Hanging On

In his last post titled "The End Is Near", Chang has said that he no longer has the energy to continue updating his blog and that his August 18 post would be one of his last. The response from his readers and friends have been overwhelming, many requesting to be updated on his condition.

During my last visit to him, he said that there are no more stories to tell his readers. Instead of just waiting for more stories, I believe all of us just care.  We wish to know how he is doing and we wish to provide our continuing support, prayers and love to him during this very, very difficult time. As his friend, I shall endeavour to provide some updates about his health and well being.
He checked into UH on Wednesday, 25 August to get an abdominal tap done.

What is an abdominal tap?

An abdominal tap or paracentesis is a medical procedure in which a small tube is inserted through the abdominal wall to remove fluid from within the abdomen. Inside the abdomen is a membrane called the peritoneum. The peritoneum covers the organs inside the abdomen and produces a fluid which lubricates these organs and helps them to glide smoothly over one another. Sometimes too much of this fluid can be produced causing discomfort. This is known as ascites. 

 

 There are several possible reasons for this build up of fluid:
• If cancer cells have spread to the lining of the abdomen they can cause irritation, leading to the build up of fluid.
• If the liver is affected by cancer it can cause a blockage in the blood circulating through it, leading to a build up of fluid in the abdomen. Alternatively liver damage can change the body’s fluid balance, causing fluids to build up in the body’s tissues, including the abdomen.
• Cancer can also affect the lymphatic system. This is made up of the tissues and organs that produce and store lymph, as well as the network of vessels carrying lymph fluid throughout the body.

What are the symptoms of fluid build up?
The symptoms of this build up of fluid include:
• Swelling of the abdomen, with associated pain or discomfort.
• Difficulty in moving or sitting comfortably.
• Breathlessness.
• Tiredness.
• Nausea and vomiting.
• Indigestion.
• Reduced appetite.
• Altered bowel habit

Abdominal tap is usually done under local anaesthesia. It is an outpatient procedure, which means you can go home after it is done. An ultrasound is sometimes done to locate the area where the fluid has collected and a mark is made on the skin where the paracentesis tube is to be inserted. A small tube is then inserted into the abdomen and is sometimes secured by stitches. The fluid (ascites) will drain through this tube into a drainage bag. You will be able to move around whilst the fluid is being drained into the drainage bag (Sometimes doctors also put an internal tube under the skin to permanently drain the fluid and prevent this from constantly happening). 

However, for Chang, what was supposed to have been a 25 minute procedure turned into a 25 hour ordeal. He was told that there was a shortage in manpower at the hospital that day and and ended up putting up a night at the hospital. The next morning he was wheeled to the operating theatre. There was initially no bed there and Chang was wondering if they were intending to perform the procedure with him in the wheelchair. After that was sorted out, they administered the anaesthetic but horror of all horrors, before the anaesthetic had time to take effect, they jabbed the needle into him. He screamed in pain. It was, all in all, a nightmarish experience for him! He came back home on Thursday evening.

He spends most of his time resting in bed. He is weak and has lost quite alot of weight. However, he has an army of well wishers and commented that he received more visitors during the recent Hari Raya than the Chinese New Year.

(Updated by Chang's friend)