Solace in the Lord, Part I

In the weeks where I was experiencing tremendous amount of pain and there seem to be no end to it, these verses were a solace to my soul, a constant reminder that the Lord is with me and will carry me through. He has and will continue to do so. Just look to Him and He is beside you.

Psalm 23:3-5 (NASB)

3 He restores my soul;

He guides me in the paths of righteousness for His name’s sake.

4 Even though I walk through the valley of the shadow of death,

I fear no evil, for You are with me;

Your rod and Your staff, they comfort me.

5 You prepare a table before me in the presence of my enemies;

You have anointed my head with oil; My cup overflows.

Philippians 4:4-9 (NASB)

4 Rejoice in the Lord always; again I will say, rejoice!

5 Let your gentle spirit be known to all men. The Lord is near.

6 Be anxious for nothing, but in everything by prayer and supplication with thanksgiving let your requests be made known to God.

7 And the peace of God, which surpasses all comprehension, will guard your hearts and your minds in Christ Jesus.

8 Finally, brethren, whatever is true, whatever is honorable, whatever is right, whatever is pure, whatever is lovely, whatever is of good repute, if there is any excellence and if anything worthy of praise, dwell on these things.

9 The things you have learned and received and heard and seen in me, practice these things, and the God of peace will be with you.

Psalm 116:5-7 (NASB)

5 Gracious is the LORD, and righteous;

Yes, our God is compassionate.

6 The LORD preserves the simple;

I was brought low, and He saved me.

7 Return to your rest, O my soul,

For the LORD has dealt bountifully with you.

Ephesians 3:17-19 (NASB)

17 so that Christ may dwell in your hearts through faith; and that you, being rooted and grounded in love,

18 may be able to comprehend with all the saints what is the breadth and length and height and depth,

19 and to know the love of Christ which surpasses knowledge, that you may be filled up to all the fullness of God.

2 Corinthians 12:8-10 (NASB)

8 Concerning this I implored the Lord three times that it might leave me.

9 And He has said to me, “My grace is sufficient for you, for power is perfected in weakness.” Most gladly, therefore, I will rather boast about my weaknesses, so that the power of Christ may dwell in me.

10 Therefore I am well content with weaknesses, with insults, with distresses, with persecutions, with difficulties, for Christ’s sake; for when I am weak, then I am strong.

There is this story about footprint in the sand. It is a well-known story and it spoke about how God carried us when it seems He was far from us. Although the story, its meaning and intentions were uplifting and is edifying to those who are seeking the Lord when they seem to be at a lost, I have another take on this story.

Whenever this story is told or whenever it comes to mind, the image that comes to me is not one where I am carried on the back of Jesus but rather there continues to be 2 pair of footprints. In instances where I needed Him, He is there, not carrying me but is beside me, walking with me, consoling me, uplifting me, talking to me, listening to me, one arm beneath my arm ready to support me when I stumble.

There were moments where there are knee prints and a set of footprint that are set deeper in the sand. That is when I stumbled and Jesus lifted me up leaving an imprint that is deeper in the sand. I know He is there all the time because He is beside me. Even when I sit down, He is there with me sitting beside me, looking at me. I have tears in my eyes but He has a smile on His face. I grimace from the pain in my abdomen but He is there holding my shoulder.

The Lord does not carry me. He upheld me and stood where I know He would be.

In God We Trust and in Christ alone my hope is found.

Hebrews 11:1

What’s Next? Part II

Sometimes, things that happened are just too good to be true but in no way am I implying that God renegade on His promises. I thought I was on the mend as far as the pain and discomfort is concerned but 2 days ago, 22nd July, the pain came back with a vengeance and it was simply gnawing at me. The morphine did not help and I had doubled the amount of morphine that I was supposed to take. The antacid, other medications and various sitting and laying down postures did not help either. It was quite excruciating. I was on the verge of admitting myself to TTSH just because of the pain. Josie and I, we prayed and I prayed as well and I am not blaming God against anything but this time the pain simply did not go away or subside sufficiently for me to be marginally comfortable. Needless to say was that I hardly slept at all that day and it was not until about 5:00 am on 23rd July that the pain subsided sufficiently enough for me to have a half decent sleep.

