09 March, 2011

Dengue - Ruthie


Allergy

Before lunch time of February 24, I received a call from the guidance counselor of the school, informing me that Ruthie has fever and that they are going to bring her home. The school was in Rodriguez Rizal that time for a 2-day retreat. I said “ok”, thinking that it was just an ordinary fever. That probably, she just got exhausted from the activities that they have done, that she would just need to rest. I was even willing to bring her back to the camp, if ever she would want to.

Noong dumating ako sa bahay mula sa opisina, nadatnan ko siyang nakahiga, mukhang pagod ang hitsura. Mataas ang lagnat. Puno ng rashes ang mukha at katawan nito. Hindi siya ordinaryong rashes, pantal siya. Inakala namin na nahigad siya or nakagat ng kung anong insekto. Wala rin siyang tigil sa pagkamot.

That night, we brought her to the nearest clinic in our town for check up. Sinaksakan siya ng gamot para sa allergy. The doctor told us that the medicine will relieve her from itch. We were asked to go back after three days, for follow-up check up.

Friday and Saturday had passed. She still had fever, though no longer as high as before. She just laid there in her bed the whole time, feeling weak, not eating much. About two weeks before that time, she had flu. She had stayed in bed for three days, and on the fourth day, she just got up and was already ok, makulit na ulit. And so we were expecting that the same thing would happen, that she would recover soon.

Hanggang umabot ang Sunday. Ganoon pa rin siya – may lagnat, nanghihina, ayaw kumain, masakit ang tiyan. We brought her to the doctor para ipa-laboratory yung dugo niya. Pero sarado ang mga laboratory clinics. And so we just went home, planning to just bring her to the clinic on the following day.

Pero noong gabi, nagsuka na siya. Nagpasya kami ng asawa ko na dalhin na siya sa ospital, sa Amang Rodriguez Memorial Medical Center. Iniwan namin si Gracie at si Bunso sa mga magulang ko.

(photo sourced from the internet)
Emergency Room

Pagdating doon sa Emergency Room ng ospital, tiningnan naman siya agad ng duktor. Binigyan kami ng request para ipa-test ang blood and urine niya. Nakuhanan siya ng dugo ng mga alas-diyes ng gabi. Pero yung urine sample niya, matagal bago namin nai-submit. Hindi kasi siya maka-ihi. Siguro, around 12 midnight na namin na submit yung sample. Yung unang result ng CBC, nakuha namin ng around 1 am. Mataas naman yung platelet count niya, normal naman daw. But her white-blood cells (WBC count), medyo mababa. At nung lumabas yung result ng urinalysis, infected daw yung ihi niya. Sinaksakan na rin siya ng suwero, dehydrated na kasi siya.

Ipinaulit yung CBC. Kinuhanan ulit siya ng blood sample. The result – her platelet count is still normal but is decreasing, and her white and red blood cells are below normal. Sabi ng duktor, “Dengue na po, stage 2. Kailangan na po siyang i-admit sa hospital.” Umaga na iyon, mga 7 am.

Noong time na iyon, sarado ang ward ng hospital. Hindi sila nag-aadmit, Hospital Holiday daw sa Pediatric Ward. Mayroon daw bacteria sa loob ng mga kuwarto. Tatlo na raw ang mortalities nila and yung ibang pasyente, mabagal daw yung recovery. We have no choice but to place her sa private room. But if we would insist that she be placed on the Charity Ward, we would be asked to sign a waiver, that the hospital and the doctors will not be held liable for any untoward incidents - like if our child would worsen, or if she contacts the bacteria while inside the room. Nakakatakot!


Philhealth Ward

When I told the doctor that I am a member of Philhealth, she mentioned about the Philhealth Ward. She explained that the room is covered by PHIC but the professional fees of the doctor is not, which is around P1,500 to P2,000 per day. I computed that if my daughter would stay there for at least 1 week, we would have to pay P10,000 to 12,000 for the doctors alone. Whew!

