My Emergency Surgery in India

Surgery in India

What started out as a pretty normal day in India quickly transcended into what became one of the most unique weeks of my life, never mind my time in India. I don’t tell this story to feed people’s fears of traveling to India. In fact, I mean to do the complete opposite: to explain that while challenges might arise and bad things might happen, it isn’t India that causes them. These things are just as likely to happen anywhere in the world. But, being based here, you are sure to be well looked after, with sincere generosity and kindness.

I’ve had the unfortunate experience of falling victim to infected mosquito bites before. It’s grim for sure, they take a long time to fix and you end up with scaring.  I’ve tried to be super careful about not getting bitten, and if I do get bitten, I use copious amounts of coconut oil and try not to scratch the bites, etc. So when I noticed a small wound on my puffy leg that was a bit sore and weeping, I knew I needed medical assistance.

On Monday morning, I visited the local doctor. I had a quick examination, and learned that yes, it was infected (oh great), and got some stuff to take to solve it. I went on my merry way thinking, ‘Ah, I’m glad I went now,’ and felt pretty confident that it would be okay the next day. Tuesday came and the swelling seemed to have reduced but it was still quite sore so I went back to the doctor. I literally sat down, rolled up my trouser leg and then found myself out the door, being told I had to get to hospital!

It’s a weird system here–you either turn up and wait, which could take hours or book an appointment. So the appointment was made for 5 PM. Then, I just had to wait. I felt perfectly okay, so with my brain still working, I went back to work. However, as the day went on, my lower right leg and foot just got bigger and bigger to the point where it was getting really uncomfortable to do anything. By 4 PM, it was really bad and the only slight relief weirdly came when I walked on it. So I stood outside the office and shops with a few of the staff discussing the pros and cons of taking a rickshaw or taxi to the hospital.

This was my leg around midday:

swollen foot in india

All of a sudden, I was overcome with nausea. I sat down, but the nausea was intense. I felt incredibly hot, my hearing went, things started spinning around me, and I couldn’t move. I vaguely remember being given some water but as much as I tried, I couldn’t lift the bottle up to get any in my mouth. The guys tried to carry me inside and the next thing I knew, I was sitting on the floor with no recollection of how I got there. At this point, I felt scared, tired from the pain, but most of all, frustrated that it had all come on so quickly and because of an unknown cause! Needless to say, I started crying.

Just getting to the hospital gave me some relief; at least I was in the right place! Rosemary Mission Hospital is a modern private hospital in Tirunelveli. Hospital waiting rooms are not much fun at the best of times but as the only white person in a non-touristy town, it was even less fun! My patience levels are usually good–I don’t mind the same questions a million times from curious bystanders but right then, I just wanted to be invisible.

An hour later, I was lying on a bed with various staff looking at me, in a lot of pain and just wanting to be told what was going on. If the people with me were not so persistent, I think they might have let me lie there, but I was in a lot of pain, so my friends, Swathi and Johnson pushed the staff to give me painkillers. What followed then was a series of injections. I’m not sure what half of them were but I think we counted four, plus a blood test. The pain subsided considerably, but the problem still wasn’t fixed.

Eventually, a doctor examined my leg properly. He told me, “The only thing we can try is an old medicine, which has been used for centuries. It will bring down the swelling and draw the infection out. We’ll do this for 48 hours, and if the swelling is reduced sufficiently, we’ll make a small incision to drain it.” I understood that not only would I have to spend two nights there, but he was already talking about surgery!

Then there was a flurry of activity: the staff coated my leg in this magic medicine and bandaged it up, Swathi and Johnson headed off to buy some provisions for me, intravenous (IV) tubes were put in, and more injections were given before I was finally shipped to a private room. Once inside the room, I got three more injections by IV, two tablets, and instructions to sleep with my leg elevated.

At 7 AM the next morning, Swathi asked if I wanted tea. It was at this point that I realized that not only would I be there for 48 hours, but so would she!  She would be there to collect all of my medications three times a day, get me food and drinking water, and translate for me.

Much of Wednesday was spent in apprehension of whether the medicine had worked. In between the wait, I continued to receive injections, tablets, numerous temperature and blood pressure checks, and a thousand questions about what I’d eaten and drunk, as well as my toilet habits. There’s little privacy in India at the best of times–and even less so when it comes to medical things!