Tuesday continued to be quite bad but I guess I had dosed myself sufficiently with morphine that I was able to manage some routine activities. Praise God that today was fantastic compared Monday but I do not wish to be overly optimistic at this point but to continue to monitor my condition especially since I am supposed to have my chemotherapy on Friday. From the lack of rest, I am not sure if the body had produced sufficient platelets for the chemo to proceed.

I ask that you pray that:
a) The pain and discomfort will stay away.
b) The body would product sufficient platelets so that chemo can proceed on Friday.
c) For the chemo, that there will be no side effects.
d) Nathan will behave so that Josie will have less things to hassle over.
e) God will sustain Josie.

God is good and I believe this is one instance where He really showed that He will not allow us/me to bear beyond what we could bear. I firmly believe that if the pain had not subsided on Tuesday, I would probably had collapse from the pain or at least admit myself into the hospital.

In God We Trust and in Christ alone my hope is found.
Hebrews 11:1

Happy Birthday Mr. Yue

Last Tuesday, 16 July was my 46^th Birthday. It was the 2^nd birthday since the discovery of my cancer. What a way to be celebrating my birthday! I had received a lot of messages from friends wishing me well with added notes of encouragement and support.

I had wanted to write something on that day or at least the next day but my constitution basically prevented me from having the desire to want to write. What you may not know is that whenever I sit down to work on my computer, especially in the last month or so when I had this problem with my stomach and the pain, sitting at the desk compresses and thus put additional pressure on the stomach and this increases the pain. I have to either lean back or sit ram-rod straight so that there is no additional pressure on the stomach but those positions are not really very comfortable over a long period of time.

As I had mentioned in my earlier post, the pain is easing with medication and knowing when to administer both the pain killer, the drug that decreases stomach acid production, antacid and food intake to reduce refluxes. During one of the prayer, I had received a prompter from God that I need to talk to Josie, to confess to her about a hidden sin of mine that I had kept from her. Strangely or should I say miraculously enough, when the prompter came and I who is no longer in a position to bargain with God in any case agreed to tell Josie, the pain started to ease off. It did not disappear but it eases quite a bit. Spoke to her yesterday and by God’s grace and mercy, things turned out better than I had expected and I thank God for his hands at work in this matter. No… It is not something that I will be writing about as it is a matter for me, Josie and God. If I can at least boast, I can boast that I have nothing else to hide from God and Josie. Kind of oxymoronic as we cannot really hide anything from God but my earlier statement is metaphorical anyway as far as God is concerned. I did not get to go scot-free though as according to Josie, I have to live longer than her in order to pay her back…

God is kind, God is gracious and God is full of whatever we would termed as “good” and He had given me Josie and whatever that may had transpired, Josie said that we are still in this journey together and God will carry us through.

In God We Trust and in Christ alone my hope is found.

Hebrews 11:1

Where Is The End?

I am sort of upset that in April, the blockages happened to the bile duct and the duodenum as this had delayed and postponed all the various therapy and treatments and all the pain and discomfort all started from that time. It is also considering that my treatment was progressing well up to that point. It gave the tumor the opportunity to regrow and metastasise. Even as I write this post, I have to stand up and walk around every few minute so because of the pain and it is really driving me up the wall.

In the last few weeks, as I was going through this harrowing period, I was constantly reminded of what I had written earlier where there is no misery despite the suffering that I am going through. However, with the constant pain it does seem like all I have to look forward to everyday is just more pain and discomfort and herein lays my dilemma of belief. Life indeed looks miserable from where I am now but there is always hope.

I found myself praying more and more simply for the pain to go away, the cries from a son to the Father. I found myself occasional telling myself that I want to “go home”, home where the Father is, where there is no pain and no suffering and just to be in His presence. I envision an angel sticking his hand into my abdomen and removing the tumor cells. Every song that I hear that spoke about the goodness of God, of His grace and mercy, of dwelling in His presence, of the untold blessings that He brings, etc will bring tears to my eyes for there is nothing else for me to look forward to.

What do I do now, what shall I do and where is the end?

