Warded in TTSH: Day 02

Coming to a close for yet another day in TTSH.

Nothing much happened today and I did not have the MRI done as the doctor said that the information from the CT scan done on 6^th Feb was sufficient for the planning the stenting procedure tomorrow. The procedure should be done sometime in the afternoon to try and open up the bile duct but it will also depend on whether the scope can be inserted through the small intestine (duodenum) to access the bile duct. This is the part that I am concerned about because I know that the intestine blockage is really bad. Pray that the scope can be inserted through.

The doctor had allowed me to take some food but I know the stomach will not fully empty out before the procedure and so I may have to force myself to vomit again.

 
A couple came to pray for me today with some prophetic words. Won't be posting it now but will do so retrospectively as well as sharing the word that Vicar had shared on Tuesday's Communion.

I need to rest and for the stomach to clear before the procedure. Just ask that you pray for these two things.

In God We Trust
Hebrew 11:1

Warded in TTSH: Day 01

Sigh... I got warded in TTSH again. This time around it is on the advice of my Oncologist as my bilirubin level is getting higher and need to do something about it before going for radiotherapy. I will be going for a MRI tomorrow (hopefully) to ascertain how much obstruction there is in the bile duct and then plan for stenting.

There is also the obstruction of the small intestine that at the present moment the doctor is not able to determine if they can open it up with stenting.

Because I am not absorbing much nutrients from the food and also dehydrated, my potassium level is low they are infusing potassium. It is very painful.

End of this first night.

In God We Trust.
Hebrew 11:1

Radiotherapy: Pre-therapy #04

I am still waiting for TTSH to call me concerning my chemotherapy.

The last few days were a challenge for me. Trying to eat and I still can eat and some food does get past the stomach but a substantial quantity gets stuck in the stomach and these needs to be cleared every now and then. Vomiting is indeed a daily affair now and very often for several times a day. Drinking water is also a challenge as it adds to the bloated-ness but when I do need to vomit, water helps to push the yucky stuff out.

I can tell that I am losing fat and muscle mass and I lost another 1kg+ in the last one week. I may have to go on a higher sugar intake for the energy and to help to reduce the muscle mass lost.

The jaundice is not improving but that is to be expected from the obstructed bile duct. The eyes are more yellow now and the skin has a touch of yellow and fairly obvious.

Can wait for the radiotherapy to start on Wednesday because for now, that is the best solution to shrink the size of the tumor and relieve the pressure on the stomach and the bile duct. For the bile duct, a stent can be inserted to help with the flow but with my impending radiotherapy, not sure if that is an option for the immediate future. As for the stomach, I am not sure how to ease the pressure except to eat more soft diet or go on liquid supplement.

Spiritually, the challenge is to remain strong for the family and to God. Previously, it was easy to say the “good” things because you can see God working with general improvement in my condition. With the recent turn of event, the situation is different as I am undergoing actual “suffering” so to say and focusing on God becomes an effort rather than norm. I am kind of incline to think that God is also at work in this aspect because if things had been really “bad” from the start, would I have the mental clarity to develop the faith and dependency on Him? It is perhaps God’s grace and mercy at work here to strengthen me for the tougher journey ahead having taught me to regard Him in everything, the good, the bad, the highs and the lows. I have no doubt about God’s grace and mercy and my faith in Him. Although it is a challenge to maintain that faith but if I can get through this, knowing that God is with me, I know my faith would have weathered the storm and would be stronger. Therefore, as was the case in the past, it will be moving forward that in God we trust and I cling on to the assurance of things hoped for.

On a happier note, Formula1 started yesterday in Australia. So wonderful now that I can get it on Starhub TV and I am still boycotting Singtel Mio. My 2 favorite drivers, Kimi and Alonso were on the podium in 1^st and 2^nd place respectively. So happy… So much for Seb, he is good only in a good car, on equal footing, he can never be better than Alonso and the Iceman is just so cool.

In God We Trust

Hebrew 11:1

SARS

If you read the papers, Singapore is commemorating the 10^th Anniversary of SARS (Severe Acute Respiratory Syndrome) occurrence here. This brought back some memories of my time in TTSH as a staff in 2003. I was then under the employ of TTSH as an Operation Manager (Clinical Ops, Outpatient Services) in the Department of Infectious Diseases. Yes, I was right smack in the middle of it all.

One of my responsibilities was management of the Travelers’ Health and Vaccination Clinic in TTSH, the largest vaccination clinic in Singapore by volume. I still remember at that time there was the bird flu situation in China and so we at the clinic monitors the news feed closely for development of the situation in China closely as one of the services provided by the clinic was travel advice for people coming for vaccination.

