Thirteenth Day - The GAMA Treatment

The GAMA Helmet was one torturing device, the one 007 wear  was more streamlined. This one is crude and detrimental. Four screws, two in front and two behind. 

Morning Preparation

At six I was woken up by the iPad alarm I set last night. It was dark and I did a few minute stretching on the bed before I pressed the alarm for the nurse. It was all quiet. Amazing. I was quiet please that I had a good night sleep last night.

I washed up and cleared my bowel. They served me a simple piece of cake and the Milo. The milo was very sweet. I had breakfast and took my medicine, Lirica 25mg.  I packed up my belongings as I would be shifting to a single room for quarantine after I return from Mount Elizabeth Novena. The room was 1043, with a window view. As I was all ready by about seven, and I had time. I started to do some light walking. I accomplished 2,000 steps and the BADuanJin routine. 

The ambulance was not here yet at 7:40am so I decided to make the move to the new room. The facilities were the same except the room for a single person is larger and it also have a sofa with a window view. I could see the hotel opposite the road. The sun was shining warmly. I had not seen the sun for twelve days. The previous room was windowless. I took some photographs and did a few self portraits to document this journey. 

The Journey to Mount Elizabeth

At about Eight the nurse and the driver came to fetch me.

The driver was also the person who wheel me to the ambulance. The staff nurse checked the document and briefed the chaperon nurse regarding the trip to the Radiology lab in Mount Elizabeth Novena. All document was readied and they put me on a metallic while chair, covered me with a thick white blanket, with a huge Raffles Hospital text on it. I took a snake sling bag with water, identification, pen and paper. I might have to write to communicate when the nurse was not around.  

I was wheeled through the A&E corridors towards the ambulance. Along the ways, there were many checks and sealed doors. Only the nurse and the driver had the access pass. I had to put on the mask through out the journey to the ambulance.

The driver was well skilled and careful. I am glad that they eventually used their own ambulance. He looked quite elderly. From the way he folded the special chair cum stretcher bed, I could see that he had the required skill. His posture was right, holding the end part of the stretcher and lifting it up close to his body, squat a little, extended the height and elevated the stretcher. I was relieved. 

In the ambulance, they checked that everything was alright and the male nurse, started to remove my telemetry device that checks my Heart Rate (HR) and my Respirator Rate (RR). A very neat device that I wore since I was admitted to the hospital. Now he attached the same three cables to my body, the right arm with the blood pressure, and the index finger to the oximeter, all were connected to a central machine that constantly displayed the data. The journey was smooth and soon we arrived at Mount Elizabeth Novena. 

We went through more checks, with the papers we were allow to access the Radiology department. I did hear that it is a Nuclear Lab that we were going for my treatment at basement one. We went through many corridors and the basement is a maze. We passed through the laundry area; both sides of the corridors were stacked with huge trolley of linen. Eventually we arrive at the department. Dr David Choy was already there waiting. I could see that he was puncture and a responsible person. 

Here I was interviewed at length about my condition, drug allergy, and consent for the operation. I made two signatures. I was also briefed on the procedure of the GAMA treatment. The female Chinese nurse advised that I should go to the bath room as the whole procedure may last more than an hour which I followed diligently. There was also a new nurse, one middle age Indian lady not dressed in uniform came to observe the procedure. 

At about 9am. A group of men came, two with gadgets and equipment in hand, one westerner and Dr David Choy. The mounting of the helmet started. I was injected with local anesthesia in many areas. The first screw that went in, at my left temple, was excruciatingly painful, the anesthesia was not injected at the right area. Then two screw went in at the back, last at the right temple. As they tighten the screws, the pressure was immense. I could hear my bone creaking and the metal spinners tightening at the same time. I signal for them where were the pain and more injection was done in that area. Through out I had to breath calmly, restrict any head movement and my teeth was clenching tight. However, this pain was different from the attack that I experienced during the fainting spells; it was still bearable, although torturous. It reminded me of one 007 movie, Spectre, where the hero was strapped on a chair with restraining helmet with a tiny drill targeting his brain. 

I can have a view of the screw behind my skull. The weight of the titanium frame was heavy. It strained my neck.

The specialist that came with two glass-like helmet to measure the distance between the surface of the glass helmet and my skull; a precise procedure. 

Monk-like, a towel giving a false sense of the robe. The stoned look due to the pain and the discomfort of the weight. 

After my helmet was tightened, all left the scene. The Chinese nurse started to wipe some liquid off my face and the back of my head. She consoled me that the pain would settled and it would be more bearable. I signaled with a thumb’s up. One white haired specialist asked for my name and I was not able to answer him. Fortunately, the she came to my assistance. I read the document, gave him a thumb’s up. He came back later with another specialist, they mounted a glass like shield over my head frame and started to measure with a probe, reading out loud the measurement to be recorded by the other. They were quiet and very serious in their work. No small talk among them nor with the nurse. They left after they had done the measurement.

Next I was wheeled through the maze again to go to the second floor for my MRI. They fixed another shield on my frame, put in some sponges around my neck and laid me down, locked my head, advised that I should not move my heads to my face or head area during the scanning. They would scanned me for half an hour. They also inserted a hear plug, as the machine produces loud sound. I was so stiffed and immobile, even swallowing  saliva was such a difficult task in such a lock down position. 