It is hard, very hard but by the grace of God, there is always a silver-lining. We just have to know where to look, where to see and feel His presence and my heart cry is “Father, help me!”

In God We Trust and in Christ alone my hope is found.

Hebrews 11:1

Clinical Updates, July 2013, #01

My apology again to those whose who are following my blog that I had not posted for quite a while now. It is progressively getting more difficult for me to focus on writing due to the pain and discomfort. I will be making 2 posts today, this one that focuses largely on my clinical condition and another where I will focus largely on my thoughts.

The last 2 weeks was terrible and “terrible” might be an understatement. I was not able to sleep well because of the pain and discomfort and somehow the pain and discomfort were more pronounced at night when I try to sleep. It could be that there were no distractions like TV such that all attentions were focused back onto the body and I start to notice the pain and discomfort more. For the Radiation Gastritis, it is progressive getting better although not as fast as I would have hoped. I am getting less of the bloated feeling and I can consume more food (quantity-wise per meal) but the condition is still in a sort of flux and I got good days and bad days. Last night was quite bad and the total hours of peaceful sleep I got from 12:15am till 7:30am this morning was roughly about 3 hours. The remaining of the time, I was in a half-sleep zone and getting out of bed every now and then and moved about just to elevate some of the discomfort. The only fortunate thing is that during the day I seem to be able to catch up on my sleep.

I am still losing weight and this morning, I had crossed the sub-50kg mark with my weight at 49.6kg. It translate to me having less energy and physically less desire to move about although psychologically I do try to motivate myself to move about at least in the morning by sending Nathan to school and occasionally heading out in the afternoon for a short while just to occupy myself. I went a watch World War Z at the cinema yesterday. Again, it is one of those distractions that I had at least for a few hours.

I had my CT-Scan done last week on Tuesday and I saw my Medical Oncologist on 8 July, Monday. The good news is that the stents are where they are supposed to be and still functioning as what they are supposed to. The bad news is that the cancer had metastasised again to the liver with multiple ill-defined hypodense lesions in both lobes of the liver. The pancreatic tumor appears to be larger but not really very conclusive as it is sort of like a “blob” being inseparable from part of the stomach and intestine. There seem to be a “hypodense” area within the pancreatic tumor and it could represent “necrosis”.

What does all these means?

My Med-Oncologist is not too concern at this point about the Liver lesions/metastasis as he says we can make do with even just 1/3 of a liver. He is somewhat concerned about the pancreatic tumor and will be targeting treatment on that region. Since it would seem that the previous chemo-drugs used are appearing to be losing their effectiveness, the treatment is going to be switched to a more traditional drug Gemcitabine used for treating Pancreatic Cancer. I will be having 2 cycles of therapies with each cycle consisting of 3 treatments (once a week) and a week rest before staring the next cycle. The first treatment will be this Friday. I am trying to psych myself up for the treatment because I do not know how “bad” the side-effects will be considering my current weaken state and the ongoing discomfort I have with the stomach.

I had a follow-up with my Radiation-Oncologist on the same day and I got a little optimistic  after seeing him. I kept asking him if the “necrosis” could mean that the tumor is “dying” but he was trying not to be committal about it because I think it is still really too early to tell. He was saying that the effect of the radiation from the Radio-Therapy could last up to 12 weeks after the last therapy session (my last session was on 31 May) and we would need to wait and see how the situation develop especially now that I am going to start on chemotherapy again.

In any case, I do not sense the same optimism from both my Med- and Rad-Oncologist as I have from April of this year but I will still have to go through the treatment as it will provide some hope. In the meanwhile, the pain is really getting to me and I am finding it hard to tolerate it, this despite the increasing dose of pain killer. The Fentanyl pain killer patch is now 50mcg instead of 37.5 and my consumption of morphine is more regular and frequent now. I believe the main pain is coming from the tumor and lesser from the gastritis. I can also only pray and hope that this pain is from the tumor in the grip of a death-roll.

In God We Trust and in Christ alone my hope is found.

