Improving Condition

Since Saturday, Jo's condition has improved considerably.
She's been eating better and feeling better. Body aches, tiredness and bloatedness still present.

She'll be taking her blood test tomorrow afternoon before seeing Dr Leong on Wed morning. We'll know by then when the next treatment will be - either on the same day if not on Thursday.

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.

Maundy Thursday Chemo

Well we had to miss our Maundy Thursday service @ 8pm since Jo wasn't in the best of health and importantly she had her first Chemo session @ NCC today slated for 2pm.

I rushed back from a lunch appointment with a client and got off to NCC. She was walking slightly better today after yesterday's Bee episode. The cream must have worked.

At NCC
We arrived at NCC and had to wait nearly 3 hours before her number was called. This place is called the Ambulatory Treatment Unit or ATU (3rd floor) is always jam packed with patients the eve of any holiday. Today was none the different. We could have had ours done yesterday however Jo specifically requested for Julia who had been attending to her chemo treatments off and on since 2004. Julia's an extremely nice lady (as with all of the staff at the ATU) and we share and chat quite a fair bit before and during each treatment if time permits. The nurses here are so overworked and shorthanded (high staff turnover) that more should seriously be done here.

Julia
As in most cases, Julia pricked Joanne quite effortlessly with almost no pain involved. You could see her with her smiles in the top pix. It was really great to see her smile these days since it's been extremely difficult for her.

The Treatment
Today's treatment of Avastin took some 1hr 45mins for 300ml to drip through. A new machine has been installed that indicates the amount of medication left. Near the end of the treatment, Jo complained of chest tightness and we had to call the attending Doc in to review her. They also gave her an ECG to ensure all was ok with her heart. Doc listened to her lungs and all was fine. The nurses gave her oxygen to breathe in to alleviate this. About 15 mins later she was better and we left NCC.

Heavily Burdened
I feel heavily burdened with Prayer each time I step into NCC let alone the ATU floor. There are just so many people with cancer. My heart just goes out to the man in the wheelchair vomiting constantly, the mother with 2 kids tagging along...the list goes on. What hit me most today were 2 young patients. As I was entering the lift, I saw a mother pushing her 5 or 6 year old with nosedrip out of the lift. It was simply heart wrenching. The kid was scrawny for his age and bald...obviously from the chemo treatments. Another scene was that of a 10 yr old in the treatment cublicle opposite Jo. He was bald and had his mom and dad with him. It was painful to hear him scream when the nurses pricked him for the chemo infusion. I prayed there and then for them...that God would show mercy upon both the kids and their family.

All in all we started from 5:15pm and ended about 7pm. Typically as pictured, I would read her passages from "Streams in the Desert" by L.B. Cowman. Excellent daily devotional readings for the "weary desert traveller"

Jo and the Bee

Poor Jo was "harassed" yesterday morning when a bee flew into our home.

While she was trying to flee the creature, her legs buckled and she apparently fell flat on the floor. She bruised her knee cap, ride thigh, right hip and right forehead. She said that she also pulled her groin muscle or hamstring and can only move slowly for now.

She's ok now. Not serious.

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.

He Suffered For You and I

As we journey towards Good Friday, I wish all believers to contemplate and remember what our Lord Jesus did on the Cross for us and all mankind. That we will never forget that great act of love, mercy and courage. That we will not forget that great suffering & humiliation He endured:

1. Whipping - After the verdict of crucifixion was pronounced by the court, it was customary to tie the accused to a post at the tribunal. The criminal was stripped of his clothes and severly whipped. The whip known as a flagrum, had a sturdy handle to which were attached long leather thongs of varying lengths. Sharp pieces of bone and lead were woven into them. Jesus was probably given a minimum of 39 as with Jewish law...

2. A Crown of Thorns - After placing a crown of thorns on Christ's head, they began to mock Him and spat on Him and beat Him with a rod. The thorns were needle sharp and you only need to imagine what one would do to your finger...

3. The Crossbar - Christ had to carry his own crossbar from prison to the place of execution. The crossbar weighed somewhat about 50kgs and was strapped to Christ's shoulders.

4. Crucifixion with Nails - Upon reaching the execution site, Christ was nailed and bound by ropes to the cross. He was nailed at his hands and feet.

