cycle3b, cycle 4a

cycle 3b, cycle 4a

[30 Dec 2008, 06:49:48 PM]

I'm still around, just tired. The side effects have temporarily dominated over me. I still want to log what I went through, hopefully when I am up to it soon. There's a change in one of the drugs used in cycle 4a, which is making me miserable. Anyway, hope the new year 2009 will be better, healthier and happier for everyone!

cycle 3a, day6

cycle 3a, day 6

[10 Dec 2008, 04:02:41 PM]

"I have good news for you." That was what my doctor said when we entered the consultation room. "Your marker has come down nicely to 77," announced a rather delighted Dr Chia. It was a great relief to us too, seeing that adding avastin to the regime works.


It wasn't so anxiety-free. Though "Shuai Ge" and I had talked about my death, we haven't really got down to the nitty-gritty details. I thought of those I need to inform, especially those he is not so familiar with, I found myself smiling when I counted so many of them. These are my young friends and friends I got to know through the internet. I think I may have to trouble littlegeo, starrie and gin to help me do the informing. I must find the energy and time to do a list of who-to-inform.


SSN Tan came to find me while I was waiting for my prescription. She passed me my Christmas present. I was surprised how she knew I would be in the clinic. She laughed and said she had a radar hidden somewhere. She invited us to join the Christmas party this coming Saturday and I agreed. I hope I won't back out last minute. *fingers crossed*


It was another crowded day at the clinic. The nurse who helped me do the plug was Cristle. She tried to be gentle, but the pain factor was still 7. There was a case of allergy, which I found out was a reaction to oxaliplatin. The patient next to me had bouts of vomitting which also made me want to puke. It might be psychological, but the smell of a certain medicine really made me sick. I couldn't understand the way the clinic works. Two other nurses tended to me when Cristle wasn't available. Both had to take off tapes to see which tube lead to which medicine. In the process, they caused me much pain. The plug was heavy and they didn't hold it (or asked me to help support it) while examining the other tubes. I wondered why the same nurse couldn't administer my medicine since she would be the one who knew about the way the plug was set. I don't care. I'm going to tell the nurses to label those tubes properly in cycle 4a, rather than un-taping and taping each time they need to see which tube goes to where.


The same side effects tormented me. Insomnia, loss of appetite, nauseating, fatigue and stomach wind. I went over to Joyce's house after a two-month hiatus. I don't know if the increased dosage has caused the side effects to be amplified. My tongue has lost any sense of taste. The vomitting was worst on Wednesday. Dr Chia did prescribe me anti-vomitting medicine. I didn't take any. I prefer to puke. I feel better after the puking. If I take anti-vomitting medicine, I always feel worse. That is my experience.


This is for record purpose.
Cycle 1 Gemzar + oxaliplatin
Cycle 2 Gemzar + oxaliplatin + avastin
Cycle 3 Gemzar (increased dosage) + oxaliplatin + avastin


I can now conclude that CTX and MTX affect one's ability to process information and think logically. Now I'm wondering which of these affect(s) one's moods.


Sharing with you this steamed 9-layer kuih/kueh which helper and I attempted. Did this the day before my review. My way to de-stress.

cycle 2b, day8

cycle 2b, day 8

[28 Nov 2008, 04:07:55 PM]

It has been a week since I finished cycle 2b. My emotions went on a roller coaster, as did my state of well-being. After cycle 2b, I was so hyper-active, I had insomnia last Friday, my mind was in an overdrive mode and I talked practically non-stop during the weekends. Whilst I was lying on the bed, trying to bore myself to sleep, I thought of at least a week's blog-worthy entries, as though my life was "played" in my mind. I was in a happy mood that night. However, it didn't start as so.


My chemo appointment was at half past twelve. I needed to be in the clinic an hour early for the blood test. When I put in my blood test form in the tray, mine was the first. "Oh, good," I thought, "It shouldn't take long before my turn." I was wrong. One of the counter staff went for her lunch break, leaving this rather slow-moving lady manning the counter. Before she processed my form, there were several others in front of her computer (which I missed). While keying in the necessary information into the computer, she was interrupted several times. There was this man who kept insisting she didn't return some of his forms and kept asking her for them. She also insisted she didn't keep any of the forms and she did return everything to him. Then came the social officer, who asked her. Then the lab technician. Then the social worker again. I was quite disturbed by what I saw. After all the interruptions, the counter staff entertained this query from a patient's family member about a bill. She went on to proceed that request instead of processing the blood test forms. I thought I was going to lose my cool and storm towards her to tell her to hurry up with the blood test forms. I was getting impatient because I knew I was running late. Of course I was playing all these emotions in my head.