Hebrews 11:1

Clinical Updates, June 2013, #03

Yes, yes… it has been almost a week now since I had last posted and I am not exaggerating the fact that this was how uncomfortable that I was and still are and that I really don’t feel like switching on my computer and write.  I have not read any book in the last few weeks and the only reading I made were the newspaper in the morning during breakfast or the online version of Channel News Asia on my Smartphone in the evening. The rest of the times were spent sleeping, lying down, sitting or watching the TV. Eating is also getting progressive difficult due to the pain, bloated-ness and the occasional vomiting.

Sounds bad huh?

Probably is quite bad or probably not as bad as some other folks but it has been difficult. In fact, “uncomfortable” may be an understatement but I don’t have any other words that seem to be more suitable because I am not quite miserable nor in extreme agony although occasionally it had reach that stage but thank God that they were transient and lasted only a short while.

Last Thursday, I saw the Gastroenterologist as part of the follow-up for my duodenum and bile duct stenting. Both seem to be stable and need not put too much attention on it but since I was there at the clinic, I explained about the Radiation Gastritis but the Gastroenterologist wasn’t quite convinced that it was all due to the Gastritis as some symptoms are odd but there are some indications for it. Anyway, she increased my Nexium dose from 20mg twice daily to 40mg twice daily for 2 weeks and it does help but not to the fullest extent. Suspect that the discomfort is due to both the gastritis and cancer tumor.

I ask that you pray:

·       That I recover from the Radiation Gastritis quickly as then I only have to deal with the pain from the tumor and that is so much easier to manage with just pain killers.

·       For now, food intake is low and I am losing weight gradually and would be hitting 51kg very soon. Pray that whatever I eat, I can absorb the nutrient and thus to maintain and increase my weight.

·       “Peaceful” sleep and rest is hard to come by. Pray that the pain would be resolved and that the food would pass through the stomach smoothly so that I don’t have bloated-ness.

Some people who saw me may not think that I am going through all these pain and discomfort or that I may be exaggerating but I got to put on a brave front and be stoic for the family sake and the tolerance is also by God’s grace and mercy. Stay with me a couple of hours and you will start noticing the discomfort that I am going through  as occasionally I will zone out from trying not to focus on the pain and discomfort.

Nathan was ill over the weekend and from observing this son of mine, he seem to be as stoic as me in that he usually cries for a very short while whenever he fell and cuts himself or knock against sometime hard and most time he does even react to the “pain”. Last weekend however, he was clinging to the mother and complains of pain in the tommy area and cried quite a bit and we had no choice but to send him to the hospital to have a look and he was hospitalised on Sunday evening for observation for possible intussusception (i.e. obstruction caused by infolding of one part of the intestine into another) due to his recent history of fever and coughs or viral illness (e.g. stomach flu). Fortunately, the pain got resolved and Nathan was supposed to be discharged on Monday but we kept him in KKH for one more day just to be certain.

In God We Trust and in Christ alone my hope is found.

Hebrews 11:1

What Else?

Once again I know I had not posted for a few days and some of you might be wondering what is happening to me? I had consciously not posted anything because I do not wish my post to be just about the pain and the discomfort. It would either be the pain is here and then there, how it is giving me sleepless night or the discomfort is making me less willing to move about as every step that I take focuses somehow onto the bloated feeling in the stomach. I am also not quite up to writing as most of my time was spent lying or sitting down or sleeping.

I still have to put in some update but what else can I write?

For those hoping for something a little different and perhaps uplifting, I have to disappoint you for a little longer.

The new medication is helping but only to a certain extend as the pain still comes and go but at lesser intensity. Occasionally, there will be a sharp pain that runs through from my right side near the stomach to the middle of the chest on the right. I’m still talking the morphine but I had reduced the amount I took as the pain is less intense. Since what I am having is Radiation Gastritis, I’m assuming that the vomiting is part of it too. In the last one week, I had vomited three times from bloated-ness but I believe this is not because of the duodenum obstruction like the last time but simply because of the direct effect of having Gastritis. I really got to watch the quantum, the frequency and the texture (not too hard) of the food that I eat. In the meanwhile, I will having to depend a little more on the Glucerna supplement for my nutrient intake.

Josie is coping as best as she could and emotionally she is far stronger now than she was when this journey started. I believe God’s gift of Nathan had helped in this development as she has sort of a “distraction” and also a reason to remain strong. I wonder how she would have coped if all her attentions and focus is just on me alone and seeing what I am going through especially during this period when I’m having this Gastritis.

