Laughter's The Best Medicine

Here are some funnies that happened......

* Ever heard of a poking negotiation? Here's one for the road! "Doc, okay! I let you take my blood on 1 condition that is if you miss the 1st time, I will poke you once too....." not easy being a doctor
* Much anticipation on a new menu order - Speical tandoori chicken set! Finally the meal arrived but without the chicken.... only a piece of lime!
* Heavy rains had sky juice seeping through the ceiling boards. Soon it also started to drizzle in the room. He got upgraded to A class and slept like a king...... err for only 1 night!
* A fellow patient sleeping beside him that sings, talks, shouts...in his SLEEP throughout the entire night. Should have seen the fellow foreign patient panic at midnight!!!

There's more coming soon.......

Simple Mechanics

For many, most medical terms are heard of but never fully understood. Through experiences one would seem to have gained a "wealth" of medical knowledge, in fact it is only a drop in the ocean of vast and complex medical knowledge and research.

Our simple layman version of Stem Cell Transplant in Kevin's Case:
It is a salvage treatment used when the traditional regime of chemo and surgery fails to tame the tumors. There are 2 parts to the treatment, the stem cell collection and the stem cell transplant.

Preperation and Stem Cell Collection
Intermediate dose chemo is given in an attempt to shrink and contain the tumors while allowing the body to generate new cells after the course of treatment. Drugs are given to stimulate the cell growth. After which, blood is taken through a tube and pumped through a machine with the ability to seperate the newly grown cells. The blood is returned concurrently.

The Stem Cell Transplant
High dose chemo is the main attempt to wipe out all the cancer cells in the body. This however leaves the body with no immunity. The stem cells would be returned through intravenous drips after 3 days of the chemo. The body would require 2-3 weeks to recover from this cycle. In total, there will be 3 such cycles.

Upon completion of transplant, much care has to be put in the diet and surroundings for at least 3 months as advised. This is to avoid any source of infection which will impact the recuperation.

Triple Joy

It holds true how God's love, faith, life values, family ties and true friendship overrides all material and secular comforts. This birthday holds many poignant memories........

Many tried to plan on how best to celebrate this wonderful occasion, only 3 actually materialized with much adjustments.

Here's some exampled of aborted plans due to logistics, change in health status.. attempt to bake an organic cake at a borrowed kitchen, book an organic cake, a unexpected hospital visit on actual birthdate but have already discharged and many more.

1st Joy - Surprise dinner party @ Swensons, Compass Point
A week before the BD, his closest buddies from M'sia decided on a surprise trip down south (Nomis, Kim, William and Jonny). A morning sms triggered the 24hr planning team to activate the emergency plans within half a day.

Lynette liasied with the buddies, Jessica overcame all hurdles in getting the desired table at the desired time decorated with the desired balloons, Siang and Juan scrambling from work to keep schedule and help the ladies and Mum Anne, the accomplice, prepared "dinner" and trying to keep a straight face.

The KL fantastic four sped down barely hours after they decided and managed to sneak their way to Compass Point, Sengkang Town at 8pm. What a surprise he had, especially to see William who is back from Shanghai for a family event and Jonny who is based is Hong Kong.

Meanwhile our birthday boy was already suspicious:
- Nomis called prior to this day if he is well for a visit and suddenly saw Linda's mobile had "Message fr Nomis" flashing across the screen
- Linda came home early to shop at Compass Point for beddings
- Mum Anne did not cook usual fanfare
- Linda suggest dining out when is so particular in what & where he eats

The dinner was filled with laughter and noisy conversations.... it ended with a platter of ice-cream scoops and a entourage of swensens singers belting out together with the gang the loudest Happy Birthday song ever heard!!!

2nd Joy - Surprise tea party @ SGH, Ward 48, Rm 18
As most family and friends work late during the weekdays, it was a plan sparked off by a conversation between Gerald and Debbie the week before......hospital being quiet on a public holiday would be ideal for a small party for Kevin along with plans to book a renowned organic cake which needs 4 days advance notice....

