Updates

I must apologise to all, but all visitations will be limited for now.

At this stage, Jo
- can hardly walk or stand
- is very weak
- is extremely tired all day
- she sleeps some 22 hours a day and wakes occasionally
- is on liquid diet as she's been on the last 2 weeks

The water is still draining quite well @ 2 litres per day.
We've also got a nurse and doctor (from the Assissi Home) that makes visitations at least once a week to oversee Jo's condition.

Jessica and MIL are here the next 2 days to help me with my busy schedule for this short time being. I just want to get through this week...

Please pray for His Will to be done in her life. Please pray for Jessica, FIL and MIL cos' I know it's extremely tough with them as it is for me.

"The LORD is close to the brokenhearted and saves those who are crushed in spirit." Psalm 34:18

12 June 2007

Today marks our 1 week in SGH.
A couple more days and we would've set a new record for longest stay in any hospital thus far.

Jo rested well last evening.
No major situations.
Was very glad.
Gave thanks as always.

I was only anticipating that we could have been discharged today, but she had to stay for further observation. Just to be absolutely certain that she would be fine when discharged.

Water was released this morning measuring some 500ml.

Jo however still felt a little nauseous (thanks to DD and Jotan for highlighting the error), thank God she didn't vomit or retch so far. Appetite was a little better. Last night she had some duck noodles (perhaps the only edible item at the SGH kopitiam) and cheng thng plus etc etc. Today she had a little bee hoon and fav Solero lime ice cream.

May brought tomato soup and garlic bread. Kett as usual, brought sandwiches and bread from the Provence Bakery & Cafe at Holland Village along with chicken rice for me. Really nice stuff at Provence if you've not tried it.

Jo's stomach is still a little bloated, mainly from gas within. Dr Leong had suggested some sort of enema to release the air if it's still bothering her.

Well, a quiet day so far. Managed to steal an hour and half away to the office to complete some paperwork. Am really thankful for such a working environment along with an understanding boss and all.

3 patients were discharged when I returned to the ward. Only Jo and MIL was present. It seemed really strange to see a room devoid of patients except one. And just as soon as I'd said this, the beds were once again filled. Cancer is a no. 1 medical problem and I hope all of us will remain diligent in maintaining regular health checks for this.

The poor malay lady opposite Jo was in tears this afternoon after returning from an operation. It seemed that the doc had made an error (?) and needed to redo the procedure again. Just tried my best in consoling her and her husband with my limited but legible Malayu.

May God watch over all who are suffering and grant them peace.

Our Journey: Scaling the Mountain

"Do not fear, for I have redeemed you;I have called you by name; you are Mine! When you pass through the waters, I will be fine with you;And through the rivers, they will not overflow you.When you walk through the fire, you will not be scorched,Nor will the flame burn you.For I am the Lord your
God."

We are now at the phase of our Journey where we're scaling a steep part of the mountain.

In fact we began the ascent, as I sit back and reflect, some 6 months back with the first occurence of Jo's back pain.

We don't know how much farther there is to climb before we reach the summit, but it's been lengthy and tough...really tough. At this point, we can't see all the way up but we can see quite a bit of how far we've come.

For those who know me, I've got a natural fear of heights or acrophobia. I don't know how this developed but it must have happened during one of the inter-island flights I took while I was studying overseas. So climbing let alone mountain climbing is the last thing on my mind and perhaps to me - a mindless life endangering activity which can be hardly considered as recreational.

April 19, 2007 - A night I'll never forget.

I usually never have Jo out of sight for too long, but this evening she had ventured into the bedroom and it was quiet for awhile. I thought she could've beenin the toilet, but I was sure I never heard any toilet flushing or water flowing from the taps.

I walked into the bedroom to check. The lights were off except for the glow of the toilet lights streaming into the bedroom.

There she was, huddled in a corner at the edge of the bed sitting on the floor, sobbing away...I rushed immediately toward her and gave her a hug as we sat silently. We knew each other's thoughts, we knew our hearts were strained and our tears were jointly flowing as if two streams coming together as one.

The reality is that her situation has gotten serious. In fact, it was serious since the recurrence in 2004.