During that time, we encounter all sorts of people who come to clinic for vaccination and advice. Prior to WHO declaring the SARS pandemic, I still remember families who came to the clinic asking about vaccinations for bird flu or what we know about the “new” flu as they had booked and paid for holidays to China. It was difficult managing these groups of people because there was really scant information available at that time and how do you then provide “proper” advice.

When SARS as “SARS” was announced and TTSH became the designated SARS hospital and we went into a kind of lock-down mode, I was assigned to CDC (Communicable Disease Centre) to provide operational support and there I stayed for 8 weeks. It was take the train to work in the morning and take the train home in the evening. Outside of work, there were zero social activities, no church and no unnecessary interactions. It was alright because it is a small sacrifice to keep Singapore safe. The only “bad” experience that came out of it was that I did not get to interact with my god-daughter who was very young at that time and by the time the self-quarantine was over and when I saw my god-daughter again, she refused to let me carry her. It was a sad moment but not anymore as she had grown up and still acknowledges this “god-pa”.

The nastiest experience during the 8 weeks was when an American girl was sent to CDC for quarantine and observation because she had developed a fever. She was sent to CDC accompanied by her parents. The girl was terrified as she had never been hospitalised and will be “isolated”. The father kept asking when they will know if their daughter will be alright and when they will get the call with information about their daughter’s condition to which the nurses replied that they will call the family as soon as they have information. This was obviously not sufficient for the father and he ranted that his daughter has not been away from them alone before and that he works for a big American firm (while pointing a finger at my face) and I was specifically threaten with lawsuit from his firm’s lawyer if anything untoward happened to his daughter. Here we are fighting a pandemic and the doctors, nurses, support staff and myself are putting our life on the line and I get threaten with a lawsuit! Such is the indulgence on individual rights over community rights and anyway, I would not know who the dude is going to sue if he does sue especially since he did not ask for my name but I was wearing my name tag and I was wearing a mask that might make recognition an issue.

I am proud of my contribution to TTSH and Singapore no matter how small that contribution might be. My name was not listed in the commemorative book published by TTSH the year after as I had left the employ of TTSH and so did my immediate operational boss and so there was no verifiable source of my participation in the SARS epidemic. If there is any consolation, in the book, there was a picture of me with CDC’s nurse manager and senior nurses during one of the morning’s briefing.

Here’s to all the Healthcare workers in Singapore, generally an underappreciated group of people.

Radiotherapy: Pre-therapy #03

I went to TTSH for my blood test yesterday. The results should be out by now and I am just waiting for my Oncologist to contact me concerning my chemotherapy in the coming week. Supposed to have my chemotherapy together with radiotherapy but I am not sure how the arrangement is supposed to be done. In any case, whether I can proceed with my chemotherapy is very much dependent on my blood tests result particularly my pancreatic and liver function. Previously, primary concern was my platelet count but now because the tumor is pressing against the liver, the results pertaining to my pancreatic and liver functions are also of concern. The wait for the call from my Oncologist is “killing” me (not literally).

I am jaundice due to obstruction of the bile duct. You can see from the pic the yellowing of my eyes. Easier to cope now that I know what I have to do. I spent about an hour this morning on a bench near my place just to sun myself and to help clear the jaundice.

Food is also retained in the stomach due to obstruction of the stomach outlet. This is the most comfortable part of my condition now as there is a feeling for bloatedness and my stomach is churning and having spasm in trying to push the food out. I had to force myself to vomit several times a day just to clear the retained food.  During the night, not only does this disturb my sleep, it disturbed Josie’s sleep as well as she is very concerned about me. This morning, at about 4am, I was trying to vomit and she knew about it from the noise and got ready a cup of warm water and waited for me to come out of the toilet. So touching and conscientious and the warm water really helped. Also easier to cope now that I sleep on an inclined position so that there will not be any reflux of the stomach content into the throat.  I managed to have a relatively good night rest this morning.

It is just a matter of resting and waiting. The waiting is the part that is agitating me as I wish that things can move along quickly. Hit the tumor and hit it hard. I can and will bear the side-effects from the therapies as God will give me the grace to bear it.

In God We Trust

Hebrew 11:1

Pain in the Heart

The situation is getting somewhat less bearable. It is not unbearable but just “less” bearable. Vomiting has become a constant affair since last Saturday as food keeps getting retained in the stomach and I need to vomit this retained food out just to make myself more comfortable. It also means that I probably am not getting sufficient nutrients into the body as I am losing weight and getting lethargic. Good thing I have a tin of the Glucerna nutrient supplement and I got another 5 more tins coming.

It pains me that I am shutting myself in the room because I really do not have the energy to play with Nathan. Hearing his voice through the room's door and forcing myself to stay in the room really pains me.

