My parents were on holiday in Tokyo when it happened. They were in the middle of their twelve-day trip which was planned from 20 March to 31 March.
Here’s a timeline of everything that followed.
And even though we do not understand why Dad’s plans for the year had to be put on hold for the time being, we can clearly see God’s graciousness, faithfulness, and Hand of Protection on his life – even in the darkest of moments.
Monday, 25 March
Dad and Mum were on the stairs outside the Tokyo Imperial Palace when Dad missed a step and fell. (It was about 2.30pm there.) He landed hard on his left knee. A stone bench stopped him from rolling down further.
Thankful for: Passersby who helped call the ambulance and assisted in English-Japanese translation.
Paramedics from the ambulance had to call several hospitals before the fourth hospital, Tokyo Medical And Dental University Hospital, agreed to take on Dad’s case. An X-Ray taken confirmed that he had fractured his left patella (kneecap). He was fitted with a knee brace, purchased a crutch to improve mobility, and was sent away with painkillers. This was because the hospital could not operate on him due to its policies.
Thankful that: Dad and Mum managed to make it back to their hotel via taxi, even with Dad unable to move much.
While frantically packing back at the hotel, Dad noticed his eyes getting smaller and his vision getting poorer – he had an allergic reaction to the painkillers taken earlier that afternoon. (We later found out he is allergic to NSAIDS.) They had to leave for the airport at 10pm, so we could only pray hard that his breathing would not be affected by the allergy.
Thankful that: God answered our prayers, and the allergy only caused puffy eyes, which subsided in due time.
As a family, we decided to fly them both back on the next available flight. After about 1.5 hours negotiating on the phone with SIA, Kevin managed to get them rebooked on a 2.30am flight the next morning, with them flying out from Haneda Airport instead of Narita International Airport.
Thankful that: SIA allowed us to rebook the flights at no extra charge, and that there was ground assistance (wheelchair all the way) at both ends that made the impossible, possible. Both Dad and Mum were also given 3 seats each, across the aisle from each other – Dad needed the seats to stretch his left leg out, while Mum could rest after a harrowing 12 hours since the fall – as the flight was not fully booked.
Tuesday, 26 March
They landed in Singapore at 9am, and we rushed Dad to TTSH A&E.
Thankful for: Paramedics and nurses who helped us move Dad straight out of the car and onto a gurney. I later found out from the Triage staff that this isn’t normal protocol as the gurneys near the drop-off point are for ambulance use.
Dad was given IV painkillers and his left leg was put into a cast that immobilised him from thigh to foot. We wanted to push for admission due to his pain and discomfort, but we found out it was hospital policy not to admit “simple” fractures. We purchased a walking frame so that he could still move around, albeit a lot slower, and went home with an appointment to see an orthopaedic specialist the next day.
Wednesday, 27 March
Dad was seen at the outpatient clinic. We were given two options. One, we could do nothing and cast the leg for three months, thus allowing the patella to heal naturally (there’s a risk of future arthritis). Two, surgery to insert wires and screws into the patella. Dad chose option two, as surgery will speed up the healing process. However, as his knee was still red and inflamed due to impact of the fall, it was recommended that the swelling subside before surgery commenced. Hence, surgery was scheduled for the following Tuesday.
Tuesday, 2 April
Dad was operated on at about 3pm.
Thankful that: The surgery was a success, and that there were no complications from the anaesthesia.
He was in the recovery ward overnight and discharged the following day. He was advised to change dressing every two days at the nearest polyclinic.
That said, the pain was very bad post-surgery, with Dad rating the pain 9 out of 10.
Friday, 5 April
At the polyclinic for his first wound dressing post-surgery, it was discovered that the surgical site was red, inflamed, lumpy and oozed discharge when squeezed. Dad was also running a slight fever of 37.8℃. We were advised to bring him back to TTSH A&E immediately, as post-surgery infections are serious. Dad was warded for cellulitis, but discharged on Monday.
Thankful that: The painkillers were stopped after one night as the pain got more and more bearable, and Dad felt a lot better.
Thursday, 11 April
At around 11.45pm, Mum helped Dad up from the bed to the dining table to eat something before his midnight dose of medication. As he approached the dining table, he suddenly exclaimed “pain, pain, pain”! Dad then, to the utter surprise of Mum, brisk walked back to the bed, threw himself down, and began gasping for air like a fish out of water. His face turned ashen and his eyes were blank. He kept gasping and struggling and turning to his side in an attempt to breathe. While slapping his face, Mum yelled at Eunice – who was fast asleep in her room – to call the ambulance. In a state of shock and panic, Eunice dialled 991, 911, and then finally the correct number, 995.
