So the story began when I went home in September as usual. Not particularly eventful but obligations settled within the first couple of days, and the rest of the week I was busy getting coffees, running errands, meeting people. The mother was under the weather and coughing the house down, but I didn’t think I’d catch anything, until the final night. Or maybe the final couple of days when I felt something coming which is the usual dry throat that I tried to suppress with loads of water. But Saturday night chills and fever came anyway, after I went home from a night out with the BFF duo. 

Sunday morning we sent our parents off at airport to Malacca for my aunt’s funeral, and at that point I could barely keep my eyes open for the rest of the day - anytime I sat down somewhere - in the car, on the sofa etc I slept. I don’t know how but I made it to my own flight back to SG, slept throughout except during meal, and when I reached home I couldn’t even unpack, the horror. Thermometer confirmed I was running a high fever - 40.6, I was pretty sure I’ve never seen this before. So MC it is.  

The good news was that the temperature came down the next day, maybe with the help of medication, and I was actually pretty energetic throughout the day that I was even able to work a bit to clear my one week’s worth of emails, and gradually I got better during the rest of the work week which I felt the need to be present because of appraisal battles. I did take Wednesday afternoon off because the whole morning I felt out of sorts again, and I slept through the whole afternoon. The lethargy was there definitely and I assumed it’s aftermath of whatever virus I caught. Little did I know this wasn’t even close to the end. Just the end of chapter 1. 

Friday came and it was a WFH day. Felt a bit bloated after lunch, in fact throughout the afternoon so I delayed dinner, and actually went to gym for my first workout in a couple of weeks. Towards the end of the session I actually felt a tinge of dizziness and I remembered, maybe I should have eaten dinner first because come to think of it, I didn’t eat much for lunch too. So grabbed a quick but small dinner because I still feel a bit bloated. 

Over the weekend was when things got worse. I woke up on Saturday feeling out of sorts and lethargic again, but I had a scheduled dental appointment so I headed out anyway, and had McD breakfast which I stomached with some difficulty. Almost fell asleep waiting for my turn at the dentist’s, then decided to cancel the rest of the day’s plans and tapao-ed lunch home, which I didn’t touch because you guessed it, bloated. At this point I should also point out that I noticed that my pee had this abnormally sharp yellow color, I wanted to say bright yellow but when it hit the toilet bowl it is more of a dark yellow color (yes I’m aware bright and dark yellow are two very different things). And it has been the case for a couple of days now. Slept through the afternoon, woke up and ate my lunch as dinner, and proceeded to have the worst night I’ve had in a while - because I was bloated, maybe there’s a bit of acid reflux, and the whole abdomen was feeling so uncomfortable that I was passing gas which eventually became puke - ended up vomiting out my entire dinner before body agreed to rest. Knowing something was wrong I telemedicined again on Sunday, getting some antacid and other medicine to help with the bloating but again it was a similar story as Saturday - ate breakfast because I felt the need to (rather than hunger), and a light dinner where I only picked out the fish and meat slices from a soup and didn’t drink much. The good news though was that I didn’t puke it out after. 

Monday in office, again I felt obligated to be there because of meetings and I was also gingerly eating lunch which surprisingly I managed to finish the entirety of it. I should mention at this point the thought of food made me nauseous and I couldn’t even look at food pictures including those food influencer ones on IG. But I was also very lethargic and I napped in my cube after lunch, and almost couldn’t wake up to work. And I thought something was wrong so after my meetings, told my boss I’m heading off and went to A&E at TTSH. 

I realize I am very ill equipped with such knowledge. I went to TTSH because I didn’t know where else I can go under such circumstances. I didn’t want to go to GP and wait for a specialist reference, and I think polyclinics are out of the question too. I thought it’s good to get some tests and scans - at this point, my research based on my symptoms are pointing towards something called obstructive jaundice (side note I kept thinking of it as obstruction of justice), mainly because of the pee colour and one of the reasons could be because the bile duct is obstructed by possibly stones. 