Last night after dinner (part of it I had just vomited a moment ago), Josie, Nathan and me, we took the train to City Square Mall to see the fountain as Nathan really gets the trill when the fountain is “performing”. We had walked around a little bit before settling ourselves down on a bench by the fountain and Nathan was wide eyed as the water sprouts does its performance. Part way through the performance, Josie leaned over and places her head on my shoulder and cried. I do not know exactly what was going through her mind but for me, it was a moment filled with deep pain and sorrow in my heart but as most man being man, I stopped myself from crying.

If you had been there, you will probably notice a tender picture of a child sitting on his mother’s lap watching the fountain as the mother leaned her head on the husband’s shoulder and the husband staring blankly ahead as he contemplates what does the future holds if God chose not to heal. So it was during that night, after reaching home that I took the resolve to pray for healing. If you understood where I am coming from, I would not have under normal circumstances pray directly for healing as I believe that God’s sovereignty and will is paramount and thus I pray according to His will which may or may not involves healing for my condition. Josie’s tears broke this resolve and I prayed then for healing but it is also more for the sake of Josie and Nathan.

I was in church this morning talking to the lady who looked after the welfare and visitation of the sick and ill in church. We spoke for about an hour and a half and I told her about what I had written in the above paragraph. I told her that in praying for healing, I do not just simply pray for healing but in the prayer, I also pray that God’s will be done because ultimately it is up to God what He wills. This lady said something that reminded me of what I had written before that for the will of God, it is “God’s will be done on earth as it is in heaven”. We cannot bend His will but I pray as Jesus had prayed, “If it be thy will”, take this cancer away from me.

She was also talking about journaling but in the more physical sense of using a pen and paper and that in journaling, there can be an avenue of release not just for the writer but also for the reader. She was saying these from the perspective of an after event whereas in my case, I’m doing it online and everyone gets to read the journal (blog as it is called in this case) now and not when I am gone. We continued talking and I was talking about my perspective on “Faith” and she spoke about my “testimony” and when you add 1 + 1, it could be that my testimony in this whole journey is about faith in God. Again, this is the subject for another blog entry.

If my entire blog was to be collected and printed into a book, it would be entitled:

There is no misery in the suffering

A journey of faith

In God We Trust

Hebrew 11:1

Radiotherapy: Pre-therapy #02

From now onward for the next 6 to 8 weeks, you will see a lot of entries with the “Radiotherapy” heading. This particular entry is entitled Pre-therapy Consult #2 because today was really the 2^nd consult and last Friday was the 1^st consult.

Last Friday’s consult was to determine if I should have radiotherapy and today’s consult was an assessment to determine if I can proceed with the therapy and take a CT scan for measurement, creating a mold for immobilisation during radiotherapy and planning.

My radiotherapy will start on 20^th March and it will go on for every day except weekends and public holidays for 30 sessions. At the same time, I will also have chemotherapy concurrently but whether chemotherapy can proceed will depend on my blood test results. The last chemotherapy could not proceed because initially my platelet count was low and subsequently there was some problem with my liver function and this was due in part to the bile duct been blocked indirectly by the pancreatic tumor. Due to this blockage, I am also beginning to have some jaundice and the “white” in my eyes are turning yellow.

The tumor is also blocking my stomach outlet causing food retention that also causes me to be bloated. Last Saturday’s night, I forced myself to vomit and huge amount of food came out and I can recognise some of the food as from Friday’s night dinner.  Today, the doctor was saying that with radiotherapy, if all goes well, I should be able to see improvement to my situation, i.e. less blockages and the jaundice should slowly fade and if the jaundice persist, may have to put in a stent to drain the gall bladder.

For now, I am just waiting for a call from TTSH to let me know when I should go from my blood test to determine if I can also proceed with my chemotherapy. The double-therapy is probably the best option at this point since surgery is out of the question and to hit the tumor hard with more aggressive dosing. As for the side effects, with the double whammy, not sure how “bad” the side effects will be as I will be having higher radiation dose for the radiotherapy but I may be placed on a less aggressive chemotherapy drug.

Over the next couple of weeks, I may just have to “drop off the face of the earth” temporarily but I could be found “online”. Pray for tolerance to the therapies’ side-effects and effectiveness of the therapy.

In God We Trust

Hebrew 11:1

Pain In the Journey

For the first time since the start of this journey, the pain has returned. As mentioned in the last post, the pain and spasm that I am experiencing is possibly due to the tumor pressing again the stomach and small intestine obstructing the stomach outlet and the bile duct. The feeling is not something to be taken lightly as it is constant and nagging.

