Diet for Cancer Patients

We now lead a very healthy lifestyle. I cook meals with less oil, salt and sugar. Pork has been totally cut out and now our daily diet consists of mostly vegetables, fish and small portion of skinless chicken meat. We have soup to go along with every meal, be it just a quick boiled soup or a long hours brewed herbal soup. Ian loves soups so much so that he can finish a full bowl most of the time.

Mom's daily diet concist of the following:

8.00am Breakfast: A bowl of unsweetened Oats and a glass of Bean & red dates Soup OR a slice of wholemeal bread with St Dalfour's Fruit Jam Spread. 1 tab Amlodipine 5mg (Anti-hypertensive drug) and 1 cap fish oil 1000mg

Snack in between – Grapes or wheat crackers and a glass of Mangosteen juice.

12.00noon – Lunch Steamed fish / Soup / a vege dish or taufu with skinless and boneless chicken meat

3.00pm – Tea-Time A glass of Nutren Optimum Whey Protein Powder and bread with jam spread or wheat crackers. Fruits (Honey Dew / Mangosteen / Apples depending on availability)

6.00pm – Dinner (Steamed fish / Soup / a vege dish or taufu with skinless / boneless chicken meat.)

7.00pm – Vege Juice (Brocolli/tomato/celery/carrot and sometimes beetroots are added in)

9.00pm – Supper (Wholemeal bread with jam spread / Nutren Optimum Whey Protein Powder)

Dim Sum @Yuen Garden Dim Sum House, Puchong Jaya

We had Dim Sum for breakfast at Yuen Garden in Puchong Jaya last Sunday with papa. He definitely deserved a break from the household chores and having to attend to mom both mentally and physically. He was reluctant to leave home without mom coming along for fear she would not eat well or should anything happen to her in his absence. Mom was reluctant to go out as she would have to frequent the toilet every now and then and she has been experiencing loose stools after the operation and doctor said this was all normal as her body was still adjusting to the food after hemicolectomy.

We ordered quite a lot of dim sum, porridge, loh mai kai (glutinoous rice with chicken in a bowl), yam puff (Ian liked this one the best and whacked all). The bill came to only RM40++ for 4 of us, quite reasonable considering the quality of food though service was just so-so, guess they have shortage of staff. Overall, we had good experience dining there. The shop had extended to the next shoplot despite having a two storey corner shoplot. The shop enjoyed brisk business as the place was very crowded and packed with customers especially during weekends and public holidays.

After breakfast, we headed to Puteri Mart to get mom some nyonya kuih. Papa wanted to get her some food varieties as mom had been having wholemeal bread and oats only for breakfast and she was getting bored with the food.

Colorectal Cancer - Stage II (Duke B1)

Today is the big day where mama's biopsy result will be out. We left the house around 7.30am as I had to drop Ian at Yeh Yeh's house. I did not send Ian to the kindie today as hubby had been nagging me not to as my backup driver, Yeh Yeh was down with Chikungunya and would not be fit to drive for the next few weeks and I might get stuck at the hospital the whole day. Luckily Mah Mah is there to take care of Yeh Yeh.

We reached the Surgical Clinic of UMMC at 1st Floor about 9.30am, crawling up the UMMC car park at the T&E (Trauma & Emergency) building and looking for a parking alone took me ½ hour. The clinic was beaming with patients when we got there and I got a waiting number 42. Dr Tee was the doctor on duty under Prof. Dr Chin's team. He came and greeted us the moment he saw us there. It was finally our turn after waiting for 2 hours and luckily Dr Tee noticed our presence at the clinic. The reason of the delay was that the nurses could not find mom's file and Dr Tee personally got them to trace the file. I asked Dr Tee for the biopsy report the moment I stepped into the room. He then opened the file from the computer and the report reads:

Posterior abdominal wall: Inflammed fibromuscular tissue. No maglinancy seen.
Colon: Moderately differentiated adenocarcinoma invading the serosa. 9 lymph nodes with no maglinancy. Duke B1.TAHLSO: Benign serous cyst. Inactive endometrium.
Mucin from tumour: Haemorrhagic inflammatory exudate. No maglinancy seen.