This is some of the medication that was used:

medication in india

Of course, I also provided the student nurses with entertainment–they thought it was brilliant to have a white person to talk to. I got the usual list of questions, followed by a lot of giggling. One of the girls paid me compliments about my eyes and smile, and continued to come in and just to look at me with a big smile on her face! 

This was my leg after 24 hours:

second leg

On Thursday morning, 36 hours into my hospital stay, the doctor whistled in. He said, “So, we got your blood test results back. This measure here indicates infection levels. It should be five or less, and your’s is 50, so the infection is huge.” But he looked pleased that the swelling had reduced enough for him to do the incision. “Oh, and you’ll be asleep the whole time!” Small incision, full anesthetic–it seemed like a bit of a mismatch to me!

But even with the anesthetic, I would be able to eat and drink before my evening surgery. So, I happily sat there at 12:30 PM, getting through my third liter of water and strategically planning when to eat when a nurse entered my room and said, “Do not eat or drink anything now!” From that point, there were a series of people coming in to give me drugs, do blood tests, do an ECG and ask a further million questions. At 6 PM, a different doctor came in to talk to me about the operation. After much discussion, I opted for local anesthesia, which meant I’d have numbness from the hips down. At 7 PM, it was time.

Anesthesia was injected into my spine, which hurt quite a bit. Then, I lay down on my back with both arms out to the side. A new IV line was put into my right arm, and my left arm was connected to a blood pressure machine.  Because I was shivering so much, they had to hold my arms in place.  They also covered my eyes with cloth, though that did little to reduce my fear.

Then the anesthesia started working; first my legs got warm, then I felt pins and needles, and then nothing.

“Jo, can you try lift your legs up?”

My brain said yes, but nothing happened. I knew it was supposed to be like that but it really freaked me out. 

I stayed awake during the procedure, and the doctor kept trying to reassure me by telling me, “Don’t worry, it’s a simple procedure.  Relax.”

I had no idea how much time had passed before 50 ml of puss was removed, my leg was re-bandaged and I was on my way to recovery.

In recovery, I spent most of my time trying to move my legs but the anesthetic was strong so I had no chance. Finally, I did start to get feeling back.

Having been in India for a while, I’d learned how to master sleeping anywhere–buses, trains, taxis, and probably even a rickshaw. But I’d never tried to sleep with my legs half numb, connected to an IV with rehydration liquid being pumped in, and my leg elevated. If that wasn’t enough, Swathi had to get up every two hours to check that the IV bottle was still full. That meant another sleepless night for her too.

Friday was recovery day. The swelling was reduced by at least 90%, and I felt no pain at all from the operation. I was told I could leave if everything looked fine after the dressing was changed.  Unfortunately, that didn’t happen until the next morning.

The incision was about 9 cm long and about 5 mm wide.  They  left space for further infection to come out if necessary. After a new bandage was put on, Swathi and I could finally go.

I’m sure most people fear getting ill abroad. There’s so much unknown–is it clean? Is it safe? Will they look after me? Who will check on me? Perhaps the fear is even greater when you think about India. It has a reputation for a lack of hygiene, immense chaos, and noise, and as a volunteer, I’ve heard horror stories from some of the medical volunteers. But my experience couldn’t be further from these stories. The medical attention and support I received was first-class, though I’m not naive enough to think it’s got nothing to do with the fact that I paid for it.  But, the staff genuinely looked after me, asked how I was, and took time to talk. 

What has touched me even more was the incredibly support I received from my new adopted Indian family. Swathi has been with me the whole time I’ve been here, doing everything for me when just a month ago, I’d only met her twice.  Johnson has been running errands for me, and his mum has sent me three home-cooked meals every day.

So now as I look at the bandage, the last thing I feel is sad, fearful or frustrated. I’m actually smiling because I feel fortunate, if not lucky.  As the wound heals with an inevitable scar, I sit and wonder what it is that makes me love this country so much.

It’s people. It’s as simple as that.

About Jo Clay

Jo ClayJo Clay is the operations manager at Vi-Ability, a UK-based social enterprise. Check out their new crowd funding bid here.

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