Just last Tuesday morning, Dr Leong pulled me aside when she made her morning rounds. She told me that looking at the latest reports/results of Jo's X-rays and blood tests. She may no longer be suitable for the NUH clinical trial and to be prepared for the worst. It was bad news, but nothing all too surprising from the development of things over the past months...the bloatedness, water in the lungs etc.

That night, we decided to lay everything before the foot of the Cross - our fears, grief, worry, anxiety, thanksgiving and confession about everything we thought was hindering our walk with God. We got rid of things in the house that could be strongholds by the devil. We reaffirmed out Faith in Christ and it took off a whole load of our burdens.We decided importantly, to work on our Will too.

No, we're not giving up in anyway! Simply acknowledging the inevitable. It's extremely hard when you realise that Jo and I have dreams and hopes we grieve for:
a. not being able to retire together
b. not being able to travel/vacate to our favourite locations (mainly island beach resorts...with good sand and clear blue waters!)
c. never having kids (which we love so much)
d. not being able to be parents
e. not being able to check out foodie places that Jo loves

We continue to pray for a miracle daily. We believe that God is omnipotent and can accomplish what He wants, whenever He wants without any need for man's intervention. God can heal in response to prayer whenever He chooses to do so.

Can God heal? Yes! Do all get healed? No!

So the question at the end of the day is "what is His Will for Joanne?" And what does He desire for Joanne to accomplish through this? We need to be mindful that God's Will for us supercedes all things. Just as in the book of Jonah, we see Jonah running away from God because he didn't want to go to a far away land but eventually does so because of God. We don't have the answers but we've seen one thing for sure, that many are being touched by Christ in following us on our journey.

Having said all that, we aren't climbing alone for sure. We have a Master Climber that guides and leads us every step of the way, he knows every thing there is to climb this mountain be it crossing a crevice or scaling the side of a steep rock wall with no hand or foothold in sight.

We need to realise that sometimes the Master Climber may not always be by our side but instead ahead or above us searching for the right path to climb. However we are ALWAYS tethered to Him (with a rope) and He IS with us.

Ultimately, our lives are in the palm of God's hand. Whether we live or die, we are the Lord's (Romans 14:8) and therein lies our victory!

Discharged Today?...No Tomorrow...

We'll be out of SGH today in about 2 hours time....and so I thought.

Then Jo started throwing up for the 4th time at 1:30pm and we decided along with the doctors to stay on for another day at least till this is resolved.

Yesterday's pleural tap part 2 removed some 850ml of water from her right lung. She's in stable condition, not eating much but definitely glad to have the water out.

Again, many thanks for the prayer cover and all who came.

Today she needs to catch up on her rest.

God Bless
Alex

Updates - 26 May 2007

Sorry for the long delay. Needed sometime off to chill and besides was rather busy too.

The NUH Clinical Trial Saga ... (driving me mad)
We will be @ NUH on Monday, 28 May to meet with Dr Goh and find out once and for all the exact trial timetable for Jo. What gets me all worked up is the inefficiency of the trial coordinator who keeps saying she's gonna call us for updates on this without ever calling back! That's the key peeve I have with NUH/NCI vs NCC, just can't understand how clueless they can get...

So to all, no the trial won't start this coming week, but rather sometime in June. I just hope it doesn't clash with CommunicAsia 2007 which I'm involved in.

Bloated, Bloated, Bloated
Jo's still feeling really bloated to the point that the water seems to be all over her mid abdomen area, thighs and knee area. Her feet and ankle are nearly always bloated as long as she doesn't lay them straight.

Just yesterday she vomited twice for no real apparent reason, once at home and the other at our Small Group...arrrgh, just hate this. God help us.

Marche's
We managed to go by Marches for dinner on Thursday and it did a whole lot of good for her. She had a bit of steak, rostie's, ham & cheese crepe and some veggie dish. She's hardly out of the house anyway since walking can get painful due to the bloatedness...pain in the joins etc etc.

Small Group
Last night we were quite adamant to attending our Small Group since we've missed it for nearly 3 months now, and Jo really misses this. From the moment we sat down at CS's place she was already feeling a little queasy. After her throwing up, we left at 10-ish.