The pain I can bear and tolerate as I am dependent on God for that. If I can bear 9 cycles of chemotherapy side effects, I can bear this “small” pain. How long I can continue to bear this pain is largely depending on how well the radiotherapy works in shrinking the tumor and on God’s grace that is the mainstay of my tolerance.

The part that I find it hard to bear is the emotional turmoil that comes with the discords and disharmony at home. I had and am still trying not to say too much about what is considered an “internal affairs” not be spoken or written publicly but I am at a stage where sometime death and escape is preferred. I had spoken constantly about the fact that in God there is no misery in the suffering and I still maintain that stand but then what do I call what I am going through right now, an aberration of grace? What I cannot bear is to lose is Josie and Nathan.

The real pain is not physical and for once doubt is creeping in and I pray for forgiveness. For once there is no desire for healing except for alleviation of the physical pain and for once I cannot in true honesty end this blog with my tagline.

Clinical Update, March 2013, #02 / Pre-Radiotherapy Consult #01

I saw the Radiotherapist today and this is basically what’s going to happened next.

The latest CT scan report indicates that the Liver is alright except that the common duct and some biliary ducts are dilated (bigger) but is not the cause of my stomach pain and spasm. Everything else concerning this scan remains the same as compared to the last scan but there is definitely a new tumor tissue growing in the head of pancreas region. The pain and spasm that I am experiencing is possibly due to the tumor pressing again the stomach and small intestine obstructing the stomach outlet and the bile duct and this may be related to my higher ALP number.

My Oncologist feels that the existing chemo-drugs used could be losing its effect and is causing neuropathy which could explain my continued numbness and tinkling in my fingers and toes.

Between the Oncologist and Radiotherapist, they both agree that I should move on to radiotherapy as soon as possible. Based on my age, past tolerance to therapy side effects as well as general improvement and depending on initial outcome and my liver function test, chemotherapy may be employed concurrently but with a different drug. Also they will be employing more aggressive treatment, i.e. higher dose of radiation that could be modulated if I do not tolerate it well.

There will be some side effects and because of the region treated, common side effects could be nausea, tiredness, diarrhea and darkening of the skin around the therapy region. Although rare, long term side effects could include perforation of the small intestine and damage to the liver.

The therapy will start very soon. As TTSH is under-capacity at this point because they are changing to a new machine, I am referred to NUH for my radiotherapy. I will be having a therapy planning CT scan done on Monday, 11 March and the actual therapy will start on 20 March for 6 weeks, Monday to Friday. Yes, you read it correctly, every day except weekends for the 30 days. The procedure is relatively fast lasting about 30-40 minutes from start of session till end.

Well, that is as much as I know and can share for now.

This is a new phase in the journey and there are relatively much unknowns. This creates a lot of uncertainty and confusion in terms of thoughts and feelings. In actual fact, I am not really uncomfortable with going for radiotherapy but it is the current pain and spasms that is bothering me and knowing that I have to live and cope with it until the therapy and hopefully some relief of the pain that is creating the anxiety. Mentally I am alright but like having anticipatory nausea from the chemotherapy, I think right now I am suffering from some form of anticipatory anxiety. I can’t put my finger to it but it could be that there was relatively little pain when I was going through chemotherapy that I was able to bold and stand firm in Jesus. Now with the constant pain and from it a lack of sleep, it is difficult to put a smile on the face.

Sometime I think God has a sense of humour and of course knows what we are and will be going through and had thus inspired my previous blog “By Faith Give All to Gain All”. I thought that my blog would be an instrument to encourage others but in this case, it is an instrument to encourage myself and help me to push on, reminding me of my faith in Him and to know that he will carry me through.

A few days ago, someone from church sent me an old song “He Will Carry You” by Scott Wesley Brown and how appropriate for this moment in my life and I believe too for Josie.

HE WILL CARRY YOU

Words and Music by SCOTT WESLEY BROWN

© Copyright 1982 Birdwing Music/Cherry Lane Music Publishing Co., Inc.

Verse:

There is no problem too big He cannot solve it,

There is no mountain too tall He cannot move it;

There is no storm too dark God cannot calm it,

There is no sorrow too deep He cannot soothe it.

Chorus:

If He carried the weight of the world upon His shoulders,

I know my brother the He will carry you;

If He carried the weight of the world upon His shoulders,

I know my sister that He will carry you.

Tag:

He said,

"Come unto Me all who are weary, and I will give you rest."

In God We Trust.

Hebrew 11:1

Clinical Update, March 2013, #01

Recently I have been having stomach spasm and pain after meals and as it was getting quite bad as it disturbed my sleep, I’d had requested for an urgent appointment with my Oncologist. I guess it was fortunate that I had “forced” my appointment in as we did a STAT CT scan yesterday and report is out today.

