Jen’s Cyst and Appendix issues – Our Medical Experience

TLDR: Jen was sick. Getting diagnosed was harder than it should be.

Update: Thankfully there was no major surgery required. Just some antibiotics.

Summary

Jen was rolling on the floor in pain, had major bloating, some fever and other issues.
We went to the hospital believing it to be appendicitis.
The clock starts ticking. You want to be operated on it within 36hrs to have a decent chance of survival.
Got Blood and urine tests, then Ultrasound. The results were inconclusive. The gas in her stomach stopped them from seeing the appendix.

Talked to surgeon, next step was a CT scan. We couldn’t get scanned until the next morning.
Used the last of our money, even after being loaned some from a friend, on getting a Covid test so they could operate on her.CT scan results finally arrived.
The appendix is prominent, but the main issue looks to be a complex ovarian cyst.
Need another Ultrasound to be sure.
We’d run out of money, but thankfully my clients let me invoice unexpectedly for the work already done and they paid immediately.
The International transfer took less than 24hrs which seems to be a record time.
We saw that the money arrived at 4:15pm but the ultrasound room finished operating at 4pm, so tomorrow we’ll go get that.
My prostate also seems to be acting up. So we might have to go through a bunch of the same stuff again, but for me.

The Full Story

A quick note that at the end of this story I reflect on the Capitalist system we have and how it doesn’t prioritise human health and wellbeing.

So myself, my life partner Jen and our 2yr old boy Xavier are night owls. We don’t normally sleep until 4 or 5am.

We begin this journey at 4am on Tuesday the 18th of January 2022. Our main theme for this year is savings. We used up all our financial savings last year when Jen’s Mum had a stroke and later died from Covid, or at least something similar to the delta variant. Of course to have savings your need to make money so for her part Jen has setup the spare room with her bags and clothes for doing live selling, it’s her first time trying to sell bags via Facebook live. I’m busy in my room and Xavier is watching his cartoons in our room.
Jen starts to feel a bit of pain in her stomach, but is both excited to be selling and a little stressed. She’s prepared for weeks for this, she’s watched nearly 100 hours of other live sellers.
Of course she starts without telling me. It was just meant to be a quick test run, but people start watching.
I notice what’s going on and sneak in and setup the ring light and a bit later a more brighter light.
At 5am she’s still going and I’ve been looking after Xavier for a while and we are all getting tired. I let her know it’s time to wind down. 10mins later I give her a 5 min warning as she’s selling.
She stops, but is on a high. She’s sold a bag had 18 people watching when she stopped and apparently over 200 views in total. Not bad for the middle of the night.
We finally settle in to sleep, Xavier, who’s normally the one wanting to stay up forces us to turn the lights off. It was cute. Just as we are closing our eyes Jen complains about her stomach. I assume it’s the nerves and stress or maybe Xavier kicked her.

I put my eye mask on and ear buds in. I need a good night’s sleep so I can do some good development work. I’m the only back end developer for 3 main projects.

At 7:45am Jen wakes up, clutches her stomach and goes to the toilet.
She comes out a few minutes later and instead of going back to bed and cuddling me she slumps down by the wall around the corner.
I’m still doing my best attempt at being able to get back to sleep fast, so I hazily ask if she’s OK and hear some pained response.

I get up, and see she’s now sprawled on the ground and seems to be crawling away.
I take my eye mask off and pull my ear buds out and she’s already halfway out the door.

I’ve not seen her in such pain since giving birth.

Her stomach is bloated. She’s not in a good state. So I giver her a mefenamic tablet so ease the pain and maybe any swelling.
I order a Grab (the Asian equivalent of Uber) and we get Jen’s nefew Mac Mac to look after Xavier.
We go to the same hospital Xavier was born at and there’s no one else at the Emergency Department.
After a quick message to my Dad who’s a VET, we are worried it’s appendicitis. She’s got nearly all of the symptoms, including the one about how pressing on the stomach and the quickly releasing the pressure hurts. She felt every bump in the car ride there.
They do a urine and blood test.
The Mefenamic seems to have kicked in and the pain has subsided to just when she moves a lot.
We waited an hour, got the results and found out she’s got pus in her urine and there’s higher than expected Leukocyte count (white blood cells).