The biopsy findings came out normal except the colon but it has not spread to the lymph nodes. Duke B1 is the staging classification of cancer and it indicates that mom is in Stage 2 (Duke B1 means moderately

Grading of the Colon Cancer
The malignancy (or aggressiveness) of the colon cancer is documented by assigning a grade to the cancer based upon the appearance of the cancer cells and how they are arranged together. These scores are broken down into three main levels:

low-grade cancer: this is the least-aggressive type of cancer. Cells from low-grade colon cancer have an appearance most like normal cells, and tend to be slow-growing. Such cancer cells are called well-differentiated.

intermediate-grade cancer: by the time the cancer has become intermediate-grade, it has turned more aggressive than a low-grade cancer. Intermediate-grade cancer cells have an appearance that is less like normal cells and is often faster growing than low-grade cancer cells. Such cells are called moderately-differentiated.

high-grade cancer: this is the most aggressive type of cancer. Cells from high-grade colon cancer are the least like normal colon cells. They are rapid-growing and highly aggressive, often spreading into the lymph nodes and bone. Such cells are called poorly-differentiated.

Pseudomyxoma Peritonei

I was given a case report written by one of the doctors on mom's diagnosis upon discharge and was advised to bring along the report to T&E Unit (Trauma & Emergency) should mom needed immediate medical attention.

Mom's diagnosis: Pseudomyxoma Peritonei, sounds so alienated to me. I started doing a search on the internet to get more information about this new term.

What pseudomyxoma peritonei is

Pseudomyxoma peritonei is a very rare type of cancer that usually begins in your appendix as a small growth, called a polyp. Or, more rarely, it can start in other parts of the bowel, the ovary or bladder. This polyp eventually spreads through the wall of your appendix and spreads cancerous cells to the lining of the abdominal cavity (the peritoneum). These cancerous cells produce mucus, which collects in the abdomen as a jelly like fluid called mucin. The cause of this type of cancer is not known. Most cancers are caused by a number of different factors working together.

How pseudomyxoma peritonei spreads

Pseudomyxoma peritonei does not act like most cancers and does not spread through the bloodstream or the lymphatic system. It spreads along the internal surfaces of the abdomen, rather than into nearby tissues of the bowel or liver. The mucus collects in the peritoneum and causes symptoms. It may be many years before you have any symptoms from this type of cancer.

Symptoms of pseudomyxoma peritoneiSymptoms can include:
* Abdominal or pelvic pain
* Not being able to become pregnant
* Abdominal swelling and bloating
* Changes in bowel habits

Some people will not have any of these symptoms, so pseudomyxoma peritonei can be difficult to diagnose. In women, this type of cancer can sometimes be confused with ovarian cancer, because ovarian cancer may also cause a swollen abdomen. Some types of ovarian cancer cells also produce mucin. Often, it is only after an operation to look into the abdomen (a laparotomy) that pseudomyxoma peritonei is properly diagnosed. Once diagnosed, a CT scan can help the doctor find out how much of the abdomen is affected by the cancer.

Treatment for pseudomyxoma peritonei

You are most likely to have
* Surgery
* A specialist type of chemotherapy called IP chemotherapy

Surgery

You are most likely to have surgery to treat this type of cancer. There are two types of surgery
* Debulking surgery
* Complete tumour removal (Sugarbaker technique)

Debulking surgery is the most common. The aim is to take out as much of your tumour as possible. This might mean removing your womb and ovaries if you are a woman, and sometimes part of your bowel. Unless you have intensive surgery, it is hard to remove all of the tumour. So the cancer is likely to come back. Then you need to have more surgery, and sometimes several debulking operations. But each operation becomes more difficult to do. If you have a lot of abdominal surgery, you are also likely to develop complications, such as ‘adhesions’, where the abdominal tissues stick together and cause problems such as pain.

Recent research suggests that some people with pseudomyxoma peritonei may benefit from a very intensive type of surgery that involves trying to remove all traces of the cancer from the abdominal area. Your doctor may call this intensive treatment the Sugarbaker technique after the doctor who developed it. A large section of your bowel, spleen, gall bladder are removed and, if you are female, your ovaries and womb.This intensive surgery is not suitable for everyone. The surgery takes a very long time and you will be in intensive care for about 5 days. You will need to be fed by a tube, and will stay in hospital for about a month. About 3 out of every 10 people (30%) have serious complications after treatment.