Audio Sermons
We've finally seriously started our quest to listen to God's messages via audio sermons (both online & offline) since it's hard for Jo to go to church nowadays. After David's & CS's recommendation of Pastor Benny Ho's "Nurturing Your Inner Life" series, we decided to borrow it from our Church's AV library. It was great listening and after that we started getting hungry for more, so we tune back into our favourite site - Strength for the Journet @ www.rbc.org with Pastor Jo Stowell. Nice crisp and simple messages that last between 12-20 mins. What I do is that I run the player on my laptop (with wireless broadband), plug the headphones in and share it between the 2 of us. After the message, we discuss and recap the key points. It's helped mine and Jo's Spiritual intake very much now. It's like atteding Sunday service every evening, and Jo says that its the best time of the day which she looks forward to always.

You should try it too.

Updates - 13 May 2007

Esther (Pastoral Care) and Sandy (YM) from Church came by on Wednesday to chat and pray with Jo...not forgetting Dave too. Thank you for your prayer support.

Bloatedness - Tummy and Feet

Seems to have gone back to the previous size. As you can see from the pix - her tummy is almost similar to that of a 3-4 month pregnant lady. Mainly air / gas trapped within along with water. Because it's so enlarged (tummy) it causes back pains and stretches the skin so much it becomes dry. We apply moisturising cream to both feet and her tummy in the evening.

Her feet has remained bloated similarly. It's an interesting pix you see above. You can't even make out her veins and ankle joints. It gets a little pain in walking since the skin is quite stretched. She sleeps with her feet raised on a pillow at night.

I leave you with the words of Paul in 2 Corinthians 4:16-5:1

"Therefore we do not lose heart. Though outwardly we are wasting away, yet inwardly we are being renewed day by day. For our light and momentary troubles are achieving for us an eternal glory that far outweighs them all. So we fix our eyes not on what is seen, but on what is unseen. For what is seen is temporary, but what is unseen is eternal. Now we know that if the earthly tent we live in is destroyed, we have a building from God, an eternal house in heaven, not built by human hands."


We remain focus on what He has in store for us..

Updates - 4 May 2007

We had a rather busy morning (and afternoon) meeting with Dr Leong and Dr Cythia Goh (Palliative Medicine) today.

Jo's Lethargy & Bloatedness
The above symptoms that Jo has been experiencing for the last month can be diagnosed with the following solutions:

a) Blood Transfusion - to increase her low haemogloblin count. Doc will decide whether this is required on Monday.

b) Thyroid Hormone Replacement - since she has low thyroid hormone production (due to her Radiotheraphy to the neck in 2001 affecting her thyroid gland located in the neck) The medication (Levothyroxine Sodium) serves to increase the metabolic rate of cells of all tissues in the body. In adults, thyroid hormone helps to maintain brain function, food metabolism, and body temperature, among other effects. She should feel less tired in the future with this medication.

c) Abdominal Tap - see below

Jo's Monday (7 May) Procedure - Peritoneal Tap / Abdominal Tap
Jo will undergo an outpatient procedure called the abdominal tap @ NCC on Monday. The following has been extracted from Healthline.com to better explain this process.




Definition
An abdominal tap is a procedure in which a needle is inserted through the abdominal wall to remove fluid from the abdomen. Normally, the abdomen contains only a small amount of fluid. In certain conditions, large amounts of fluid can accumulate in the abdomen.

How the test is performed
This test will be conducted in NCC. The puncture site will be cleansed and shaved, if necessary. The patient receives a local anesthetic. The tap needle is inserted 1 to 2 inches into the abdomen. The fluid is then withdrawn into a syringe. The needle is removed, and a dressing is applied to the puncture site.

Why the test is performed
An abdominal tap may be performed to diagnose the cause of fluid accumulation, to diagnose infected abdominal fluid, or to remove a large amount of fluid to reduce abdominal pain.

Prayer Request
a) That there will not be any complications with the Abdominal Tap procedure.
b) Jo's energy to return.
c) Jo's appetite to increase.
d) Jo's faith and spirit to remain like a strong fortress - unwaivering.

Thank you and may the Lord Bless you all.

SGH - Day 2 & Home!

Ahh, finally managed to catch my breath after a hectic day @ SGH.

Day 2 - 26 April 2007
We bumped into an old sunday school student of ours Dr Andrew Wong. Instantly
he recalled who I was, what a small world ain't it? Interestingly enough he was tasked to "plugging" Jo which he did a good job of.