The wait was horrifyingly long as usual, but I think I was in a better shape than the last time I was here (I had kidney stones back then and the abdomen was hurting the whole time). So I didn’t mind the wait plus I was nodding off most of the time. Blood tests, X-rays done, then I was waiting for results. At around 7 the ED doctor summoned me again, and with a very grave look told me “I need to admit you today.” 

Briefly, my liver readings are haywire. Like very off - one of the indicators, where the normal range was supposed to be 50 units (let’s called it units, I can’t remember what the actual measurement unit is), was at 2700. That’s like more than 50 times above the normal range oops. So all these is pointing to liver damage which can turn into liver failure very quickly, so investigation is needed to see what was causing it. 

I think I took the news relatively well, to be honest. Wasn’t fearful or anything (or maybe I didn’t know how severe it was at that point). It was more like “aha I knew something was wrong!”. I wished I could say everything was a flurry from that point (because isn’t this an emergency already?) but no…got ushered up to a bed, and wheeled to observation ward while awaiting for ward space. And here’s where I thought the admission process is a bit weird, because admission office called me (am I not already in hospital? Can’t you just find me?) to ask me to specify which ward class I want after giving me some brief descriptions - and i hadn’t had time to ask my insurance agent yet so I just blindly chose one. 

Another hour of waiting maybe, and the observation ward nurse came over to ask if I want to take another ward type - basically I will be parked along the corridor in a makeshift ward space while waiting for an actual ward space, reason being they are very full now and I may have to wait until noon the next day before I get a space. And only after I get a space can the doctor come and visit me and I can get the necessary attention (more tests etc). Whereas if I opt for the temporary one I would at least be officially admitted and the process can begin. So fine, I didn’t think I want to wait further so agreed. Even then, it was another half an hour or so before they came over to wheel me up to the ward. 

At this point I just felt like I needed rest, so after changing I duly went to sleep - it wasn’t comfortable by any means, because I had to deal with the drip which was coming in through my arm, even with a corridor makeshift bed space I still have a fan for myself but it was too powerful, and after switching it off to sort of rely on the ward’s air conditioning it was too stuffy. 2 hours into my sleep I was unexpectedly woken up by the staff nurse to sort of interview me a bit (symptoms, what did I eat/do throughout the day etc), and best of all - admissions staff (“I went down to the observation ward and couldn’t find you” and it was only the next morning I realised that dude tried to call me and couldn’t reach me because my phone was on a DND mode after 11pm) to get me to sign forms and stuff and explain the charges. And gosh I can tell you I can’t process much at that point in time and I don’t think I know what I signed hahahah. The rest of the night I basically woke up every hour - it was dark enough but aside of the ventilation issues, the ward is also full of sick elderlies who were maybe coughing or insomniac and there’s this uncle who woke up for a walk, sat (I think) next to my bed and ATTEMPTED TO CHAT WITH ME WTF. I couldn’t see him because of privacy blinds but he was like “Bro, bro, what happened to you” until the staff nurse told him off. God. Now that I know what I was eligible for, never again (I always tell my insurance agent that she can explain to me every year but I will probably not remember it and will still call her when shit happens, unless I have experienced it and here we go, the experience). 

And the lights come on at 6am. By 7am I was up and magically breakfast appeared in front of me and even more magically, I actually had the appetite to eat it. And hallelujah, doctor showed up at 8am with a whole convoy, explaining to me that she had read my notes (by staff nurse and ED doc I guess) and test results, and she suspected the liver damage is caused by a viral infection but there will be a need to run a whole series of tests to find out exactly what. And she expects that the earliest I can be discharged is on Friday, so my natural question (which I have been thinking about for a while) was to ask if it was possible for me to go home for an hour or so to get some essentials - underwear, more specific toiletries like my skin creams, charger (I had a power bank with me but it’s the less powerful one which can only last 2-3 charges max, and I had used 2 charges at that point). Was told that she prefers not to, but if further tests later showed that the indicators are showing signs of coming down then she can consider but meanwhile she asked me to get someone to help. TBH I think I do have candidates in mind and it’s not difficult for them to access my place because I can let them in remotely but I always felt like I don’t want to trouble anybody, even at such critical juncture. 