Initially, the suspicion was that the pancreas was trying to function and “push” enzyme out and thus causing part of the pain. Another suspicion was that there might be some stones in the biliary ducts causing partial blockages and because the duct is trying to push the bile into the gall bladder, that it was also causing the pain.

The scan report came out today and the liver is still ok as in there is not prominence of any cancer in the liver, there is also no stone in biliary ducts but the head of the pancreas where the tumor is bigger with a “spot” been observed. Part of the pain could be that the tumor is pressing against the stomach and that caused the spasm and pain. My Oncologist suspect that the chemo-drugs may be losing its effect and would like to move me to Radiation Therapy as soon as possible and an urgent appointment was arranged for me with the Radiation-Therapist for Friday morning to plan for the radio-therapy.

Based on the appointment with the Radiation-Therapist and subsequent consults, my Oncologist may still try Chemotherapy in conjunction with Radiation-Therapy.

Not so good news but it is also good news at the same time because the cancer is localised to the pancreas and planning for the therapy is more straight-forward and focused.

I still have full confidence is God’s grace and mercy and would like to reiterate that there is no misery in this suffering.

In God We Trust.

Hebrew 11:1

By Faith Give All to Gain All

Josie was away on a business trip last week from Tuesday evening till Friday morning. After picking her up at the airport, we went to the McDonald near our place for breakfast and as usual we talked. Interestingly, the first thing she asked me to do was to read from a passage from a devotional book “God’s Creative Power” about faith giving substance to hope and the reference was from Mark 5:25-35 and Hebrew 11:1.

Mark 5:25-35 (NASB)

²⁵ A woman who had had a hemorrhage for twelve years, ²⁶ and had endured much at the hands of many physicians, and had spent all that she had and was not helped at all, but rather had grown worse— ²⁷ after hearing about Jesus, she came up in the crowd behind Him and touched His cloak. ²⁸ For she thought, “If I just touch His garments, I will get well.” ²⁹ Immediately the flow of her blood was dried up; and she felt in her body that she was healed of her affliction. ³⁰ Immediately Jesus, perceiving in Himself that the power proceeding from Him had gone forth, turned around in the crowd and said, “Who touched My garments?” ³¹ And His disciples said to Him, “You see the crowd pressing in on You, and You say, ‘Who touched Me?’” ³² And He looked around to see the woman who had done this. ³³ But the woman fearing and trembling, aware of what had happened to her, came and fell down before Him and told Him the whole truth. ³⁴ And He said to her, “Daughter, your faith has made you well; go in peace and be healed of your affliction.”

Hebrews 11:1 (NASB)

¹ Now faith is the assurance of things hoped for, the conviction of things not seen.

Recently, other than the tagline “In God We Trust”, we have grown and decided to accept Hebrew 11:1 as our tag-verse.  We were talking today and when we talk about “trust”, it is synonymous with belief and faith in God and you cannot dissociate “Trust” away from “Faith” or vice versa. They are truly integrated because how can you say you trust God but have no faith or how to have faith in God but no trust in Him?

The story of this women and Hebrew 11:1 resonated with me because in the small devotional book, the subject matter was “Faith Gives Substance to Hope” and it was further explained that for this women and quoting from the book “Her faith gave substance to and brought about the manifestation of healing that was already hers because of the covenant.” Thus we believe and trust and have faith that God will give substance to our hope and therefore give rise to our conviction of the things not seen.

And all this leads me to the following passage:

Philippians 3:7-11 (NASB)

⁷ But whatever things were gain to me, those things I have counted as loss for the sake of Christ. ⁸ More than that, I count all things to be loss in view of the surpassing value of knowing Christ Jesus my Lord, for whom I have suffered the loss of all things, and count them but rubbish so that I may gain Christ, ⁹ and may be found in Him, not having a righteousness of my own derived from the Law, but that which is through faith in Christ, the righteousness which comes from God on the basis of faith, ¹⁰ that I may know Him and the power of His resurrection and the fellowship of His sufferings, being conformed to His death; ¹¹ in order that I may attain to the resurrection from the dead.

It is as Brother Lawrence had said “So I made up my mind to give all to gain all,..” and further exemplified by Philippians 3:7 where it says “But whatever things were gain to me, those things I have counted as loss for the sake of Christ.”

You might be wondering where the connection between Hebrew 11:1 and Philippians 3:7-11 is?