We decided na ipa-admit na siya doon, dahil tiyak na mas mahal sa ibang private hospital. We waited while the doctor to be assigned for Ruthie was being arranged and the room was being readied. Grabe! Tatlong oras din kaming naghintay. Kawawa naman ang anak ko. Doon lang siya nakahiga sa kamang walang sapin, na hinigaan na tiyak ng kung sino-sinong pasyenteng pumasok sa E.R.. Wala siyang kumot o unan. She can’t even stretch her legs because she was sharing the bed with another patient. Poor Ruthie!

Mga 10 am na siya nadala sa loob ng Philhealth Ward. Mga walong beds rin ang naroon, but it was fully airconditioned. May divider na kurtina ang bawat pasyente. Malinis. May sariling C.R. yung kuwarto. May lounge area pa sa labas ng room. Naks! I thought, “At least, my daughter would be comfortable here and my wife could rest a bit habang nagbababantay.”

When everything had been settled, I left for home. Maysakit din kasi si Bunso, may lagnat din. Kagabi pa namin siya iniwan sa bahay, kasama ang Ate niya at ang mga magulang ko.

After a few hours, my wife called, informing me that Ruthie would need to be transferred to the ICU.


ICU

Intensive Care Unit? ICU? Bumababa raw kasi ang blood pressure ni Ruthie. They have to constantly monitor her. My wife was very much concerned. Yung Private ICU, P10,000 daw per day. Joke yun?! Hindi raw. Sabi ko sa asawa ko, hindi namin kakayanin. Mabuti at available naman yung Pedia ICU (PICU). Doon dinala ang anak namin.

About 10 babies were inside the ICU. Ilan sa mga babies, may mga tubo sa bibig, to help them breath. Yung iba, nasa incubator, mga premature marahil dahil maliliit. Yung iba, nasa tapat ng ilawan, may takip yung mga mata, tahimik na umiiyak. Sari-saring aparato ang nasa paligid. Yung anak ko, ang natatanging bata sa loob, nandoon sa isang sulok.

Noong makita ko si Ruthie, she was very much asleep. But her face looks so pale, mukhang hinang hina. Apat na suwero ang nakasabit sa gilid ng kama niya, nakakabit sa kanyang dalawang braso. Kinabitan rin siya ng oxygen sa may ilong, nahihirapan daw kasi itong huminga.

A catheter was also attached to her, so she won’t have to rise up and get dizzy when she needs to urinate. When the tube was inserted inside her, as my wife told me, Ruthie did not cry. But she grimaced in pain, holding her mother’s hand. Ouch!


Stage 3

The following day, when I had a chance to talk to the doctor, I asked about the condition of my daughter. “Bakit kailangan po siyang i-ICU, dahil lang po ba sa kanyang blood pressure?” And the doctor answered: “Tatay, stage 3 na po ang dengue ng anak ninyo. Yung pagbaba ng blood pressure ay epekto lamang po ng dengue, na isang virus. Inaatake na ng virus ang katawan ng anak ninyo. The body is in shock, affecting her internal organs.”

Shock? Ano ba iyon? Nayayanig na ang katawan ng anak ko? (Tiningnan ko kailan lang sa internet ang technical definition nito. It says, “Shock is a serious condition in which blood pressure is very low and not enough blood flows to the body's organs and tissues. Untreated, shock may result in death.”)

Upon hearing this from the doctor, I realized that her case is really serious. Outwardly, she may look ok and that she seems to be recovering, but inside, the virus is attacking her inner parts. I dawned on me that dengue is not just about high fever and low platelet counts. I began to worry.

Ruthie went through a number of laboratory tests. CBC tests were done twice a day. They get blood samples from her arm, from her toes, from her fingers – kung saan makaka-extract sila ng dugo. A chest x-ray was also done on her, to check her lungs. Na-check na may tubig na sa kanyang baga. She was having a hard time breathing so she also underwent some tests for her heart, ECG and another one (I can no longer recall what it was called). They checked that her heart is a bit swollen. All of these are complications of the dengue virus.


Prayer

I went to the rest room. Basa ang sahig doon, mabaho at marumi ang paligid. But still, in the corner of that place, I found solace in the presence of my God.

