Here's My Story

After a week of taking increased dosage of Oxycontin , my dad's leg pain didn't get better. In fact, it continued to worsen: he frequently needed walking stick to walk. Since we were going to Pg GH's early Friday morning to meet mum's anaesthetist on the day she received ECT, I suggested to my dad to meet PCU specialist while I would meet the anaesthetist. PCU recommended radiotherapy but asked my dad to meet the oncologist. He was called to see the oncologist about 1hr 25mins since arrival, just after I met him there after signing the consent form for my mum's ECT. That was really quick: 2 specialists within that time! Oncologist spent time asking some questions and gave us some information about the limited options (med, chemo, radiotherapy) dad had, along with their risks and benefits. She then went out to consult with a senior specialist. They recommended a single fraction radiotherapy on his left leg but it would be done at Mount Miriam Cancer Hospital (MMC

By Mon, according to a doctor there, mum's restlessness in the morning worsened. It was getting harder to restrain her from banging her head on the floor. Apparently, she heard "voices" telling her to do that. The team discussed and recommended Electroconvulsive Therapy ("ECT"). The idea was to significantly improve mum's condition and thus allowing medication time to take effect. There would be a minimum of 3 sessions, conducted on odd weekdays (Mon, Wed, Fri). During each session, her brain would be stimulated by electrical impulses lasting less than a minute and done twice. Thus the whole procedure would last less than 2 minutes. This would be done in an operating theatre and she would be under general general anesthesia during this procedure. If she response to the first two sessions (i.e. 4 stimulation), then this procedure would be conducted during future sessions to achieve two more positive response i.e. a total of 6 effective stimulation. If the

Except the first night of admission , I had been visiting my mum at the psychiatric ward. Poor mum. She wanted so much to get better and would want to recuperate at home as it would be a "calmer" environment, with loved ones. I agreed with that but she was in no condition to be discharged, as I explained to her. If she was home and got into one of her "banging head" episodes, what are we to do? We would need to either make appointment or bring her to A&E, thus delaying the help she would need. Imagine this repeated everyday @@ So it was best for her to be at the ward where doctors and nurses could monitor her condition and act accordingly. On a Friday, they changed her medication once again: Olanzapine 2.5mg twice daily Replace Alprazolam with Lorazepam 1mg night Remove Epilim The geriatric psychiatrist wanted to ascertain whether Epilim was the culprit or not. If mum was ok over the weekend, then they would give her Lithium (as a replacement). W

More than a month after the last consultation with Dr D , (about 4 days before my mum's admission to the psychiatric ward ), my dad's leg pain occurred more frequently. As a result, my dad was taking more breakthrough than prescribed for. So, we consulted Dr D again: (1) Dad could take the breakthrough (Oxynorm) up to 6 times a day (we thought the maximum was 3). (2) She advised us to approach Pg GH's PCU as a walk-in patient and tell them what happened so that they could adjust and prescribe more Oxycontin and Oxynorm until the next appointment. It's much cheaper than getting it at Mount Miriam. She expected that they would double the dosage of Oxycontin. We went to Pg GH the next day. During the consultation, the PCU specialist took up my dad's suggestion of looking at the PET/CT scan. As a result, he (after consultation with his senior), increased the dosage of Oxycontin (from 10mg twice a day to 20mg twice a day) and also asked my dad to see the oncologist

2 days after her last appointment with Dr N , I got call from mum. She had gotten worse. She couldn't think, head was heavy, face was stiff, she wanted to scream  and she was afraid she might take her life. Said that the day before she scratched herself with fork. I didn't know what to do except to tell her either she go to GH's A&E then or wait until a few days later for her appoint with Dr N. She didn't respond and so I offered a third choice i.e. I texted Dr N. Dr N (via text messages and phone call) advised us to admit her to Penang GH's psychiatric ward. She contacted her ex-colleague there, briefing him about my mum. She asked us to bring mum to the GH's A&E, telling them that we had been asked to admit my mum and that mum's psychiatrist had spoken with the geriatric psychiatrist. I was still in PJ then and would later be driven by Ban to Butterworth that night. Meanwhile, my sister and my dad brought my mum to GH's A&E. It took lik