Due to a decline in the immunity counts, all plans were held back till the very day. Nurses were consulted before the final go-ahead. Urgent smses were sent if all are available and it was heartening that everyone found time to gather even though it was the wedding anniversary and birthday for some.

Lynette and Siang put together some simple sandwiches for the tea party. By means of chance, Nomis and Kim also made arrangements for a visit over the weekend and were a part of the surprise too!!!

Everyone were in high spirits which helped boost his mood as he was suffering from terrible bone aches caused by the drugs needed to stimulate the cell growth. Even his dedicated doctor popped by to join in the mood later that night to end off another eventful day.

3rd Joy - Home Sweet Home @ 121A Rivervale Drive
The stem cell collection was very fruitful which led to shortening the timeline and thus the sudden decision to allow discharge on the exact Birthday! A birthday wish came true..... the nurses were happy for him and even presented a gift and a birthday song to him before discharge.

Family members were called for an impromptu dinner. Dad Raymond managed to buy a variety of food which is very much a treat as most meals are homecooked with selected ingredients only. It was a very simple and ordinary meal but it was in no way ordinary to all as every gesture showed how much everyone means to each other.

"Treat everyday as a special day for your special someone not just one day in a year"

Tribute To All

Looking back at how far this road less travelled has brought us, it would be an almost impossible walk if not for.....

The Lord for His Strength and Guidance
"Yea, though I walk through the valley of the shadow of death, I will fear no evil; for thou art with me; thy rod and thy staff they comfort me" (Psalm 23:4)

Yeo & Oh Family
For all the prayers, love, encouragement and support showered upon us during this difficult period.
For all loads of organic food, fruits, juices, soups, pasta sauces.... to nourish the body, the different "cuisines" catered to the difficult and everchanging taste buds, jokes and games to cheer the spirits, last min plans for impromtu gatherings and many more..........most importantly just being who you guys are!

Extended Family Members & Family Friends
For all the unconditional love, prayers, encouragement and support even when far away in other continents.
For all the nourishing drinks, delivery of healthy foods, encouraging life stories, health tips and many more to list........

Friends All Around the Globe
Have always known we are blessed with sincere and true friends.........
For all the prayers, love, encouragement and support through even the simplest gestures.... taking care of our 3 babies -Baby Meagan, Oldie Wolfie and Budi e Bully (special thanks to Blessing & Paris for tolerating being bullied by Budi everyday & Kimi for tolerating sibiling rivalry), numerous visits during lunchtime to send favourite foods to boost appetite like the famous lychee cakes, salted duck soup from Sim Ming Rd..., the most comfortable tempur travel pillow to aid rest, skype conversations and facebook games to cheer the spirits, instant messaging & sms to keep busy, countless visits even after a heavy day at work, quick trips to Singapore for a surprise, putting everything down for an impromtu gathering, staying late into the night for games........the list goes on.

The Medical Team

For all the dedication, patience, widsom, concern and gentle care made all the difference in our lives........

Our Sincere and Heartfelt Thanks to All!

............................

GOD BLESS and WITH LOTS OF LOVE,

Kevin & Linda

An Encouraging Moment

News from the doctors that the body was stimulating plenty of new cells gave much cause for rejoice. The inital plan for 10 sessions of cell collection has been reduced to only 2. It also shows the body is fit for the fight ahead!

Thank You All for the constant prayers!

The Tough Terrain

The green light to stem cell was a difficult call but was ultimately made! Doctors were already starting to preparing even before the call was made to ensure treatment could start the soonest.

Within one week, everything was geared up to run the most difficult terrain. We met the team of doctors that specializes in stem cell transplants and two other doctors specializing in germ cell tumors. Correspondance have also been made with specialists from overseas who wrote articles on stem cell transplants for germ cell tumors.

Upon admission, a round of test of bone marrow was required and so an extraction of the marrow was carried out. The experience was one of extreme bone ache and it was very uncomfortable for a few days.

