This has probably been the most stressful day of my life. After hurting for eight hours my stomach did not start to feel better, rather it got worse. At nine hours I started to get sick hourly. After it got light out I told Stacy that I wanted to go back to the main island. Luckily the family that lives on Black Coral had their boat there and were willing to give us a ride in at 9:00. I spent a few more miserable hours curled up in a ball on the porch of our hut. At nine Stacy and I climbed into the boat where I curled up again. The short ride back to Pohnpei was terrible - it was flat out, but every slight bump was agonizing. Back on shore I tried to curl up in the Nos while Stacy ran to get the trunk, but as soon as I laid down I was up and running for someplace to be very painfully sick. Stacy came back with the truck and told me that she had called a private clinic and made an appointment. The ride back into Kolonia was even worse - way worse - than the boat ride. About half way I really started to get scared when I realized that something was really wrong with me. At the clinic we didn't have to wait long to see the doctor. He was reassuring, but after poking and prodding what he had to say was not. It was a textbook case of fairly advanced appendicitis. He wanted me to go to the hospital right away. I asked if I could wait for tomorrow's flight to Guam and he said it wouldn't be a good idea. He went to call the specific surgeon that he wanted me to see. When he came back he said that the surgeon was doing something but was going to stop and meet me at the hospital. I asked about maybe getting on the evening flight to Hawaii - he said no I shouldn't wait that long he was worried about my appendix rupturing which could kill me. As we were leaving he gave me a letter to give the ER doctor and a request for some blood work to be done so no time would be wasted when the surgeon got there. He also reiterated that it was extremely important to go directly to the ER. We paid the bill ($22.50) from our dwindling cash (I'd left my wallet at PATS - and my passport and tickets) and left.
At the hospital I sat down at the ER desk and put my head down while waiting for someone to see me. After 20 minutes (Seemed way longer) a nurse came over and asked us to come back in two hours. I tried to explain that Dr. Isaac had sent us here to see Dr. Hedson and it was an emergency, she only seemed to understand that neither of them was there. Finally Stacy got her to agree to send us for the blood tests while she would show the ER doctor the letter. Getting the blood test meant walking to the other side of the hospital, paying at the cashier, and then walking across the hall to wait at the testing center. I was happy to sit and have no idea how long it took. After they took the blood we were walking back towards ER when the nurse found us and told us to go to admissions - I was being admitted immediately - I wish I knew what the letter said. Getting admitted meant going back to the cashier to pay a five dollar filing fee, then waiting at the admissions window down the hall. There was no place to sit at admissions and I was getting very woozy. When the lady showed up it only took a couple minutes then we trekked back to the ER about half way back I realized that I wasn't going to be able to walk much more. At the ER Dr. Hedson was waiting introduced himself and had me lay down on a stretcher. Up until this point I had been super stressed - surgery in a developing country had never been in my list of things to do. But once I laid down I felt a huge burden lifted - the decision had been made, it was out of my hands and in a sense not my problem anymore.
I think dozed on the gurney for three or four hours. During that time I was given a shot for the pain, an EKG, and had an IV started - it's all a bit hazy as I was definitely out of it - these events and people running into my feet (which hung off the end of the gurney) are all that I can recall. While I was dozing Stacy also left to get sheets, a pillow, some more money (the admissions had used up the last of what we had), and miscellaneous supplies - apparently the hospital didn't provide any of that! Eventually I was moved into the Men's ward (which was about a third women). Shortly after that Stacy came back with sheets, a fan, toiletries, and all kinds of supplies. Almost immediately it was time to go to the operating room. While be wheeled through the halls I kept noticing the roaches in the light fixtures and the paint flaking off the ceiling and I started to get stressed again - was it really to late to get out? The OR was quite a bit better looking, but I still couldn't help but notice the rusting O² tank, the dirt in the corners, and that all the equipment had adapter plugs so they could plug into the US style power outlets. In the OR they shaved half my stomach while the anesthesiologists explained what was going to happen - I was to get a shot in my spine and would be at least partly awake for the operation. Yikes!! The shot wasn't pleasant, but want too bad (or it could be that the Demerol was still in effect). As my body started to get numb, I started to relax again - now it truly was out of my hands. I sort of fitfully slept during most of the preparation - I remember that they put up a cloth barrier so that I couldn't see - I asked if I could watch (jokingly - I think), and was told no. Mostly I was ignored. The surgery itself was kind of boring - I slept a lot, talked with the anesthesiologists, and really didn't link the doctor and nurse moving around in my peripheral vision with anything important. There was also quite a bit of joking. At one point I woke up and the nurse said something in Pohnpeian, which the anesthesiologists responded to and everyone laughed. When I asked for a translation because obviously it was a good joke she looked quite embarrassed and said that she hadn't realized I was awake - and quickly changed the subject. At the time I thought I was only getting Oxygen, writing this now I wonder if I was also getting Nitrous.
After the surgery they finished up by putting in a catheter (I was very glad to not be able to feel that!) and I was wheeled out of the OR. It was amazing how much better I felt - I couldn't feel anything below my chest, but I was in a great mood - not sure if it was the weight of choice gone, or lingering drugs, or just getting some sleep. Stacy and Father Seussy (my neighbor at PATS) were waiting for me - both were amazed at how gregarious I was. Apparently Father Seussy just happened to be at the hospital - I'm glad that he was there to sit with Stacy as I think she was far more stressed than I was.
In the ward Stacy had made my bed and I was dropped pretty roughly from the gurney to the bed - didn't bother me at all as I couldn't really feel anything. The rest of the afternoon I hung out with Stacy and then Eileen who dropped by some books she had collected from the expat community - apparently everyone knew that I was in the hospital. I kept fading in and out. When I was awake I kept feeling my legs - I couldn't believe they were mine as I still couldn't feel anything. Slowly the numbness started to recede - everything itched first - it was kind of maddening. Around eight Stacy left and I was by myself. As I looked around the room I realized that I was the only one who was by myself everyone else had at least one family member, and sometimes the entire family camped out with them.
Shortly after Stacy left I started to hurt I had been told that would happen and that I should ask the nurse for a pain killer. Getting the nurse proved to be a little difficult and I started to realize that the attending family might actually be useful as well as comforting. I finally got another shot of Demerol and tried to go to sleep. The problem was that the shot didn't seem to help much and the pain just got worse and worse. When I told the nurse that I needed something for the pain I was told that I couldn't have anything for another four hours. The next few hours where surreal - a bit like the night before except I couldn't walk around to distract myself. It was a long few hours. Finally the next shot (more than five hours later - it took a long time to get the nurses attention) worked for a couple hours and I was able to sleep for a few hours.