I updated Dr N via text on the s econd change of medicine by the public hospital and what happened following that: mum improved daily but still had blank look and slept a lot i.e. 8pm to 9am next day; slept after breakfast and after lunch. It was hard for her to comment without seeing my mum and so I made an appointment for my mum to meet her almost a week later (it was supposed to be a few days later but mum had flu and so it was postponed). Meanwhile, I got to know that for the first time a proper psychiatric specialist (instead of medical officers) would see my mum at her next appointment at the public hospital. My dad overheard his name, Dr A, and so thought it should be Dr N's friend. On the appointment date with Dr N: (1) Mum was unhappy even before her previous appointment . This was news to me. Dad said she pretended to be happy. After the session, I advised her, via my dad, to tell us and the doctor in future of such feelings (as it could matter to the doctor's

Recently, I made one change to the mod compared to the previous build : (3) Missile Barrage - Focus Fire (3 loadout points) I'm still not sure whether this gives better value or not compared to Double Trouble: does it deal more damage overall? Double Trouble has longer CD but activates twice in a row. Focus Fire deals more damage when it activates and its CD synergises with Heavy Metal. Sometimes that additional damage is all that's needed to get a kill. Here's a recent gameplay that I'm quite proud of:

The morning after the visit to the public hospital , she felt better but worsened towards the evening and that continued to the next day. They called me and I urged them to follow the instruction of the public psychiatrist: consult her if mum's condition worsened. Since it was already Thursday, I warned them that they should decide very soon because forgoing a visit on Friday means needing to wait untill Monday. Later that day, I had a thought and I told my dad: for the first time ever, after the appointment with Dr N , my mum asked me why Alprazolam (anti-anxiety medicine) would eventually be cut off. I explained to her that it was not needed to treat bipolar disorder. It would be like giving cough syrup to someone down with fever. Since then, coincidental or not, her condition deteriorated. Hence, I suspected that she was anxious at the thought of forgoing this medicine in future. I strongly advised my dad to inform the public psychiatrist about this. To help him, I texted him

Three days after the last appointment with Dr N , my mum started experiencing this: Felt numb Not herself (wanted to scream) Blur Couldn't think well Took time to sleep It intensified the next day and so my parents asked me to tell Dr N. After telling Dr N via sms and answering her questions, she increased Alprazolam back to 0.5mg per night and to observe. Coincidentally, my mum had appointment with the public hospital's psychiatrist (both psychiatrists are aware of mum continuing to see both, and that the plan is to eventually go back to public system fully) and my parents updated her on the latest prescription by Dr N and the symptoms above. As a result, the public psychiatrist prescribed the following: (1) Continue Epilim 200mg twice daily (2) Slowly replace Olanzapine with Risperidone (because they don't have the former). Hence, Olanzapine 5mg nightly for 1 week, then cut down to 2.5mg for 1 week and then off. (3) Risperidone 1mg nightly

While waiting for Monday's appointment, I discovered that, once again, my dad had acted as "doctor": few days ago, he decided to discontinue taking Gabapentine without consulting with any oncologist. Reason? Wanted to reduce medicine. The funny thing was that he had forgotten what it was for. Yet, he confidently stopped taking it. I chided him (once again) for being naughty and told him that it was for his pain, so that he could sleep better at night. Guess what? Slept much better on the very night he resumed taking it. Also, since letting out gas gave him much relief from his tummy pain, I suggested domperidone to him: a medicine that Penang GH's oncologist prescribed to him before. Fortunately, that helped a lot. He remarked that his tummy ached after dinner but it wasn't the case after one particular dinner. The difference? Absence of rice was the obvious answer. So he would be trying to cut down on rice and increase intake of protein (on oncologist'