Then we bumped into Dr Mark Tien, our Small Group friend who was working in the ward. Was really thankful that God had placed these people at strategic occasions for us. Mark shared the amazing testimony of a Mennonite pastor who recently passed on...we have been encouraged!

Protein Drip
Dr Darren Lim came by to chat a bit and said that Jo was required to have an Albumin (Protein) drip since her blood test showed low levels of this. The nurse plugged the yellow glass bottle and within 30 mins it was done. Albumin would serve to reduce the water retention in Jo's body.

"Albumin refers generally to any protein with water solubility, which is moderately soluble in concentrated salt solutions, and experiences heat coagulation (protein denaturation). Substances containing albumin, such as egg white, are called albuminoids."

Avastin Treatment
Nurse came by @ 3pm yesterday and it was done within the hour. No side effects post treatment so far though. Amen!

A few friends came by from late afternoon all the way to the evening. Thank you all for being with us.

Palliative Care Nurse
A nurse from Palliative Medicine came by and had a long chat with us - asking about Jo's current symptoms, sharing about pain management and current medication history.

Palliative care is any form of medical care or treatment that concentrates on reducing the severity of disease symptoms or slowing the disease's progress, rather than providing a cure. The goal is to prevent and relieve suffering and to improve quality of life for people facing serious, complex illness. (Wikipedia)

Day 3 - 27 April 2007

Didn't really get a good nite's sleep since the aircon was freezing in the room. However managed to sleep outside in the common lounge area. Dr Leong finally came by this morning and discussed about her case. We will continue to see her next Friday morning. Dr Leong also mentioned if the bloatedness got really bad, that was an option to remove the liquid via small procedure.

Dr Alethia Yee

Dr Yee (Palliative Medicine) came by and had a long chat with Jo too. She chatted everything from pain management to discussing our treatment goals...as in what do we hope to achieve with Jo's current state of health - quality of life or etc etc. Importantly, she added another dimension in answering Jo's many questions about medication, treatment and home care options. Wow, it was a handful just taking all that in in one go, but it was very helpful.

Going Home

We finally checked out of the hospital @ about 4:00pm.

SGH - Day 1

Wireless @ SG
Finally got the darn Wireless@SG thing going...almost impossible to obtain a good reception where I am (between 37% to 45%). Had to tilt multiple angles and all...anyway here I am blogging away again.

This Morning
We saw Dr Leong this morning and she commented that the blood test was fine, in fact it was a marginal improvement over the initial test 3 weeks ago. She then proceeded to admit us to SGH. The nurse confirmed that it was a packed day today as no one seemed to be checking out from the A1 or A1+ Wards. We settled for a B1 Ward anyway when the nurse called us at 3pm. (We had decided to go home and await the nurse's call when she had confirmed the ward details)

At SGH (Ward 48, Level 8 Room 11)
On arrival, I ushered Jo to her already vacant bed in the 4 bedded room. There were 3 other ladies here. Ward 48 is a Medical Oncology ward specialised in caring for Cancer patients. I tucked Jo into her bed and got her comfy then rushed down to get the admission done...little did I know that it took some 1.5 hours to complete this!!!

Treatment Postponed
By the time I got up at 5:10pm, the attending MO had mentioned that it was too late for the treatment and we would have to wait till tomorrow morning. I was flustered as we wanted this done today - that was the sole purpose of coming in. Anyway, I soon calmed down. Jo should have the treatment done 1st thing in the morning and prayerfully without major side effects. The infusion will last 60 mins as compared to 90 mins previously.

CS and wife & friend (Apple) came by and got a little piggy & card for her. A really cute one :) Thanks folks for your prayers too.

As of 1:00am, she's sleeping soundly having taken Lorezapam (sleeping pill). She had some chicken rice thingy for dinner but that couldn't quite make it for her and CS went down to the foodcourt to get some fish porridge which she enjoyed. Her parents came by too.

Please contact me first before coming by, am not too sure how she'll be feeling tomorrow. In any case she would love to have your company.

Once again, thank you for your continued prayer support.

Tonite

© Copyright 2007 by Christian-pics. http://www.christian-pics.com/index.php

Jo told me just a few hours ago that she wasn't feeling good at all. In fact she was depressed...really depressed. She poured out all that was on her mind... She hasn't been eating or sleeping well. Nausea, bloatedness and aches all over. Watching TV, reading or eating doesn't even excite her anymore...restlessness... In essence her quality of life has deterioratated.