Office laptop was with me because I came directly from office so duly set my OOO message, contemplated a bit and decided to just indicate that I’m on hospitalization leave and the message was meant more for big boss because I have no faith that he will leave me alone otherwise. But it eventually did trigger quite a few of messages of concern from colleagues which I was hoping to avoid at first, but oh well. 

The other bigger problem was that the sister was scheduled to visit this week, on Thursday evening through Sunday. And I was only scheduled for discharge earliest on Friday so some arrangements will be needed and I came clean with her hahaha but asked to keep it from our parents first. Until I have some certainty on what I have and my recovery. 

Also texted other miscellaneous people - insurance agent, for one. Told her I was admitted last night for blah blah at TTSH and point blank asked her which ward I should be going for, the answer was quick - Class A which is individual room with en-suite toilet hallelujah. Come to think of it I should have known earlier but I do empathize those who are in the common wards - must have been due to financial reasons and at that point I am grateful that I have provided for myself. 

The other person was of course my PT - have been canceling my sessions last week due to the flu and now I’m just going to be suspending sessions indefinitely urgh. Just when I was looking forward to cutting because I felt that I have bulked enough. Though this episode gave me a natural cut just that I probably will lose muscles along with it sigh resetting progress. 

All these settled, I proceed to drift in and out of sleep throughout the rest of the morning (for one I was lethargic still, and I did not have a good nights rest). The biggest event of note was blood test where a grand total of 19 vials of blood was taken from me ouchhh. Towards the end I felt like the entry point of the needle was hurting a bit even zzzz (true enough that area bruised for a few days eventually). But it was necessary because the doctor ordered all sorts of tests to get to the bottom of this.  

Lunch, resting, and waiting for updates on my ward upgrade application - here this the other odd part about processes that I found - first I had to fill in an online form which asked me all sort of details. You’d think that’s the application itself, but no, it’s just to register interest of sorts and the admissions dept will call you to confirm your interest, after which you (or your rep, but I didn’t have one) have to personally make your way down to the admissions dept to formally apply. Told staff nurse in charge about this, she took my blood pressure and temp and agreed to release me temporarily for this, so off I go. And you know what, even after visiting the admissions dept and listening to explanation about charges (again), at this point the ward upgrade is still pending approval from beds dept (guess need to check vacancy and all) and the lady told me I will be informed in due course but no timeline given of course. But what do you mean all these can’t be done online? The only reason I can think of is that they need you to confirm that someone had explained the charges to you personally and you sign off with that understanding, to cover their asses. I suppose there must have been enough disputes for them to refuse to digitize this, but still, sigh. 

Back from the little excursion, continued with the nap/screen time cycle, managed to shower too because at this point I was very annoyed with my still gelled up hair, then finally a doctor from the medical team came over for further interviews and to report that my liver indicators have come down a bit so they agreed to give me home leave for an hour or so, I asked for 1.5 hours instead and it ended up being 3.15pm to 5pm lol. Of course it came with indemnity forms etc to absolve them of responsibility if something goes wrong oh well. So I changed and waited for my release - apparently some miscommunication and staff nurse was waiting for the clearance from doc when I had already signed it earlier? But I ended up leaving at 4.20pm and I told the staff nurse I’m just gonna come back at 6pm lol. I think somewhere in between I also heard from staff nurse that my ward upgrade has been approved, but I told them I’ll go home first and to process the ward change after I return. And with that I left after a full 24 hours in the hospital. 