As a kind of record, I had asked Josie to take pictures of me while I sleep, sit of simply lying down and the various postures that I adopt just to ease the pain and discomfort. I kind of joked that I could be a yoga teacher because some of the posture I had adopted would showcase my flexibility.

In God We Trust and in Christ alone my hope is found.

Hebrews 11:1

Clinical Updates, June 2013, #02

The last 2-3 days can be considered bad days for me because the pain was quite excruciating. Fortunately it had not developed to a “debilitating” state but it came very close to it.

On Monday, I saw my Med-Oncologist and a couple of things to report:

a)     The blood test results were alright, not the best but alright. Kidney and Liver functions are within normal range and that’s good. Platelet was 102. Could be better but I’m thankful because it could have been worse. Lymphocytes number was borderline low but it is within the patterns observed from previous tests and not much to worry about. The CA19-9 Tumor marker had dropped to 158 from 300+. Still can’t make much out of it because at 300+ the reading is not definitive and thus a reading of 158 may seem like an improvement but again it is not definitive but a good indication none the less.

b)     The stomach pain is also as expected and my Med-Oncologist suspects that the “worsening” symptoms were probably due to the higher radiation dose used in my radiotherapy. My medication had been changed:

              i.         The Fentanyl dose was increased from 25mcg to 37mcg.

            ii.         Omeparzole was replaced with Nexium (Esomeprazole), kind of a more potent form of Omeparzole.

          iii.         Buscopan was replaced with Sucralfate although I can take both at the same time since they function differently.

          iv.         Given some more morphine and advised to take as much as I need (not “want”) within the prescribed dose to ease the pain.

After a couple of doses under the new medication, they do help to ease the pain but not totally. I have to make sure I don’t put any pressure on the stomach like sitting in a slouch position as it compresses the stomach and that often create quite sharp intense pain.

I have a CT scan scheduled on 2 July and follow-up with both my Med and Rad-Oncologists on 8 July. Depending on my current condition especially whether I would have recovered from the Radiation Gastritis and the result of the next blood test, my Med-Oncologist would restart me on Chemotherapy.

It has been nearly one year now (11 months to be exact) since the preliminary discovery of the “mass” at the pancreatic head with “invasion” of the liver and duodenum. A tough 1 year and clinically the best news was that the cancer in the liver is gone but beyond the fight against the cancer, the year was also rewarding in terms of building relationship with family and friends and more importantly with God.

Don’t really want to say the journey is coming to an end because the journey never ends. The end of one part of the journey is beginning of the next and I pray that God will grant me the opportunity to enter into a fresh new journey with Him when He call to a closure this current journey on this current path.

In God We Trust and in Christ alone my hope is found.

Hebrews 11:1

Clinical Updates, June 2013, #01

I will be having an appointment with my Med-Oncologist tomorrow and I had gone to TTSH yesterday to have my blood taken for tests and at the same time have my porta-Cath flushed to keep it patent.

I had originally intended to post only after the appointment with my Med-Oncologist and sort of “save” one post but the last couple of days were horrible with the pain in the stomach. I had written to my Rad-Oncologist and he replied that the symptom that I am experiencing is radiation gastritis and that it will last probable another 2 to 3 more weeks. Sigh… That is another 2 to 3 more weeks of agony. The pain had gotten so bad that I am on regular morphine and no longer just at night to help me sleep and most of the time, I have to sleep in a sitting position in order to ease the pain and get some form of decent sleep. It helps also if I twist my ankle or wrist at certain angle in order to “create” some pain and thus divert the attention of the pain away from the stomach. I know it sounds kind of funny but it is true and in my case it does helps because by releasing the tension on my ankle or wrist I can ease the pain away relatively quickly and the pain doesn’t last, not like to pain in the stomach.

I hope my Med-Oncologist will have some means of helping me get pass these few weeks other than Omeprazole because other than the “normal” and regular pain, I got very sharp and short intense pain whenever I eat. Fortunately, these pains after meal does not last very long and were only very short but very intense. These of course make it psychologically difficult in attempting to eat but eat I must in order to maintain the energy and not to lose weight.

