August 5, 2022

JB’s update : While I’ve been feeling totally fine these past few days—went for a run on the beach two days ago, went on a motorbike excursion yesterday—I wake up with excruciating stomach pain and nausea. At first, I think it’s food poisoning, because we’ve been eating really local for a few days and I’m not a huge fan. But I can’t throw up, and the pain is so intense that I tell myself we’ll have to go to the hospital if it doesn’t subside quickly.

1 AM: I’m asleep when JB wakes me up. He’s been in horrible pain for an hour and asks for my help. We’ve been staying in a fishing village (Ninh Tinh), 30 minutes from the nearest town, for a week now. I encourage him to call his friend Vincent, a French doctor, since it’s only 5 PM in France. Vincent always told us we could bother him with any health issues. We call, and luckily, he answers right away. What we tell him doesn’t sound good: JB is in severe pain, we had seafood yesterday, but he can’t vomit or use the bathroom. He tells us to go to the ER if things haven’t improved by 6 AM, and he’ll keep his phone nearby all night.

2 AM: I try to make him vomit by giving him some Vietnamese remedies that induce vomiting, and he finally manages, but the pain doesn’t ease. The more he drinks, the more he vomits, but it’s just bile. I’m worried: it means he’s not getting properly hydrated. He’s in so much pain he can neither lie down nor sit. Meanwhile, I’m packing our bags so we can leave this little village as soon as he’s better.

4:30 AM: Seeing no improvement, I wake up the hotel owner and ask him to take us to the ER. Everyone springs into action.

5 AM: All our luggage is loaded into the car, and JB is taken to the clinic in the nearby town (Ninh Hoa). I wanted to go to Nha Trang, but the hotel owner advises going to the nearest town to get the pain under control first.

5:45 AM: JB is treated at the clinic and given two shots: one for pain and one anti-nausea. They tell us that for tests and ultrasounds, we’ll have to wait for the doctor who arrives at 7 AM. Since the big city is only an hour away, I decide to head straight to Nha Trang. There’s only one private international hospital anyway, and they say the doctors there speak English. The ride is rough for JB, but we’re lucky there’s no traffic, and our driver keeps his cool the whole way.

JB’s update : The journey was grueling, with a basin on my lap for obvious reasons. I’m relieved to arrive, but my hopes are quickly dashed. It looks like a small clinic with four beds facing off. I still think it’s food poisoning, so I think it might be enough. They give me two shots that don’t seem to have much effect, and we hit the road again.

In the car, I make a flurry of phone calls:

• I call the hospital in Nha Trang to let them know we’re on our way and will need assistance and tests.
• I update our French doctor on the situation.
• I inform my parents, who are in Hanoi, Vietnam.
• I call the hotel in Nha Trang I booked in a rush to tell them someone will drop off our luggage.
• I ask our driver to drop us at the hospital first, then deliver the bags to the hotel and head back.
• I pay the remaining bill online for the hotel we left in a hurry this morning.
• I pack a bag with our valuables and important documents that I’ll keep with me all day, so the rest, which is worthless, can be left at the hotel. The only thing I forgot was to grab chargers and power banks.
• I transfer money to my checking account and raise all spending limits—we’ll need it. Since we’d planned to spend time in a remote village, we also had a lot of cash. I take as much as I can.

7 AM: We arrive at the ER of the private hospital Vinmec Nha Trang, and JB is seen immediately. I’m running around to create his medical file, translate for JB, and pay a deposit. As his wife, I have decision-making power over all the care and tests he’ll receive. JB gets an IV to relieve the pain. Meanwhile, the doctor explains the three serious hypotheses and suggests a list of tests. It’s tough for me, even though I speak Vietnamese, to understand what people are saying. Their accent is totally different from Hanoi’s, where I’m from, so I have to ask them to repeat a lot.

The tests cost around 10 million VND (€400), but they think a deposit of 15 million VND (€600) is better. Here, you have to pay upfront, even in emergencies. They accept credit cards, so I was able to pay quickly.