Back home, I’m actually pretty impressed by how organized my thoughts were. Grabbed everything I need - charger, cables, iPad, underwear, jacket, toiletries, laptop, power bank etc - then proceeded to organize the house a bit in preparation for the sister’s arrival, including changing bedsheets lolol and even detailed enough to leave a spare key behind. And stuck to my word and I am back on my corridor bed at 6pm. 

And promptly served dinner.

Dinner, waited a bit and finally time for ward transfer, thanked the staff nurse and paiseh max because I had to be wheeled up on a wheelchair to my new room despite my mobility and it was by an elderly uncle oh well. Off I go to Ward 13D, Room 49. And what a relief it was to finally have some privacy and I felt like I can rest properly. Staff nurse on duty came to introduce herself, junior doctor came again to let me know briefly what’s happening next, vitals nurse came by every 4 hours to take blood pressure and temperature, I showered and found myself super sleepy and dozed off by 10pm. 

Upgradeeee. My only complaint throughout the stay was that the walls are thin…I am sandwiched by one neighbor who had this bad coughing fit once every 5-6 hours, and another one who was constantly writhing in pain.

Up early again on Wednesday like a regular workday, and just after breakfast doctors came by and finally we have a diagnosis! They found two viruses in my body, first being the cytomegalovirus (CMV) that was causing the fever and fatigue in the earlier part of the week, and drumroll…..Hepatitis A. Which is the chief cause for my liver damage. 

My first reaction? Damnit I shouldn’t have ignored my health screening reports all these years and just take a vaccine. 

Anyway my demeanor is calm la and doctors went on to explain how it isn’t life threatening, there’s no medication available at all, young enough so my liver should be able to recover on its own. But I need to stay hospitalized for them to monitor the liver indicators because it did spike by quite some distance and they needed to monitor if it is really on a downward trend or is it going to spike again, which if it does I will be able to receive attention quickly.   

And at this point I think they are way more interested in the source (which is likely food that has not been prepared properly or contaminated) and thus begins a long interview of travel history (which I briefly shared the day before, but now it’s a lot more relevant), what I ate and so on. And this interview was done a few times to various parties too - the virologist that came by in the afternoon, an officer from CDC who called me a few days after my discharge etc. I was mildly interested in the source too at first but I couldn’t figure it out because whatever possible source…I was never the only one that ate it - sashimi at Kaizen for example, or street food from Pasar, even that one time when I felt that my mother’s stir fried pork liver was kinda undercooked. I eventually concluded that I must have been really unlucky to get that one piece of questionable sashimi (for example). 

There’s actually nothing to be done for the rest of the day, other than the aforementioned visit by virologist, and visit by two separate groups of NTU medicine students. They must have gotten wind of a Hep A patient being warded and hey it’s a good chance for some practicals. So they went through their whole procedure, feeling their way around my belly (coz I allegedly was complaining about being bloated, I guess), and repeat 6 times because well everybody wanted a go. Oh well in the name of grooming future medical professionals I guess I don’t mind much.  

And I think at this juncture I must say I found hospital food to be surprisingly palatable. Maybe it’s because I just had a weekend where I had zero appetite. But everything felt flavorful, and I managed to stomach everything without feeling bloated - though come to think of it the portions are small (except the rice). They didn’t manage to take my orders for Wednesday because I checked in the ward late, but I placed my orders for Thursday and was actually looking forward to it. Until I was given the instruction to fast 6 hours before my scheduled ultrasound scan blegh. 

Surprise, nothing. Staff nurse eventually came about around 7pm to discharge me - I was to come back next week for blood tests and consultation, pending arrangement by the appointments team, and couple months down the road. Feedback form. Bill will be emailed to you. MC (I get another week of hospitalization leave at home). And that’s it. Oh. 

Went home! Colleague OKL insisted that she want to come over and drive me home, because she didn’t manage to visit me over lunch, I thought there wasn’t a need plus she needed to go home and collect her car first before coming over. But after a couple of rounds of futile dissuasion I let her be. It was a nice gesture la and am glad to talk to familiar people la. 