I started to think why she was working as a counter staff and about her attitude. Then I thought, since it was near year end, it would be nice to take the feedback form and give my comments and observations. How about someone reviewing the blood test form processing procedures? I was smiling to myself, dwelling on such matters. After some waiting, it was my turn. The lab technician looked like a mini-size Yati. I asked her to help me pass the VCD to Yati and Prue. She poked the wrong place and hurt my arm. I would want that sweet-looking lab technician anytime. Her needle-poking skill is superb, with pain factor almost close to zero.


Then it was another waiting game. Usually it takes half an hour before the blood test results are out. It took more than an hour that day. By the time I went to the 3rd floor, it was way past my appointment time. I heard the counter staff calling the nurse station about my case. I went forward to explain why I was late. The counter lady gave me another appointment time. Yes, I needed to wait another one and half hours. All the time she was smiling and explained the clinic has been rather crowded of late. She understood my situation.


I took a quick bite with "Shuai Ge" at the cafe downstairs and returned to wait for my turn. I began to look at my past marker readings (since I had nothing to do, except listening to my walkman handphone) and discovered to my horror, the recent reading was the highest since epotoside (2007 regime). All the waiting had made me tired and sleepy.


If not for Imelda, I think my day would have been worse. I was given a bed, instead of a recliner chair. Plus a remote control for the tv. Yay! Imelda's plugging skill rocks. I rate her skill with pain factor 2. She made sure I was comfortable, apologised when she had to attend to something else first and got me a hot pad nicely wrapped up. It was a comfortable infusion after that. The young Chinese nurse however paled in comparison, and hurt me when she removed the plug. Ouch! I wondered why she couldn't feel the weight of the whole plug. How could she remove it without supporting it first? *Shrugs*


I was reflecting on the side effects of this regime, and thinking to myself that I didn't get headaches. I thought too early. A headache started on the right side on Sunday. It then moved to the usual left side, tormenting me for a few days. It got very bad on Wednesday night that I had to wake "Shuai Ge" up to rub my temples with medicated oil. I lost my appetite to eat and that "conquer the world" feeling I had. I just wanted this phase to pass quickly.


My rest week starts today. I will be seeing my onco next week for my usual review and of course the result of this regime. Please keep me in your prayers.


P.S. I think littlegeo could smell my tiramisu when I made one. Hahahaha!

regime#7, cycle2a, day1

cycle 2a, day1

[14 Nov 2008, 08:17:17 PM]

I had an early appointment with Dr Chia today, leaving the house shortly after nine. When we entered the room, I saw the expression on Dr Chia's face and instinctively guessed it. My marker has risen from 106 to 187. However, I was thankful for the overall better blood counts. My liver function readings, without the MTX, are within the normal range.


We were abit shocked by the almost double in readings. Dr Chia suggested adding avastin in today's cycle as previously planned. I agreed. He was really understanding, as that would mean additional costs for us. He doesn't want us to exhaust ourselves and not being able to continue the marathon fight. He was hoping to see my condition stabilised first before going away. I was really touched by his concern and thoughts, and a kind gesture. We were still recovering from the shock when I went to get my queue number from the clinic. Since it was going to be more than two hours wait, we rang Dr See's clinic to see if it was possible to drop by. (Dr Chia also suggested that.)


On my way there, "Shuai Ge" and I discussed about the latest readings. It was unexpected as the last treatment with gemzar and carboplatin/cisplatin in 2005 brought my readings down to single digit. I don't know if my cancer cells have become more resistant. We discussed and decided there were some questions we wanted to ask: At what point would we consider the gemox regime as ineffective and to change cocktail? What are the options then? Do I need to do another CT scan (as Dr Chia suggested)? We are seeing a rising trend of CA125, how many more rises do we then change regime?


Dr See answered our questions and shed light on my options and action plan. We were alot calmer and settled after the consultation.


Back at the clinic, it was really packed. Waited almost two hours before my number flashed. There were three Filipina nurses and only one local nurse in the room I was in. Apparently they were short-handed and held back by a meeting. The Filipina nurse Cherise did the plug for me (pain factor 7). The plug looked like a centipede (I took a pciture of it) because of the three cocktail drugs plus two liquids sequentially entering my body. Learnt something new today. Oxaliplatin is not compatible with normal saline and must be flushed with G5. And for flushing avastin, normal saline is used. That explains the two bottles of liquids. Since no nurse was in the room when the machine beeped, I pressed the call bell twice, each time for the two drugs. By the time I finished the treatment, it was already six o'clock. Sleepy, tired and hungry. And moody.


