Conclusion to Azim's Story?

Remember my brother Azim? Well, it has been around 2 weeks now since he was released from hospital after the accident. In the two weeks, Azim has been followed-up twice by his surgeon and the surgeon is happy with Azim's progress. Azim has also had several sessions of physiotherapy to mobilise his hand.

This is what his hand looks like two weeks after the operation. The graft has mostly healed well, with a few areas of breaks (which Insya Allah, will heal by itself after several days-weeks). To me, the wound seems to be nicely progressing. However, Azim says that his hand is very stiff - he is unable to move his fingers more than around 3 degrees - and that the hand is slightly swollen. He will need extensive physiotherapy to mobilise his digits in order to regain normal functions.


Now that all is well, Azim has been booked his flight back to Malaysia for this weekend. Everything was nicely planned, I was supposed to fly to Ireland tonight to help him with his bags and we were supposed to fly to Heathrow tomorrow.

However, bad luck seems to be following Azim like a shadow - this time in the form of fog.

(Picture: http://www.guardian.co.uk)
For the past 3 days, England has been blinded by fog. Driving back from my oncalls last week at night, the visibility was limited to only 10-20 metres. To make matters worse, the weather was cold and the roads slippery with ice.

In response to the fog, Heathrow has grounded most, if not all, domestic (mainly British Airways) flights. Most other flights are either delayed or cancelled. Meaning that our flight to Heathrow had a high chance of being grounded too, diminishing the chances of Azim flying back to Malaysia! The weather was reportedly going to remain terrible until after Christmas - affecting tens of thousands of people intending to fly from Heathrow.

Thank goodness however, we responded quickly. We had Azim book another flight to Birmingham (where the flights are not grounded, as visibility there is probably better) at the earliest possible opportunity. Alhamdulillah, we managed to book a flight for Azim for this morning and now Azim has arrived safely with us.

It is still far from over though; Azim is supposed to fly from Heathrow tomorrow - and I hope there wouldn't be utter chaos. We have already booked the bus tickets to arrive at least 8 hours before the flight, to include delays. It normally would be a horrible day to travel tomorrow, as it is the Christmas Weekend, but I'm hoping that would not be the case.

Wish us luck.

PS

1. For larger fog images, do visit my Fotopages :)
2. Oncalls has forced me to neglect my blog - I'm terribly sorry. Many updates planned for this Christmas holiday though :D
   

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.

PS


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.

Azim in Hospital Day 3

Today is Azim's 3rd day in Ulster Hospital, Northern Ireland. His day started with a consultant lead ward round. In the ward round, we learnt nothing new. The consultant re-confirmed that they were aiming to bring Azim back to theatre as early as tomorrow for reconstructive surgery including skin transplant. They were aiming to discharge Azim probably on Monday, and after discharge, Azim would require extensive plastics rehabilitation to bring his arms' functions as close as possible to normal.

Azim's left hand in bandage. His left hand is his only functional one at the moment. With it he is able to text message, and attend to some (but not all) personal hygiene. It is still difficult for him to for example, put clothes on by himself or flip pages of a magazine or feed himself.

Azim's right arm, in plaster of paris and elevated. He is able to move his right fingers to a limited extent but so far the arm is of limited function.



Azim is mostly pain free but occasionally complains of cramps and throbbing on his arms. He complains of eye pain too, but on inspection there are no obvious alien particles and the eyes do not appear red. He says today is the first day he could finally feel discomfort and cramps in his shoulders, back and arms. The sites where they inject intravenous antibiotics hurt too, but that is natural.


More than physical pain is, in my opinion, Azim's mental worry - bordering on distress. It is very obvious he misses his wife and three small children back in Malaysia and I always either try to avoid the subject of his family or tread the subject with extreme care. Apart from missing his family, he has many other problems to worry about too...

We try to reassure him to worry only about his present state, and to push everything else to the back of his mind, and worry about them when the time comes.

Seeing him, for someone who is severely burdened by problems, he always seems calm and collected. His expressions would only occasionally break to reveal the sea of worry underneath but mostly, would not even show a slight crease or grimace.


Another non-physical problem, and also a common one among patients is boredom. Who could blame him? 24 hours a day he lies in bed doing next to nothing, unable to watch TV (his glasses were lost in the smashed up car) and unable to read his magazines (difficult to flip the pages). I tried to entertain him with some DVDs I carried and they did seem to help, if only a little.


One thing that touched my heart to see was how much support Azim has received from his friends. Every day, droves and droves of Azim's friends come to visit and he receives torrents of calls from many others, from all around the world (apparently). People has brought him gifts, cards, books, magazines, clothes and plenty of food especially from Jas. Jas has brought food specially prepared from home (some cooked even by himself) daily, and even takes the trouble to feed Azim himself.

All of Azim's friends uttered prayers on Azim's behalf for him to get better quickly, and get over these troubling times.

Today, my jaw almost dropped to the floor when a social worker approached Azim to ask about whether Azim needs more help after being discharged from hospital. Basically, the social worker has offered for special carers to visit Azim at regular intervals daily and assist him with hygiene and any special needs. That is the amazing thing about this country; they think of everything. Care is excellent in hospital and they even provide care after discharge.

It is as if the government is saying; "don't worry, we know you have family and lots of friends but WE will look after you. You are OUR responsibility."

Amazing.

PS
As usual more pictures on my Picasa Web Album.

A misfortune

I wasn't joking when I mentioned in one of my posts way back about how my brother Azim's life has not really been easy sailing. To list all his cumulative trials and tribulations to this day would probably be more than I could stomach but enough for me to say that his life leading to his graduation has not been easy at all.

We thought that after he graduates things would get better, but unfortunately so far, things has become worse; his visa application to work in the UK has been declined and he has been forced to move back to Malaysia all in the past 3 weeks. In fact, his family are all back in Malaysia and he's here just to conclude the move.

I was shocked again to receive a phonecall from him this morning; a call I thought was for my birthday. Instead, Azim revealed that he had been in an accident on the motorway near Belfast.

Apparently, he lost control of the car as the car skidded over a patch of ice and he hit the road divider. He hit another car too, but according to him the other car appears virtually unscathed. Azim's car though was badly damaged and reality struck me when Azim said, "I thought I was going to die" ...

When he said that, my thoughts immediately went to his wife and 3 children back in Malaysia, awaiting his return - his flight back was booked only 4 days from now, on Thursday. A flight which now has to be postponed indefinitely.

We are all grateful Azim is still alive - though both his arms are injured. According to him, there'll be a debridement operation tonight and he has been put "nil by mouth" (fasting before an operation) since noon. On the phone he sounded extremely drained, or maybe it was the morphine to make him cope with the pain.

Insya Allah I will be making my way there early hours of this morning. Please pray for him.