Wednesday, November 29, 2006

Azim's 4th Day in Hospital

Friendly message from the author: WARNING: Disturbing, gory images to follow - please look away or close the page if you think you may be offended. (alternatively, if you're using Firefox and you want to see the pictures in full screen detail, press F11 and click the link to my Picasa Web Album).

Today has been the last day of my stay in Belfast. I am now back in Coventry due to work - tomorrow I'll be starting a week of nights.

This is the exterior appearance of Ulster Hospital, it looks small. Ulster Hospital is located around 15-20 minutes from Belfast City Centre by bus (buses 4B, 19 and 20 in case you want to get there too) and the bus fare is a mere £2.50, return.

Despite the small size, Ulster Hospital is the centre for plastics surgery in the whole of Northern Ireland. Some of the best (hand, plasctics and maxillo-facial) surgeons operate here. The nurses and doctors all seem friendly and helpful.

Azim was noticeably brighter today. He said that he has had a good sleep, good food and despite morphine and codeine he has finally managed to open his bowels for the first time after 3 days. He felt fresh after the nurse-assisted morning bath and the bandages on both his arms look ed fresh. However, his left arm appeared slightly swollen.

Here is how Azim spends most of his day; writing and answering text messages and phone calls (despite his bandaged hands). If you were wondering how he managed to type those messages I hope the above picture presents a clue.

Noon time, Azim was visited by the Consultant Surgeon and a nurse, who opened his bandages. The Consultant took a quick look at Azim's hands and asked Azim to flex his fingers, which he could to a limited extent, better with his left.

One look at Azim's right hand, and the Consultant instructed the nurse, "Prep him for theatre, nothing to eat and drink starting now. Aim for surgery at 6-10pm. Home tomorrow."

He then explained that they were going to attempt a skin transplant, and that after discharge Azim would be followed up in his clinic after 3-4 weeks, with regular plastics rehabilitation. Azim asked, "I'm a dentist and I really need my fingers to function fully ...". Before Azim could finish the sentence, the surgeon replied, "I'm a hand surgeon, and the skin graft is exactly what I would have in the same situation" ... and soon left.

A quick phonecall to inform everyone the change of events. Preparations were made if Azim was to be discharged tomorrow.

An SHO arrived to explain the procedure, the nurse rebandaged Azim's wounds.

Signing for consent before the procedure.

So from 12 noon, Azim was nil-by-mouth until 630pm, when a group of nurses approached Azim to bring him to theatre. It was then when I left Azim's side & Azim's friends kindly offered to drive me to the airport.

As soon as I arrived to Birmingham, I received a phonecall from Azim saying that the procedure was completed. Unfortunately, they discovered pus and infection inside the wound and instead of doing the skin graft, Azim had further debridement and cleaning of the wound of foreign objects ("grit", as written in the notes) and a drain has been inserted into his arm to drain the pus over the next few days.

Azim has been moved from a normal ward to a posh sideroom, complete with it's own TV, washroom and privacy and comfort. Probably because Azim is a fellow health professional (?). I remember when Puan Mama Sarah and Amar (PMS&A) was giving birth to Amar and she was whisked off to a posh side-room too, without us asking for one. At that time I was still just a humble junior SHO.

It is still up in the air on what's happening to Azim, but I suspect they would want to drain the pus fully and continue with strong intra-venous antibiotics before proceeding to doing the skin flap. Only after then would Azim be discharged.

A good news is that we are planning for Azim's wife and son to come to Belfast in the next 2 days. We feel that with Salamiah around, they would be someone to care for Azim after hospitalisation and also someone to always keep him company. Goodness knows how long he'll still have to remain here.


Above is a picture of Azim's wound right after the accident and before any operations. Azim mentioned how, during the accident and after his car has stopped spinning he got out of the car through a smashed up window (a window that was probably smashed by his own flailing fist, causing his injury) and on remembering his valuables especially his passport, Azim opened his boot and carried his bags to safety with his injured arms.

As usual, larger (and more) pictures on my picasa web album.


Anonymous said...

Aaaa... you should put a warning of 'disturbing images' content first... seriaunya tengok luka!

naja said...

The picture of the hand right after the accident caught me off guard too. Alhamdulillah his wife is coming over to be at your brother's side. I know that your brother is a dentist but it didn't click to me the crucial need of fully recovered hands and his job, until you mentioned it. Hopefully they manage to drain the pus completely and continue with the skin graft soon.

OK said...

Dear Min, thanks for the updates. Though the injuries do look bad, the good news is that everyday there is an improvement.