About 1 out of 5 patients (20%) need a stoma after surgery. In about half of these people the stoma is only needed for 3 to 6 months. And it is not always possible to know how far your cancer has spread until the operation takes place. So the surgeon cannot guarantee to remove the tumour completely. Chemotherapy into a vein or as tablets does not work well for this type of cancer. Because the disease has a poor blood supply the drugs can’t get to the tumour cells if you have them as a drip or tablets. But after surgery to remove all the cancer, doctors may use a different way of giving chemotherapy called intraperitoneal chemotherapy. This means putting the chemotherapy drugs straight into your abdomen, where they can directly contact with the cancer cells. To have intraperitoneal chemotherapy, you have a heated solution of mitomycin C put into your abdomen during and after your operation.

After your surgery, you may also have another chemotherapy drug called 5FU put into your abdomen for 4 days. NICE (The National Institute for Health and Clinical Excellence) has produced guidance on this intensive surgery with intraperitoneal chemotherapy. They are uncertain about its risks and benefits and recommend that it is only carried out in very specialised centres. And the risks and benefits must be discussed with patients before they consent to treatment.

Hemicolectomy & TAHBSO (Part 3)

The next morning, I took over sister in-law's shift at 7.30am. Dr Khairil wrote me a prescription to get Enoxaparin (Clexane)Injection 40mg/o.4ml and Etoricoxib (Arcoxia) 120mg tab from UMMC pharmacy. Clexane by Sanofi-aventis is a "blood thinner" which helps prevent formation of blood clots. It is used after certain surgeries. Arcoxia is a painkiller by Merck that works by blocking the production of prostaglandins, chemicals in the body which cause pain, swelling and inflammation. The PCA connected to mom would be removed soon and she would be on oral painkiller for the next 10 days.

The physiotherapist came and demonstrated the following exercises to reduce the effects of the general anaesthetic and speed up the recovery process.

• 
  
  Deep Breathing Exercises
  Practise the breathing exercises sitting up in bed, supported by pillows, or out in a chair. Take a deep breath in through your nose, hold for two seconds and then sigh the air out of your mouth. Repeat four times then try to ‘huff’ the air out.
• 
  
  Coughing
  Support your abdominal incision by holding a small towel or pillow firmly over your tummy.
• 
  
  Circulatory exercises
• 
  
  Ankle - Bend and stretch the ankles up and down firmly and quickly. Repeat 10 times.
• 
  
  Knees - Tighten your thighs by pushing the backs of your knees down against the bed. Repeat five times.

When I got back from the pharmacy, the Ob & Gyn was at mom's ward examining her and she apologized for not telling us before the TAHBSO was performed as it was an unplanned surgery.

The small tubes dangling all over mom were taken off on 2nd and 3rd day post-op except a drip (infusion) which gives sodium and glucose through a thin tube (cannula) inserted into a vein in mom's hand. The nurse said it would be taken out once mom was able to eat and drink normally again. Mom was now able to sit up on the chair and went to toilet with little help.

The last tube was finally removed on the 4th day and mom was allowed to take porridge. I ordered fish porridge for mom. The four meals provided daily was quite tasty and satisfying and there was a menu to choose from. Breakfast with a hot milo, lunch with fruit, tea-time with milo and dinner with fruit.

Mom was recovering well and I took turns with sister in-law to take care of her. UMMC allowed visitors anytime of the day as long as the crowd wasn't too big and noisy. We brought a foldable lazy chair so that we would be able to catch a nap whenever possible. The days in the hospital were almost unbearable for me seeing mom with all the tubes, nurses poking her every few minutes and all these made her almost impossible to rest but she reassured us that she did get her rest especially at nights. Well, a tough mom I have here, she would endure all the pain and suffer in silence and would try her best not to let us worry. But mom, this time around, you just can't shoulder this alone, it would be just too much for you to bear, let us walk through this journey of life hand in hand as a family.

Mom was discharged on the 8th day of readmission. The total hospital bill including the 1st admission bill came to slightly over RM2k which I personally reckoned to be reasonable.

Mom was given an outpatient appointment two weeks from the date of operation at the surgical clinic for her removal of clips and post-operative check-up. Another appointment was fixed four weeks later with the ob-gyn clinic.

