Inspired Momx1

Friday, June 12, 2009

Hemicolectomy & TAHBSO (Part 1)

Professor Dr Chin would only be back on Monday and mom was admitted earlier on Saturday as advised by Dr Tee due to fever and suspected infection in the abdomen. Mom was put under observation and on alternate IV sodium, glucose and metronidazole (Flagyl) drips. She was fasting to prepare for the surgery scheduled for Monday or Tuesday.

There was only a doctor on call during public holidays and Sundays at the Surgical Unit. Mom had been fasting since Saturday, the day she was readmitted. Professor Dr Chin visited my mom with his team of doctors on Monday morning, did a check on mom and confirmed a surgery on that day itself. I was then briefed by Dr Adzli on the procedures and signing of the consent form by mom. He briefed me that the older the patient, the higher the risk of surgery. In mom's case, the risk would be 20% and complications might set in in between the surgery.

I was briefed that a right hemicolectomy surgery would be performed on mom. It is a partial colon-removal procedure in which surgeons excise the right (ascending) part of the colon in mom's case. The procedure is relatively common for treating diverticulitis, inflammatory bowel disease, benign or malignant polyps of the colon, and colon cancer. The hemicolectomy procedure traditionally begins with an incision in the abdomen, opening the area for access to the colon. Thereafter, the surgeon cuts away the infected or injured portions of the colon and reattaches the remaining tissue. After hemicolectomy procedures, the surgeon reconnects the bowel with stitches.

By 2pm, there was no sign of mom's surgery to be performed as yet and Dr Adzli came and told me that it was a very busy day at the Operation Theatres (OT) and as my mom's surgery was a last minute slot in, there were a lot of pre-arranged surgeries.

We waited until 4:30pm before the OT was finally calling for my mom to be wheeled down. As mom could only understand Cantonese, my sister in-law and I got to stay with mom at the OT waiting area. There were 5 emergency cases of c-section and one very "tricky" case where we were being cut queue. The number of OTs opened after 5pm would be reduced from 4 to 2. We waited until 9pm before mom was wheeled into the OT. It was a very long and tiring night for us as the surgery took 9 hours before mom was wheeled out. Dr Pok, one of the surgeons came out and updated us on mom's progress. He told us that the tumour removed from mom's colon was not a "good" one as it was surrounded by mucous/jelly like stuff. The removal of the tumour was quite a difficult and lenghty process due to the size of the tumour, which was even bigger than a woman's fist.

Now that the tumour removal part had completed, the Gynae Surgeon was called in to do another last minute decision surgery called TAHBSO (Total Abdominal Hysterectomy And Bilateral Salpingo-Oophorectomy) and Dr Pok, one of the surgeons in-charge, came out and apologized profusely for not informing us earlier. He explained that there was a cyst that ruptured in the right ovary and this could be the location of the tumour which then spread to the right colon.

TAHBSO is the removal of the uterus including the cervix as well as the tubes and ovaries using an incision in the abdomen. A hysterectomy is the surgical removal of the uterus . Hysterectomy may be total, as removing the body and cervix of the uterus or partial, also called supra-cervical. Salpingo refers specifically to the fallopian tubes which connect the ovaries to the uterus. Oophorectomy is the surgical removal of an ovary or ovaries. Hysterectomy is also referred to as surgical menopause.

Mom remained in the OT Observation area as her BP reading was high and the doctor had to make sure her BP went down before wheeling her back to the ward. As ICU was full, my mom was transferred to the observation ward with closed circuit camera next to the nurses' station.

To be continued...

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