JB’s update : Arriving here, I feel relieved. They immediately put me on a clean, comfortable bed. The ER is air-conditioned. Curtains are drawn to isolate me from other patients. Three nurses who speak English ask me questions, take my blood pressure, and put an oximeter on my finger to monitor my pulse. The pain is still unbearable, but I feel like I’m in good hands.

The IV is slowly starting to take effect. JB is undergoing a series of tests, including an ultrasound. No one told me anything, but I could see on the screen and hear the sonographer talk about a huge gallstone. I wait until the ultrasound is over to ask her what it is, and she tells me: “biliary calculus, but the doctor will explain everything to you.”

JB’s update : During the ultrasound, the doctor presses firmly on my right side asking if that’s where it hurts. The pain is so diffuse that I can’t tell any difference between pain on the right, left, middle, top, or bottom. It’s only once the painkillers start to kick in that I realize that it’s indeed on the right side.

The CT scan is also unpleasant for JB. I have to sign a document authorizing them to perform the test, and confirming he’s not allergic to a certain product. Since he’s never been in contact with that product, I point out that we can’t know since he’s never had it. Every time I’m asked to sign something, I feel like I hold the power of life or death over JB. It terrifies me enormously, but I know I have to decide—the faster I decide, the faster he’ll be saved.

Meanwhile, my parents managed to contact their friend in Nha Trang. She comes to the ER while JB is having his scan. Her presence helps me a lot because at least I have someone by my side and I’m not alone. She offers to take some unnecessary items back to her place, so I can just keep a light bag with the documents & some money.

10am: all the results are in. They give us the diagnosis. The doctor is accompanied by a French interpreter and explains that he has inflammation of the gallbladder due to a gallstone, and the solution would be surgery. At least other serious hypotheses were ruled out. After the announcement, he says he wants to confirm the diagnosis with the hospital director. The diagnosis is confirmed again.

However, they don’t have a surgeon available for this type of operation and propose transferring us to the regional hospital next door.

Since my hometown is Hanoi and my parents live there, my instinct is to bring JB there. Because we’ll have all the connections, knowledge, and facilities needed (there’s even a French hospital), rather than staying here. I ask the doctor if the operation can wait and if we have time to go back first; the answer is yes.

The nurse asks if we want to sign a discharge document. My gut tells me that this time, we should take the time to think.

I ask JB if the pain is bearable for such a journey (2h flight + 4h for transport and waiting), after which he tells me his priority is to feel less pain. His French doctor confirms over the phone that it’s an easy operation.

JB’s update : If you have Vietnam’s geography in mind, you know it’s a long, skinny country. Hanoi is in the north, Nha Trang is in the south. By car, it takes 23 hours. The only option is to take a plane. Unless it’s a medical flight (which was never mentioned), I don’t see how I could have made such a trip. Besides, the airline would surely have refused me given my condition.

My parents’ friend gives me important medical info (e.g., about the two types of operations) because she’s been operated on, and her friends have had operations for other issues. So in 10 minutes, I had to absorb a ton of medical info and be able to understand it to ask relevant questions.

I ask the two doctors additional questions and learn that the risk of the gallbladder rupturing during the trip to Hanoi is 50/50. If that happens, it could be life-threatening. My parents’ friend asks if they could bring in a surgeon here (since a private hospital’s facilities are better than a public one), but they refuse. I ask for info about the other public hospital, and they tell me that the type of operation (open surgery or laparoscopy/coelioscopy) will depend on the surgeon available there, and they have no recommendations (for a surgeon) to give me.

I resent them for kicking us out so quickly, and for not informing me about the risks. It shouldn’t be my job to ask those kinds of questions; they should have informed me and given me more info than that. Anyway, that’s another story. In the end, I managed to ask relevant questions thanks to Google and my parents’ friend, and that’s what matters.

Now it’s time to make a decision. I mentally calculate the time it takes to get to Hanoi or Saigon and accept the transfer to the other public hospital, if only to get a second opinion, and especially to see if they offer laparoscopy.