Will be back at the clinic for cycle 2b in a week's time. Let's hope there will be more (gentle and alert) nurses on duty then.

regime#7, cycle1b

cycle 1b and rest week

[11 Nov 2008, 02:42:04 PM]

It was my first time having chemo on a Saturday. The clinic was on half staff strength and only Jasmine Suite was available. Went to the clinic before eight to get my blood tests done. Was attended to by a male nurse. They almost missed my number.


While Chan was preparing the plug, we had a brief chat. He asked if I have been having treatment for awhile, I replied, "Four years plus." He was surprised and told me he only joined this clinic for a year. I jokingly said I was more senior than him then. He didn't pre-warn me or ask me to take deep breaths before setting in the plug. He didn't inflict much pain (maybe I had no time to think about the pain or feel it). He injected the pre-med very slowly into the tube and the "needle-pricking" sensation was minimal, much to my delight and surprise.


I am blogging how I felt so that it could be used for future reference. I had fatigue during the first four-five days. The tiredness just hit me, especially in the afternoon, where I had to lie down and sleep it off. There was also loss of appetite or the lack of it. If I wanted anything to eat, it would be something salty or fried food. I had bouts of stomach cramp and intestinal discomfort. The cause could be drinking vitagen or cold food. I had to avoid cold drinks, cold food and even vegetables direct from the fridge. I need to keep warm too as coldness can cause much discomfort. I try not to wash my hair so often to minimise the hair loss. The constipation problem was no longer an issue after consuming the herbal medicine prescribed by Zhang yishi.


Other than extreme fatigue and poor appetite, I have no other complaints. I would be seeing Dr Chia this coming Friday to see if I respond to this chemo cocktail combination. Five more cycles to go!

regime#7, cycle 1a, day 6

cycle 1a, day 6

[29 Oct 2008, 02:35:26 PM]

I requested for the morning glory suite and was given that for this cycle. I was glad to be attended to by Imelda, who is really great with the plugging. She made me comfortable by getting the blanket ready, making sure I was warm. She forewarned me when she was about to administer the pre-med, one of which gave me this "needles pricking" sensation at the butt. After the drug gemzar started to flow, she got me a hot pack to be put on my arm. The "burning sensation" was familiar and I almost wanted to pull out the plug. Grrrrrr. Then when oxaliplatin was going in, I felt cold. Brrrrrr. Hot then cold. What a combo!


I measure a nurse's competence in plugging needles by how much (or little) pain when she sets the plug in and if there is any bruise (aka "blue-black") after the plug is removed. There is a certain angle of plugging in where the pain is minimal and how straight one pulls the arm (to straighten the veins) to plug in. I must clarify I am not a trained nurse or have any knowledge of such. I only have the practical experience and going through countless pokings to derive those observations. So far, I had encountered two nurses who gave me totally painless plugs. Incredible I tell you.


I felt very tired after day one and have been feeling such since. One of the side effects of gemzar is constipation. I am also seeing some hair loss and feeling rather hot, perspiring incessantly.


Not wanting to be defeated by the side effects, we went to consult the Chinese physician yesterday. His prescription of herbs three years ago was of great help. Yes, I like my "yi shi" too. He complimented my oncologists for taking such good care of me all these years. I totally understand why he only gives consultation and does not dispense medication.


LX called me on Monday to share a joke. She made me laugh so much and chased the moodiness away. Joyce called me this morning as I have not been to her place for quite awhile. She asked if I have any food cravings so that she could buy them. No, I don't. I just want to rest and fast forward my life to the last cycle of this regime.

7th regime

Taken from my old blog.
New regime / protocol
[23 Oct 2008, 05:31:24 PM]

My scan and blood tests results were out. I went to the clinic on Tuesday. The cancer marker CA125 has risen to 106. The scan showed two of my tumours being larger than previously. They caused one of my kidneys to be enlarged too, though I don't feel any discomfort. Maybe just "sng sng" feeling sometimes. The rise should not come as a surprise as the marker has been on the up trend during the last few cycles.


My blood count is not pristine anymore. My white blood count is still below the normal range.My red blood count is also marginally low. I was still on oral CTX and MTX without the avastin. Dr Chia concluded that the two oral drugs without avastin do not work out for me. I wanted to rest some more but he felt it is better to start this Friday on the new regime. He was considerate and understanding, seeing my anxiety, to suggest consulting Dr See for her opinion. We did, on the same day. I laughed when he said the new regime would not cause hair loss and I should be able to tolerate the side effects well.