Let us come before Him in Thanksgiving always.

The Warrior Is A Child (Twila Paris)

Lately I've been winning battles left and right
But even winners can get wounded in the fight
People say that I'm amazing
I'm strong beyond my years
But they don't see inside of me
I'm hiding all the tears

Chorus:
They don't know that I come running home when I fall down
They don't know who picks me up when no one is around
I drop my sword and cry for just a while
(Look up for His smile)
'Coz deep inside this armor
The warrior is a child

Unafraid because His arrow is the best
But even soldiers need a quiet place to rest
People say that I'm amazing
I never face retreat, oh no
But they don't see the enemies
That lay me at His feet

Chorus:
They don't know that I come running home when I fall down
They don't know who picks me up when no one is around
I drop my sword and cry for just a while
(Look up for His smile)
'Coz deep inside this armor
The warrior is a child

They don't know that I come running home when I fall down
They don't know who picks me up when no one is around
I drop my sword and cry for just a while
(Look up for His smile)
'Coz deep inside this armor
The warrior is a child

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.

Rescue (NewSong)

You are the source of life
And I can't be left behind
No one else will do
I will take hold of you

Chorus
I need You Jesus
To come to my rescue
Where else can I go
There's no other name by
Which I am saved
Capture me with Love

My heart is yours for life
And I need your hand in mine
No one else will do
I put my trust in you

I will follow you
This world has nothing for me.

Indigestion & Chest Pains

Its been a harrowing past 48 hrs.

Jo's hardly been eating cos' of the pain and gas that comes after every simple meal. Even though she's been chewing and taking in food really slowly, it causes severe indigestion and most recently, chest pains.

We'll see the doc on Monday asap to see what can be done.

She was just well enough to get out for awhile just an hour ago and she wanted so badly to go to the Melbourne food & wine festival at Duxton Hill...so we went. Unfortunately, most of it was closed by the time we got there...how sad. :(

As for now, she'll have to stick to a liquid diet till the effects wear off - taking Ensure (nutritional powder formula for Cancer patients) and soup perhaps.

Please pray for the pain and indigestion to go away. She's been resting alot already and I figure its probably the tumour in the left liver causing all this. The pain from the Spine has since gone and she can cough & sneeze without discomfort, Amen!

Joy Tested

"Consider it a great joy, my brothers, whenever you experience various trials, knowing that the testing of your faith produces endurance." James 1:2

I've been reflecting much about this passage the last 2 days recently, yet I'm finding it extremely difficult coming to terms with it.

What was James thinking about when he wrote this? How does one find real Joy (let alone "great joy")when you're in the midst of overwhelming physical pain? When the suffering is in your face?

I think about Job and I cannot even begin to grapple with how Job managed through the incredible suffering he faced.

Yes, the immediate good that does come out of suffering is endurance or perseverance.

I continue to meditate on this and seek His enlightentment.

Faith Tested

A close friend once told me that bad news seemed to roll off me like water off a duck's back. Apparently, I always appear so calm and even quite cheery despite all these years of struggling with my cancer.

Well, I can only tell you, it's not me, it's God. It's His strength, His peace and His grace that support me and Alex all this while.

I'm quite a simple person. I trust in God's power to heal me, but IN HIS TIME. This means He may heal me in my lifetime, or He may heal me in eternal life, where we will all be made perfect! Also, I believe that God uses doctors and modern medicine as His healing tools. So I always trust my doctors to give the best recommendations for treatments, and so far, I've been truly blessed with very caring and efficient doctors and nurses who show genuine concern for me.

So once I sorted those things out, I just try to get on with normal life. No need to worry about seeking strange alternative treatments, or trying to attend all the miracle healing rallies in Singapore.

But over the past few weeks, my faith has been severely tested. Somehow, the radiation treatment to kill the cancer cells in my lumbar region has triggered off some unexpected side effects. Because the radiation beams were shot through my stomach, they destroyed quite a bit of stomach/intestinal lining. This made me perpetually nauseous, some days worse than others. To me, this is one of the most traumatic things that can ever happen - not being able to eat or enjoy food, aarrrrghh!

I also started to feel more tired. Going out for lunch and simple grocery shopping will wipe out my energy for the day, and I'll have to take a 3-hour nap to recover in time for dinner. I've not checked my emails for a month. Even watching TV tires me out.