I call my parents, who ask if I want them to come. I say yes, in tears. JB, hearing “50% risk” and seeing me in tears, starts to get scared and gives me important info in case…

JB’s update : Wow, rereading this, I can’t believe I had to do that. I’ll never know what the real risk was, but we were at a point where I thought it was relevant to give administrative info to Anh to make things easier for her if I were no longer here. During our end-of-first-world-trip review, we said that fulfilling our dream brought us a lot of serenity. I was able to experience it for real: if it were my last day, I’d have no regrets; I’ve lived life to the fullest.

But this is no time to cry. I’m given JB’s medical file for the transfer. I barely have time to snap a few photos of the test results when it’s snatched from my hands and never returned.

My parents’ friend abandons us and will come see us later.

11am: We are transferred to Khanh Hoa Regional Hospital by ambulance (with the “wee-woo” of the siren), accompanied by a nurse and a doctor. In the ambulance, I inform our French doctor of my decision and send him all the test results I could photograph.

11:15am: JB is placed on a very uncomfortable stretcher to Vietnamese standards. This is where we start to feel less reassured, because the facilities have nothing in common with the private hospital. No one takes care of us anymore. JB no longer has any IV, not even a sheet. The beds are placed 50cm apart, everyone is suffering. The other beds each wait their turn for someone to come care for them. All patients are accompanied by their family. Alone, I can’t even leave JB for a second, I haven’t eaten or drunk anything. In my head, options flash by but none seem better than this one. We just have to wait. I send the name of the new hospital to everyone.

JB’s update : It’s even before we’ve crossed the hospital door that I realize the drop in standards. I’m transferred from the international hospital bed to the local hospital bed. The mattress is dirty, it must be half the width and a quarter the thickness. The nurse even takes a moment to recover the comfortable, clean sheet that was rolled between my legs.

Meanwhile, my mother activates her network by contacting all the doctors she knows, to find the name of a surgeon specialized in gallbladder. My parents, who are on an excursion 3 hours from Hanoi, find a taxi at the last minute to take them to the airport. With two minutes to spare, they manage to get two plane tickets departing from Cat Bi (near Hai Phong). In Vietnam, plane ticket sales stop 3 hours before departure.

12:07pm: The most important message of the day arrives: my aunt, a doctor, gives us two surgeon names who work at the regional hospital where we are. If it’s this type of operation, it’s this surgeon. I memorize this message by heart, because I’m afraid of not having enough battery for the rest of the day. Fortunately, JB also gave me his phone, so I keep both and keep his family, my family, and our doctor updated on what’s happening.

A doctor finally comes to see JB. He asks for another blood test and an ultrasound. They ask me to pay a deposit before doing the tests. Fortunately, I have a lot of cash on me, so I did it in seconds. Forget those paying by transfer or credit card!

12:40pm: After long waits (JB no longer has any IV, fortunately this morning’s IVs are still having an effect so he’s in pain but a bit less), someone draws his blood, then after another long wait, he’s taken to the ultrasound room. We see the gallstone on the screen again, and the doctor explains what it is and that we need surgery. I ask him what type of surgery it is, and his answer reassures me already: of course they offer laparoscopy.

Shyly, but I have nothing to lose, I ask if we can choose our surgeon, to which they say no, because it’s an emergency operation. I clearly ask if surgeon Mr. X is on duty. They reply: “which Mr. X?” Desperate, thinking my aunt didn’t give me the right name, I try: “Mr. X who works in this hospital.” And the ultrasound technician points to the doctor who has been following JB from the start: “that’s him!”.

You can’t imagine the relief I feel at that moment. My 10,000 options vanish in an instant.

There is only one option now: stay here and get surgery here, ASAP.

JB’s update : Since I’ve been a useless wreck since the start of the day and I’m completely doped up, I didn’t follow the whole surgeon story. But I think it’s the first time I’ve seen Anh smile. It reassures me.