Physically the body is an amazing thing machine and will heal, with help much faster or course. At the same time the emotional and spiritual healing must also take place. I am happy to hear the the family will be there. At least your brother can really start his healing process. InsyaAllah

As always, our prayers to your brother and the entire family.


mynn said...

thanks for the heads up. betul jugak the pictures are disturbing and may traumatise some people. I've put up the warning now.

i guess im quite desensitised to such images due to my profession, if i recall, I was eating a sandwich while they were changing the bandages, unperturbed.

sorry about the images. yeah, i think having salamiah by his side would solve some problems and yes as a dentist he needs control over fine motor movements of his hand and fingers to use the various tools etc.

alhamdulillah, azim did seem better. Last night azim called and sounded tired all over again after his surgery. hopefully today he'll still have visitors to keep him company and hopefully his wife will be able to join him soon too.

azim sms'ed this morning saying that the surgeons are still planning yet another operation - this time for the skin graft. when? i don't know.

Anonymous said...

wahh wahh tgk terus sakit perut..

ahnali said...

very gruesome indeed!
thank god ive seen more scary pictures when i was studying forensic medicine XD
hopefully whatever they are doing will work out and your brother will recover fast! insya-allah..

moby said...

Hi Mynn, good to know that Azim's well taken care of by so many of his friends and family. Hopefully the procedure will be successful without complications and with the subsequent rehab, he'll regain full use of his hand, insya'allah.

Reading your description of the accident, I'm reminded of how F1 drivers always keep their arms and hands tightly across their chests whenever they get into a shunt.

Do keep those updates coming, ya?

arep said...

errkkk...teruknya tangannnn, get well soon!!

Shafiq Ayman said...

I pray he will get better.My poor brother Azim....

azwan (UCL 2000-03) said...

Send my regards to Azim, moga cepat sembuh dan pulih. I got the news from Ust Has and know this blog from Affzan.

Aizul (Imperial 00-02) said...

My Du'a is for Azim's speedy recovery. May Allah grant him patience. Azim is a great guy with great determination. God Bless!

Anonymous said...

With the very poor reputation of the Ulster Hospital he'll need a lot of prayer. My wife who has multiple sclerosis was in the hospital a couple of months ago. She still has nightmares of unprofessionalism of some of the staff there and was appalled at the poor hygeine.Still ill, she was told she'd be safer at home than to risk staying in the hospital.
I'm posting this comment anonymously as the last time I went to see my GP he told me to see my solicitor and take the Ulster Hospital to court due to their admitted negligence. This negligence affects me daily and is now inoperable.

pycnogenol said...

Dear Azim,
Sending you this message through Mynn,
Is just one little way,
To let you know
you're thought about,
Much more than words can tell,
With wishes that it won't be long
'Til you're completely well again!!

ikelah said...

apasal banyak sangat skin loss? nampak macam superficial wounds with skin loss and muscle damage as the main problem. nampak macam tak involves bones and tendons.

semoga cepat sembuh. kalau tak jelas hikmah, kadangkala ujian atau kifarah dosa yang lalu. wallahu 'alam. berat mata memandang, berat lagi bahu memikul. he must be very patience with such wound.

mynn said...

thanks for all the comments, i'll definitely convey to azim.

i've been on nights oncall lately, and haven't had time to update the blog or answer comments, alhamdulillah, tonight seems much easier (the word "quiet" is taboo during such nights as many consider it'd be tempting fate)

the latest news on azim is that, today he was put nil by mouth and was due for his third operation at 5pm, this time finally for his skin graft, hopefully if the wound is clean. last i spoke to azim was 5pm today, he was still waiting for the operation to be done.

i called at 9pm but no answer - probably he's in the operation theatre or tired after his operation.

he's hoping for discharge next week, insya allah.

to be honest, i thought the wound would be worse. like ikelah said the damage seems limited to only the surface. according to azim, the wound was initially much deeper exposing tendons and such, however after his 1st operation the wound was sutured close.

thank you for the kind wishes. unfortunately, i am away from ireland at the moment, but i do try to call azim many times in a day. thank goodness for his good friends who has been visiting him every single day to keep him company.

much indebted to his kind friends in ireland!

will convey the wish to azim. tak sangka2 pulak jadi accident ni. azim sama batch dengan fendi.
they are good friends.

shafiq, azwan, aizul
i've conveyed your msgs to azim, i've also requested azim's friends in ireland to update him with the comments on the blogs:)

goodness me, your story scared the heck out of us. i hope that the care is different from ward to ward. so far from what i could see the care in the surgical ward is very222 good - no complaints at all (so far).

oo, i see your pantun fever has still not left you. are you trying to trigger another set of pantun wars? (it was fun though eh ikelah?)

i agree it looks superficial. apparently the injury didn't sever
any blood vessels or nerves. i'm not sure about tendons though. some say the tendons were broken, some say they werent. but no bones were fractured. azim said the injury happen as he was covering his face while the car was spinning and his arms broke the glass of the cars windows. he said the arm looked burnt at first.

betul, mesti berat lagi bahu dia memikul. right now i'm hard thinking how i could help further from such a distance.

dyanna said...

What is the reason of nil by mouth prep before any operation? tapi nak operate kat tangan je kan? bukan kat perut...

hiyoshi said...

I haven't seen my cadavers for quite some time now. So I guess that's why I was caught slightly off guard at the image.

*scrambles off to the dissection hall*