Prayers work

For my family, 2008 was a roller-coaster year.

On the down side, Medy continually got into medical trouble. On the up side, every time she did, the Catholic, Christian, Islamic, and Jewish prayers of friends worked to bail her out. Perhaps most touching was the prayer of a usually skeptical friend who said, “I am praying (not something I do very often), so I hope my prayers are given extra force!” The prayers confirmed my belief that God does not give us sufferings we cannot handle nor problems we cannot solve.

After prayers helped them solve the problem of Medy’s acute renal failure, the doctors had to contend with one crisis after another, such as cardiac asthma, congestive heart failure, pancreatitis, anastomotic stenosis, diverticulosis, and a fistula (hole) in her small intestine, not to mention infection of all kinds, among them the life-threatening pseudomonas aeruginosa (which doctors dread because it is so difficult to fight). She was bombarded with several antibiotics, some of which were so new even non-specialists in Infectious Diseases had never heard of them.

Even after she was moved out of the ICU and into a private room, she had tubes going into and out of her body, at one point ten in and four out.

On July 3, after 47 days of confinement, even if bile was still flowing from her body through a tube, Medy was discharged, because a continued stay would have increased chances of hospital-acquired pneumonia.

She continued her medication at our home in Alabang. We were told to look out for signs that would mean immediate trips to an emergency room: high fever, chills, low blood pressure, vomiting, or worst of all, jaundice.

We asked Alabang Medical Center to send a nurse every day for two weeks to administer injections, to dress Medy’s wounds, and to measure the bile leak. We went frequently to the emergency rooms of Alabang Medical Center and Asian Hospital and Medical Center whenever she developed a high fever, needed more injections or another bile culture, or had to replace her ostomy pouching system (colostomy bag). We went regularly to Makati Medical Center for consultations and tests. This went on for more than three months.

The key problem was the bile leak. The second operation was supposed to have solved the problem of the bile duct accidentally cut during the first operation. The bile leaking from Medy’s body was assumed to have been spilled from the cut duct. That leftover bile should have already been totally drained. If the bile were seeping out of the small intestine through what radiology showed was a fistula, even that hole should have healed by itself. But the bile kept flowing, and she kept getting infections.

We started consulting doctors from other hospitals, not just in the Philippines, but in Singapore and the United States. The doctors were leading figures in their fields, many of them published scholars, a couple of them doctors of Philippine presidents. One liver transplant surgeon from Harvard Medical School even asked for copies of Medy’s MRI tapes.

A renowned hepatologist (hepatos in Greek means liver) from St. Luke’s Medical Center gave us a clear explanation of what was happening. This was a race, she said. The bile leak should stop by itself eventually, but that could take months. Meanwhile, the longer the tube remained inside her body, the greater the chance of infection, because the cause of infection was the tube itself. The worst possible case would be that infection could no longer be controlled because we would run out of effective antibiotics (since bacteria develop immunity to drugs); Medy would then go into sepsis, which could mean death in a few days.

The solution, therefore, was to have a third operation to fix whatever was blocking the bile flow to the small intestine. We asked several other specialists; they unanimously agreed that Medy needed a third operation.

Since Medy was shedding not just bile but weight (she had, by then, lost almost 30 pounds), we scheduled a third operation for Oct. 21 at Makati Medical Center. We contracted a leading liver transplant surgeon to do the operation.

On Sept. 28, the bile leak suddenly stopped. On Oct. 15 the tube was removed. Medy continued to have fever and even got readmitted for four days into Makati Medical Center for an IV-administered antibiotic, but the doctors theorized that the leftover bile had finally all been drained, the fistula had closed, the anastomosis was working, and it was only a matter of time before antibiotics would kill all the bad bacteria in her body.

Because it looked like Medy no longer needed another operation, we scheduled a Thanksgiving Mass and a reception in Makati on Dec. 1. On Nov. 25, however, friends noticed that Medy’s eyes were turning yellow. She had also started itching all over (medically called pruritis).

On Dec. 2, it became obvious that Medy had jaundice, which meant that bile had been blocked from flowing into her small intestine. Bilirubin, normally excreted in bile, was leaking instead into her eyes and skin. The race was entering its last lap. (To be continued)