When leaving the ultrasound room, I have to wait a long time again before signing a very scary document where, basically, I’m aware of the risks and what will happen next and I’m responsible for the decision made. The doctor tells me he has to operate on 2-3 people first, and we don’t know when JB will be operated on, but it will be today.

I call the international insurance to inform them of the operation.

Since Vinmec International Hospital gave us an unreadable CD of the scan images, I call my parents’ friend, who has to go pick up the X-rays and the insurance certificate in English from Vinmec. Unfortunately, this lady is rather elderly, so between the time I asked her and the time the documents arrived, an hour passed and the doctor kept asking me for this document. I was considering a second option when she arrived.

JB only starts getting a fever around 2pm (no fever before), so the inflammation has begun.

3pm: The doctor, very kind, suggests hospitalization before the operation. JB is transferred by wheelchair to a room with 5 beds, more comfortable than the ER bed. I borrow an iPhone charger, finally. I leave JB with his phone and with my parents’ friend to grab a bite, but the nurse calls me over and has me sign more documents. Another person arrives and tells me that the international insurance contacted them, and that I need to sign such and such documents. JB receives an IV again and has some pre-op exams. They tell us to remove all jewelry and metal objects.

JB’s update …since I had no sense of time, it’s only when rereading the article that I realize I spent 4 hours in that emergency room, how awful! But the bed is already much more comfortable.

I’m not hungry but I need to eat: I finally settle down at the restaurant across from the hospital to eat a plate of rice that’s not very good, but the rice is filling and will help me.

4:15 PM: JB changes clothes, is put in a wheelchair, then the nurse pushes him through the crowded hallways at a run.

4:30 PM: In front of an elevator, she asks me to stop there, and I have 2 seconds to explain to JB that I can’t follow him and wish him “good luck”.

JB’s update …that’s a pretty rough separation :- (The nurse leads me to the entrance of another building. Gives me flip-flops, helps me take off my gown to give me a simple sheet to wrap around my waist. She signals me to go ahead and I understand she can’t enter this space herself. It’s inconvenient because I have a lot of trouble walking. I pass two operating rooms where I glimpse operations in progress. Then a third that seems to be being prepared. The nurses signal me to enter. I’m reassured to see that everything looks clean. They have me settle on the operating table, attach sensors to my body. I’m on my back, even though the only position I could tolerate was being on my right side. The surgeon arrives, I say “xin chào”, which amuses everyone. They give me a mask to breathe, after three breaths I feel myself drifting off, then blackout.

The nurse returns five minutes later and shows me a door “you wait for his release there!” and tells me to go get changed, eat a bit, because he’ll be out in 3-4 hours.

I see the other families, sitting on the floor, waiting for their loved ones. The patients coming out are all naked on a bed, barely covered by a white sheet, like corpses, completely out of it. They’re then taken by the nurse and their family to their room. I watch carefully to note down things to bring back for JB.

Meanwhile, my parents are already on the plane and I have to handle their arrival at the hotel.

I go ASAP to the hotel for check-in. Explaining to them why JB isn’t there even though he’s the one who booked, and that three people will be taking the room (instead of two) took me a good half hour. My suitcases are already in the lobby (thanks to the driver from this morning). I have time to take a shower and prepare a small bag, with our two down jackets to cover JB as soon as he comes out of the operating block; this bag contains everything needed for this first night at the hospital.

5:30 PM: I’m already at the operating room door because I’m afraid he’ll come out earlier than expected and freak out if he doesn’t see me. I listen to meditation music to recharge while thinking about the day. At no point was I panicking; I was serene and calm from the first hours. I even wondered why I wasn’t more scared than that. Probably because I was so unwell and felt so in danger in Bali that not feeling danger in Vietnam is a state of calm for me. It’s also thanks to this absolutely surprising calm that I never considered the worst, and I was always confident. During our trip, we had to face stressful situations where we saw no way out/immediate solutions, but I always managed to find the solution and decide quickly. This time again, my intuition guided me well. If we had spent even just one more week in Bali, the outcome might not have been as favorable. That’s why I felt in mortal danger in Bali and kept telling JB we had to leave and go back to a more developed country. My intuition knew something was brewing.