In the ambulance, paramedics kept Dad conscious by fact finding. They also called for the resuscitation team to standby. Upon arriving at TTSH, two doctors met him before rushing him into the resuscitation room.
We were told that Dad was in a very critical condition and there was a 50% chance he could die. There was a chance of survival, though, because he was brought into hospital promptly, and was relatively young. The medical team suspected blood clots in his lungs and needed to scan him immediately to confirm this.
Praying against: The contrast dye (which had to be injected into his blood for the scan) affecting his kidneys.
After the scan was done, it was confirmed that Dad had multiple blood clots in both sides of his lungs, with the right side being almost 100% blocked. His heart was also severely swollen due to the blood clots in his lungs. This condition is known as Pulmonary Embolism, or PE for short. He was transferred to the Medical ICU (Intensive Care Unit) for treatment.
Thankful for: God’s divine timing and intervention that this episode happened right before Mum’s eyes. I dare not imagine what things would have been like if this had happened in the afternoon when Mum was at work and Eunice fast asleep in her room; or if it had happened in the middle of the night when Mum was in deep sleep. Also, it happened on the bed, and Dad did not crumple on the floor (which would have hurt his knee further).
Thankful that: Dad got medical attention promptly, and that God preserved his life.
Thankful that: Dad’s condition improved drastically – with just an oxygen mask – and did not end up needing to be intubated, despite what we were told earlier.
Friday, 12 April
In the ICU, Dad was started on blood thinners as the clots in his lungs needed to be broken up. We were told that side effects include internal bleeding, but that was our only option and it was a risk we needed to take to save his life.
Praying against: Bleeding in the brain.
Dad was also hooked up with multiple lines, one of which went straight to the heart to administer blood thinners (the clots were in the artery between the heart and lungs). His right thigh, the entry site into his femoral artery (the line to his heart), bled out though. Bleeding had to be stemmed immediately as his body’s clotting ability had been greatly reduced due to the strong blood thinners he was getting intravenously. Blood test results also showed that there was bacteria in his blood.
Thankful that: Dad crossed the 24-hour mark! It was really critical and touch-and-go.
Thankful for: Extended family support (Dad’s siblings really rallied around us) and prayerful encouragement from our various circles through the entire ordeal.
With our families, friends, and churches all lifting Dad up in prayer, Mum was led to declare Psalm 91 over Dad.
Whoever dwells in the shelter of the Most High will rest in the shadow of the Almighty. I will say of the Lord, “He is my refuge and my fortress, my God, in whom I trust.” Surely he will save you from the fowler’s snare and from the deadly pestilence. He will cover you with his feathers, and under his wings you will find refuge; his faithfulness will be your shield and rampart. You will not fear the terror of night, nor the arrow that flies by day, nor the pestilence that stalks in the darkness, nor the plague that destroys at midday. A thousand may fall at your side, ten thousand at your right hand, but it will not come near you. You will only observe with your eyes and see the punishment of the wicked. If you say, “The Lord is my refuge,” and you make the Most High your dwelling, no harm will overtake you, no disaster will come near your tent. For he will command his angels concerning you to guard you in all your ways; they will lift you up in their hands, so that you will not strike your foot against a stone. You will tread on the lion and the cobra; you will trample the great lion and the serpent. “Because he loves me,” says the Lord, “I will rescue him; I will protect him, for he acknowledges my name. He will call on me, and I will answer him; I will be with him in trouble, I will deliver him and honour him. With long life I will satisfy him and show him my salvation.” Psalm 91 (NIV)
Saturday, 13 April
Due to the bacteria in his blood, Dad ran a fever of 38.3℃. Source of infection was still unknown at this point in time and he was thus prescribed a wide spectrum of IV antibiotics. Side effects of blood thinners could be seen – right hand was swollen and bruised, and urine was bloodied. The strength of blood thinners given to Dad was reduced as well (from direct line to IV), a positive indication that he was getting better!
Because his need for life support was no longer present, Dad was transferred to the HDU (High Dependency Unit) that afternoon. An Echocardiogram done before he left the ICU also indicated that the size of his heart has gone back to normal.
Thankful that: The blood thinners managed to reduce the size and amount of clots in Dad’s system – with no internal bleeding – and his heart was no longer swollen.
Sunday, 14 April
(First photo taken of him since admission.)
The bacteria causing his fever was identified as pseudomonas, and targeted antibiotics were given to fight the infection. The administration of blood thinners progressed from IV to a painful injection into his abdomen.
Monday, 15 April
Due to his bacteria infection, Dad’s medical team arranged a scan of his chest to check if there were any colonies of bacteria amassed there.
Because he did not need the close monitoring of the HDU anymore, he was transferred to a general ward.