Dr See's view is the growth is considered slow. She is still keen to be put me on oral drug tamoxifem later on so that my bone marrow could recuperate. She said to monitor my response to this new regime and would consider adding another drug (couldn't remember the name now) to enhance the effectiveness. Dr Chia's suggestion was to have avastin added at a later time.


The new regime will commence tomorrow. Oxaliplatin is a new drug I am using. I had gemzar before in 2005 with carboplatin (4 cycles) and with cisplatin (later 2 cycles). I remember I was so bloated that I almost couldn't fit into "M" size pants. The drug gemzar when going into the veins would cause this "burning" sensation and I needed hot packs to be put on my arms. My veins after that regime were constricted and had many "valves" (spelling?) that the nurses had a hard time looking for "big" clean veins to plug me. Needless to say, what I dislike most about this regime is the numerous needle prickings.

Before regime starts: blood tests (needle poke #1)
Day 1 : chemo infusion for one and half hours (needle poke #2)
Day 8 : blood test + chemo same as day 1 (needle pokes #3 and #4)
rest one week (day 15-20)

Day 20 : blood test (after chemo blood tests) (needle poke #5)
day 21 : doctor review + chemo possibly on the same day

Okay, who is counting the needle pokings?

Profiling myself

Profiling myself

[20 Feb 2008, 12:07:10 PM]

This is an overdue entry. I had meant to do a profile on myself with regards to my health, eating and diet habits. However, I doubt the usefulness of such an entry. On Sunday, churchie SG was teaching in Sunday school and commented (relating to the morning's topic), "I had cancer because I din watch my diet. Snowcloud watched hers and yet got it too."


A few years ago when I first saw Prof Tay, he lamented that till today doctors couldn't put an exact profile on cancer patients. Whilst it is easy to do a profile on heavy smokers/drinkers, people with genetic and family history, people with unhealthy eating habits etc, it is very perplexing why some others contract unrelated dreadful illnesses. Take for example "Shuai Ge"'s late sis-in-law's sister a non-smoker with lung cancer and with no second-hand smoke environment. Nobody has the answers. It takes me awhile before deciding on this entry. If you have been following my blog since two years ago, it wouldn't be hard to know some of my eating habits.


Eversince I read my brother's health education textbook in primary school eons ago, I have been interested in diet and nutrition and health related issues. In my years where internet access was unheard of and borrowing from a library wasn't so easily accessible (perhaps because I was too young to know of such an option, plus books of such topics weren't so popular), I acquired and accumulated my knowledge from whatever print media I read (aka Chinese newspapers and magazines). I don't just read for head knowledge. I believe I have a bland tongue which explains my little tolerance for salty and oily food. I practise what I know.


Since young, I love eating vegetables and fruits. Before I was sick, there was an unwritten rule that I only cooked fried food once a week, had fast food only once a month or on special occasions, canned food (eg luncheon meat) occasionally and I didn't stock up on frozen food. I read food labels like a hawk. I spent more on vegetables and fruits than on meat stuff. My cooking methods were varied since I only fried food once a week. The food I love to eat are what most say highly beneficial and with anti-cancer properties. My friends used to tease me whenever I had laksa/curry sans the gravy or soupy noodles minus the soup (because it was laden with msg). There is a joke in the house because whenever my mum cooks soup for me, she has to specify it is all natural ingredients with no added msg. I relied more on condiments and stuff without compromising on the tastes. I think you know what I mean.


I treasure my organs which are hard at work for me. I used to drink a cup (sometimes two) of plain water in the morning before breakfast. When lemons were the "in" thing, I added the juice of one green seedless lemon (ya, the expensive and at one stage hard to get type) to my water. (Anyway, I love lemons which I often used in my cooking.) It helps to cleanse organs and flush toxins out (not that I had many at that time). Whenever I had headaches, I didn't pop in painkillers. My remedies were found in my pantry. I used to take panadols when I was plagued with migraines in jc and while working. After I learnt that the liver has to work hard to rid it, I sought alternative remedies. I found rubbing ginger on my temples and at the back of my neck ease the tension and pain. My friends would tell you how I hate to pop in painkillers, even till today. "Shuai Ge" oftentimes had to persuade me to take tablets whenever I was in some kind of pain or suffering from nausea or gastric pains. I super scared of taxing my liver and kidneys.