6:30 PM: My parents arrive in Nha Trang and go to the hotel to drop off their suitcases

6:33 PM: An orderly I ask if he’s seen “a foreigner” tells me JB just arrived in the post-op room. He’s alive. I inform everyone.

7:18 PM: My parents arrive in front of the operating room where I’m waiting for JB. I cry with joy. That’s it, I can finally let my guard down and rest a bit because the hardest part is over. Dad hands me a sandwich (banh mi), very good, but I eat it mechanically because I’m no longer focused on it at all. My mother asks around, and we learn that JB will come out at 9:30 PM.

9:00 PM: The doctor explains how the operation went. In the end, it was more difficult than expected because the gallbladder was quite swollen and very full. The stone was bigger than what we saw on the ultrasound. We could have waited 1 to 2 days for the operation, but the chances of a successful operation would have decreased too. Luckily we got an excellent surgeon. We were able to inquire in the following days, and JB was really lucky to catch the 24 hours when he was on call, because within 24 hours, we wouldn’t have had him. My poor JB no longer has a gallbladder. He’ll have to be more careful with his diet.

9:30 PM: JB comes out of the operating room. He has lots of wires and tubes hooked up to him, including a tube connected to his stomach, from which a small yellowish liquid comes out.

JB’s update : Naturally, I have no sense of time. I wake up in a new room. I look left, right, other beds with patients are present. I don’t feel anything special, but the noise is very unpleasant. I hear laughter, people talking very loudly. I notice that what must be a rest room for the caregivers is on the left. My senses are probably disordered and amplify the volume. I realize that my arms and legs are restrained. I call for help, but the sound coming out of my mouth seems insignificant compared to the volume of the rest room. I wait, no one comes. I eventually try and manage to free my right arm, I discover what is attached in a small plastic pouch: the stone they removed from me. It’s huge! I tell myself it would be a very bad idea to get out of bed on my own, so I keep waiting. Finally a nurse arrives, changes my sheets and bed, we leave the building and I quickly find Anh and her parents.

We are transferred to a room with 5 beds. Each bed is equipped with a small cabinet and we share a fridge and a fairly clean bathroom. Each patient is accompanied by a family member. The family members have to sleep on the floor next to the patients, because the service is far from being like in France. It’s me who has to watch over JB: his IVs, give him something to drink and eat (not provided by the hospital), help him if he needs to go to the bathroom, … I put in my AirPods to listen to relaxing music, but I set an alarm that goes off every 20 to 40 minutes, depending on the IV JB has, so I can check his condition and go get the nurses. Poor JB keeps apologizing for what he’s putting me through. Whereas in my place, he would have done exactly the same thing.

It’s probably one of the hardest nights of my life. I burst into tears in the darkness, to release the stress. I must have really slept 30 minutes. My father wanted to take my place but I wouldn’t have been able to sleep peacefully at the hotel anyway, and JB will feel more reassured this first night with me by his side.

JB has both hands taken by the IVs and can’t do anything. I have to watch over him constantly. I put podcasts and earphones on him. At one point, I wake up with a start and discover that there are only 2-3 drops of IV left. If I hadn’t stopped it in time, the blood could have flowed in the opposite direction and pumped JB’s blood.

So I sleep on the floor on a bamboo mat that my father bought for me. It’s very cold because the patient in the next bed insists on turning on the AC and especially the fan super strong. Luckily I brought our two down jackets with me. JB, on his side, isn’t cold. At 1am and 2am, the nurses make a remark about the AC and only then were we able to lower it and I stop suffering from the cold.

August 6, 2022

5:30am: the light turns on, all family members have to get up ASAP to make way for the nurses. I am completely exhausted. It’s been 28h30 that I’ve been awake.

6am: My father arrives as backup to take over and allow me to go sleep a bit at the hotel. A doctor comes to see JB and prescribes the day’s IVs.