Blood Test Results
Urinalysis

Just based on the tests they’d expect she’s got a bad UTI. But the specifically localised pain in her lower right abdomen and bloating indicate it’s likely appendicitis.
We get an ultrasound done. It takes a bit of waiting around because they haven’t opened yet and when they do, they need Jen to drink enough water so it feels like she needs to pee. I rush off to the mall nearby to get some water… and the last of the money we have out, so we can cover the cost of the ultrasound.

Eventually they scan Jen and after waiting a bit more we find out that unfortunately, it’s inconclusive. The gas in her stomach has obstructed their view of the appendix and also some other organs like the ovaries.
I mean, we’ve ruled out liver, kidney, gallbladder, pancreas, spleen and bladder issues, so it’s not a complete waste. But it’s not what we need.

From what we’d read and heard there’s a crucial window to appendicitis. 12 to 24 hours is the most likely time range for getting it operated on, then after 36 hours the chances of it bursting increases dramatically and so do the chances of death.

My step-mum had appendicitis and it took them 2.5 days to diagnose it and it had already ruptured and she needed to spend basically a week in hospital after the surgery with an antibiotic IV drip. We don’t want that for Jen. We likely can’t afford it either.

We talked with the ER doctors who referred us to the surgeon who said it was inconclusive. The signs and symptoms of appendicitis are very similar to things like an Ectopic pregnancy or Stomach Flu (gastro).


Symptoms of Appendicitis:

[✔] Pain in your lower right belly or pain near your navel that moves lower. This is usually the first sign.

[✔] Loss of appetite

[✔] Nausea and vomiting soon after belly pain begins

[✔] Swollen belly

[✔] Fever

[✘] Can’t pass gas

Of all the signs and symptoms the only thing that didn’t click was that she could pass gas.
Although given Jen looked like she was 6 months pregnant, the bloating was obviously bad and we’d soon find that she would have issues passing gas for the next few hours, but eventually she’d be fine.

The Surgeon referred us to another hospital to get a CT scan done.
The thing is, we were pretty much out of money.
I did a google search and found that most CT scans cost in the order of ₱5-10k and even that was more than what we could afford right now.
The hospital we went to, whilst being very nice, was also expensive and they quoted ₱21k.
We walked out of there and sat down outside. We were feeling broken. We’d only gotten 1.5hrs sleep, had been alternating between running around and waiting at hospitals for 4 hours now and there just wasn’t any way we could cover the costs of the scan right now, but without it, they wouldn’t operate (unless it got super worse). Jen’s life was on the line.

So I did some more googling and found a different hospital with a CT scanner that was not too far away. I called and they quoted ₱12.7k. OK, well even if we max out every bit of money we can’t pay for that, but let’s go get the scan done first and worry about that later.

We get to the hospital only to find they need to do another set of lab tests, the BUM and Creatinine tests, these ensure her kidney and liver are working fine and she’ll be able to take the contrast enhancing solution.

They get the samples and tell us that it’ll be 2-3 hours to get the results.
It’s about 1:30pm and we are certainly not waiting around to get the results when we’ve got a 2yr old at home and we are desperate for sleep.
I’m mostly worried that when we get the results we’ll need to have the CT scan done, get the results ASAP and get her into surgery so they can remove her appendix before it ruptures. The clock is ticking, but it could all be done within 12 hours from her first symptoms.