Spoke to the oncology nurse yesterday as she was flushing my porta-cath and generally chemotherapy will not resume under such circumstances. My Med-Oncologist will probably assess the situation tomorrow and will assess me again probably in another 4 to 6 weeks to see when I can proceed to next phase of therapy. The nurse also mentioned that I am “darker” but then it is also normal for someone on Xeloda (the chemotherapy drug) and the “dirty” patches on my feet.

The bright side is that if my Rad-Oncologist is correct, the pain will last only the next 2 to 3 weeks and by God’s grace, if I can get past these 2 to 3 weeks then I should be alright and as for prayer, please pray that the pain will subside quickly and that I will have the extra measure of “strength” to tolerate the pain.

In God We Trust and in Christ alone my hope is found.

Hebrews 11:1

Testimony of the Journey In Faith

In my post “Journey in Faith” posted on 28 April, I spoke about faith, hope and the promise of the things to come. I sort of remembered a while back, I had posted in “Pain in the Heart” on 12 March that there was this thing Josie mentioned about the testimony and faith and that I told myself I should write about it.

Having re-read the post “Journey in Faith”, I thought the title for the post was quite accurate because this journey of mine is not just about the battle with this cancer that I wage against on a daily basis but it is also about a journey, a journey of faith that I would say I constantly learn new things about although not on quite a daily basis but I would say often enough.

The journey is not an easy one despite what I may have written about in this blog filled often with positive news and development. When I posted “Pain in the Journey” on 10 March, one of Josie’s good friend texted me to encouraged me and one of the things she said that this was one of the darkest post I’d made. Often isn’t it true that the physical pain is not the one that will literally bring us down but it is the emotional turmoil and pain that could destroy us completely and totally. I therefore say that it is an understatement to say that God will “carry us”, He will “see us through”, “pray to Him”, etc etc… Not unless you are truly willing to give all to Him. I may profess my faith but I am a long way from absolute, total and complete surrender to Him as can be seen from my occasional anger and my report for disharmony and such. Thus I say the development of faith is a journey and it never really ends; that despite whatever pain (physical and emotional), emotional turmoil, hurts, uncertainty and fear, we really need to seek Him, to depend on Him and look towards Him for the resolution of what we cannot resolve. It is at these times that He is strong as we are weak.

Back to what Josie mentioned concerning the faith and testimony. At the point we were talking and I was talking about my perspective on “Faith” and she spoke about my “testimony” and when you add them up, it could be that my testimony in this whole journey is about faith in God. You might ask what has the earlier paragraph to do with faith and testimony of faith. In my case, it has practically everything to do with it. What is there for me to depend on at this point other than God? I know that there are medical sciences but medical science do not have an answer for all the ailments in this world. There is no definitive cure for my type of cancer especially one that is non-resectable. Who else can I depend on when I am emotionally down? I know that Josie and friends are supporting me but there is just so much that they can do physically and practically but they cannot take away what is embedded in the head, in the heart, only God can.

In short, if you had read my blog, you will know that it is a record of my journey but it is more than that, it is also about my journey in faith and my testimony to God’s goodness and faith in Him. I pray that what I had written would be a legacy, a testimony about faith and that it will lead others to a stronger faith in God, a greater trust in Him and formation of the foundation of our hope.

In God We Trust and in Christ alone my hope is found.

Hebrews 11:1

My Topsy-Turvy Days

You have read about me talking about my physical pain and before that concerning my motion and stools… It really has been a topsy-turvy 2 weeks in my life.

Yesterday was a bad day and that led to my blog post about my physical “Pain In The Journey”. Yesterday, I had slept for practically the entire day. After breakfast I slept, after lunch I slept again and all the while the sleep was fitful due to the pain and the discomfort.

Today was another story. Although I did not really have a very good night sleep, again due to the pain and discomfort, I was generally alright for the day. Attended the wedding lunch banquet of the worship pastor (I guess I can call him that) who is also one of the worship leader in church. As with any wedding banquet, there were plenty of food and I was happily enjoying them and consuming quite a lot of it without any undue discomfort.  You can say that it was thus a good day for me. Although I was not really in a positive mood or position to attend the couple’s wedding solemnisation yesterday, I was none the less very happy for them and in fact, when I first knew that they were a couple, I was already genuinely very happy for them. They are such a lovely couple.