She said that she just looks forward to the end of day, so that she can sleep...sleep it all off.

And it doesn't help when the evil one lurks and puts stupid thoughts in her mind. And so I prayed fervently in Jesus name to cast out every evil influence in whatever form upon her. Mark 16:17 states that we have power over demons and the evil one.

It's easy for me to say that God demands Jo's fullest attention at this point...yet I know she's been praying unceasingly for His will to be done. So what does God want of her at this time? But perhaps to continue living in FULL faith knowing that He is our only Hope. No "answers" will answer all our questions, or take us through life's hard times. However I've learned a little gem from "Bruised But Not Broken" (Stanley Baldwin, Multnomah Press 1985) that "It is not what we know but whom we know that is critical to our survival. It is Christ who is our Rock. It is in Christ we can do all things."

Tomorrow
We will see Dr Leong tomorrow morning for the usual check up. If her blood test results are fine, then she'll be taking the next round of Avastin treatment either the same day if not on Thursday.

Admission to SGH
Jo wants to be admitted to SGH for the treatment just in case the side effects return. She'll probably be warded for 2-3 days pending nothing serious happens post treatment. We'll most likely be @ Ward 78. We'll keep you posted on developments.

Updates - 23 April 2007

With each passing day I thank God for little blessings that come our way: when Jo eats, when she smiles, when she doesn't feel any discomfort or pain...

All was fine last Thursday till Sunday evening. She'd been dining out with a couple of friends for lunch and dinner...her appetite typically increases a little more when she's out eating.

But...

Yesterday
She had fish & chips for lunch and she'd vomited that out the moment we got home...

This early morning, she wretched and wretched at the toilet bowl but nothing came out...her stomach was churning again...

Today
For lunch, she had a little chawanmushi and still she threw them out about a half hour later...we thot that this was the "safest" food for her since it's totally reminiscence of the same event that happened 2 weeks ago after her chemo treatment...

For dinner, her parents cooked porridge and steamed egg...and yet she threw it out too...

It was a really tough day for her... at times she couldn't lie down for no position was comfortable...

Our Prayer Requests that the following will stop:
- Body aches
- Nauseas and vomiting
- Headaches
- Stomach bloatedness
- Water retention @ feet

And that she would be able to just eat & sleep well

He brought me out into a spacious place; he rescued me
because He delighted in me. Psalms 18:19

Updates - 14 April 2007

We had a slight mixed up in terms of Jo's treatment regime. Currently:
a. Oral Chemo (daily)
b. Avastin VEGF treatment (infusion) - once every 3 weeks.
Next treatment, 60 mins on April 25 or 26th.

1. In general, she's been sleeping alot. Averaging 14 hours per day. Its a combination of the medicine making her tired (chemo drugs) and sleepy (morphine) together with her already weakened body.

2. Now she has occasional cough with phlegm deep within. As mentioned, she's had water retention detected in her lungs 2 weeks back. She's taking medication for this too.

3. Her medications:
a. Maxalon before meals - to aid digestion
b. Morphine - for pain management
c. Chemo drugs - 2 varieties
d. Magnesium Carbonate - to relieve gas buildup
e. Flumucil - to relieve water retention
f. Kytril - for nausea (when necessary)
g. Arcoxia - for fever

4. How she feels:
a. Bodily aches everywhere
b. Pain when coughing
c. Mouth dryness
d. Rib pains
e. Bloatedness
f. Indigestion
g. Lack of appetite
h. Tiredness
i. Weak, not able to climb stairs or stay out for too long

Out of the House
It's good that she managed to get out of the house for the 1st time in 7 days to attend our Elim Small Group last night. It was an enriching time that we had as always. We did Bible Study on Psalms 40 and ended off praying for each other and for Joanne specifically.

Updates - 7 April 2007

Jo's condition has improved a fair bit since Friday. Thank you all for your prayers!

No need for the hospital at this moment.

She's begun to eat a little more - steamed cod fish, steamed egg (Japanese version - Chawanmushi) which her wonderful sister Jessica has been preparing for over the last 2 days. Her mom & dad's fish dishes are incredible, the least to say. And she's also had some soup this evening...she still looks extremely scrawny

She's been really tired too, resting nearly every 2-3 hrs of waking time. It takes lots of energy to fight this dreaded thing and besides, her limited food intake doesn't help at all.