I return to the hotel, have breakfast (all-you-can-eat buffet, awesome!) and sleep until 11am.

Meanwhile, my mother takes care of JB, massages him, does reflexology on him, and he no longer has a fever. The nurses are supposed to remove a needle from him since 2am already, but they didn’t do it despite my insistence, they only did it because my mother, as an authority figure, scolded them. During this time, we keep asking for a private room.

JB’s update : The room isn’t very comfortable, I’m 100% dependent because I have both hands taken by the IVs, but I can’t complain. I’m completely stoned and I’m no longer suffering like crazy like yesterday. The only real annoyance is the nurse taking care of me. Constantly in a bad mood, she makes me bleed by bumping my IV, squirts a lot of fluid when she changes my IVs, … I imagine she must be handling dozens of patients and her days must be very long.

Afternoon: JB is transferred two floors up. The whole bed is put in the elevator for the transfer. Then, he has to change beds (very painful for him), but we now have a private room with two beds, one of which for me.

JB’s update : Bliss! Especially since I change nurses at the same time and the quality will be incomparable.

The nurse asks us to buy surgical dressings. There is a shortage of medical materials at the moment and hospitals can’t provide them. Patients (or their families) have to buy them themselves. They give us an address, the dimensions of the dressings, and my father buys them for us.

Following the favorable observations since this morning, the doctor decides to remove the tube attached to his belly. It seems very very painful. The “hole” closes up immediately upon removal of the tube, because the stitches are already made by the surgeon and are just waiting to close, I don’t know how it works, but it’s very good work. JB has a lot of hair on his belly and they didn’t have the reflex to shave him before the operation (since Vietnamese people don’t have hairy bellies). The nurse had to shave him before putting on another dressing.

JB’s update : “a lot of hair on his belly”? Maybe for Asian standards. My belly hairiness is perfectly within the norm.

JB has to chew gum to help with bowel movement. And thankfully it worked.

I stay with him until the next day. This time, since there’s no IV, I can afford to wake up only every two hours just to help him with his needs and put the blanket back on him…

Our French doctor calls us regularly to check in, and I keep him updated on every development.

August 7, 2022

I leave the hospital in the morning as usual because my father takes over. All the follow-up medical visits happen with my father present since I always leave before.

This time, I’m feeling better, so I come back at 9 a.m. after checking my parents into another hotel. I leave the hospital again around noon to have lunch with my mom and look at apartments (for JB’s recovery).

The nurse points out that JB isn’t even changing positions, which isn’t good. He needs to move a bit more. I encourage him to turn over a little, but he feels nauseous and almost vomits. We’ll later find out these are side effects of an antibiotic, so no big deal.

His bandage comes off, and they redo it—this time, really well and really neatly.

I tell JB he needs to try to move, and not only does he manage to stand up on his own, but he also brushes his teeth standing up, without any help.

I have a pleasant night at the hospital because JB can now get up by himself without bothering me. I only woke up once.

I send all the info to our French doctor as usual.

August 8, 2022

One of the surgeons who operated on him comes to see him and lets JB leave the hospital that very afternoon. He gets a few shots before leaving.

Meanwhile, I handle the payment, insurance, paperwork…

And we all end up in an apartment with a stunning view of Hon Chong beach in Nha Trang. For a month of recovery, at least.

In the meantime, we make a few discoveries:

• that the stone is like a tube of varying density, hollow inside. That empty space likely allowed bile to flow, which is why such a large stone caused no pain for a long time.
• the stone must have been covering the gallbladder walls.
• then, it detached from the walls, and that’s when JB started feeling pain.
• this explains why there was no inflammation when he was admitted to the ER, but the inflammation began just before his surgery when the stone was moving freely inside.
• all of this explains why the gallbladder was so “fresh” and why such a huge stone went unnoticed.
• JB took treatment in April for nail issues—was the stone accelerated because of that medication?
• we were right to operate ASAP; the surgeon said we could have waited another 2 days, but it would have been increasingly difficult and risky.