For some reason, the pain is more obvious at night and I am now feeling the discomfort again and the pain.  On Tuesday, I have a medical appointment with my diabetes Consultant and hopefully he can have some advises or make some prescriptions that can help me until I can see my Med-Oncologist on 13 May. By the way, the stool is getting very light in colour and is not really a good sign.

I guess the topsy-turvy part is not just on a day to day basis but within the day as well but to be able to enjoy the banquet today and see church friends and receive encouraging words really make my day too and thank I God for it.

In God We Trust and in Christ alone my hope is found.

Hebrews 11:1

Pain In the Journey

Have I reached another milestone in my journey?

The title for this blog entry is that same as the one posted on 10 March but the difference is that this blog is about the physical pain in the journey.

God had been good to me as I was spared the suffering and the pain for about 8 months with the chemotherapy sessions. Since my last hospitalization for duodenum and bile duct obstruction, every single day are a constant struggle to get better and so was the pain. While in the hospital, I had experienced the most excruciating pain that I had ever known. Just to give you an idea of what it is like, for those of you who had the misfortune of been hit in the shin really hard by a hard object, you will know that it is one of the most painful experience that one can have. The pain that I had experienced in TTSH was worse, so far worse that I really needed strong pain killer (morphine) every 2 hours just to ease the pain and even then, the pain wasn’t totally removed. Ha!!… I thought I have a strong tolerance for pain and even one of the doctors in TTSH described me as “stoic” or the surprise from one of the nurses that was helping to flush the port used for my chemotherapy that I had never used local analgesic whenever the needle was inserted for chemotherapy.

When I was discharged, I thought that I would be alright as the pain was not too bad and that it was just a residue from the stentings. Oh how wrong I was. It has been 2 weeks since I was discharged and now the pain is not only constant and nagging but I can feel that it is progressively getting worse. I don’t think I can use “stoic” to describe myself anymore as I reach for the morphine bottle every night to help ease the pain so that I can sleep. At least for now, I had resisted the temptation to consume the morphine more than what was prescribed and in fact I am actually taking less.

In the last review with the Radio-Oncologist, I was told that the tumor will not shrink immediately and will normally be noticeable about 2 months after the end of the therapy. 2 months… I was kind of downcast when I heard that as I know that I will have to live with the pain for that much longer. I hope the chemotherapy can be restarted soon and even then, the therapeutic effect even if it is just palliative will also not be noticeable immediately.

What can I ask you to pray for? For now, at least:

a)      For the easing of the pain.

b)      For the tumor not to grow further.

c)      For the radiotherapy to work.

d)     For the chemotherapy to resume soon.

e)      For the sovereignty of God to be present in my life and for healing

Most importantly, pray for Josie as she is really the one that is bearing most of the burden at home, at work, for me and for Nathan. I can probably say that she is the stronger one at this point as I had not heard any complain from her. This is the emotional pain that I am feeling for her and from her I know that she is toiling through her own emotional pain too.

Having said all these, am I losing my faith in God? No… definitely not and I feel that God must have a purpose for putting me through all these. In one of my earlier blog, I had quoted from a book by Bernard of Clairvaux and I append it here again for your reference.

“‘A healthy man has no idea what an ill person is suffering, neither does a well-fed person know what a hungry person goes through.’ A sick person can feel for the sick, and a hungry person can understand the plight of the hungry, especially when those who suffer are in similar circumstances. Just as pure truth is only properly understood by the pure in heart, so a brother’s sadness is best understood by the sad in heart.”

Not only the pain but God is a constant as well in my life. I trust and believe that this phase of the journey is also something that God is allowing me to go through if I am truly to understand the pain of those that are suffering from illnesses and pains. I am not saying that it is a process for me to learn how to empathise but rather it is a process of gaining an understanding of what “sufferers” are going through and thus form the basis of where I hope I can help through my blog.