I am thankful for God's Blessings whether big or small. In this case, just seeing her slurp the Chawanmushi and not seeing her vomit and suffer in pain is all I am delighted and grateful to God for. She's walking rather fine, might have also pulled a shoulder muscle due to the Bee episode (go read about it..) a few days back, but in general she's smiled and even got on a call with her good friend.

"They that wait upon the Lord shall renew their strength; they shall mount up on wings as eagles." Isaiah 40:31

Updates - April 6

The reality about Jo's condition at this point isn't good.

I forgot to mention that she's been vomiting nightly since Monday. She's not been eating well at all. She can't digest solids too well and so we've got her to take Ensure to gain as much bulk for this treatment.

Tonite she vomited again.
She took 2 spoonfuls of porridge (from Crystal Jade) and then set back to rest. Another sip of Ensure and she was already beginning to feel nauseas again.

She's on morphine daily to alleviate any pain.

Her stomach is constantly bloated.

Fever is manageable.

Her bruises are recovering.

The next few days will be critical as we decide whether to ward her in the hospital to ensure
she gets dripped at least.

I ask God only to lead me to do the right thing during this time. I ask for His wisdom, his strength and courage.

Again my dear fellow brothers & sisters out there and even to those whom I don't personally know - I thank you for your prayer support for us.

As LB Cowman says "Prayer is the link that connects us with God. It is the bridge that spans every gulf and carries us safely over every chasm of danger or need." He goes on to mention that we should be careful in limiting God by our unbelief or by thinking we know exactly what He can do. We need to learn to expect the unexpected, beyond all that you ask or think.

Updates - 3 April 2007

We couldn't wait any longer for the trial @ NUH since the assistant said that it may take some 6-8 weeks before she started the screening process which would see her in hospital for about 3 days. The pain and overall discomfort was getting worse and this couldn't go on.

New Medication

We caught Dr Goh yesterday at noon and discussed the alternative possibilities. My suggestion was to first arrest the growing tumour in Jo's liver (left lobe) before beginning the trial - since there was some lag time. Dr Goh suggested Avastin - a medication similar to that of the clinical trial. Avastin is a VEGF (Vascular endothelial growth factor) inhibitor.

What It Does

In essence all tumours are fed and kept alive by numerous intricate blood vessels that feed it. To cut off the blood supply would mean to retard and hopefully kill off the tumour. This in essence is what it does. VEGF inhibitors are not toxic in nature and therefore do not have the major side effects of normal chemotherapy medications. It does however have the following possible side effects:

• clotting,
• gastrointestinal perforation,
• bleeding,
• high blood pressure

Avastin is to be administered via infusion taking abour 30 mins.

Back to the National Cancer Centre (NCC)

So we told Dr Goh that we were very comfortable with the staff at NCC and he said that Dr Leong could also administer this drug, and so he made an appointment for us to be there this morning.

It was was bitter sweet stepping back into NCC. Bitter since we still had to "step back". Sweet because everyone here was so much more nicer, warm and friendly. We first met Rosie on entering the building at level 2. She's been serving at Clinic C - and all this while radiating her warm smile and friendly disposition. "Here comes Joanne and her hubby" she would sometimes call out. Annie the admin staff at the ATU department is another example. Then you have the very efficient blood takers - Prudence and the malay lady (can't recall her name) Not forgetting doctor support staff and the nursing team @ Jasmine & the Morning Glory suite. We only have words of praise to them all.

Met Up with Dr Leong

Dr Leong suggested immediately for a CT Scan and Blood Test to assess Jo's situation. What followed was hours of waiting and waiting, while I was freezing all this time in "sub-zero" temperatures. Jo had to maintain an empty stomach for the CT Scan which by then was already about noon time and she was getting hungry. Later on we got some siew mai to munch on.

After the scans, we saw Dr Leong for the full assessment and it wasn't very good...

New Tumour Sites - Lungs

The CT Scan showed new nodules in Jo's lungs. Somehow, the tumour was spreading aggressively...first the left liver, spine and now the lungs. When Dr mentioned this, we both looked at each other and we understood...what that meant. It was tough, but I strongly sensed God's calming presence. The left liver had several small ones, but the largest were 1.8cm and another at 3.2cm. Dr also mentioned that there was water retention at the base of the lungs which has caused Jo to be breathless at times.

