Discharged from hospital and now resting at home.
No guys, I know I am 38 weeks into my pregnancy but this
blog is not about the happy news of baby popping. It is about - I choked on a
fish bone yesterday during dinner.
I am a fish bone. Swallow me.
“I know so and so also choked on fish bone before, its ok
one”… maybe comments like these are trying to be reassuring… even good for a
laugh when its over. But I assure you this is not an emergency to be made light
of.
Immediately post the horrible ordeal which for a moment I thought might cost my life, I also hear
helpful been-there-done-that advises like “…you can point your finger to the sky and write some
chinese words then swallow some rice”…… “ Fish bones very fine what, swallow some banana or
rice and push it down then ok liao”…what can I say? Distressing comments to hear but people are
entitled to their own views on how they prefer to handle situations.
Back to the beginning… I was eating a big fish and I was
picking at the bones when the exact moment happened. The bones I was fishing
out were all round 3-4cm long so I knew the one I swallowed may be similar.
Sharp bones of this length is not considered small nor fine.
Immediately I started to choke. My airway was blocked and I
was unable to breathe. Gasps of air are rare and my mind is racing to think how
not to gag and breath while I still can breathe.
Emergency at Mt Alvernia
was an ultra bad experience (from an emergency patient’s perspective that is). Not
that service is slow. A&E is practically empty when I arrived (First sign
that all is not well… You mean not a single emergency case on a Sunday evening?) And I
was pushed into an observation room immediately with 2-3 nurses attending to
me. But none knew what to do. (Bad sign number 2… I have been to TTSH A&E several
times and despite being severely short of staff, every medical officer there know what to do! Someone wheel me out again to check the
signboard… maybe this is just a 24 hr. clinic I have entered)
Universal sign language for " I am choking but just ignore me"
Obvious to all that
I am bending forward drooling huge amount of salvia and mucus, gasping for air,
holding onto my neck and signaling with my hand that I am choking. Ok maybe it
is not obvious but the nurses asked me to lie in bed, rest my head on the
pillow while waiting for the doctor. Stupidest advice coming from a medically
trained personnel because the back flow of mucus and salvia will certainly
block my airway, cutting off my oxygen supply.
One nurse asked me
what happened and I tried my best to croak that I swallowed a fish bone. She
got it, then persistently asked big or small fish, what type of fish… My love, I
wish I can patiently explain to you that “in my opinion it is quite large and I
regret I was not diligent enough in my diving days to identify fishes but the
skin is a mix of red and grey and my helper cooked it in the oven with soy
sauce and garlic. Any idea the species yet?” vomiting and choking to resume
after explanation.
The other nurses
stood behind, openly ask one another “how ah? What to do? Call which doctor
huh”…
A doctor who did not
inspire much confidence came and wanted me to open my mouth to look into my
throat. But first thing first… where the hell did they keep those expensive latex gloves for emergency doctors? Where oh where?
Legal needle torture
I vomited onto
myself when the doctor tried to peep into my throat. Very natural response
called gag reflexes but for the nurses in A&E, this must be the first time
they witness vomit because they were helplessly lost. Ken was scrambling my bag
for the small pack of tissue paper he knew I had. “Tissue, tissue” I heard the
nurses behind him suddenly murmur in a scramble to find a tissue box.
Now which
cabinet did they lock those expensive tissue paper? Found it! YEAH!!!! And they
found a plastic bag too!!! Way to go, forward thinking nurse! This must be the
most efficient day in your life in A&E!!!
The forward thinking
nurse detached herself from the wall and came forward to help me with the newly
acquired product. But as I continued to throw up and the vomit soaked my whole
hand and Ken’s, she immediately withdrew and left Ken to assist me, leaving the
tissue box on my lap. It is to note that from my angle, I can see and hear 2
nurses trying to merge into the wall. All these while, non was assisting the
doctor or even trying to help Ken who is obviously overwhelmed.
Run for your life! It's vomit!!!!
Visual inspection gained
nothing so the next stage is X-ray. “You are not pregnant right?”, doctor
asked… URGH!!!! Have I heard Ken told you twice I am due in 2 weeks!!!? Is that
considered pregnant?! “Must be uncomfortable, ate the fish this afternoon
during lunch?” Yes doctor, ate the fish at twelve noon then decided to regurgitate
a bone to choke myself at 8pm!!! WTF.
X-ray showed nothing
other than a suspicious white dot… Was recommended we wait for the ENT
specialist to arrive. With all the throwing up, I guess my airway is all clear
and I can breathe slowly with both my mouth and nose. Away from incompetent
medical staff, I contemplated my option to leave Mt A and head for TTSH. But
Ken told me all has been paid for, even the ward which I would stay for the
night… Yup yup.. like I say, efficiency is not the problem here, medical competence
is.
A few floors up, the
ENT specialist arrived at my ward. He was very assuring and very professional.
A huge change from downstairs. When another visual inspection revealed nothing,
he did a scope by inserting a long tube through my nose into my throat. Still
nothing. We are now left with no other choice but a general anesthesia
operation to retrieve the bone. It will be done around midnight to avoid the
risk of reflux since it is not long after my last meal.
A general
anesthetist came and briefed me on the procedure. Again, very professional. One
marked difference I realized, between the medical staff downstairs and upstairs
is that the latter are committed to listening.
When I could not speak, the GA
asked me to give hand signals. When hand signals cannot be comprehended, I was
given pen and paper. I have seen this simple pen and paper communication done
at the very chaotic TTSH emergency before. It suddenly dawn on me that Mt A
emergency never tried to communicate with me other than pressing me to answer
the ever important “what type of fish”. My hand signals indicating to them the
size of the fish and the size of the bone was also actively ignored.
Anyway, to finish up
the hospital story, the operation was successful with the ENT surgeon basically
telling Ken and me that I was damn suay. It was a big bone and it was stuck
pretty deep right across my throat with both ends firmly wedged on both sides
of the throat, no way its coming out and everything I swallow after the bone will just sit right on top of it. Hence explain the pain and the difficulty to breathe. It also
explains why X-ray reveals nothing but a white dot.
He admitted it was one of
his more challenging operation due to the way the bone decided to secure
itself. But all is well. I am to stick to a liquid diet since the walls are a
bit torn and swollen plus to monitor for fever. 10days MC and no talking.
The fish bone IS OUT!!!
A few lessons I learned from this unfortunate episode:
- Be careful of fishbones! Well, if me being so blind as to swallow something so big and the result is death due to choking. Then I seriously deserve it. Can't blame anyone for an accident I caused myself right?
- The nearest A&E may not be the best A&E. No wonder Mt A emergency is not doing a brisk business, dying patients are willing to travel further!
- One’s experience in something does not equal to good advise for another. If I were to heel words of wisdom to swallow rice and bananas, I have no doubt me and my unborn child would be dead by now.
- Be patient and listen to the needs of others. The emotional distress of me trying to communicate but no one willing to take me seriously is certainly my biggest take away from this fish bone incident. I admit I have been one of those assholes many times before. The excuse I gave myself is that I am too busy to listen so hurry up, be efficient then leave… The helplessness and distress I have inflicted on others unable to defend their positions must have been hmm. I really must be more mindful in future.