What's more, I can literally feel the tumours growing bigger in the left lobe of my liver, because it's stretching the diaphragm and straining the rib cage/muscles. This causes more pain and the weight of the enlarged liver presses down on me when I lie down, so it's almost impossible to find a comfortable position to sleep. The tumours also cause internal inflammation so my fevers are back with a vengeance. I have to pop 2 panadols every 5-6 hours to control it, even waking up during the night, or the temperature will just shoot through the roof...

So I was definitely not a happy baby over the past few weeks. I was harbouring all kinds of dark thoughts in my mind and feeling sorry for myself, asking God many questions, mainly "Why me"?

The last straw came when 2 nights ago, I actually threw up after taking panadol. Somehow, this aggravated the lower back pain and the stressed liver, and caused so much discomfort that I couldn't sleep the whole night. Poor Alex was quite worried and ran off first thing in the morning to get a stronger painkiller from my GP.

Thank God! After taking the medicine yesterday, I had the best sleep ever in a long while! I woke up today feeling so rested that we actually went out for lunch (Alex decided to work from home since yesterday to make sure I'm ok, so sweet, right?). And I could finally find the energy to switch on the PC to check my email and post this blog : )

So again, I can only say this, BY GOD'S GRACE, I have overcome this moment of weakness and depression in my journey of faith. And I constantly give thanks for my long-suffering partner on this journey - my dear hubby Alex.

Before signing off, I just want to share some thoughts from a good friend Mr Foo:

"God wants us to draw strength from Him daily. It’s a reverse spiritual principle that nonetheless is true: We get beaten down so that Christ might rise in us. It’s the whole idea God has of avoiding confusion. See, he doesn’t want people confusing human power and achievement with his power and what he is achieving in and through our lives. If all Christians were super-Christians, people would be impressed with us. As it is, God wants people to be surprised at us, not so much impressed – surprised that we can keep on believing, given what has happened to us. Surprised at us – impressed with God. That’s the way it should go. It’s important to know this so that the things that happen don’t throw us into a tailspin. Paul wrote 2 corin 4:8-10 that troubles, confusions, knock-downs, and drag-outs are all to be expected in a life of faith, and they are not just something to suck it up and endure, they are what will actually release the power of God in our lives. We encounter death-like experiences so that Christ’s life-like nature may clearly be seen in us, despite what is happening."

Thank you to our family and friends for your prayers and support, and big thanks to all the lovely people who just happened to read our blog and left such encouraging and heart-warming notes. May God bless you!

PS: I'm still waiting for the hospital to call me with an appointment date for the pre-clinical-trial tests, so don't know when I'll be starting on the trial yet.

Jo @ Wild Rocket Again

Jo is truly Blessed by a bunch of friends from all over and I thank God for having brought them to her at the most opportune time. Apart from praying for her, they have cooked for her, brought flowers and most often - asked her out for lunch (when she's felt ok)

Just yesterday she was invited to lunch by L (who first introduced Wild Rocket to her!!) to Wild Rocket once again... Jo managed to eat a little more today. She SMSed me and say she ate 2/3rds of the rack of lamb.

The fever's come back to every 6 hour interval now that she's stopped taking Arcoxia (pain killer & muscle relaxant).

She had cravings for White pepper crab a moment ago, however its been changed to Teochew Porridge along Havelock Road... we're off now.

We serve a Lord that is faithful and true.

Psalms 62

My favourite verse:

Psalms 62:1-2

1 My soul finds rest in God alone;
my salvation comes from him.

2 He alone is my rock and my salvation;
he is my fortress, I will never be shaken.

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.

Radiotherapy Sessions Over!

Well 5 Days have gone by just like that! Yahoo! I must say a BIG Thank You to the folks at the NUH Radiotherapy centre, they've made our stay (although very short) there an excellent one. Concerned and caring staff & always smiley. Keep it up!

Side effects: Still feeling nauseas at times. Lack of appetite compared to her eating spree in Jan. Tiredness. Restlessness. Doctor reviewed her after the final treatment and said that the side effects should go away in the next 4-5 days. Radiotherapy kills some of the stomach wall lining and so once off it, regeneration begins and she should be better by then.

We continue to hold fast unto the Lord!