The sister reached about an hour after I did and the next few days, I guessed I overestimated my fitness level a bit? Scaled back activities by quite a bit as compared to her past trips (no buffet, for instance lol) but I got tired very quickly. We basically spent mornings at home just slowly eating breakfast and watching shows and preparing to head out. Lunch somewhere and all three afternoons we were in some sort of mall but I felt tired after an afternoon of walking about. On the first day I even felt a tinge of bloatedness which I was rather alarmed about but it went away after a night of sleep. And that eventually became the norm for most nights. On the last day I actually bailed out and camped somewhere while she went around and that somehow helped quite a bit because my energy levels came back after that. 

And the second week of HL at home, I mostly spent mornings planning my meals, screen time, and log in work laptop in the afternoons and despite being away, work hasn’t piled up thankfully and I usually can log off after a couple of hours. I did make my presence known so my staff know they can reach me and still that didn’t translate to much work so I am rather thankful I guess? I even went in office on Thursday because there’s an appraisal session and battles to be fought haha though that sort of coincides with my blood test appointment. 

Speaking of which that was a messy part post discharge. Appointment lady (she introduced herself as Cindy) called on Friday to arrange my November appointments. After which she was about to hang up when I got very confused and held her back asking about my appointments next week, to which she insist she don’t see any instructions on her end. Back and forth a bit and she told me she will text doctor to check hmmm. End of the day she told me doctor didn’t reply her, and I reminded her to check my discharge note because it was clearly written there, told her I prefer Thursday afternoon, and she told me she will get back to me on Monday coz they don’t work weekends. 

And she did, first thing on Monday morning, and told me doctor did reply and she will arrange for blood test. Come Thursday I discovered yet another cock up - she only booked for a blood test and no doctor’s review after that when I had it on my discharge note sigh. Reception told me this doc only run clinics on Mondays anyway, and on top of that he is on leave till end Nov. Okay what a coincidence sigh. Nothing much I can do, so I went home after the 5min blood test. And the results came out mostly good - all indicators coming down expect the bilirubin which went up instead which explains my continued struggles with itchiness. So I was initially prepared to just let it go. 

The more I think about it the angrier I got at the mess up though. So Friday I called them up again and eventually was put through to Cindy who told me doc didn’t tell her to arrange for a review and she will text again to ask. And a couple of hours later a doc did call back to explain the report and I took the chance to finally ask my burning questions. The main takeaway is that bilirubin is usually the last to start showing signs of coming down, I guess you’d need to wait for the liver to be back to normal before it regains its ability to filter and break down bilirubin. 

And also told me he will order for another blood test next week. Oh. Cindy called back later to confirm that too, and also explained that doc had been meaning to call to begin with just that he hadn’t got around to doing it and my chaser was sort of a reminder. Yeah right. 

So that’s where we are now, sort of. I had the follow up blood test and it came back disappointing because it’s largely the same as the week before which meant I didn’t make much progress this week. In fact one of those that had been dropping went up by a bit even. Doc didn’t call back this time, and I am left wondering if he hadn’t or he wouldn’t. Hence on this note I’m not scheduled for further blood tests to verify if progress is still on track. 

I don’t feel hindered physically, even if I hadn’t resumed exercise much, but I can last through the whole day without feeling too tired, I’ve been back at work in office everyday, appetite is largely there though I’ve been watching the volume of food a bit because the random bloated feeling still resurfaces every now and then. I haven’t been able to sleep through the night because I’d wake up at least once scratching to relieve itch which is the part that I wish will go away soonest. Mentally I was feeling upbeat last week but this week’s result had me feeling slightly depressed over how long drawn the recovery process can be. 

Though I think I will be ok! For those of you (including my future self) who have stuck through this very long post. Haha.