn’t stop being emotional you’ll have to have the surgery tomorrow due to high blood pressure”. Cameroonian’s are not the most sympathetic to pain, or fear. They are pretty hardcore people and apparently la blanche are not.
On a side note:
To prove the point further I once saw a two-year-old fall smack face first onto cement. In the US the child would start crying and run to his mother for comfort. But not Cameroonian babies- this child stood up kept walking and looked at me with this scary angry face. His mother was right next to him and never once budged to pick him up.
Basically the Cameroonian staff thought I was acting weird.
At 7pm I left surgery and was wheeled into a room filled with a large amount of ASOY staff, who were making sure I was ok, my medication was all there, and my bills were being paid successfully. The school had to foot the bill ahead of time, hospitals here are afraid of people not paying because there is no way to track anyone down. Can you imagine being Cameroonian and doing this? You would have to ask every friend, family member and neighbor to lend you money in cash in a matter of hours. Unbelievable.
I spent two nights in the hospital after that where both nights Sarah and Nick, friends of mine, slept on a cushion on the floor. They were basically my nurses. If I needed anything they where the ones to get it, even reminding the nurses to change my medication or saline bag. I was never really alone, everyday my friends from work visited me in shifts.
I was supposed to stay in the hospital till Monday but convinced the doctor to let me go home. Sleeping in the hospital was making me increasingly nervous. The night before I left, Sarah had to search the floor to find the nurses sleeping in a lounge. So I figured I was ok to handle things in my own apt since I was only on Tylenol and antibiotics. That week a friend of mine stayed over night to make sure I could handle things and then was visited regularly.
In the end, although I could have gone skipping this whole experience, I feel very lucky to have the people around me that I do. This school pulls together like a family. This also made me realize how lucky we are for being born in the United States. We are all very comfortable in the US and although I have noticed this in the past 3 months pretty consistently, it is definitely engrained in my brain now. Although people in the US still have bad hospital experience, there is always toilette seat and toilet paper in the bathroom, possibly even soap- and you will most likely wake up with a pillow and blanket after surgery with some type of beeping contraption to tell an alert nurse your saline bag is empty.