Here are some pics of the treatment.

Jo walking into the "oven"...it's actually called a Linear Accelerator room.

Awaiting to lie down on the table. The machine behind is called the Linear Accelerator.

Staff making the correct callibrations. There are laser guides on both ends and markings on Jo's body to ensure 100% accuracy.

On the ceilings they have light boxes of underwater marine life...really beautiful. Helps to ease the patient.

We await the red light to go off once treatment has begun.

The thickness of the "blast proof" door.

Radiotherapy Session #2 and Radiotherapy 101

Today's session was like lightning quick. She took about 10 mins only...guess there was no one else and the radiologist was just waiting for her.

Anyway I've got a new name for the Radiotherapy Room - "The Oven". It sure looks like one and I'll post a pic tomorrow. Basically she goes into this room with the radiologist. She lies down on this platform with a rotating arms. The radiologist walks out of the room and shuts what looks like steel blast doors. After a few seconds later a red light on top of this door is lit indicating treatment in progress. The radiologist maintains visual communication via a CCTV from his counter. Inside, X-ray blasts are shot from both arms of the machine.

Anyway we've confirmed this afternoon that the reason for her nauseousness is due to the beams penetrating through her stomach.

So what is Radiotherapy?

External radiotherapy is the most common type of radiotherapy used. It is usually given as a course of several treatments over days or weeks while internal treatment may only happen once or a small number of times.

External radiotherapy is usually given during outpatient visits to a hospital cancer centre. A machine directs the high-energy rays, usually x-rays, at the cancer site and a small area of normal tissue surrounding it. The patient is positioned carefully on a treatment couch and then the machine will be directed exactly at the area to be treated, often from different angles.

Treatment takes several minutes and is painless. Before the patient starts a course of radiotherapy, they will usually need to attend the hospital for treatment planning. External radiotherapy doesn’t make one radioactive and one can safely mix with other people, including children, at anytime.

What are the Side Effects?
There are hardly any side effects. But because radiotherapy affects normal tissues within the treatment field, the side effects will vary depending on which part of the body is being treated and the number of treatments one has. Most side effects are temporary and they are rarely severe. They start at varying times during treatment anddisappear in the weeks after the end of it.

Some side-effects may not start until treatment has finished. Tiredness is quite common, particularly towards the end of treatment and this may last for sometime afterwards.

Very few people feel sick during radiotherapy – it depends on which part of the body is being treated. Some people feel sick at the beginning of a course of treatment but find that nausea often disappears within a day or two. Others start to feel sick later on.

Radiotherapy Session #1

Jo's 1st treatment went very smoothly. The attending radiologist asst provided all the information we needed as we awaited her turn. All in all it took a mere 15 minutes from the time she stepped into the treatment room (which resembled a bomb blast shelter with it's heavy metallic doors and lead walls) till she came out.

In the evening, she suddenly complained of nauseousness and so I got her to lie down on the sofa. Could it be the computer games she's been playing? She's recently been hooked on these free trial downloadable games. Playing games such as Stand O' Fast (Run a Fastfood joint and flip burgers!), Cake Mania (no need for me to explain eh?), Diner Dash, Family Feud (which we play together) and much more...

So thank you for your unceasing prayers...our Lord is faithful.

Oh by the way, we've moved her sessions to the 5:00pm time slot. Again, this will end next Tuesday.

Radiotherapy Preparation Today

The Radiotherapy Centre @ NUH was deserted when we arrived @ 2:40pm last Friday. Quite glad to have it that way. The nurses and staff were really helpful, smiley and courteous too. We met with 2 young doctors and had each others questions asked and answered. They conducted a neurological test on Jo to check that her nerves and sensations are normal. Apart from the slight numbness of her left thigh, she was fine. Treatment will start immediately once "planning" is done.

Next Steps

1. Proceed to Tan Tock Seng Hospital (TTSH) later today to mark the spots for radiation via CT scan.

2. No. of Sessions: 5 x 30 minutes each

3. Treatment duration: 7 to 13 February @ NUH

4. Side effects - tiredness, redness on the back.

Overall Jo's feeling quite fine. Her painkillers help to relieve the backaches daily. Docs say that it'll take about 4 weeks from the last treatment to see the improvement. She should be free of backaches by then.