We get home and the pain in her stomach is a low level ache, not a constant piercing sharp pain.
Thankfully Xavier is doing fine.
I contact my main client and ask if it’s OK to invoice right now, in the middle of the project. Thankfully Aaron is fine with it and I send my invoice through. We’ll now have enough money to cover any major medical bills. Although it’s going to be a few days before we can get the money.
It wouldn’t have been a problem but only the day before all of this I booked and paid for my flights to Australia and back. I’ve got to leave the Philippines as I’ve been here for nearly 3 years and they’ll kick me out. Because of all the Covid restrictions and Omicron sweeping the globe it doesn’t make sense to do a quick overnight trip to Hong Kong, Vietnam or Malaysia like people in my situation used to do. Instead I might as well go visit my family in Adelaide and spend a few weeks there, that way I can also return with a bunch of stuff I left at my Dad’s place. But I pushed our finances to the limit when I booked the flights. I used up the last remaining money I had access to on my Credit Card. I emptied out my other accounts and only had AUD$120 sitting there. At the time it seemed OK. I knew one of my clients was paying $800 soon and we had enough money and food to last until that came through.
But then suddenly we’ve wiped out what tiny amounts of money we did have and there’s a major bill. We had allocated money that was meant to be for our rent and was already halfway through that and now had nothing.
At least there’s money on the way, but when I get paid it’s in AUD and then have to do an International transfer which usually takes 3+ days to get into Jen’s account so we can actually have it in Philippine Pesos and buy stuff here.

When I first moved to the Philippines I could use my Credit Card. Of course that expired and my bank sent me a new one. My Dad forwarded it on to me and it arrived over 3 months later, despite it not being Covid times. The postal service has gotten even worse, so when that credit card got cancelled because of a stuff up at the bank, I simply got my Dad to scan the card and I activated it online. It’s still at his place and I’ll pick it up next month. But that card is the only way I could directly convert the AUD $ in my bank account into PHP ₱ without needing to do some International transfer and taking days. Ohh how I wish we could use Crypto or that Gcash could accept my Visa credit card.

Whilst waiting for the lab results we get a couple of hours sleep. I wake Jen up a couple of times to check her phone. We should’ve gotten the results by 3pm, maybe 4pm at the latest, but it’s now 5:30pm, so I call them, they find the results. They’ve forgotten to send the results and she gets them emailed a few minutes later. It all looks fine.
We are ready to go there and get the CT scan and then get admitted into the hospital and hope we can pay at the end of it in a few days, when the money arrives.
I call the radiology department and speak with a guy who says that the schedule is from 9am to 12 noon tomorrow. So I take that to mean that even if we go there now, there won’t be anyone to interpret the results until there’s a Dr doing the rounds from 9-12 tomorrow morning. This is pretty standard. Especially at hospitals we are used to. So we book in for a CT scan at 8am the next day.

I’m nervous. I can feel the clock ticking. What happens if Jen’s appendix ruptures? I’ve read that she’ll get pain everywhere and her fever will be sky high. I’m prepared to rush to the ER if that happens and get her operated on straight away because we’ll know what the issue is.
I wonder. Just how crazy is that? You wait until someone is worse and MIGHT DIE, before trying to help them.

I’d asked a friend and old neighbour, Travis, for money and he thankfully sends us ₱15k. Excellent! We might actually be able to pull this off.
I’d just taken our last ₱7k from the ATM, when I try to get ₱10k out it errors about the daily limit being exceeded. We should be able to get ₱20k out per day. I try the ATM again to get out ₱9k and errors again. Ohh well, I’ll have to get the money out tomorrow.
Whilst I’m near the pharmacy I also get a pregnancy test and some milk for Xavier. The PT comes back negative as expected.

I’d been told that Jen couldn’t eat past 4am and at 3:45am she finally had enough of an appetite to have a single biscuit. She’d only eaten some slices of Apple before then.
We wake up, catch yet another Grab and we’ve now gone past the initial 24 hour time window.
I figure everything is laid out. CT Scan -> results -> operating room. She should be able to have her appendix out before noon, seeing as 4pm is the 36hr window mark.