I prayed, “Lord, you are the One who created my Ruthie. You know every part of her being. You can heal her body.” I was crying. Pinipigil ko ang hikbi ko dahil ayaw kong marinig ako ng ibang tao na pumapasok doon sa C.R.. But the tears just kept running. “Hindi ko alam ang gagawin ko, Panginoon. Maawa ka sa kalagayan ng anak ko.”

That time, wala ang asawa ko. Umuwi siya sa bahay ng nanay niya para umidlip sandali. Tapos, wala rin akong natatanggap na text messages mula sa mga kaibigan at kamag-anak namin (yun pala, napuno na yung inbox ko). Wala akong malabasan ng saloobin at pangamba ko.

But the Lord was with me that time. I felt his presence and his comfort, even there inside the dirty comfort room. And I knew that a lot of people were praying for her healing. I no longer worried.


Medicines

Sabi ng duktor, wala raw gamot sa dengue. Only her body can heal itself. Kailangan lang magpalakas ng anak ko, with enough food and liquid intake. The doctors said that they just need to deal with the effects of the dengue on her system and stabilize her condition.

Sunod-sunod ang reseta ng mga gamot. Kung ano-ano. The doctors were to trying to explain to me what the medicines were for but I could not comprehend them. Basta, we need to buy them. ASAP.

May ipinabiling tig-P800 plus ang isa. Noong una, available pa sa pharmacy ng ospital. Nakabili kami doon ng lima pero naubos din kalaunan. Sa apat pang botika na pinuntahan ko, wala rin. Sa Mercury Drug, hindi rin daw available sa branch na iyon. Itinuro ako sa isang branch, sa Q Plaza sa Cainta. Kinailangan kong maglakad ng kaunti, pumila sa sakayan ng jeep, umakyat at bumaba ng footbridge, at maglakad uli ng malayo. Ganoon din pabalik. Whew! Pawis na pawis ako.

Tapos, naubos na din yung stock ng nasabing branch ng Mercury (I was able to buy 4 bags). Ang pinakamalapit na mabibilhan raw ay sa may Philcoa. Ang layo! Mabuti na lang at may nakapagsabi na available daw iyon sa isang private hospital malapit doon. Mayroon nga pero P1,200 plus na ang halaga. Bumili pa rin ako. Nakabili kami doon ng mga limang bag, kasama na yung pagbili ng asawa ko doon ng 2 bag noong mga 12:30 ng umaga nang Miyerkules.

Mayroon ding ipinabili na tig-P3,200 plus ang isa. Tatlo. Human Albumin, ayon sa pangalang nakalagay sa botelya. Akala ko nga nagkamali lang ako ng rinig, pero iyon talaga ang halaga. Kaya ko pa ba? “Lord, help us…”

May iba’t iba pang ipinabibili. Labas pasok kami ng ospital para bumili nung nasa reseta. Nakakapagod! At unti-unti, lumilipad ang hawak naming pera.


Help

Isa-isang dumating ang mga bisita – kamag-anak at kaibigan. Karamihan, may mga dalang prutas, pagkain at Gatorade drinks for Ruthie. Kasama na rin doon yung mga nagbibigay ng comfort at pag-alalay, pinalalakas ang loob naming mag-asawa. May iba na nagte-text, nangungumusta, nagbibigay ng encouragement.

Yung iba naman, dahil nalaman nilang naipasok sa ICU ang anak ko, nag-aabot ng pera. May malalaking halaga, may maliliit. Alam ko na ang iba sa kanila ay gipit din pero nakuha pa rin nilang magbigay, sa abot ng kanilang makakaya. May nagbigay nga ng P100, pero very much appreciated iyon kasi alam din naman namin ang kalagayan nila. My wife and I were really touched by their generosity.

I was telling my wife that the Lord is really faithful to us. We didn’t have to beg from people for money, or to some politicians, just so we can buy the needed medicines for Ruthie. Hindi namin naranasang magmakaawa sa mga tao. Help just came. “Thank you, Lord.”