I am suffering but I maintained that there is no misery. How can there be misery when at every turn, I see the support from Josie who out of love for me is making the sacrifices that she is making. I know that there are those around me who are supporting me in whatever ways that they can and in the mails and messages that they sent. Furthermore, God had carried me so far and I know that He will carry me further.

In God We Trust and in Christ alone my hope is found.

Hebrews 11:1

Radiotherapy: Update #07

Once a week, as part of the radiotherapy regime, I will be assessed by the radio-oncologist to check on my progress and managed any side effects. So far, I had undergone 5 sessions of radiotherapy. The patient before me was late and so I was able to have my session earlier followed by the assessment by the doctor. You can say that today was another regular session.

Physically, today was kind of a down day and I was really very lethargic and slept a lot. Practically slept for the entire afternoon after lunch and took another half an hour nap before dinner and after returning from church from communion arranged by Vicar. The pain is getting to be irritating but I am coping with it and it is also one of the reasons why I don’t feel like moving too much.

The medication that I am taking for the greasy stool seems to be working. I am passing motion less and the stool is no longer greasy. I am still monitoring the situation and if it does really work, I hope to be able built up sufficient energy to start gaining weight and be less listless.

God is watching us. Despite some reluctance, Nathan is slowing but surely adapting to childcare. He is somewhat cheeky and finds ways and means in order not to go to “school” like lying on the bed and refused to be changed and he still cries whenever my mom brings him to the childcare. However, once there at the childcare, he will cry a little and settle down in a few minutes and start participating in the activities in the childcare. Nathan also knows that Josie wakes up early so that she can leave the house without “disturbing” Nathan but nowadays, Nathan wakes up just as early in order to stick to his mother and refuse to let her leave for work or recently, to follow me to the hospital for my radiotherapy. Josie is coping too having to double up on watching after Nathan especially since we do not have a helper now but I know it is still tough for her having to hold down her job as well.

In God We Trust

Hebrews 11:1

Radiotherapy: Update #06

Today’s radiotherapy session was a regular one and unlike yesterday’s there was no luck in having arrived early. The patient before me was on time and I had to wait my turn. Anyway, I was in and out of the Radiotherapy Centre in 45 minutes. Arrived at 8:20am and left at 9:05am.

Today was a busy day. Had to go to Roche’s office at Tiong Bahru to exchange my gluco-meter because it was faulty and fortunately it was under warranty. They made a replacement and the new meter has a 5 year warranty on it. Don’t think that it is a good thing, Roche make most of their money from the consumables, essentially the Accu-stik (the test strip). Giving 5-years warranty ensures a captive market for their consumables.

Came home and rested a little and went to for my appointment with my surgeon at TTSH at 12:20pm. Hung around after that to arrange for an appointment with the Gastroenterologist that is in June (yup! real long time away), re-confirm my appointment for my by General Medicine Consultant who is taking care of my hypertension and hyper-cholesterol that is sort of in remission and for my diabetes. Tried to arrange for an early appointment with my Oncologist but was not able to do so but the assistant will check with him and see if I can get an earlier appointment. In any case, I will be calling the Chemotherapy Clinic at the end of next week as per my Oncologist suggestion to arrange for a blood and see if I can go in early for chemotherapy assuming that my liver had recovered sufficiently.

When I saw my surgeon, not much that he can do as I am still undergoing chemo and radio-therapy. So the appointment today was just a regular follow-up but because my surgeon specialises in Hepato-pancreaticobiliary Surgery, I asked him about my frequent motions and the oily faeces and the expression on his face plus the comments that he made tells me he knows what’s going on. Essentially, my pancreas is not releasing sufficient digestive enzymes that help to digest the fats in my food and because of the “grease” in my food, it “lubricates” the food and it gets passed through the intestine faster. It also explained why I am not gaining weight as the food was not sufficiently digested and the nutrient absorbed. I was prescribed “Creon” which is a digestive enzymes replacement. I will know how well the medication works in 1 to 2 days’ time.

Sort of a fruitful day and at least I know the reason for my frequent motion. If I did not have this appointment today, I would be continuing to suffer from the frequent motions for a few more weeks before my appointment with my Oncologist. God is good.

In God We Trust

Hebrews 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

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.