After the first cycle of intermediate chemo, the extreme fatigue and lost of appetite were again the side effects. With the need to boost the bone marrow for new cells to be later collected, three injections of growth factors were needed daily. This stimulation caused bone aches which turn nights into sleepless ones. Fortunately, paracetemol was invented and it soon gave much relief to the aches.

Faced With A Higher Mountain

Looking forward to start the last set of chemo courses , plans were made out for a short recuperation in a nearby resort....

Once again, another hurdle has been thrown across as the tests has shown the tumor markers rising again. It is now the question of how the markers are trending over the next 2 weeks before another decision is to made - a few more rounds of the original chemo or to start the stem cell transplant.

With the finishing line looking so far away, family and friends kept up the encouragement. Visits from family and friends overseas.... family and friends gatherings for dinner and social games like Taboo and Genga kept the spirits up. Even tiny gestures like short 5 min visits, short instant messanging, cooking a tasty meal, a bunch of flowers, a conversation over skype made a world to us especially when everythings seems to be at a standstill.........

Finally the tests showed a regression in the disease and the doctors have concluded that a stem cell transplant would be best medical choice. Armed with prior knowledge on what this entails led to many unanswered questions and worries. Even the a second opinion at another hospital could not answer the innermost fear. The fear of not making it through.

Emotions were running high as all were grippling with the news and what lies ahead. Ultimately, it is a personal choice and a very difficult one but is to respected by loved ones. It is now living out the best in life or to go ahead even when the odds are against us at 25% success rate.

The Difficult Hurdle

As the day of surgery approaches, the mind makes a mental list of what we wanted and have not done....raising a family, vacations..... Each time fear sets in, we prayed together and strength is drawn to take on yet another day.

The Lord blessed us with a team of dedicated and experienced doctors. Upon admission, doctors were working on the case till 10 the night before the surgery and nurses even introduced the operating and recuperating facitilies for additional comfort.

Facing the unkown unsettles the mind and heart with much anticipation and fear.... At that point, it is pure reflection from the heart on what things in life means most..... how to let go of all the things planned in life if things don't turn out well.

Dawn approaches and preparations were underway for surgery scheduled at 7.30am. Nurses and aides bustled around and it was time to make headway to the operating theatre. When the doors of the theatre closed, our hearts said a silent message... a message of encouragement and love.

4 hours became 6 hours and soon it became 8 hours. Family and friends from all regions anxiously waited for news... finally after 9 hours at 6.30pm the theatre doors opened and the surgery was over.

The surgery was considered successful even though the main tumor could not be fully removed as the tumor was found to be attached to the heart. The surgeon skillfully removed as much tumor possible and 10 pints of blood was infused.

It is now the road to recovery as the biospy showed 95% dead tissues and a few cycles of chemo will kill the rest of cancer cells in the body. With quiet determination, recovery from surgery was quick and smooth.

Crossroads

Entrusting everything in the hands of The Lord to direct doctors in their wisdom in making the best decision, the days were spent savoring every minute with constant visits and tele-conversations from family and friends in Singapore and all other parts of the world.

It was a quiet Saturday when the decision was to be made. While a minor procedure was carried out to remove the infected chemo line in the room, it was a calm yet reflective wait outside the corridor.

Many minutes passed before footsteps were heard approaching... the doctor while awaiting the latest blood test came to gently deliver news to family that the outcome of the past trends shown regression of the disease (Beta HCG previously undetectable shooting to a high 12). With the news sinking in the heart, the burden was lifted to the Lord for direction and strength. Grave yet calm was the wait for the test results for the review with the doctors.

With the procedure finally over, the doctors gathered us in the quiet room.... Miraculously, the latest test showed the Beta HCG declining unexpectedly which surprised the doctors. This outcome swung the decision from stem cell transplant to surgery.