Thankful that: Scan of his chest showed no abnormal masses of bacteria or clots present.
Thankful that: Dad is recovering slowly but surely. He has come a long way; from ICU to HDU and now, to a general ward.
Tuesday, 16 April
A scan showed that the blood thinners caused some bleeding in his gluteal muscles, but we will rely on his body’s natural mechanism to break up the clot.
Thankful that: The bleeding was in the muscle because the blood wouldn’t be able to travel and clot; as compared to if the bleed were in the arteries or veins or worse, brain.
The General Medicine team decided to stop the thinners for now due to the bleed. A scan will be done after seven days, and if bleeding has stopped, they hope to restart thinners. Meanwhile, the Orthopaedic team has not allowed Dad to walk yet. To minimise further risk of bleeding, he has to wear compression socks plus do light exercises on the bed to strengthen his muscles.
Praying against: Anymore internal bleeding during these seven days without blood thinners in his system.
Thursday, 18 April
His right wrist has been swollen since ICU days, so a scan was arranged to check if the artery has been enlarged.
Thankful that: Dad finally managed to get out of bed after being bedridden for 6 days from 12 April. He could walk to the washroom to shower and brush his teeth after not doing so since admission. He also sat on a geriatric chair to eat lunch, instead of eating in bed; and was wheeled down to the Atrium for a SCO lunchtime concert.
(Sidebar: That evening, Valerie had three febrile seizures within four hours, with the last two only 10 minutes apart. We called the ambulance and she was warded for two nights.)
Mum had a dream of me that night. She saw me crossing some stairways with a gap between them. I slipped, and family and friends pulled me up to safety. But in the gap, Mum saw the palm of God’s hand. And knew right there and then that God was trying to remind us that, even when we walk through the valley of the shadow of death, He holds us securely in His palm.
Friday, 19 April (Good Friday)
Thankful that: Drip was finally removed, and that the wrist scan done the previous day showed no abnormality.
Monday, 22 April
Remember the bleed in his gluteal muscles (caused by the blood thinners) on 16 April? It was confirmed that Dad’s system is sensitive to them and his medical team will have to take this into serious consideration moving forward.
Thankful that: The bacteria in his blood was clearing.
Thankful that: Dad’s kidney function is back to normal. (Remember the contrast dye that had to be injected into him for the emergency lung scan done upon admission to A&E on 11 April?)
Tuesday, 23 April
A CT scan was arranged to check if the bleed in his gluteal muscles and clots in his lung have been resolved. Plan would be to resume blood thinners if bleeding / clots have reduced significantly.
Wednesday, 24 April
Results of the scan done the previous day came back and the bleeding in his gluteal muscles has stopped, the clot is not moving, and has reduced in size. What is of concern, however, is that there are still some blood clots – though markedly reduced – left in Dad’s lungs. As the presence of clots in the lungs cannot be monitored, blood thinners will have to dissolve the clots. This will hopefully and prayerfully prevent another life-threatening PE episode.
Dad’s medical team decided to start Dad on Clexane (40mg) – a blood thinner – administered subcutaneously via injection, twice a day. He will be monitored closely, with a blood count done after six doses.
Thankful that: The bleeding in his gluteal muscles has stopped.
Thankful that: The blood clots in his lungs have reduced in size and amount.
Praying against: Anymore internal bleeding as Dad’s system is sensitive to the blood thinners.
Thursday, 25 April
With Dad being slightly more mobile, physiotherapy commenced. His leg brace was adjusted to 60 degrees.
Monday, 29 April
Blood test done to test the effect of Clexane on his system was normal. His medical team will monitor for a few days and if there is no bleeding or bruising, Dad will finally be able to go home by mid-week!
Thankful that: The re-administration of blood thinners (after 8 days without it) did not cause any bleeding nor bruising.
That said, his blood pressure remained consistently low. As a precautionary measure, he was put on an IV drip to prevent his blood pressure from crashing.
Tuesday, 30 April
Thankful that: Blood pressure returned back to normal.
Thankful that: Dad’s left knee wound is healing well and he’s making good progress with physiotherapy (leg brace was re-adjusted to 90 degrees).
Thankful that: Clexane has been doing a good job of breaking up the blood clots without bleeding or bruising.
Wednesday, 1 May
After 20 days (and 37 days since his fall), Dad was discharged from the hospital!
Wednesday, 8 May
Thankful that: Dad’s full blood count has returned to normal and has been cleared to leave the home!
Two months on… We give thanks for God’s faithfulness and healing. Dad can now walk without his knee brace at home, and can walk to the MRT with his walking frame unaccompanied. Physiotherapy at TTSH has intensified as well, and Dad will resume teaching soon. To God be the glory!