{edited version 28/10/07}

Complaints:

I haven’t been feeling well for five weeks. It started the day after MvdM. his birthday and back then I thought it was a stomach bug so I didn’t think much of it and thought it would go after some time. The fourth week I felt better and most symptoms were gone or back to normal again. Everything was okay for a week or so but after that I started to feel weak. All the symptoms I had earlier were back again: no appetite at all [I lost over 2 kilos], I was nauseous, had headaches, cramps and felt extremely drained all day. I could only work and focus for a few hours and after that I would have no energy left at all. Then last week, two more symptoms showed up that really started to worry me and I realised something had to be wrong. The final straw was last Tuesday when I found out by coincidence that my eyes had turned yellow…

Tuesday 23rd:

I went to see the GP in the evening and because I had no appointment [it takes a week to see the doctor] I had to fill out an emergency form explaining the reason[s] why I needed to see him. I wrote at the top that I had these complaints for five weeks already so this GP decided that I was no emergency case and sent me home, telling me I’d had to try again the next morning.

Wednesday 24th:

I went to the doctor’s early in the morning, knowing I had to wait for several hours before he would be able to squeeze me in [or not and then I would have to try again the next morning… there was no guarantee he could see me that same day]. So I waited for three hours and spent my time reading a book. I can’t remember the last time I read a book so in a way it was good that I was forced to do so. Then when I finally got to see him, he was kind of upset with me because he could see straight away something was wrong; he told me I had left it too long. [This is a different doctor than the one yesterday who told me to go home…] He cancelled the last two appointments [also emergencies] to arrange a bed for me at casualties at the hospital and told me to go there asap. I went home and packed a bag with clothes, toiletries and a book to read because I realised I probably would have to stay there.

At EMC/casualties, they took about five blood samples and placed an IV [intravenous] soft catheter on my left arm. Then they wheeled me to a different department to have an ultrasound done. It took hours to get the results back and when they finally came in I was told I had to stay at EMC for observations for the next 24 hours. I had a really bad night and couldn’t sleep at all. At 22.30 they decided to take me to a different room opposite the one I was in, it would be more quiet there… Still I didn’t get much sleep because of the fact that I was in an emergency ward where people were brought in and out during the night, lights would be on and off, monitors were beeping every ten minutes, my blood pressure was checked every two hours and so on. I managed to doze off at four in the morning and when I finally got to the REM phase the lights were on again because it was six and time to wake up…

Thursday 25th:

I felt drained all day because of a lack of sleep. Every two hours my blood pressure was checked, every four hours my blood sugar level was checked and again I had to give blood four times during the day which became a nightmare in the end since this is a university hospital and I was kind of a guinea pig. Groups of students would walk in accompanied by their professor, they would ask me questions for half an hour and examine me which was fine but I really didn’t like them practicing their injection skills on me just to get my blood samples. My arm is bruised and sore and at some point when they came to collect blood sample tube number 16 to 20 I really had enough of it all and had a good cry, I just wanted to go home…

Yet I had to stay another night because the results were still tricky. In between examinations and tubes I tried to get some sleep but there was just too much going on all the time. AS. came over to visit and MvdM. called me in the evening which was a really nice surprise and two hours later he came to visit me too. He left me a special letter from a very special person that put a smile back on my face instantly after having such a really bad day. It was so good to see someone and talk for a bit even though I was extremely tired. This day was such a bad day for me, I just had enough of it all and wanted some peace, go home but I knew that was impossible…

During the second night I had earplugs in and I slept much better than the previous night although at four in the morning some drunk decided to wander around the ward and disturb the peace. They had to call security twice and the police came over but nothing was done really. It took hours before he finally fell asleep. I was wide awake before six in the morning and felt a lot better than the day before even though I again didn’t get much sleep.

Friday 26th:

More tests were done, more blood samples were taken and another weirdo decided to disturb the peace for hours… He was paranoia and slightly aggressive trying to get out [this ward was secured and you needed a special code to open the doors]. Three men had to hold him down and they sedated him in the end.

In the morning I had to see a dermatologist and was wheeled through the corridors of the huge Victorian building which was nice because it was a bit of a sightseeing tour after spending two days in the same room with the same boring view. The dermatologist reminded me of Thatcher [her hairdo did] but with an extremely good sense of humour; we had a good laugh when she made a funny remark about cannabis. Once people find out that I’m from the Lowlands somehow the conversation always seems to get herbal… I don’t mind I think it’s kinda funny. An hour later a porter came to collect me and wheel me back to EMC.

I saw five doctors today but nobody could really tell me what was going on since the results are still not in. I was told that if my last blood test would have improved I could go home for the weekend but had to be back on Monday for more blood tests. So basically I have been waiting all day for the results to come in and I was thrilled to know that I could go home… I asked the nurse in the afternoon about the progress and she told me that I had to stay over the weekend because the doctor didn’t leave a note on my medical chart. I was very disappointed to hear that I might had to stay after all. I noticed one of the doctor’s team members and asked her about the situation, she called the doctor and told me they were still waiting for the results, she would push the lab for the results in the meantime and the doctor would come to see me before 17.00.

So she did… she explained the situation and said that my blood tests were still not good although there was a tiny improvement and they weren’t sure whether I had reached the highest peak already or if it would get worse than that still… so basically she would take a risk by letting me go home. But I was taking up an emergency bed and they wouldn’t be able to test over the weekend anyway because the lab would be closed so she decided to let me go if I would promise to be back at the hospital when things would become worse over the weekend or if there would be any change… I’m not supposed to do stuff and rest as much as possible so hopefully the tests will be improved by Monday.

An example: they did a liver function test and one enzyme that they check for is called ALT which is an enzyme present in liver cells. When a cell is damaged, it leaks this enzyme into the blood, where it is measured. ALT rises dramatically in acute liver damage, such as viral hepatitis or paracetamol (acetaminophen) overdose. Elevations are often measured in multiples of the upper limit of normal (ULN). A normal dose would be between 40-45, mine was measured 2750 when I came in on Wednesday and it was still on 2500 two days later…

Another thing she was worried about was INR which wasn’t normal either and to her the main reason for keeping me at the hospital. The liver is responsible for the production of coagulation factors. The international normalized ratio (INR) measures the speed of a particular pathway of coagulation, comparing it to normal. If the INR is increased, it means it is taking longer than usual for blood to clot. The INR will only be increased if the liver is so damaged that synthesis of vitamin K-dependent coagulation factors has been impaired. It is very important to normalize the INR before operating on people with liver problems (usually by transfusion with blood plasma containing the deficient factors) as they could bleed excessively out.

Anyway, I’m home for now and it took me over ten hours to write this post on and off. I do need to get some sleep as soon as possible because I feel drained again. Forgive any typos, I am too tired to proof read and have more important things to worry about at the moment *hehe*. Oh but the good news is that I got my NI number in, finally!