Unlike those that we’ve met in the hospital who constantly cries because they do not have the needed resources. Naririnig namin silang nagmamakaawa sa mga kausap nila sa telepono para lang makautang. Para patuloy na mabuhay ang anak nila. Yung iba naman, umiiyak na lang dahil walang-wala talaga silang makukunan. Ang hirap pakinggan at pagmasdan. Nakakadurog ng puso.

Umabot ng P30,000 plus ang ginastos namin para sa gamot. Oo, nakapangutang ako sa ibang tao at sa kumpanyang aking pinapasukan. Pero hindi namin mairaraos ang malaking gastusin na iyon kung wala ang mga taong tumulong. The Lord bless them!


Death

Before my daughter was admitted to the ICU, an eight year-old girl was confined there in the same room. She also had Dengue Hemorrhagic Fever (DHF) III. She succumbed to death on the 2nd day, a day before Ruthie was placed there. We even saw the child’s mother when she went to the doctors one time to have them sign some papers. She was still grieving.

On Ruthie’s 3rd day in the ICU, another child was brought inside. She was Kyla, a six year-old girl from Concepcion Marikina. She was loud, complaining about all the tubes attached to her. She was begging for water but she was not allowed to have it, as per order of the doctors. Again, on the 2nd day, she passed out. Silent cries from her loved ones filled the room.

I witnessed how Kyla struggled to live and how slowly her life ebbed away. She was lying next to Ruthie’s bed. I saw how her father bid her goodbye. When she finally died, I again cried. I felt sorry for her parents, and for her lolas and titas who were all there.

But I was also crying because of gratitude to God, for sparing my daughter from death. What happened to the two girls could have happened to Ruthie. Looking at her face, I was overwhelmed with grief at the thought of losing her and with joy at the fact that she is still with us, alive. I was just in awe for God’s merciful hand in healing our precious daughter (her blood pressure was already stable that time).

With all the commotion and emotion inside the ICU, Ruthie was just there sleeping like a baby. Her face now radiates with peacefulness. Praise you, my Lord.

(We just learned that another girl with DHF III, aged 12, also died from the ICU. Ipinasok siya doon a day before we were discharged from the hospital. Sigh.)


Food

When she woke up, I asked her to eat. Sabi ko sa kanya, “Kailangan nating labanan si dengue na nasa katawan mo. Kailangang kumain ka para lumakas ka, para matalo natin si virus. Kunwari, superhero si ‘food’ na tatalo sa mga kalaban niyang dengue”. Pinilit ko rin siyang painumin ng tubig, paunti-unti. Dalawang lagok, tatlong lagok.

Kahit na wala namang ibinabawal na pagkain sa kanya, maliban sa mga dark colored like spaghetti and chocolate, medyo controlled yung liquid intake niya. Mino-monitor yung liquid na pumapasok sa kanya, kasi nga may tubig siya sa baga. Mini-measure din yung output niya through her urine. Mas marami, mas maganda. Mayroon pa ngang inireseta para makaihi siya. Noon ko lang nalaman na may ganoon pala.

Noong medyo malakas na siya, she asked for a sundae. Tinanong namin yung doctor kung puwede iyon. Ang sabi, “Ok lang po. Kung iyon ang makakapagbalik ng gana niya sa pagkain, ok lang. Ang importante, makakain siya.” And so I bought a sundae for her from McDonalds. Sosyalin.
  


Sosyalin

Bukambibig ni Ruthie ang salitang “sosyalin”. Kapag may nakita siyang kakaiba, maganda, o pang-mayaman, sinasabi niya, “Sosyalin.” Katulad noong minsang pumunta siya sa bahay ng kaklase niya. May swimming pool daw. Sosyalin.

When Ruthie was transferred to the ICU, she complained that she would like to go back to her previous room, sa Philhealth Ward, yung airconditioned. Mainit daw kasi sa loob ng ICU. Sosyalin.

Init na init talaga siya sa loob ng kuwarto (dala marahil ng kanyang karamdaman). Nagpapapaypay. Gusto pa tuloy-tuloy. Nagrereklamo kapag tumigil ka sa pagpaypay. Sosyalin.

