Appe, Peri and Morphi

I had a Skype conference with Topacio*.  Topacio used to live in Holland and she’s been living in Spain for the past three years but still she wanted to tell her story for Paracetamolland.  After we greeted each other, she began with her story:

“I woke up one morning with abdominal pain and I was puking.  I went to the “huisarts” (General Doctor) and he diagnosed Gastroenteritis so he gave me Paracetamol.  After one day, I was not feeling better so I went to the Emergency Department at the hospital.  They took a long time to see me and when they did, they examined me by touching my abdomen and they took a blood test.  They did not take any ultrasound or any other kind of test. 

They told me that I had some infection parameters and they let me go with antibiotics.  What the antibiotics did was to disguise the symptoms.  I was at home with abdominal pain.  After three days I went back to work but I was not feeling much better.  The pain persisted and I was not able to walk straight anymore.  When I finished work, I was in the bus going backing home and this bus line has a stop next to one of the biggest hospitals in Amsterdam.  I don’t know what got into me but I stepped out of the bus and went to the Emergency Department at the hospital.  I was walking very slowly and bending from the pain.  They wanted to make the same kind of tests that they had already done three days ago.  I told them that those tests were already performed so I requested an ultrasound.  When they got the results from the ultrasound they could see that I had Appendicitis.  They told me that they were not going to operate but they were going to give me some antibiotics and they were going to keep me there for observation”.

WHAT?  They were not going to operate you?  That is the first thing that needs to be done!  Where on Earth do they not operate you if there is Appendicitis?

“Well, in that hospital in Amsterdam!  As I had just come from work, I was with my working clothes and they didn’t even give me a pajama or something to sleep on.  I slept on my own clothes! As it was late I couldn’t even ask my roommate to bring me some till the next day. I was getting the antibiotics intravenously. I called my parents who were living in Spain; my mother was very worried.  I was still in a lot of pain.  The second night I spent at the hospital I woke up at around two or three in the morning with a pain that I cannot even describe.  I believe pregnant women get the same pain when they are delivering the baby.  I’m almost sure it is from when my Appendix got perforated. And this is when my addiction to morphine started!”

Topacio said these last words with an ironic tone, frustrated and laughing at the same time.  I just cannot imagine how you must feel on situations like this one.

“When my mom heard that I was getting morphine she booked immediately a flight to Amsterdam. In Spain they give morphine to terminal patients, here it seems to be a common practice.  They made a CT-Scan to see why had the pain increased on that night and they couldn’t find anything. They just continued giving me antibiotics and controlling the fever.  Each day I had a different doctor.  Each day I had to tell my story to a new doctor with a bunch of students following him around.  It was so tiring.  As I didn’t have enough fever they were not doing much more than what it had been done.  In the meantime I was feeling very bad, I was not hungry and the abdominal pain increased and spread.  My mother told me that in order to get some attention I must make some drama, so the next time a doctor passed by with his students I cried and complained a lot.  He told me that they were going to make another CT-scan-as a favor to me- as my fever was only 37.5 and not high enough.

When they made the CT-scan, they found out that my abdomen was infected but they didn’t know what had been the cause of the infection.  By abdomen I mean my intestines, ovaries, stomach, etc.  As they didn’t know what had caused the infection, they were going to perform an Emergency surgery.  My mother, who is normally a sweet person and who doesn’t say much, got really angry and started to shout in Spanish.  She was angry on how I was being treated and why they hadn’t taken any action before.  She said that she would only allow the operation on two conditions:  That the head of the Surgery Department was the one to perform the surgery and that they had to make a pre-operation plan.  Of course, I had to translate all this while I was weak and in pain.  There was also a friend’s husband, who is Dutch, and he was also translating and talking to them in their language.  I believe that helped a lot to get what my mother demanded”. 

I was in shock to hear all this.  How can that be possible?  Was it because she was not Dutch that she had a different treatment or what?

“I had the surgery and it was a success.  They realized that I had Peritonitis. The appendix had been perforated, and as a result I had infected fluid in my abdomen. Luckily, none of my organs had been infected. They left me with a horrible big scar.  In the surgery they took a sample from the infected fluid and found out that I had some rests of E. Coli. They isolated me for ten more days after surgery because it could be contagious.   In total I spent almost three weeks with antibiotics and I lost seven kilos.  You know what they told me?  That it was an atypical case of Appendicitis”.

Atypical case?  All of these could have been avoided if they would have had performed the surgery on the first place! What’s atypical is NOT to perform surgery when a person has Appendicitis!

 "I got three teddy bears at the hospital from my friends.  Even though this was really tough for me my friends tried their best to make me feel comfortable and loved.  We named the teddy bears:  Appe (for Appendicitis), Peri (from Peritonitis) and Morphi (from Morphine).  I still have them in my room”.

She laughs nervously and nostalgic.  She dissimulates a little bit the irony from the teddy bears names.

“And guess what?  I went afterwards to Spain to rest and to be with my family.  I needed it.  When I was there I got problems and went to the hospital again.  I had something called abdominal adhesions.  Basically when I was operated the intestines moved from their original position and it was painful when they were trying to put themselves back into the correct position.  I was on a diet and observation for a few days in order to see if the intestines could position themselves correctly. Luckily, they did it for themselves, but otherwise I would have needed to go again into surgery…”

There was a question that was at my head when I was listening to this story and I needed to ask:  Did you move to Spain because of this?  She responded:

“Yes, part of it was that.  I had enough from Holland and I had some rejection to the country after this experience.  But partly is because in the meantime I had a very good job offer in Madrid which made me take the decision.  If I wouldn’t have had that job offer probably I would still be there.  Who knows?”

I would like to thank Topacio for sharing this story even tough she doesn’t live in the Netherlands anymore.

I also would like to thank Caterina for helping me to correct my so faulty English.

*Topacio is a fictitious name.