Just a place for me to write whenever i feel like writing. Mainly about things and issues around me....and of course...my passions.


Saturday, 26 March 2011

Appendicitis punyer cerita...........



Orang tua-tua selalu pesan jgn makan pedas2 nanti kena apendik, jangan makan biji jambu, kunyah makanan betul-betul....apa2 lagilah. Masa hamba kena appendik dulu, malamnyer makan sambal terung. Masa tu ramai yang menyalahkan biji terung dan biji cili tu. Walau sound mengarut coz ada orang eat cili for 80+ years of their life tp ok jer, ketakutan orang ramai tu ada logiknyer sebab keradangan appendik ni (appendicitis) disebabkan oleh luminal occlusion. Dalam bahasa senangnyer pintu appendix tu tersumbat. Oleh apa??? Ha...disini ler datangnyer cerita-cerita yg biji cili lar, biji jambu lar, biji terung lar, kacang lar whatever yang dipikirkan boleh menyumbat. In most cases it is due to lymphoid hyperplasia (yg ni xreti nak translate lar), boleh juga tersumbat oleh fecaliths (najis), bendasing atau parasite (cacing).


Appendicitis ni boleh jadi kat sapa2 jer termasuklar bdk2 tp bdk2 bawah 4 thn agak jarang compare to older children...so my Widad antara yg jarang tu lar....


Kisah Widad bermula on 15 March 2011 around 11 pm bila dia mengadu sakit perut just before he went to sleep. Jam 3.30 pg terdengar suara dia merengek sakit sambil tertonggeng....badan panas macam batu tungku. Rengekannya kemudian ditambah dengan muntah-muntah.....puas pujuk akhirnya dia tido. Since then dia asyik tido-bangun-tido-bangun.....badan pun makin panas. Masalah dak Widad ni dia susah makan ubat. Paksa camanapun he will vomit it out...sooner or later...


As a doctor, I try to make my own diagnosis lar kan...tp bila bercampur dengan perasaan as a mother tu, dia punyer risau bertambah-tambah...always think of the worse scenario. Setelah menelepon beberapa org kawan untuk 2nd, 3rd and 4th opinion maka hamba pun membawa Widad ke spital. Alhamdulillah hubby dah beli medical insuran utk semua anak2 dia, boleh ler bwk pg prebet. Kepada sesiapa yang belum ada medical insuran, dinasihatkan cepat2 lar beli....


1st examination n ultrasound did not come with conclusive diagnosis. Widad cuma diberi ubat demam on the first day, 2nd day baru bagi antibiotik...itupun for pharyngitis. Doktor tak berapa confident sangat yg it is acute appendicitis pasal Widad can walk and sit, makan and minumpun ok. X-ray nampak najis jer, siap bg ubat untuk buang air besar lg. Lepas kena ubat tu, cirit-birit terus...
On the 18th (Friday) the surgeon review semula and order another ultrasound when his fever keep spiking up 40.2C!!!  This time the radiologist said it is highly likely appendicitis so surgeon give me option with suggestion that he would prefer conservative management (bagi antibiotik...then wait and see). Hamba ikut kata pakar ler.....

Setelah bagi antibiotik Widad nampak ok. Hari Sabtu dia dah bermain macam biasa. Makan pun macam biasa cuma cirit-biritnya tak berhenti-henti. Malamnya dah mula balik sakit, pagi Ahad sudah lembik semula. Masa surgeon datang round dia sangat tak puas hati dengan keadaan Widad and decide to proceed with operation. Kena potong juga anakku...

Ada rakan-rakan yang tanya kenapa in the first place tak operation terus, cepat sikit baik. As a mother, kalau boleh xnak tengok anak kena bedah, bila surgeon tu bagi cadangan xpayah bedah rasa lega and pray that Widad will recover...

Xtau lar sebenarnya apa yang ada dalam pikiran surgeon tu masa dia suggest conservative treatment...hamba rasa dia work on evident base, melalui pengalaman yang dah lama di hospital gomen. The problem with appendicitis in children is there is no classic presentation. Not easy to make the diagnosis....silap gaya boleh kena saman kalau bukak tapi tengok2 normal jer....well, kalau tak bukak then pecah pun boleh kena saman gak. Dalam satu study di US, appendicitis was the second most common diagnosis involved in pediatric emergency medicine malpractice claims. Diagnostic error was identified in accounting for 39% of the claims. Fuh....nasib baik orang Malaysia ni masih belum pandai sangat saman menyaman ni....

Well.........everything went well for Widad. The appendix was grossly inflammed. Actually dah formed mass with some bowel adhesion. Alhamdulillah he had a surprisingly speedy recovery. Lepas 3 hari dah boleh turun naik katil then pegi main gelongsor. Syukur ke hadrat Ilahi dan terima kasih tak terhingga atas doa dari keluarga dan rakan-rakan.....

Hamba doakan semoga anak-anak sesiapa sahaja yang terbaca coretan ni dijauhi dari penyakit ni....AMIN....




p.s: Untuk bacaan lanjut sila cek ...


http://emedicine.medscape.com/article/799858-overview
http://kidshealth.org/parent/infections/stomach/appendicitis.html




* picture taken from http://www.webmd.com/digestive-disorders/picture-of-the-appendix

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