But when we arrive we get told when there that it’s a 6hr fasting window not 4 hours like I’d been told. We’ll have to wait. Damn. Jen only had a single biscuit and basically hadn’t eaten the whole of yesterday.
I have to get the money out anyway, so I head out and find a weird ass ATM that’s right by the entrance to some big walled off industrial area. The ATM nearly eats my Credit Card. After what feels like 10 minutes it finally spits it out with an error. My guess is that the telephone cable to the ATM has been cut or disconnected.
I jog to the mall, which is over 1km away. Except it’s closed. It doesn’t open until 10am. I’m not used to being awake before 12 noon.
There’s no obvious ATMs that I can see from the front of the mall and I’ve run past here a few times before. We’ve even been in once before and don’t remember seeing any. But pretty much all the malls here have a bank of some sort inside.
I see an employee walk in through a side door and I do the same. I know that if I look the part I should be able to get away with it. I’m desperate, Jen needs an operation, we need the CT scan so she can get the operation, we need money to pay for it. Of course, I’ve still got my face shield on and I’m a white guy who’s looking around desperately.
Before I can find a bank inside the mall a security guard spots me, yells out and sends me back. Thankfully he tells me to go around the right side of the mall. It’s the side I’ve not been to before…. and I find out that the ATM there doesn’t allow withdrawals. Arggh.
Ohh wait, there’s actually a bank of ATMs and our bank’s ATM is here. Yay! I now have ₱10k in cash and head back.
We pay and after the radiology people have finished getting ready it starts.
I get to watch as Jen is put onto a table and it’s moved around in the CT scanning machine. There’s a whirring inner circle that reminds me of the Stargate. It’s not quite as massive a portal as that, but it seems pretty epic. It has its own big power supply in the corner and looks somewhat like an MRI machine that got chopped short.
They do an initial scan and I’m amazed at what can be seen.

Then a phlebotomist comes and injects her with a special contrasting agent. Jen seems like a trooper and doesn’t really say anything, but she’s actually in pain. Her veins feel cold and then burning hot.

The operator makes sure Jen is fine and not having some sort of allergic reaction to the chemicals they’ve just pumped into her body. After checking on her a bunch of times over the next 15mins she’s considered fine and they do another scan and WOW, there’s this animation of the different slices through her abdomen down to part of her legs and you can see the bone and muscle and everything. It’s cool to watch.
Then they inject Jen again. Now her veins are tingling as well as alternating hot and cold.
Another scan.

She’s stuck in there with her hands above her head. She can’t move otherwise it’ll cause issues with the scans. She’s also claustrophobic, plus it’s rather cold in the room, so she’s trying not to shiver.
Then another injection. Her veins now feel like they are on fire. She wants to scream in pain, but she thinks about our sons face. his cleft chin and how he loves running around. She keeps it together.

After about 40mins the whole procedure is done.
Excellent, they say they’ll email the results.

Then Jen explains that she was just told they won’t get the results until around 3pm and that’s with her given priority. Normally it takes 24 hours to get the results.

WTF??? We’ve gone through all of this so that they could have a Dr give an interpretation of the results nearly straight away and now we’ve got to wait 4+ hours? What if her appendix bursts in that time? It’ll be right near the 36 hour mark we get the results. What if she dies??

I ask the Hospital whilst we are there how much they expect it to cost.
For an Appendix operation they are suggesting:

  • ₱100k for surgery (AUD$2,800+)
  • 3-5 days recovery
  • The hospital stay day rate is ₱1,800 for their cheapest shared room and, ₱2,800 (AUD$80) a day for their private Deluxe suite and there’s some other options in between.

There’s nothing more can do here. We go home to wait.
Again we are tired and sleep a bit, but we learn from last time. so call up at 3pm asking for the results, but there’s nothing.
I call at 4:18pm, the Dr still isn’t there.

