May 9, 2013

Less of a man

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I am now less of a man – a bit of me is missing. Three weeks ago when walking to the shops the right side of my abdomen was aching. Nothing too bad. The next day the ache was still there. Checking Google suggested it wasn’t appendicitis as the ache was too high, but most of the other possibilities were also unpleasant. I went to the local GP and promptly bounced to a local Accident & Emergency. After waiting a few hours so I could complete the required 6 hour fast for surgery, I had an emergency appendectomy. When I woke up, my shaved stomach had 3 small holes and a missing appendix.

Appendectomy Results

The surgeon described my appendix as “mucky” and “within 24 hours of bursting”. The histology report backed this up. A burst appendix is a serious condition, but removing it intact is just an “intermediate” operation. Luckily it was found before rupturing as I thought acute appendicitis caused severe pain and considered not bothering a GP. Apparently my appendix was in an unusual position high up the abdomen. This is why I felt no significant pain at any point – it was being shielded by the cecum. Get your long lasting abdominal pain checked out – especially if you still have an appendix!

I also felt no pain after the surgery. Partly this is because the procedure was laparoscopic. Only three small incisions a centimetre or two across were made. One for a camera to see what was happening. The others for instruments to move, cut and remove the appendix. Now they are barely visible. Very impressive. It all went smoothly according to the surgeon. He even provided a recording from the inserted camera. The procedure took exactly a few seconds over 30 minutes. The surgeon also offered a “medical certificate”. Is this like a school participation certificate – well done for participating on an appendectomy! I didn’t need it.

Some other notes:

  • When describing possible procedures, the nurse said that the decision on whether to do a laparoscopy was based on whether the patient was “skinny” enough. I asked if I was skinny enough – the nurse hesitated, umm’ed and ahh’ed, then said it was up to the surgeon. Cue many “fat boy surgery” jokes.
  • If I was borderline “skinny” before, now the decision would be a little easier. I have lost 4kg in 3 weeks – from not eating for 2 days and then being on a restricted diet for the following 2 weeks.
  • I was in a private Malaysian hospital and the care was very good. Diplomats and partners get health insurance provided by the UK government up to the same standard as the NHS (so I had a shared room, etc). The total cost for 3 days in hospital plus emergency surgery was £2500. I believe this is comparable to internal NHS costs (as the patient pays nothing) and much cheaper than the US.
  • The first question I was asked at the hospital was about how the bill would be paid. I regularly heard “do you have an insurance card?” It was all a bit surprising for someone who has only experienced healthcare in at least partially nationalised systems (UK and Australia). Right next the the Emergency triage nurse is a payment station (with credit card scanner). To leave the post-op ward I had to walk past a Payment Office (and agree to pay the bill if the insurance firm didn’t). I can imagine it would be very intimidating for the uninsured.

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