Mom and dad were still in the dark as to what the doctors had told us about the maglinant tumour. Mom had been very optimistic about her condition and that made me even more worrisome for fear they could not accept the fact. I would get very depressed and disheartened thinking about the date that drew nearer and I just did not have the guts and heart to be the one who break the news to my two old folks but deep down, I know I must stay strong to be their pillar of strength, the time when they needed me the most.

Happy Father's Day

I bought a strawberry/blueberry and yoghurt filling cake from Cake Sense in Taman Mayang Jaya before heading home after Ian's music lesson.

JMC Book 2 - Party In The Sky

ti ti ti ti ti ti la ti do la ti sol
ti ti ti ti ti ti la ti do la sol
re ti re ti la ti do la ti sol
re ti re ti la ti do la so1

Hemicolectomy & TAHBSO (Part 2)

The team of doctors came for their morning round at 8am and I was told that mom could be in the 3rd stage of cancer. The primary examination of the tumour removed indicated signs of the cancer cells aggressively attacked the wall of the colon but they must have to wait for the biopsy report which would be out in two weeks' time to conclude the findings.

Mom regained consciousness around 10am as I was told by hubby. I got hubby to take over our shift around 9.30am while my sister in-law and I went home to freshen up. I initially thought mom had come out from under anaesthesia when she responded to me calling her before we left.

I eagerly wanted to find out more about mom's illness from the team of doctors but Dr Tee advised me to take one step at a time and at this point in time, the crucial part was the recovery of mom from the surgery and they would not be able to confirm the type of cancer until the biopsy report was out.

Mom was one obedient and cooperative patient. She would do whatever instructed by the doctors. On the first day after operation, I was given a prescription slip to buy a pair of Comprinet Pro Anti-Embolism Stockings to prevent venous thromboembolism (clot in the blood that forms and blocks a blood vessel) in immobilized patients and a Incentive Tri-ball Spirometer for use to help patients improve the functioning of their lungs and in mom's case, surgery involving extended time under anaesthesia and help minimize the chance of fluid build-up in the lungs.

I returned to the hospital around 2.30pm as hubby had to attend to some work issues. He told me Prof. Dr Chin and his team had just left and mom was allowed to take sips of nutritious fluids such as Milo and milk. To play safe, mom started with sips of water but her urine output hadn't been much and she needed to drink more.

The surgery left mom with a wound that goes in a straight line from just below the breast bone (sternum) to just above the pelvis. Mom was still confined to bed as there were tubes hooked up all over her body.

A patient-controlled analgesia (PCA) device with intravenous morphine for post operative pain control was hooked up intravenously on mom. It is a means for the patient to self-administer analgesics (pain medications) intravenously by using a computerized pump, which introduces specific doses into an intravenous line. Mom was advised to press a hand-held button connected to the machine for delivery of specific doses of medication into the vein to relief pain whenever it became unbearable. I told mom to press the button only when the pain was too much for her to bear because overdosing would give adverse side effects such as nausea, a dangerous drop in the rate and effectiveness of breathing and excessive sedation.

There was a thin tube that passes down mom's nose into the stomach (nasogastric tube). This allows any fluids to be removed from your stomach so that you don’t feel sick. It is normally taken out within two days.

A small tube (catheter) is put into mom's bladder, and the urine is drained through this into a collecting bag. This will save you having to get up to pass urine, and it is usually taken out after a couple of days. She also has a drainage tube in the wound, to drain any extra fluid and make sure that the wound heals properly.

To be continued.....

Comprinet Pro Anti-Embolism Stockings

Graduated Compression, Anti-Embolism Stockings

An accepted prophylaxis for reducing the risk of venous thromboembolism in immobilized patients, Comprinet# Pro anti-embolism stockings provide the medically recommended compression of 18 mmHg.