I’m anxious. I call the Surgeon to make sure he’s ready. Suddenly he tells us that a negative Covid19 RT-PCR test is needed so they can do the surgery. Even if he was to do the surgery without one the anesthesiologist would require it.
WHAT? We need a Covid test for an operation? Yep and he says to expect it to cost ₱5k and take 12 hours. Shit shit shit, ARGGGHHHHhhh. We’ve been at 3 different hospitals, we talked to the Surgeon and a whole bunch of other people and they didn’t mention anything about this.
We’ve got under ₱4k and that’s after getting a loan from a friend. But we know a place up the road, Manila HealthTek which does some fast and relatively cheap tests.
We are now in a quandary. The CT scan results haven’t come back yet, but Google Maps says the swab test place closes soon. Jen is obviously in pain and needs some sort of surgery. I’m sure we’ll need the test no matter what as I’m 90% sure she’ll need the surgery. But getting the test means we will be completely broke.
We catch another Grab and this time take Xavier. He loves being able to go in the car and see everything. We pay for the fastest turn around test which is ₱3,400. We are now broke. We’ve got just enough money for some apples and bananas, but certainly can’t buy something like another can of formula milk for Xavier.

I take Xavier for a little walk to see the trucks nearby and Jen is done rather quickly. There wasn’t anyone in the line.
I order a grab. This will be the 8th Grab ride since it started. I’m grateful that I put some credit on it when I got paid last.
Just as the car is arriving Jen gets the CT scan results. We get in the car and she says it’s not her appendix. Ohh?
It seems to be a Complex Corpus Luteum Cyst by her right Ovary. Although the Appendix is also prominent.
That could mean an Ectopic pregnancy or something else.
Umm, I guess that’s good? Maybe she’s not about to have her appendix rupture but well, we aren’t really sure if there’s still an important urgency or not. If it’s life threatening, not a problem or might cause reproduction problems.
Was her writhing in pain yesterday because she the cyst ruptured? Is Jen pregnant?

We contact her OBGYN and the Surgeon. It’s a complex cyst and her appendix is still prominent in size. So the next thing is a TV Ultrasound. She should also get her appendix removed as a precaution.


Except we have no money.
Also, Jen still has a lot of bloating and gas.

I video call my Dad and he suggests that she use a hot water bottle, gentle massage and buscopan, plus some general pain killers. That helps reduce the gas and by the next day it’s nearly gone completely.
At least with the threat of imminent surgery reduced, Jen can have some food and water. You need to have fasted for 6hrs before an operation so you don’t puke, and because of that I’ve been suggesting she doesn’t eat. But now we relax a bit.

The money from my client comes through. Despite him sending it at the start of the day it seems like it didn’t appear until probably some cronjob ran at the end of the working day, I’m guessing someone manually validated it during the day as well. Although I’ve seen some ETF transfers happen in under 1hr, I’m glad to have at least gotten this. Even if it’s going to take a while to get it converted into Pesos and into Jen’s PH bank account.
That night around 1:30am the negative Covid test results come through. We half laugh and half cry. Thankful we aren’t at the hospital and being rushed to surgery.
Jen is feeling better and does some live selling again. This time she sells ₱10k (AUD$285) worth of bags over the course of 2 hours. Not bad. That’s not profit though, just turnover.

She’s still sick, still has pain in her belly and even bleeding and white strips on her arms from all the needle sites where they’ve taken blood or injected her.
But we go to sleep around 4am.
I wake up 15mins later and need to pee.
I can’t sleep. Then not even 10mins later that I need to pee again.
It’s not a normal peeing sensation. It’s like there’s pee in the urethra tube in a way that simply using pelvic floor muscles doesn’t seem to stop. It also doesn’t feel like it’s from my bladder.
I need to pee again.
Ohh no, is it my prostate? Is it just enlarged or is it cancerous? Or maybe a bad UTI?
How will we afford even a urine let alone blood test? I should get my PSA checked as well as check for pus and other signs of infection.
Will I need anti-biotics? I don’t know. But I’ve got a pain in my groin that won’t go away and Jen has an ultrasound scan to be done and it’s still going to be days before the International transfer arrives.

