Pinoy Kasi

Post-op

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In Wednesday’s column I wrote about preparing for a surgery of a family member or friend, drawing from my own experience with my daughter, who had her second open heart operation last week.

A Filipino reader who apparently lives abroad wrote in to express sympathy and point out that where he is, they don’t have to worry as much as we do because their government pays for health care. It was an important reminder that, indeed, in many other countries there is universal health coverage, which reduces the anxieties that accompany serious illnesses, hospitalization and surgery.

But we do live in the Philippines and have to find ways to deal with the challenges, which go beyond finances.

We’re usually well-prepared for the pre-op period, but the post-op period will sometimes be more important than the surgery itself. In many cases the worst should be over after the surgery, but sometimes the surgery leads to a discovery of new problems, or confirms a suspicion about something more serious.

Even without new problems coming out of the surgery, the patient’s needs after an operation will still be overwhelming.  If you’re not covered by a health maintenance organization or a hospital package deal, be prepared for your first bill with operating room charges, and a request from the hospital to add more money to your deposit.

Regarding the patient, you will have to be firm with friends and kin that they should not visit if they truly care for the patient, because the last thing you need is an infection right after surgery.

Then there’s dealing with the patient’s post-op discomfort, distress, and pain. Even very cooperative patients like my daughter will become quite irritable, and you can’t blame them as they grow weary of the many tests and procedures. My daughter didn’t cry when she had to have intravenous lines inserted the day before surgery, but she wailed and protested when the IV lines were being removed.

Someone will have to stay 24 hours with the child when she’s in intensive care, which means you need at least two family members or close friends on “duty”—one to be at the patient’s side and the other to attend to various errands and requests from the patient.

Kindles and iPads

When my daughter first moved into the intensive care unit (ICU), she gasped out a request for something. Water? I asked. She shook her head. Minnie Mouse? She shook her head again. With all the strength she could gather, she tried one more time: “Kin…dle.”

I did have her Kindle (a tablet similar to the iPad) on hand, but I didn’t know she would ask for it so soon. Not only that: Right after getting her beloved Kindle—which has loads of children’s books inside—she whispered, “WiFi.”  Ha! I whipped out my mobile WiFi and soon she was searching for “Hi 5” and other YouTube videos.

My daughter’s six, so the members of the ICU staff were amused and amazed at how she could type out what she needed on the search box, especially with both her hands still with IV lines attached.

After the child was moved back into a regular room, she asked for my iPad. I reminded her that the iPad didn’t have games, but she said she wanted it anyway, and as soon as she got it she went straight into an album with her siblings’ photographs. She was to do this over and over again during her stay, even creating her own slide show with Zendee’s “Lucky” as musical background.

She had found a way to fight homesickness.

Another unexpected treat, taught to me by a friend, was using “Tango,” an app available on iPhones and android phones and which allows you to make Internet calls, including video ones. Tango was comforting not just for my daughter but for me as well, because if I was “off duty,” I could check with whoever was with her to see if she was asleep, or to say hi if she was awake.

Yes, another app, Skype, should work out as well.  Hospitals may consider using these high-tech gadgets to limit visitors to the closest of relatives and friends; what counts most will still be human presence, being able to hug, or hold hands.

And that does create problems if you have other children who need you. Planning for a child’s surgery or hospital confinement should include planning for the other kids, including being able to be with them as well from time to time.

With my daughter’s two surgeries, I’ve learned that we underestimate children’s ability to be resilient, to understand what’s going on, and to be strong about it. I’m referring here not just to young patients but to their siblings as well. One night last week I had to rush home from the hospital, having promised my son I’d take him swimming. When I told him to get his swim gear, he said he had changed his mind. “You look tired,” he said. “We don’t need to go.”

Infectious optimism

“Hope for the best, prepare for the worst” is common advice given to people about to go through a difficult, unpredictable situation.

Looking back, I think I may have overdone the “hope for the best” part, even having it spill over into a cheery column analyzing elections, which I wrote on the pre-op morning. Rereading the piece later, I thought, “Did I write all that?” I’ll admit I was overly optimistic, but I have since gotten more realistic, especially after reading Conrado de Quiros’ “Dark Side” review of some winning candidates (Opinion, 5/22/13).

I grew up in a family of almost pathological pessimists and I know that this dark element comes from a different context, with the pessimism preparing them for the worst. But I’ve learned it’s better to swing in the other direction with optimism, constantly aware that in the most difficult of times, there is still much to be grateful for.

I think of the hospital—Medical City—and its very helpful staff, 24/7, including the Ateneo medical school graduates and students. In relation to my daughter’s surgery, I’m glad that it wasn’t an emergency procedure and that I had time to prepare. There was a great surgical team and we didn’t need to use an artificial valve, which would have meant even more expenses, and more surgeries ahead.

Sure, the bills were tremendous, almost equivalent to a year’s salary at the University of the Philippines, but the stock market did well this year. (When someone at the bank told me the stock market dipped last week, I told her, optimistically again, “It’s just correcting.”)

How, too, can one not be optimistic when you see the kids jumping all over each other when my daughter returned home and how they all tried to help make her feel more comfortable?  You would have thought they had been separated for several years, and not just five days.

I’m saving the hospital bills to show my daughter when she’s older, and to get her to promise that someday, if she has enough resources, she’d help others who need similar surgery. If she can’t afford to support surgery, she could help with pre-op and post-op social support measures, down to stuffed animals and maybe even an iPad or tablet on loan.

We fixed your heart, I will tell her, and it is a heart that must keep giving. There are no overdoses when it comes to goodwill, cheer and infectious optimism.

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  • buninay

    nice read.

    • parengtony

      ya, I agree. Thanks, Prof. Michael.

  • josh_alexei

    That is a good idea to show your kid the bills when times come…We had a fellow here who in gratitude for the help the Medicare extended to his Grandpa and Dad, Donated enough of his Money to build us a world Class Heart and Lung Centre Research and Treatment, and our Sick Kids Hospital is ahead of its Target $ 1 billion fund raising event. Hospitals are among are favourite Charities.

    I am not too familiar with Visit protocols in our case, but we it is always up to the Hospital staff to rule on that matter. Post ops care is Taken care by our Family Physician in Co-ordination with the specialists and they will arrange the Follow ups Visits or Treatments…In all cases, the Family or Primary Care Physician is always involved or is given all the files of the Treatments and necessary post treatments of operative Care. And every time a patient visit a specialist, the same will report the visit to the primary care by either fax or mail for the the Records. *by 2015 supposedly we will have the eHealth in operation.

    Mr. Tan what I am really concern is the Child of an Ordinary working Family who has a health issue like your daughter? What if this befall on the other fellow’s daughter? will the parents be able to save their daughter life without mortgaging theirs into the life of debts? Or they just have to resign to Fate that it is all God’s will?

  • satoriseeker

    your attitude is commendable, michael….
    keep swinging in that direction….

  • Parigi

    Bon courage Sir Michael and your young daughter to get well soon.

  • WeAry_Bat

    Very good article.

  • josh_alexei

    Mr Tan, one more Good News, we were able to have the top notch Cancer Research Scientist from Harvard to Lead the Research at Princess Margaret Cancer Institute..His reason is that we have no problem raising Private funds for such purpose..one of the Hospital Patients for Breast Cancer donated $50 millions towards the Research as she said the Hospital is doing just fine for Giving her the Best of Care and that should be Universally be available to all women of the country from the Research..That is how generous our very rich other than supporting our System with their Fair Taxes.

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