The surgery would attempt in removing the entire main tumor located at the chest area for a biopsy for a clearer diagnosis and treatment. Another aim is to replace a main vein leading fluids back to the heart with an artifical one (the tumor has been pressing on this vein for so long it no longer functions well). It explains why the upper body is always swollen when fluids are infused.

Emotions were mixed as the news were deemed positive while apprehension was placed on the major surgery as the last experience with a open but simplier biopsy was traumatic....

Nevertheless, family and friends from around the world cheered on as the end of the race is deemed drawing closer...

Change Of Tides

Having a relatively rare cancer in their hands, the docs follow the case very closely with much monitoring and discussion.

Each week brought positive news that the AFP has been decreasing as expected and the feeling of breathlessness was greatly reduced. Rest was much easier and wholesome when one is able to lie flat throughout the night.

Into the 3rd cycle of chemo, a normal follow-up with the doc left us waiting while the doc was preparing to meet. It was unusual as the doc is extremely punctual.... After more than half hour wait, the doc presented the news that things were not as positive....

The News:
Lung function was decreased due to a chemo drug and would have to be replaced. The AFP which was dropping has now plateaued. This calls for concern as the tumors show some resistance to the chemo treatment. AFP was standing at 88 and the Beta HCG previously neglible was standing at 12.

Chemo was put off for further monitoring of the markers trend before they decide the next course of action - Surgery or Stem Cell Transplant

The Medical Terms

At this point, familiarization with certain medical terms would be useful to understand the situation better....

The 3 cancer markers for Germ Cell Tumors are known as AFP, Beta-HCG & LDH. Doctors would require the assistance of CT Scans to help with the overall assessment of the cancer.

AFP is the main indicator which is used to assess the regression / remission of the cancer. As a gauge, this level should drop by 50% every week from the start of the chemo treatment.

Total 4 cycles of Chemo treatment for Germ Cell Tumor

Each Cycle of Chemo:
Week 1 : 5 days chemo
Week 2: 1 day chemo
Week 3: 1 day chemo

Targeted date of chemo completion : End August 2007

The Smooth Transition

Armed with clear direction, the next decision is where treatment should be sought. With a patient with breathing difficulty and in ICU, the oncologist from both the private and government hospitals decided to start at least the first treatment at Mt Alvernia.

Comforted and assured with the knowledge both docs are in communication, it was relatively smooth sailing for the 1st session of chemo without extreme side-effects. There was no throwing up as it was controlled by drugs, only extreme fatigue and loss of appetite which was slept off..

The next week it was already a outpatitent treatment at the National Cancer Centre and closely monitored by the specialist over there. All spirits were up set to conquer this illness!

Power Of The Gang

Throughout the stay in ICU, family and friends kept vigil outside the ICU. Everyday, we are the 1st family to arrive and the luxury was ours to select the "Best Class Seats". The area was practically ours especially during lunch when colleagues and bosses visit. Each piece of news was delivered in a seminar style (a little exaggerated here... but due to the size of the us there...)

After days of tests, scans, bioposys, drips....the whole works, it was finally diagnosed as Germ Cell Tumor! The gang immediately took out their PDAs... Blackberrys did a search. Thank God for Internet Invention!!! That scene looked like it came from The Matrix!

To All who gave their support in their presence, prayers, efforts in driving down from KL to Sin, the constant encouragement, boosting the family and all the different gestures made like livening things up, buying nice cakes and drinks and erhmm... secret stash of tissues in case someone needs it ... Thank You! You gave us the strength to face and carry on this challenge. On top of everything, we thank The Lord for his strength and grace.

Starting of the Race

The begining of the great race were complaints of gastric pains, bloatedness, fever & overall discomfort. Even after antibiotics, the fever returned after 2-3 days. Sleepness nights due to the discomfort ... he looked like a zombie.

Decided to bite the bullet and visit a specialist whose fees were incredible.... One look at him, a full blood test was immediately carried out.

The next night, due to difficulty in breathing, the doc order admission to the A&E. That's when all hell broke loose....