Actually the initial International transfer only took about 24 hours. Although still only arrived just after the Ultrasound was no longer manned for the day. We’ll go tomorrow and I’ll also try getting a checkup as well.

Ideal Scenario

Ideally this whole situation would be very different in a Post-Scarcity Society, even just based on existing technology we would have had a much better time.
The medical industry here in the Philippines works similar to Australia and many other countries in that it’s partly government funded and partly user pays.
There might be differences, like the PhilHealth system (Philippine Health Insurance Corporation) is equivalent to Medicare in Australia, but focuses mostly on covering some of the costs once you’ve been admitted to hospital. But we’ve been trying our best not to have Jen admitted. Partly because she’s been needed to go to different hospitals for the CT scan and other lab work and partly because Jen is still a little traumatised from the C-section she needed for having Xavier.
The system works well for a monetary based system. The combination of private, public and government funding helps keep things cheaper than other countries which don’t do this well *cough* USA *cough*
I saw a great example recently about how Singapore’s healthcare system works and Australia is pretty high on the list. The Philippines setup seems fine as well

I keep thinking about how things would work in an ideal world. In a Post-Scarcity Society (e.g NL/RBE). I am a volunteer with TZM after all.
When we needed a CT Scan, the costs wouldn’t have been an issue. This is someone’s life at stake, not some plastic surgery or something just nice to have. So priority would be given.
I envisage a future where all your data is owned by you, so the various results and information would have been automatically sent into a Verida like datavault that Jen could easily share with the hospital and myself and in a secure manner. The Drs could easily add notes and information.
In the mobile app it could’ve analysed the symptoms, highlighted the likely outcomes and been helped along by the Drs recommendations. It would’ve indicated a high chance of surgery being need and right at the start would’ve suggested also getting a Covid19 swab test done to start that process in case of urgent surgery. It might even have been able to guess that the Ultrasound would’ve had issues and suggested getting the extra labwork tests needed for doing a CT Scan.
That way Jen would’ve been able to get the lab tests done at the first hospital all of it could’ve been quickly processed. We’d have then been able to search for the nearest available CT scanners rather easily and have a list of multiple hospitals to choose from along with their current availability and scheduling. Selecting one would automatically trigger a car to arrive and pick us up and take us there.

The CT scan could be done and the data could be analysed in under an hour, likely using a combination of AI and a team of experts who can analyse the data whilst working remotely from anywhere.

Even if we weren’t in a Post-Scarcity Society, just the pain of bureaucracy has lead to a snowballing escalation of issues. From the requirement of me to leave the country (a requirement in pretty much every country I know of) to the problems with trying to transfer money and how slow it all takes, to the issues with trying to get and share data. Certainly the financial issues and medical data side of things could be pretty easily resolved with DeFi and some of the ongoing Crypto projects that are in development but I’m sure will take a while to fully go mainstream.

My issue isn’t with any specific country, but with the way human health and wellbeing is secondary. Money and profit are the most important things in our society.
I love to program and film and create content and be in the flow. I’ll do that even when not paid, although maybe I’d be working on other projects.
But I’m very grateful to have a job that’s got flexible working hours and a great pay. I feel very sorry for those who don’t. Who work really really hard and money just seems to slip through their fingers.

Update:

Jen’s ultrasound results showed the cyst wasn’t particularly big and not really a problem. The bloating went away and the main issue is that both of us have a bad UTI so are taking antibiotics.
My PSA of 2.0 means I’m fine.
I’m thankful neither of us needed surgery.

By Michael Kubler

Photographer, cinematographer, web master/coder.

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