Down with a Liver Sickness

A lot has happened in the past weeks that led to my absence in writing, and unfortunately it has nothing to do with traveling. I’ve been sick and was even confined in the hospital for 9 days. Plans were cancelled, budgets had to be realigned, and I had to leave work far ahead of schedule.

It all started on the evening of August 10, when after a day of binge-eating, I felt a pain in my stomach, like being sucker-punched except the pain wasn’t going away. I wasn’t worried, then, because it happened a lot of times before, mainly due to my gallstone. Before, the pain would resolve itself before dawn, and aside from sluggishness due to a sleepless night, I was fine.

But this time, the pain wasn’t going away the next noon, and I was getting concerned, so I went to a clinic in a neighboring mall. The doctor diagnosed me with hyperacidity and prescribed me with omeprazole to counter the gastric acid. But a few hours after taking a capsule, the pain wasn’t subsiding and was even getting worse. I then had to call my sister to take me to the ER.

I was brought to the nearby Fatima Medical Center, where I was given some painkillers and diagnosed with dyspepsia, although I was recommended for admission for further testing because the ultrasound test revealed that my gallstone had already grown to 7cm (it was 1cm when it was first diagnosed in 2009, and it grew to 4cm when I had my annual physical exam last year). I had been repeatedly asked by doctors who diagnosed me in the past to have cholecystectomy (surgical removal of gallbladder) to prevent further gallstone attacks, although somehow my parents would convince me to first try gallstone flushing.

It’s the same this time. Instead of having myself admitted, my parents decided to take me first to a doctor they know, Dr. Tan, who specializes in gallstone flushing, a process in which patients are to do a certain kind of fasting before drinking certain liquids that are supposed to flush the gallstones out of the gallbladder and eventually the body. So for one week, I was on a restricted diet, drinking a glass of apple juice every meal. The pain wouldn’t go away at first, and I had to spend most of the days lying down because of it. But by the end of the week, I thought I was already recovering. Aside from general fatigue and a feeling of heaviness in my stomach, I was fine and able to get out of the house for the first time in days.

That’s when things started to get worse. The next evening, Saturday, while lying down watching a Kathryn Bernardo movie with my cousins, the right side of my abdomen suddenly started feeling an intense pain, much worse than anything I have ever felt before. I had to take some painkillers again (300 mg of Tramadol and a capsule of Buscopan Plus every eight hours), which relieved the pain somewhat but not totally. It did make me groggy, though, and I fell asleep through the pain.

But the pain did not resolve the following morning, and by that time, the pain felt like stomach cramps, severely restricting my movements. I also started feeling hot even if the air con was on and an electric fan was blowing directly at me at full power. The pain did subside a bit by the evening, and I thought all was going well.

The next morning, I was scheduled to go to Dr. Tan’s clinic for a follow-up ultrasound test. As we were about to leave the house, the pain acted up again, and it was worse this time. The pain was unbearable, and I was barely able to walk, with Kuya Diony, our driver, having to help me. On the way to the clinic, I started vomiting. I was asked to lay down in a separate room, although by this time I was barely aware of what was going on, like being somewhere between the state of consciousness and unconsciousness. All I know was that I was feeling intense pain, and no knowledge of when – if – it will go away.

The pain did subside a few hours later, and Dr. Tan’s nephew, who was the one diagnosing me, suggested I start the flushing right away, two days ahead of schedule. So that night, I drank a glass of juice mixed with laxative, another glass of juice mixed with dilator, and another glass of juice mixed with olive oil. These fluids were supposed to be taken every three nights until the stones were flushed out of my system. By dawn Tuesday, everything seemed to be fine as I was pooping everything out, although there were no stones in my stool.

Tuesday and Wednesday passed without much incident, except that I was still feeling pain in my right abdomen. It wasn’t as intense as that Monday, but it was still bad enough that I had to take painkillers and lie down all day.

Then Thursday. The pain grew worse at dawn, and I vomited. I was able to sleep through the help of painkillers, though. But the next morning, I was really feeling lethargic and without any appetite. I was served a bowl of champorado, and all I managed to eat were two spoonfuls. By afternoon, I was really feeling nauseous. And then, the vomiting started again. This time, they were regular, and they were very dark green in color. I felt like I had to take a dump, but even after a few minutes in the toilet bowl, no crap was coming out.

By evening, I was already feeling disoriented, I continued on vomiting (even the fluids I was supposed to drink for the flushing), and, according to my sister, my face was already sunken and my belly terribly big. That was then I was rushed to the hospital.

I was admitted Friday dawn at Delos Santos Medical Center in Quezon City after a few hours in the Emergency Room, where a nasogastric tube was inserted through my nose and into my stomach to drain the contents of my digestive system. The bottle attached to the tube minutes later were filled with very dark green liquid, like a pureed spinach. My WBC count also shot up to 36,000 (the normal range is 5,000-10,000), indicating severe infection. Hours later, I underwent a CT scan on request by the doctor who looked at me in the ER.

Then hours later, another doctor, Dr. De Larrazabal, a gastroenterologist, told us of the CT scan result: my liver had a lump, enlarging its size, which became too large to the point that it was squeezing my stomach and blocking the passage. It was also squeezing my left lung, which resulted in difficulty breathing. The lump had three possibilities: cancer, pus (liver abscess), or another kind of infection.

Cancer was ruled out because my liver was fine when I underwent ultrasound test in Fatima two weeks earlier. The doctor said no cancer tumor grows in a span of two weeks. So either the lump was filled with pus, or it was another unidentified infection. He also said that it probably resulted from the gallstone, which might have blocked a biliary duct resulting in inflammation of the gallbladder, eventually spreading the infection to the liver.

The next day, I underwent another ultrasound test, where Dr. De Larrazabal performed a biopsy of my liver, the result of which we would have to wait for a week. Nonetheless, I would spend the next seven days in the hospital, being administered with antibiotics. The NG tube would come out a couple of days later, and I was allowed to drink and eat soft foods later on.

A week later, the doctors looking at me (there are five in total) allowed me to be discharged. The biopsy was inconclusive, but I was responding well to the antibiotics. My digestive system was starting to function well again and my WBC count normalized at 9,000. However, the antibiotics would have to continue for at least three more weeks, after which I would have to return for a follow-up checkup. I would also have to return after two weeks for another CT scan to see whether the lump had shrunk, if not totally had gone away. Cholecystectomy isn’t possible at this point since my liver is still infected.

Which brings me to today. It’s been almost two weeks since I’ve been out of the hospital. Still, I can’t say I’ve recovered. A hep-lock is still attached to my right hand because I’m still taking ceftriaxone intravenously along with metronidazole, which I’m taking orally.

As for my abdomen, it’s not painful anymore, although I still regularly feel heaviness and tightness especially at the part where the injection was inserted during biopsy. This happens usually when I’ve been standing or walking for an extended time. Some nights, I also feel a bit feverish and sluggish.

Other than that, I do feel much better than the two weeks before I was hospitalized. But I guess I’m still far from the point where I want to be. I had to cancel one trip and postpone another one. I do hope that by late October, I’m fully fine and be able to start again where I left off.

P.S. I want to thank everyone who prayed and wished me well, as well as DSMC ER’s prompt response and the doctors and nurses who looked after me and showed me nothing but kindness. Also to my dad who was in the hospital most of the days I was there, and my sister who’s doing the IV therapy most of the time.

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