My view is that when we by faith allowed hope to take hold of our lives and we have the conviction of faith to grasp what is not seen, then we can give all in order to gain all for it is also through faith that we gain the righteousness which comes from God on the basis of faith as written in Philippians 3:9 ^“…and may be found in Him, not having a righteousness of my own derived from the Law, but that which is through faith in Christ, the righteousness which comes from God on the basis of faith…”

Faith is the one substance that binds all for it is also by faith that we believe in Salvation bought through the sacrifice of Jesus on the cross as it is written in Philippians 3:10-11 “¹⁰…that I may know Him and the power of His resurrection and the fellowship of His sufferings, being conformed to His death; ¹¹ in order that I may attain to the resurrection from the dead.” and is also an affirmation of John 3:16 “For God so loved the world, that He gave His only begotten Son, that whoever believes in Him shall not perish, but have eternal life.” (NASB)

I leave you with one last quote from Brother Lawrence “That all things are possible to him who believes, less difficult to him who hopes, still less difficult to him who loves, and easiest of all to him who perseveres in all three virtues.”

In God We Trust.

Hebrew 11:1

Caregivers

On 15 February, I received a comment from a person named Cameron with somewhat of a cryptic message. I was somewhat hesitant to reply just in case he is a Phisher or Spammer and so I had set up an email account just for the purpose of communicating, receiving comments and tracking for my blog. I wrote to Cameron and to keep the long story short, Cameron is a caregiver as his wife Heather who had suffered and is a survival of Mesothelioma and I agreed to post a link to his blog at: http://www.mesothelioma.com/blog/authors/cameron

I may not agree with everything that he said nor endorse some of his thoughts but there are a lot of things in his messages that I can empathised with and at least one thing that I would agree with him is that the role of a Caregiver is not an easy one and entails huge amount sacrifices and if I can quote Cameron when he said:

“I know what it means to be a husband, a father, and a best friend, but the term caregiver still confuses me. Most people would define a caregiver as the unpaid loved ones who provide physical and emotional care to someone who has been diagnosed with cancer. Caregivers may be spouses, partners, family members, or close friends and most often they are not trained for the job. Caregivers are there for their loved one 24 hours a day, 7 days a week, for months or even years. As well as physical and emotional support, a caregiver may help with finances, travel, meals, shopping, cleaning, bathing, daycare, and more. Caring for someone with cancer takes time and money and far too often it takes a toll on the caregiver’s health and well-being. Caregiving is a hard job!”

Therefore this post is dedicated to all Caregivers out there regardless whether the person(s) that they are caring for is suffering from cancer, diseases, dementia or any form of disabilities.

I know that some of you readers do not like long post but I ask that for this post that you bear with me and read till the end as I speak about Josie and her love for me.

To quote Cameron further:

“If I learned anything during this difficult time it was to accept the offers of help from others, and to take comfort in the fact that having the ability make choices, although extremely challenging, was a way for us to maintain a level of control during a time of such uncertainty.”

“While there are many things about my wife’s cancer that I am angry about, I’m no longer consumed by this emotion. I have made a decision to live not in fear, but to treat each day as special, a gift. I also use my time and energy to work toward an asbestos free world and better treatments for mesothelioma. I find I am both happier and more productive now that I am no longer in anger’s grasp, and I hope that for all those who find themselves overwhelmed with anger, that they find a way to move on to a happier more productive emotion.”

“I no longer place an emphasis on items that can be replaced. If something can be bought or built, it can be replaced. It‘s the things I can’t replace that I value. Friendship, love, and family just to name a few. One of the results of my new values is a greater emphasis on holidays and tradition.”

“Having had years to think about what is important to me after Heather’s diagnosis, I realize why that day means so much more to me. What I wasn’t seeing while I was sitting at the table being ashamed and feeling overwhelmed was the fact that I was surrounded by family, who on a moments notice dropped everything to be by our side. Family that was willing to help us out in any way the could. While my pride and hubris blinded me to this fact for years, it is something that I can see very clearly now. Since that day, Heather and I have been overwhelmed by all the support we received from family and friends, as well as complete strangers.”

Sound familiar?

For those who had been following my blog, you will know where I had placed my emphasis and some of Cameron’s thoughts do not differ very much from mine.

I had initially decided to hold off on this post as there were a few more things I would like to accomplish before coming back to this topic but last Sunday's was the Dioceses Women’s Sunday in our church and it gave the extra emphasis for me to start and quickly post this blog.

Ever since I was suspected of having Pancreatic Cancer in July 2012, Josie had been by my side as friend, lover and wife throughout my journey up till even two hours ago when we prayed together for God to remove the pain in my abdominal area. Without her I would not know how I would be able to cope emotionally as other than God and Jesus, Josie had been my physical pillar and comforter. Oh… the amount of tears she had shed for me and in her supplication to Jesus. More than that, the role she has to play as a mother to Nathan who was only 13 months old at that time and daughter-in-law and also continue to hold down her job despite the difficulties that she is facing at her workplace. There is much I can say but Cameron had said most of what I need to say about Caregiver with regards to this post.