Added Medication

Dr Leong suggested to add 2 chemo drugs along with Avastin - Cyclophosphamide and Methotrexate. The drugs would aid more in killing off the tumour. Thank God that these were small dosages and importantly - tablets and taken orally!

Next Steps

Treatment will begin Thursday afternoons. Jo will take chemo pills the day after. This should be the normal cycle every week for the next few weeks.

About Us
To say we're fine is to lie. But neither are we entirely upset about it. As we've mentioned before, Jo and I have come to a new understanding in God's workings. We don't always understand or have to understand how He works...we just know that at the end of the day - He IS at work...and that's all that matters.

Updates - 20 March 2007

So we saw Dr Goh yesterday finally.

He examined Jo and explained that the pain / indigestion is being caused by the tumour stretching the muscle of the diaphragm area (pulling it down) and compressing upon the stomach & intestine area. This stretching is causing compression on the stomach thereby not allowing more food to be disgested within.

He prescribed medication to ease the digestion and release of gas built up within her stomach - Enzyplex, Magnesium Carbonate (mixture that tastes yuuck!) and Metoclopramide (Maxalon)

She's also back to taking Morphine as and when she feels any pain or discomfort.

So all in all, we thank God that we've managed through this once again. In fact, she had half a bowl of Mee Rebus for lunch...

Dinner

So Jo had cravings for Xiaolongbao (Small steamed dumplings...this much I can translate lah :) and suggested we try this not so new Shanghai restaurant located in quaint Balmoral Plaza basement 1 level:

Pu Dong Kitchen
271 Bt Timah Rd, #B1-02 Balmoral Plaza
Tel: 6732 8966

We were with her parents to check this out. Nice little location, not many tables. Simple decor. Staff were true blue Shanghainese as they had a strong accent. Thank God for Jo's impeccable Chinese... she makes most of the orders most of the time. Last time round I made an order in Chinese, a dish not on the menu was prepared...

As usual I was so eager to eat, I forgot to snap the dishes first. So my apologies for the err....well "half-eaten" photos you see below. The Xiao longbao was ok, interestingly there was a hole at the top of it, unlike any other xiao longbao I've eaten or seen before. Skin thinner and sauce was quite nice. Still I find the Din Taifung ones are overall better. That goes for their Fried Rice too. Fried Rice here was very nice too. Very fragrant and loved the egg bits too. There was nicely fried French beans with garlic and chilli...this was excellent. Last but not least we had an interesing Guo tie (fried dumpling) was so hot I burned my lips twice.

Jo ate a fair bit and I was really glad about that. Amen.

Updates - 3 March 2007

This is the longest break I've taken from blogging and my apologies to all waiting for an update.

Post radiotherapy seemed ok for Jo, however the side effects gradually set in and got worse.

Jo had been losing appetite and feeling nauseous over this past week. Yesterday was especially bad as she was out for lunch with a friend and could only eat a little. In the evening she only had some maggi noodles and that was it for the evening. She weighed in yesterday at 38.6kg.

Strange aches kept surfacing throughout the day and she'd been constipating over the past 3 days. Fatigue sets in easily and she told me "quality of life" wasn't very good... and this was tough.

Prayer Items
So for all our faithful prayer warriors out there, please pray for:
1. Continued faithfulness and trust in our Lord Jesus.
2. Strength to manage through the side effects.
3. Side effects - aches, pains, fever, nauseas to be eradicated
4. Appetite and weight to be restored ... past 40kg

New Treatment Updates
Jo will be beginning the new treatment regime sometime in the next 10 days and will keep you all posted. If you managed to read last Saturday's Strait's Times article on page S10, this report explains in detail the new treatment Jo will be undertaking. The mentioned oncologist - Dr Goh Boon Cher is Jo's NUH Onco too.

God Bless my friends, more news shortly.

Updates - 31 Jan

As most of you would've received Jo's or my SMS this afternoon, this is mainly a recap of our meeting with Dr Goh. To cut to the chase:

The Verdict
1. CT Scans have confirmed that the dark spots present at the lumbar 1-3 region are cancer cells. Seems as it's "eating" at the bone. But it's not at the spine, so we're happy.

