Goodbye Biratnagar- Appendicitis Part lll

I woke up in time to see it. The inflamed calamari looking appendix that caused me so much stress and pain! Music playing in the background, I was thankful to be alive! The procedure took 45 minutes to complete. After being transferred from the surgical bed to a transport bed the surgeon sternly advised me not to move. Getting transferred to the post operating ward is hazy but I remember shivering a lot. I woke up around 1:00 AM sweating profusely. I started whipping sweat from my face with my hand and pulled the cover down as much as possible trying not to move too much. No one I knew was around and there was no call button for the nurse. A person with a patient next to me saw that I was hot and turned the fan above my bed. I gestured thank you. I started feeling pain and was able to wave down a nurse to give me pain medicine. I stayed awake for a little while then fell asleep.

When I woke up the next morning I was still lone. The epidural had fully worn off. I was able to wave down a nurse and let her know I needed a pee. She brought a bed pad and assisted with putting it under me. She came back and removed the pan when I was done. About an hour after I woke up the assistant of my host organization leader (host) appeared. He let me know that he was at the hospital the whole time to look for a place to sleep. There were no seats for the quests of the patients in the ward so he tried finding another place to sleep. I thanked him for trying to stay with me and asked him for my phone. I called my mother to let her know I was ok. This was about 12 hours post-surgery.

A portion of the ward I was in. (The only ward with A/C)

The doctor of the ward did his round around 9:00 AM. He let me know that I could eat soft foods, drink water or juice, and that I could walk with assistance to build strength. I was also told that I needed to change out of the surgery gown. I would be discharged either the next day or the day after. Once again alone I could not do any of the things that the doctor told me to do except wave a nurse down to help me to the bathroom down the hall. I did not know where my belongings were so I could not change. To eat someone needed to go out of the ward and purchase food for you. Mentally I started feeling really down. I found myself having to remind myself that my feelings were valid considering everything I had experienced. A part of me even felt jealous that everyone in the room had someone by their side in the ward except me. To distract myself I watched Easy A on my phone, which I luckily downloaded the evening I got sick in the hotel. I also wrote down my experience on the notes app on my phone (these blogs are the product of my notes).

Hanging in the ward... by myself.

When my host finally arrived at my bed along with her assistant and friend I let her know what the doctor told me. A nurse came and confirmed everything I told her. I gave my host all the money that I had in my purse. She then went and got clothes, rice porridge, and water for me. After eating and changing (with no privacy with at least 40 people in the ward) I let her know that I would pay someone to stay with me and assist me. She told me not to worry about it which I later found out that meant she would find someone for me to pay. I believe she asked the nursing staff first before disappearing for a long time again. I was able to figure this out because a stranger with a patient next to me volunteered to help me. I accepted Devendra’s (the stranger) offer and thanked him.

A little later my host returned and let me know that she found a staff member that could take off work but she did not speak English. Already experiencing the exhaustion of having a language barrier I thanked her and told her that I would prefer to have assistance from my new friend Devendra. My host left after speaking to Devendra and helping me walk around the ward once. Throughout the day I received calls from the US Embassy, and my insurance company checking on my progress. The Embassy representative told me that the hospital is supposed to provide a translator for me. My response was a fake laugh (real laughter hurt) and I let her know that was not the case! My fellowship messaged me throughout the day and we scheduled a time to speak on the phone that evening (Nepali time/ morning Washington D.C time) to discuss my next steps for my fellowship.

My Nepali brother & me. (See how I was aware this picture was being taken)

Devendra checked on me throughout the day before leaving for the evening. Luckily my host came shortly after he left to help me to the bathroom. During the many times I was alone I reflected on my fellowship experience up to that point and whether or not I wanted to continue with the host I was with. When I spoke with my fellowship organization on the phone that evening I let them know my decision of terminating my fellowship with the partner organization. They supported my decision and we discussed why I came to that decision and the next steps to get me back to the capital Kathmandu. I honestly wanted to go back home to the United States but we decided to take it one step at a time. My reason for terminating my fellowship was that I no longer trusted the people I was supposed to work with.