Features & Benefits

Comfortable
The Knit design and flexible yarns increase patient comfort, helping with patient compliance
A knitted-in heel pocket provides an easier stocking placement over the patient’s foot and helps increase patient comfort
DurableThe stocking can be laundered at 95º C without affecting compression, allowing multiple reuse.
Effective
The Knit structure of the stocking provides the medically recommended gradient compression profile for a wide range of patient leg sizes to reduce the risk of venous thromboembolism

Contraindications / Precautions

Advanced arterial disease, uncontrolled congestive heart failure, untreated septic phlebitis, phlegmasiacoerulea dolens

Incentive Tri-Ball Spirometer

An incentive spirometer is a medical device used to help patients improve the functioning of their lungs. It is provided to patients who have had any surgery that might jeopardize respiratory function, particularly surgery to the lungs themselves, but also commonly to patients recovering from cardiac or other surgery involving extended time under anaesthesia and prolonged in-bed recovery. The incentive spirometer is also issued to patients recovering from rib damage to help minimize the chance of fluid build-up in the lungs.

The patient breathes in from the device as slowly and as deeply as possible. An indicator provides a gauge of how well the patient's lung or lungs are functioning, by indicating sustained inhalation vacuum. The patient is generally asked to do many repetitions a day while measuring his or her progress by way of the gauge.

Hemicolectomy & TAHBSO (Part 1)

Professor Dr Chin would only be back on Monday and mom was admitted earlier on Saturday as advised by Dr Tee due to fever and suspected infection in the abdomen. Mom was put under observation and on alternate IV sodium, glucose and metronidazole (Flagyl) drips. She was fasting to prepare for the surgery scheduled for Monday or Tuesday.

There was only a doctor on call during public holidays and Sundays at the Surgical Unit. Mom had been fasting since Saturday, the day she was readmitted. Professor Dr Chin visited my mom with his team of doctors on Monday morning, did a check on mom and confirmed a surgery on that day itself. I was then briefed by Dr Adzli on the procedures and signing of the consent form by mom. He briefed me that the older the patient, the higher the risk of surgery. In mom's case, the risk would be 20% and complications might set in in between the surgery.

I was briefed that a right hemicolectomy surgery would be performed on mom. It is a partial colon-removal procedure in which surgeons excise the right (ascending) part of the colon in mom's case. The procedure is relatively common for treating diverticulitis, inflammatory bowel disease, benign or malignant polyps of the colon, and colon cancer. The hemicolectomy procedure traditionally begins with an incision in the abdomen, opening the area for access to the colon. Thereafter, the surgeon cuts away the infected or injured portions of the colon and reattaches the remaining tissue. After hemicolectomy procedures, the surgeon reconnects the bowel with stitches.

By 2pm, there was no sign of mom's surgery to be performed as yet and Dr Adzli came and told me that it was a very busy day at the Operation Theatres (OT) and as my mom's surgery was a last minute slot in, there were a lot of pre-arranged surgeries.

We waited until 4:30pm before the OT was finally calling for my mom to be wheeled down. As mom could only understand Cantonese, my sister in-law and I got to stay with mom at the OT waiting area. There were 5 emergency cases of c-section and one very "tricky" case where we were being cut queue. The number of OTs opened after 5pm would be reduced from 4 to 2. We waited until 9pm before mom was wheeled into the OT. It was a very long and tiring night for us as the surgery took 9 hours before mom was wheeled out. Dr Pok, one of the surgeons came out and updated us on mom's progress. He told us that the tumour removed from mom's colon was not a "good" one as it was surrounded by mucous/jelly like stuff. The removal of the tumour was quite a difficult and lenghty process due to the size of the tumour, which was even bigger than a woman's fist.

Now that the tumour removal part had completed, the Gynae Surgeon was called in to do another last minute decision surgery called TAHBSO (Total Abdominal Hysterectomy And Bilateral Salpingo-Oophorectomy) and Dr Pok, one of the surgeons in-charge, came out and apologized profusely for not informing us earlier. He explained that there was a cyst that ruptured in the right ovary and this could be the location of the tumour which then spread to the right colon.

TAHBSO is the removal of the uterus including the cervix as well as the tubes and ovaries using an incision in the abdomen. A hysterectomy is the surgical removal of the uterus . Hysterectomy may be total, as removing the body and cervix of the uterus or partial, also called supra-cervical. Salpingo refers specifically to the fallopian tubes which connect the ovaries to the uterus. Oophorectomy is the surgical removal of an ovary or ovaries. Hysterectomy is also referred to as surgical menopause.

Mom remained in the OT Observation area as her BP reading was high and the doctor had to make sure her BP went down before wheeling her back to the ward. As ICU was full, my mom was transferred to the observation ward with closed circuit camera next to the nurses' station.