2. Furthermore, the scan also showed that Jo's left liver had a few other "spots" present. The largest being 3cm in diameter. Rings a bell, sure does...as when we first discovered the spots in her right liver lobe.

The Cure
1. Radiotherapy for the back aches. We have an appointment with a Radio-Onco doc this Friday afternoon. Stay tuned for more updates. Shouldn't take too long each session.

2. Brachytherapy for the left liver which will commence after the radiotherapy sessions. This treatment is non-chemo based and not invasive as I'll explain again subsequently. So, we're pleased and happy too.

The Couple
Jo showed strength, true divine strength. I sensed real calm within her, peace to be precise.
I...I was just silent, holding back the tears. A whole bunch of emotions juxtaposed together.

When God allows us to go through this, He will provide a way for us. We've always believed that...and He has.

Dr Goh

Dr Goh as we've always said - is God sent. He is the epitome of what every doctor should be: patient, calm, sensitive and most of all - an objective communicator of the facts.

Besides he shared with us that Jo's right liver has improved quite well since the IRT procedure.

The Blessings
But we've come to a conclusion that it ain't bad after all... I mean, the Blessings are quite evident:

a. We've got a great doctor that God has provided for...
b. Very effective treatments for both cases.
c. Treatments that are non chemo based therefore have very little side effects.

d. Jo's appetite is getting better and her weight gradually rising...
e. Her right liver is improving well.

f. We have a multitude of prayer support from our Church, Small Groups, friends, ex-colleagues, relatives and the list goes on... Thank you...your prayers are so very important to the both of us. Don't ever think that God doesn't listen to your prayers!

Of course we had to have lunch after this but before that, we had to drop by Dona Manis to pick up Jo's favourite banana pie cake. Dona Manis is located at the basement of Katong Shopping Centre...take the escalator down and you'll smell the aroma. Follow your nose!



Satay @ East Coast Lagoon

Jo had cravings for this. So off we went! 20 sticks chicken & 10 sticks lamb + ketupat and all. Simply delicious. Chicken sticks were big I must say. Pictured further below is the Magi Goreng dish - basically using Magi noodles to cook Mee Goreng style...quite nice!

Finished this with a walk by the beach...how befitting! :)

Updates - 22nd Jan

After Jo had completed her course of muscle relaxants last Friday, the pain in the lower back had gradually recurred once again. She is however able to sit and stand up easily still but walking for long stretches is not possible.

We will return to see the orthopaedic doc tomorrow afternoon to seek further advice on this.

Appreciate your continued prayers in this area.

Just last evening, while Jo got out of the car and walked a few steps, she was suddenly immobilised with a sharp ache in her lower back. She gradually made it to our friend's doorstep for dinner. We had a wonderfully home cooked bee hoon with curry chicken meal plus soon kueh and strawberry shortcake from BakerzIn for dessert.

Wisdom Tooth Extraction (Alex)
I on the other hand had an "incredible" time at the dentists today. After 2 years of deliberating, I decided it was time to remove the 2 left wisdom tooths (top & bottom) that had been troubling me for a bit. Since my tooth is impacted, the dentist had to grind and drill it down before removing it in 2 pieces. All this took a simple 45 mins. Amen that all went well and my fears were quite kept under wraps. **Phew** Anyway, I get 5 days medical leave... heh!

Updates - 5 Jan

Happy New Year folks!

Sorry for the delayed updates, internet was extremely slow due to the Taiwan cable cuts...and it was impossible to log in after Dec 31 strangely.

We met up with Dr Goh on Wed to get to the bottom of the aches & pains.
First Dr Goh ran through her blood & liver test results which was very positive - all indicators showing an improving liver.

After explaining the aches to Dr Goh, he suggested for an MRI lower back / spine scan scheduled for this Monday (8 Jan) afternoon @ 4:15pm. The scan would provide comprehensive details on anything amiss. Results will be out when we meet Dr Goh again on Wed (10 Jan) noon time.

It's pretty bad now for Jo. She can't get up from bed without my help or before wriggling up after 10mins. Walking is fine. Leaning back, looking down, coughing, deep breathing, sneezing etc is tough. Some pain killers don't seem to work as effective as Panadol. Panadeine, Morphine and Semflex not as good. Thank God her appetite is still fine.

So appreciate your prayers in this area. God Bless.