I may sound like a broken record but PLEASE PLEASE cherish your loved ones, your spouse, your family, friends and those around you even if they are not close but are supporting you none the less and above all, give all to God so that you may gain all.

There is no misery in my suffering because I felt God’s love and the love of my wife and cherished ones.

In God We Trust.

Pre-Chemotherapy Cycle #10 Comment #06 / Futher Postponement

There was a little bit of miscommunication last Saturday and actually I am not able to proceed with my chemotherapy today.

Usually before the chemotherapy session, blood tests are done in order to assess if I can proceed with my chemotherapy. Usually the platelet count is one of the key criteria but found out today that my liver panel if fairly important as well.

·         ALT (Alanine Aminotransferase) readings are typically used to detect liver injury or liver disease. Reference interval for ALT is 17-63 U/L. My reading is 519.

·         The ALP (Alkaline Phosphatase) reading is slightly elevated at 183 U/L. The reference range is 38-126 U/L.

·         The Bilirubin (Total) value was 38 umol/L with the reference range at 7-31 umol/L.

You can read more about it at: http://labtestsonline.org/understanding/analytes/

All my other result are in the normal range except for the platelets and lymphocytes that are marginally low and of no major concern.

Kind of hard to determine what could be the as from the last CT scan, the cancer in the liver had regressed and although the report did indicate early sign of bile duct obstruction but it had been there for a long time and I am not suffering from jaundice. I am taking Augmentin (Antibiotics) due to the cut that I had a few days ago but unlikely to be cause by the antibiotic as I was on this antibiotics before during my therapy. I am off TMC for 1.5 weeks and so unlikely due to it.

My Oncologist is also not certain what might be the specific cause but it is known to occur for people undergoing chemotherapy with the drugs I am on. In this case I am perplexed as my previous readings were excellent indicating improving liver functions. My only take on this as I had explain to Josie is that God is allowing the earlier readings to show improvement in order to showcase healing and now that the liver is functioning as per normal, He is allowing the liver to function “as per normal” and be allowed to be affected by the chemotherapy drugs “as per normal”.

May need to go for a liver ultrasound scan after this coming week’s blood test but I am asking some colleagues to help with an “unofficial” scan.

I have been having stomach spasm, bloated-ness and indigestion for the last 2+ weeks. Not sure if this is related.

Generally disappointed but feeling more of apprehension and fear as I do not know exactly what is going on but Josie and I, we trust in God and perhaps it is His way of granting me more rest before embarking on the next phase of therapy.

In God We Trust.

Pre-Chemotherapy Cycle #10 Comment #05

I had gone to TTSH for my pre-chemotherapy blood test on Saturday, 2nd March at around 9:00am and received a call on the same day at 11:00am to say that I can proceed with my chemotherapy on Monday, 4 March.

For proceeding with the chemotherapy, the apprehension is gone and I look forward to observing how the body reacts to the 10^th Chemotherapy and reporting to my Oncologist on 1^st April. This will help determine the next course of action as in either continuing with chemotherapy, resting for a long period before resuming chemotherapy or moving straight to Radiation-therapy. However, I still have some apprehension as to how I will handle this coming therapy cycle as my body is not tolerating nor recovering from the effects of the chemotherapy drugs as well or as fast as when I first started my therapy.

In any case and in either ways, regardless of looking at this coming therapy cycle positively or with apprehension, I lift it up to God as I had quoted Brother Lawrence in my previous blog and also from Philippians (that is topic for another blog post).

“God often allows us to suffer somewhat in order to purify our souls, and so bring us nearer to Him. My own experience is such that I cannot understand how a soul that lives with God and desires only Him can be capable of misery. ”

(Referencing to my blog entry “Encouragement and the meaning of Life” posted on 03 February 2013)

Philippians 3:8-20 (NASB)

⁸ More than that, I count all things to be loss in view of the surpassing value of knowing Christ Jesus my Lord, for whom I have suffered the loss of all things, and count them but rubbish so that I may gain Christ, ⁹ and may be found in Him, not having a righteousness of my own derived from the Law, but that which is through faith in Christ, the righteousness which comes from God on the basis of faith,
¹⁰ that I may know Him and the power of His resurrection and the fellowship of His sufferings, being conformed to His death; ¹¹in order that I may attain to the resurrection from the dead.
¹² Not that I have already obtained it or have already become perfect, but I press on so that I may lay hold of that for which also I was laid hold of by Christ Jesus. ¹³ Brethren, I do not regard myself as having laid hold of it yet; but one thing I do: forgetting what lies behind and reaching forward to what lies ahead,
¹⁴ I press on toward the goal for the prize of the upward call of God in Christ Jesus. ¹⁵ Let us therefore, as many as are perfect, have this attitude; and if in anything you have a different attitude, God will reveal that also to you; ¹⁶ however, let us keep living by that same standard to which we have attained.