To be continued...

Pangkor Island Beach Resort

Hornbills

Wanted to build sand castle but left the beach tools behind so had to settle with this.

Cheers.

This is a very outdated post.

We went for a 3 days 2 nights short break.

Christmas Dinner 2008

Discharge & Readmission at UMMC

Mom was discharged after 3 nights at the UMMC and scheduled for readmission on Sunday. She was overjoyed when the doctor said she could be discharged. She experienced low grade fever ever since she was admitted and it persisted after discharge. I called Dr Tee on Friday night and informed him about the fever and he advised me to send her back to UMMC but due to mom's reluctance to do so, I gave her panadol to bring the fever down. The next morning Dr Tee called me and told mom to get readmitted immediately.

When we reached UMMC, we headed straight to Surgical Unit on 7th Floor, the unit where we were discharged earlier. We were then asked to get registered for readmission at Discharge and Admission Unit on 2nd Floor. It was a Public Holiday so not all counters were opened. I waited one hour to make upfront deposit of RM500 for the scheduled surgery.

There was only a houseman on duty during Saturdays and Sundays and the Outpatient Unit downstairs were closed for the weekends and Public Holiday. The houseman told me that urine sample and an chest X-Ray were to be taken and that mom's fluctuated temperature was due to infection in the colon and antibiotic was given.

Mom was given two bags of blood due to low haemoglobin count and had been on Sodium Lactate drip since this morning. She was not allowed to eat due to the infection and also due to preparation for mom's operation scheduled for this Monday or Tuesday.

I was horrified to hear from the patient's husband opposite my mom's that the patient had a surgery for removal of cancerous tumour in the ovary at UMSC end of last year. UMSC is a private specialist hospital under the wing of UMMC. According to the husband, RM30+k had been spent on the previous surgery and it could be due to wrong diagnosis that the tumour was now discovered in the stomach. CT Scan was not performed prior to the surgery. It could also due to the fact that the cancer cells had spread to other areas of the body.

Ian's 6th Birthday

Cheeky boy with his Ben 10 cake

Ian's Ben 10 theme birthday cake.

Today is Ian's birthday. Hubby's cousin sister bought him a Ben 10 theme cake. We did not really celebrate his birthday as mom had to be readmitted on the day itself, earlier than scheduled. I just cooked some spaghetti and boiled old cucumber soup for lunch. I did not buy him any present as he had claimed it earlier when I got him the Omnitrix through E-bay in February. Mom gave him Ang Pau, yi yi, yeh yeh, sister in-law gave Ben 10 toys and Suk Suk bought him transformer toy.

Ian was very upset when I told him popo must get readmitted on his birthday. He asked in a very sad tone if popo and yi yi would be able to eat his birthday cake and I had to keep reassuring him. Right after the blowing candles and cake cutting session, we hurriedly ate the cake and finished our lunch and headed to UMMC. Ian was sent to Yeh Yeh's house.

Nando's - Mother's Day

The interior decor
A shot from another angle

Ian's meal

Hubby's meal

My meal

This is a very outdated post.

We went and had lunch at Nando's, IOI Mall on Mother's Day. I personally felt that Nando's food was not to my liking from past dining experience. The chicken thigh was overcooked and the meat was rough and due to the fact that I did not fancy hot and spicy food. The order taker recommended the popular hot peri-peri flavour but I ordered chicken thigh in lemon and herbs sauce instead.

We ordered Kid's Meal for Ian which consisted of smiley faced potatoes nuggets, two mini sausages and some french fries. Hubby ordered Chicken Kebab with two side dishes of potato salad and french fries and mushroom soup. I ordered chicken thigh in lemon and herbs sauce with side dishes of coleslaw and corn. The bill came to about RM60++ with additional order of single scoop of ice-cream. There was also a complimentary mud cake for the mother.

After lunch, we went to Daiso but ended up not buying anything. It was very crowded and the varieties of merchandise there were much wider than their other outlet in Ikano Power. Quite a few of the shops at the new wing of IOI Mall were not opened pending completion of renovation.