Some people attribute stress as a major factor in contracting cancers. I would like to think mine has nothing much to do with diet. Although I have no answers, I do know my immune system is down. What I am currently doing is to boost it up (hopefully) and gives me a fighting chance against this illness. I am not against any form of profiling oneself. Infact the books I read have a checklist for such a profile to determine the possibility of one getting the illness. Some hospitals have a screening/profiling test. I guess prevention is better than cure and have read some people undertake steps to minimize their chances of getting it.


Knowledge is important pertaining to your illness and body. It's difficult to sell me any health supplements or products because I am always suspicious and cautious. Moreover, when you are sick, you can get quite desperate to be cured (don't let others capitalise on that). I believe what work for others may not be effective for me. And for every product there is bound to be (at least) a successful story/case.


While I am now trying to increase my immunity, I hope too my current drug regime works to control my tumours. And staying cheerful and positive helps. "A cheerful heart is good medicine." Proverbs 17:22

Regime #7, Cycle 5a

My Diary - 1 February 2008

1

Cycle 5a, review and options

[03:17:19 PM]

As I stepped into the doctor's clinic on Wednesday, he was frowning. Perhaps he had just recovered from a bad bout of diarrhea (which I learnt of it from SSN Tan) or it was my latest scan results. My cancer marker sort of plateau-ed at 120, not much change from the previous one. So, what did that mean, I asked him.


He went on to show me the scan results. The good news was the two tumors shrank slightly, which he reckoned at the early two cycles of using avastin. There was a rather stubborn tumor somewhere on the lower intestines which had grown slightly (compared to the previous scan done last August). This is cause for concern and explained the rising cancer marker readings. I spoke half in jest, "So stubborn leh, these cells. Why like that?" He replied, "Maybe resistance clones." We spoke at length the various options and he explained what I could hope for (which frankly isn't much). At one point he suggested this chemo drug which would cause hair loss in patches. PATCHES??!! So ugly... eeeeeks I don't want... You could imagine my strong reaction to this especially since I just did my hair. No way lar, doc. Anyway, we decided I would go for one more cycle of current regime. He apologised for not being able to give me a good CNY. Ah, that's alright, doc, not your fault.


I sms-ed Ser that evening to let her know that I had to leave earlier after breakfast for my iv avastin at NCC. It was nice of her to give me a lift to NCC after our usual breakfast and marketing trip. I arrived almost 45 minutes earlier before my appointment time. Couldn't explain my fatigue and sleepiness, I actually dozed off on the sofa while waiting for my turn. I slept through the short half hour drip and didn't even realise "Shuai Ge"'s arrival. We proceeded to Dr See's clinic after lunch at our usual favourite yong tau hoo stall.


Looks like the inevitable has to happen. Dr See suggested the operation, the one I resisted. She felt that it was to give myself a chemo-free holiday after the operation and also to let the body rest. What we are doing now is continual pumping of toxins into my body to keep the tumors at bay. She felt that the cost of using avastin for that little incremental benefit is not efficient (same opinion as Dr Chia's). What the operation entails is removing of all tumors visible and then continue with more chemotherapy thereafter to try eradicate residual cancer cells. Some timelines, options, surgeons involved, risks etc were mentioned and discussed briefly. Anyway, I still have time to consider and she felt this is the best option for me. Not everyone can have that operation. Age, number and size of tumours, and general health conditions are to my advantage. BUT to stay in ICU and the whole thing about operation, and we are talking about MAJOR operation, is enough to make me shudder. If this is my first operation, I probably won't bat an eyelid and agree. I had my first almost four years ago and went in without knowing what to expect. Not this time. Terribly frighten of the post-op pain and recovery. Yes, my threshold of pain has seriously dwindled to its lowest point.


During the discussion, "Shuai Ge" brought out a yellow-tinged paper with Dr See's writings. It was an outline of my options when we first consulted her almost 3 years ago. I have literally tried out all the drugs she wrote. Like she said, she has not been wrong except one which I drew no response. We left the room after letting her know I would give the option much thinking through and prayers.


Well, knowing me, if it is the ONLY option to go, I would do it. To be operated on in exchange for a hopeful at least one year or more chemo-free holidays. However, I never say I won't resist, make noise, whim first, "deh" plus other "resisting" actions. There are still other (somewhat minor to some but major to me) considerations. And the timeline? May. Sighs. What a way to welcome in the year of the Rat. I am behaving like a mousy now. *resists operation mode*








P.S. After a little thought, think the cells take abit after me: stubborn. Baaaahhh