Bukod sa catether, nilagyan din siya ng diaper, kung sakaling dudumi siya. Ang sabi nga ng panganay ko, si Ruthie raw ay tatlong beses magda-diaper in her lifetime – pagsilang, ngayong maysakit ito, at sa pagtanda. Ang brand ng diaper niya, Dr. P. Sosyalin.

Noong nagkasakit ang Ate niya, ang nabili naming tissue ay yung nakarolyo, bathroom tissue. Sa kanya, facial tissue. Scented pa. At, mayroon din siyang baby wipes! Sosyalin.

Hindi pa siya naoospital mula noong maliit siya. Ngayon lang. Pero huwag ka, hindi basta-basta ang ginastos namin sa gamot niya. Libo-libo. Sosyalin.


Ward

The vital signs of our daughter have stabilized after a few days, including her blood pressure. After 5 days in the ICU, we were transferred to the Ward. That means she was already out of danger. It was a relief.

Maayos na siyang nakakakain. Kahit ano – fried chicken, burger steak, noodles, etc. At nag-request pa uli ng sundae. Humihirit pa nga ng coke float pero hindi na namin pinagbigyan. Yema na lang.

May isang dumalaw sa kanya, tiyahin ng asawa ko, may dalang goto at pandesal. Yung malalaking pandesal. Naka-apat si Ruthie. Grabe! Ganito rin siya sa bahay, mahilig sa tinapay. Nangingiti kami ng asawa ko. Magaling na talaga ang anak namin!

Nag-request na rin ng babasahin. Dinala ko yung librong nahiram ng Ate niya sa kaklase nito. Sinubukan na ring magsagot ng crossword puzzle sa Philippine Star na nabili ko (pero isa lang ang kanyang nasagutan).

Isa-isa na ring tinanggal yung mga suwero niya. Isa na lang yung itinira, yung sa kaliwa. Kaso, nakaramdam na siya ng sakit sa bahaging iyon. Tinanong namin sa mga nurse, ok lang daw iyon. Hanggang sa namaga na yung braso niya. Ayun, inalis na ng tuluyan.

Dahil sa pamamaga ng kamay niya, nilagnat na naman siya. Tumamlay na naman. Sabi namin sa kanya, “Ayusin mo ang sarili mo. Baka akalain ng mga duktor may sakit ka na naman. Baka hindi pa tayo pauwiin. O baka ibalik ka sa ICU!”

Minsan, habang pinapakain namin siya, wala na namang gana. Eh natanaw naming paparating yung doctor. Sabi ko, “Ruthie! Act like you’re already ok. Smile! Dadaan yung duktor!” Ngumiti naman siya. Jeje.

Saturday, another CBC and ECG was done on her. Ok naman na lahat yung results.


Home

That Sunday morning, on my way to the hospital, I was praising the Lord. I had a feeling that she will be discharged that day and my heart was really rejoicing. I again thanked the Lord for healing Ruthie from Dengue, for allowing us to still have her in our lives. I thanked Him for His provisions, for the people that He sent to help us and to pray with us. I thanked Him that Grace and Pete has also been healed. I thanked Him that all five of us could be together again, after a week, back in our humble abode.

Hindi ko namalayan, tumutulo na naman pala ang laway ko, este, ang luha ko. Dyahi! Tapos, narinig ko na lang na tinutugtog pala sa radio ang kantang “Eenie Meenie” ni Justin Bieber. Ano ba yan?! Hindi man lang nakibagay yung kanta sa pag-i-emo ko. Naudlot tuloy.

At iyon nga, pagdating ko sa hospital, pinaayos na sa akin yung billing. Inayos ko rin yung mga resibo para may ma-refund kami kahit kaunti sa Philhealth (wish ko lang…). Nagpasalamat kami sa mga nurses at doctors, sa lahat ng kanilang kabutihan. Nagpaalam din kami sa mga nakasalamuha namin doon, sa mga magulang at kapatid ng mga pasyenteng naiwan pang naka-confine.

Around 2:30, nakalabas na kami ng ospital. May humabol pang mga bisita mula sa church, may hatid pang tulong. “Lord, sobra-sobra na ito! Salamat.”

We were about to leave when my daughter said, “Tatay, gusto ko ng Coke Float”. I smiled.

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