I heard machine moving as I was conveyed into a circular enclosure. This was the second time I was doing an MRI. However, this one was so restrictive that once my posture was fix I could not move at all. There were two kind of sound, one was the movement of mechanical parts, like that of heavy machinery; the other was a siren like sound, I supposed that was the scanning part. Time seems so slow and some times I had to swallow my saliva. Having the head fixed and the body not able to move made the swallowing difficult. Numbness begin to set in. I focus on breathing and relaxing the eyes, the ears, the face and the neck. The body was almost non-existence unless I moved them. I focused on the breath that passed through the nostrils, down the windpipe, then filling up the lung.

Finally, some people came in, not to tell me that it was over, but to inject me with some contrast dye to make the scan clearer. From Google the dye could be Gadolinium, which would also have some side effect. It was recommended from Google that I should drink at least eight glasses of water after the scan to detox from Gadolinium toxicity. I was not aware until today (2 days later as of this writing). I quickly drank one glass of water. One lesson to learn, always checks the Google to get prepared as it is one’s own body, one has to be proactive about it. The nurse did not tell me what to prepare nor detox thereafter after the MRI. I should do more research on it and be prepared if anyone is going for an MRI scan. Neither hospitals, the one two years ago and the present had any pre or post advice. 

I laid motionless, unable to move while I felt my fist was being injected, it did not work. She rolled up my right sleeve and injected on the forearm. I could not even feel when the needle was extracted, perhaps due to the coldness of the room. She plastered me, returned my arm to the side and covered me. 

I was returned to the MRI scanning machine and the process started over again. The converted into the enclosure, the heavy machinery sound then the siren sound. Not sure how long it lasted but it was shorter than the first. I was glad it was all done. I was wheel backed to the basement one, again through a series of maze, which I would not know how to get out if ever I was required. 

Back to the basement, I waited, with the frame intact. The nurse requested that I should take a pee before the GAMA treatment may last more than 30 minutes. I did. I walked slowly incase I trip and fall. It was top heavy and felt like a walking Panda. It was rather impossible to even see where I am peeing without the spectacles and bending down the head. I just gauge by the sound of the pee. While waiting, I took a few photographs with my mobile. Soon Dr. David Choy came to inform me that the GAMA will take 50 mins, as calculated by the computer and not 20 minutes. He was a little apologetic. I thumbs up to him with both hands. It was good not to speak at all. The framed helmet was really heavy and painful. Although the pain has lessen as the body get used to it. 

I was wheeled into the GAMA room, again they fixed another glass-like shield over the Titanium frame. The head felt heavier and the neck was strained. They laid me down and advised that during the whole process I should not move my hands over any part of my head. I could only blinked to acknowledge that I understood. 

They vacated the room and after awhile I was converted into the circular enclosure. The machinery movement was quieter than the MRI machine. It was all quiet. I only felt small little sparks like tinkling at the back of my skull and it was moving from right to left just behind my ears. It went on for a long time and in between I was quite tire and might had dosed off intermittently. 

The specialists came in, helped me up, the head felt so heavy and I definitely could not sit up without them giving me a lift up. They were looking for the nurse to help clean me up. Some fluid was oozing out of the screw points. They were in a hurry to get the frame off me. The nurse came with cotton buds. She warned me that once the pressure is off I would feel more painful or headache. Yes, I had to clenched my teeth while they unscrewed and dislodged the frame. It felt light but painful. I could feel some liquid streaming down the side of my eyes. The nurse wiped it clean and plastered the would. She consoled that the intense pain should be over in about an hour. 

Meanwhile we were waiting for the Raffles Hospital nurse and driver to fetch me. She briefed me regarding the would and how I should take care of them. She had a list printed out and read out the important parts for me. I should not bath in these two days. The wound would have discharge and I should request the nurse to change my dressing. It should be kept clean. The ordeal for GAMA treatment was over, now I should rest and nurse the screw points.

The nurse’s refusal to change dressing

Back at the hospital.

How was the pain from scale one to ten? Seven. 

We have to call the doctor.

No need to call doctor

It is normal..

I had already learned from the Nurse who assisted in the Gama Treatment.

The while fluid was still streaming from my forehead. 

Please find some cotton bud for me and some sterilizer. 

Change the dressing for me. It is all wet.

No we cannot, doctor say cannot removed the plasters.

These plaster had already been changed.

Who change it?

Your intern, so simple.

No doctor say cannot.remove the plaster 

We have to follow instruction.

We call doctor.

Ayo. I was so impatient. 

Blood and transparent fluid was streaming down my forehead.

Give me the dressing I change myself.

Cannot, please understand we cannot do that.

I know what to do. 

I know how to put dressing and clean wound.

No, please understand.

I slap my forehead and thrown my pen on the table.

Please don’t get angry.

I am impatient. 

So agonizing trying to communicate to them that these are simple wound.

I started to draw. I started to write.

Step by step explaining how the injury come about.

It is just cause by impact and the sharpness of the screw dug into my skin and fresh to fastened to my skull.

So normal dressing and cleaning it is alright.

Finally, they understood how the injuries came about.

They carefully clean the wound, removed the old plaster and give me new dressing.

So much difficulty for something so simple. 

What a world of system?

They called the Doctor and I was prescribed with Panadol. 

The pain was bearable. 

I don’t like Panadol. 

So much painkiller. 

I had only taken Panadol 4 times in my entire life.