In God We Trust.

Best Places to Buy…

This is just a fun post for me and I would just like to say that having been sort of a stay home dad and husband means that I do the groceries and marketing for the household and the following are what I found out.

Happy reading and in God we Trust.

Unless you are going for prime cut of beef, buying beef at the wet market is a lot cheaper than at the supermarkets but if you go for the pre-packed beef at the supermarket, the price could be around the same than the wet markets but at the wet market, you can ask the butcher for specific portion of the beef.

Whole chicken regardless whether it is the white or black chicken is cheaper at the wet market and the “freshness” is not worse at the wet market.  We buy our chicken at a vegetable farm at Chua Chu Kang (CCK). The price for the black chicken is 25 to 50 cents cheaper and the white chicken is 50 cents to a dollar cheaper than Fairprice and usually “fresh” as in slaughtered either on the same day or the day before.

I get most of my fishes at CCK as well. There is a live seafood whole-seller situated at CCK’s Farm Mart. They do chilled and live seafood. I buy my Red Garoupa (Coral Trout) and Soon Hock (Marbled Goby) from them but they are dead ones, not the live ones and they are usually taken out of the tank the same day or the day before and if you are lucky, you may get one of the dying (nor quite dead yet) ones. If you think “Hey, they are dead fishes, no difference from wet market”, well, those at the wet market could be dead for up to a week as they get shipped to Singapore frozen or chilled. Anyway, my mom buys most of the other fishes and usually from wet markets at Kreta Ayer (Chinatown), Boon Keng or Kandang Kerbau (KK).

I have given up buying “fresh” oranges at Fairprice as they are not really fresh especially since I had come across oranges that had mold from the carton boxes stuck on them or the oranges are plain moldy or rotten and are still placed on the shelves. I got picture proof and so Fairprice cannot claim that I am accusing them wrongly especially after 6 feedbacks since November 2012. I buy my oranges nowadays from my neighborhood fruits stall.

A 2L tub of Meiji fresh milk is cheaper at Ang Mo Supermarket than Fairprice and Giant sometime by as much as a dollar.

Infant/child milk powder is also cheapest at Ang Mo Supermarket but up to $2 per tin depending on which brand and size of the tin you buy.

The small tubs of Emmi yogurt are cheaper at Fairprice but only when they offer it at 3 for $2.80 (I think it is $2.80).

Kraft cheeses are not the only cheeses available, other brands especially those from Australian are just as good and tasty and cheaper unless the Kraft cheeses are on offer. Check the expiry date though.

Vegetable is always cheaper and fresher at the farms and so the once a week trip to CCK and Lim Chu Kang for local and organic vegetable.

Australian Calrose rice is just as good and as nice at Thai Jasmine rice. My mother is very particular about rice and used to buy the most expensive Thai Royal Umbrella brand jasmine rice. After introducing her to Australian Calrose rice, she is now a covert. The cheapest but not necessary the worse quality Australian Calrose rice is from Seng Siong that goes for S$11 to $12 for a 5kg bag but the same rice at Giant is $13+.

Unless you are a pasta Connoisseur, locally produced pasta taste just as good but maybe the texture is a little softer but is more forgiving when it comes to cooking. Prices in most Supermarkets are similar.

If you have the time and the transportation, all DIY stuff can be found around Jalan Berseh. Definitely cheaper by a lot than Home-Fix but Home-Fix is convenient.

Mineral waters are mineral water and unless you are inclined towards the gourmet water like Evian or Perrier, locally and Malaysian produced bottled mineral water are just as good. I still have this thing about buying “Home” brand and so I stuck with Ice Mountain that is cheapest at Fairprice, 2 x 2L bottles for $1.20.

Home brands are cheap but not necessary good. I had brought some Home brand nuts before and let’s just say that nowadays I will buy Nature Garden, Tong’s Garden or Camel branded nuts. The only Home brand that I go for still are Fairprice’s soft-pack tissue paper and I stock them and wait until they are on offer before buying more.

Unless you view your bottom as extremely precious and you like toilet papers with tiny blue seashells or dolphin embossed on them, buy the “Compact” brand toilet paper. They are the most value for money (not cheapest) bottom wipes out there.

For plastic containers of various shapes, sizes and uses, the best place is at Toyogo Warehouse situated along Toa Payoh Lorong 8 industrial estate.

Fairprice Unity Healthcare probably has the most value for money pharmaceutical and supplements. I used to get generic Panadol there at $2 for 20 strips. Head down to Guardian or Watson and compare the price yourself.

That’s about enough tips for now.