CT Scan At Assunta Hospital

The next morning, my sister and I went to keep my mom company at the hospital ward. It was a 4-bedded room and visitors are allowed anytime. During the doctors' morning round, I was told that a CT Scan would be done on my mom and she had been put on IV drips since last night. She was sent down for an ECG Scan and the result came out normal.

We stayed until around 4pm and the nurse came and informed us that the CT Scan schedule was called off because the slot in of the schedule was impossible seeing the long list of appointments. We then headed home and while on our way home, we received a call from Dr Tee, one of the MOs in-charge of my mom. He suggested that we send mom to Assunta Hospital for the CT Scan to speed things up as the queue for the scan in UMMC would be as long as a few days later. We agreed with his suggestion as we too were anxious to get the outcome of the result.

The next morning, after getting the referral letter from Dr Tee, I went straight to Assunta Hospital to register mom and checked the soonest appointment available for the CT Scan to be performed. The clerk at the X-ray unit confirmed that I could bring my mom over anytime. After getting mom registered, I rushed back to UMMC to bring her over to Assunta Hospital.

Mom had to finish drinking 2 glasses of "Readi-Cat II" (barium sulfate contrast). The lab assistant asked for mom's blood test result as the contrast material is filtered through the kidneys and they would need to have a blood test to determine kidney function (creatinine level) before she can be given the contrast material. I called Dr Tee and she said mom's blood test result was all normal.

Mom was then changed into the loose hospital gown and lied on the bed for IV injection that was injected into her arm through an IV line. According to the assistant, at the time of injection, mom may have a momentary feeling of warmth and flushing, a salty taste in the mouth, and possibly some mild nausea but this should pass quickly.

The scan took about 30 minutes and it was 11.20am when the whole procedure completed and we were asked to come back at 2pm to collect the Scan Report. We paid RM699 for the CT Scan.

My mom rushed to the toilet right after coming out from the room. Barium contrast is not absorbed into the body; it passes through your colon which may cause loose stools. It can cause bowel movements within the 2 hour period that you are consuming the Readi-CAT.

The doctor in-charge of my mom at UMMC confirmed a huge tumour presence in the colon of mom after studying the CT Scan Report and a surgery would be the only choice though they refused to conclude that it was cancerous. I understood from the Scan Report that the tumour could probably be the cause of carcinoma, a type of cancer. Should it be cancer, what I could do was to pray that it was still in early stage.

Mom is now discharged as the operation is scheduled for this coming Monday. She would have to be readmitted this Sunday. What I can do now is to pray hard that everything goes well during and after the operation.

Trauma & Emergency Unit - UMMC

I went to fetch my mother and sister from LCCT yesterday. After having our lunch at the coffeshop, we went straight to Trauma/Emergency Unit at University Malaya Medical Centre (UMMC). When we approached the counter, there was a doctor on duty, presumably a houseman kept asking questions as though my mom was not serious enough to get emergency treatment. We insisted and the clerk got my mom registered, we paid RM20 as registration fee.

We were attended by a doctor after waiting for 1 1/2 hrs. The doctor and nurses there were very friendly but I could see that they had serious shortage of nurses as the doctor attended to my mom had to handle everything all by herself such as withdrawal of blood samples, getting ready required tools for examination, etc. My mom was asked to lie on the bed for examination and was asked many questions which we had to be the interpreter as my mom understood only Cantonese but nothing else. The doctor instructed that a x-ray be taken and I paid RM30 for the scanning at the Payment Counter. The doctor then said my mom must be put on the observation ward for further observation before the blood test and x-ray result were ready. She also commented that the tumour in her colon was as huge as a fist and immediate attention was necessary in my mom's case.

We waited for roughly two hours before we were admitted to the observation ward. Then, the nurse put my mom on IV drip. Two doctors from the emergency unit came and did a brief check and decided to refer to Gynae Unit as the tumour was coming from between the colon and right ovary. We waited for 2 hrs but no sign of anyone from the unit came. I then enquired at the counter and only to find out that my mom was now referred to the surgical unit as appointment with the Gynae was fully booked until a week later. The doctor from that unit came and did a check on my mom and concluded admission to the surgical unit.

We arrived at the emergency unit around 3.20pm and by the time my mom did all required tests to finally admitted took a total of 9 hrs, not too bad considering the heavy patient load at UMMC.

To be continued....