My host came to check on me while on the phone. I tried telling her my plan but she protested. Her response was that my surgery was not that bad. I just needed rest for ten days then I could work for her. Not the response I expected. I decided to be nice and tell her that I was advised to return to Kathmandu. Once my host left I called my mom to vent. I was now trying to balance healing mentally and physically along with managing my host and her unrealistic expectation along with our language/ cultural barrier. After venting to my mom I finished Easy A for the second time that day and tried to go to sleep.

Sleep did not happen that night for me. With at least 40 other patients along with their visitors in the open ward, the range of noise made it hard to sleep. Crying babies, a loud creaky divider being wheeled across the room, and vomiting woke me up throughout the night. Something that my host and new friend forgot is that people do have to go to the restroom during the night. Since there was a chance that I would be discharged the next morning I decided to go to the restroom by myself (I know bad patient). Getting out of bed was the painful part but I had success making it to and from the bathroom by myself. I even made it to the bathroom that was a little further away from the ward (the closer one had huge roaches and toads everywhere).

The next day my morale was 100% down. I tried changing my perception of my experience. I focused on being thankful I was alive. That this experience was only temporary. But nothing worked. I felt like I was being punished. Devendra came by first that morning to check on me. I was able to plaster a smile on my face and ask him to bring something that I could wash my face with. I had not washed in three days. He returned with a bandana which he poured some of my bottled water on and some red tea for me to drink. I felt a little refreshed. We talked for a while about his volunteer work with a local social justice organization that focuses on child marriage in the area. It was nice to find out that we shared a passion for advocacy! Devendra let me know that he had to go take a test at his University. When he left I was able to get some sleep before my host arrived. My host either tried consoling me or convincing me not to go back to Kathmandu. Our language barrier left me confused about her intentions but I stuck to responding that I was advised to go back to Kathmandu for follow-up care.

The doctor made his rounds again and consulted my surgeon via phone. The surgeon spoke with me and asked me how I was doing. After speaking to me he advised that I be discharged. I was very happy about this decision! I was ready to go! I asked if I could fly to Kathmandu that day and the doctor let me know that was fine. The nurses let my host and I know that the discharge process would take two hours. My host took all my belongings and told me she would be back. I didn’t see her for two hours. The nurse let me know that I was ready to go. Assuming this meant I could leave them and being used to being alone I started walking out of the ward. The nurse luckily stopped me and told me I could wait for my host in the nursing station. After hanging out with the nurses for about 30 minutes my host showed up to get me. She suggested we take a picture (I was hoping it would just be me and the nurses). I guess my host took care of my outpatient processing because we just walked out of the hospital.

Still, in a nightgown with nothing on under I stood outside of the hospital with my host waiting for her driver to pick us up and take us to the hotel. It was very hot (I would compare the temperature to New Orleans for my fellow southerners). When in the car I told her I wanted to fly to Kathmandu that evening. She seemed very surprised but took me to the travel agent office to purchase my plane ticket. After awkwardly standing in the office while she made arrangements for me and sharing my experience with the staff in Nepali, I finally purchased my plane ticket. We returned to the hotel and I rushed to the shower (keeping in mind that I could not get my surgery area wet). I had a few hours before my flight so I packed, and paid back my host for all the extra expenses my initial money did not cover. I also was able to use the WIFI and catch up with the messages I received from family and friends while in the hospital.

The time to go to the airport arrived. I ended up leaving things behind to make my bag lighter just in case I ended up in a situation where I had to carry it. My host’s driver carried my bag to the car. I got checked in at the airport, said my goodbyes to my host, and waited to board the plane. Once in the air, I was so thankful that my Biratnagar experience was over! I survived!! Now I could start my real recovery!

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