Bard Chemo Port

Actual size of mom's Bard chemoport

(Mom's Model: M.R.I.* Plastic Single Lumen Port, Peel-Apart Percutaneous Introducter System

W/ Attachable Groshong* 8 French Catheter)

Larger image


The port is implanted completely beneath your skin, and the catheter is inserted inside a blood vessel. Ports are usually implanted on the upper chest, as in moms's case, on the left.



The port acts like an IV to the bloodstream. A special needle is inserted just below the surface of your skin and into the port so that medications and fluids can be given, and blood samples withdrawn.

What is a Bard Implanted Port?

A Bard Implanted Port is a device which is used to deliver medications into the bloodstream. The word implanted refers to the fact that the device is placed completely beneath the skin. The port will be visible merely as a small "raised area" beneath the skin. Daily care is generally not required and it does not affect your normal activities.

Visit To UMMC's Oncology Clinic

Dad and mom arrived at the hospital at 7.25am. I dropped them off and sent Ian to his kindy which was nearby. Ian's kindy opens at 8.00am so I parked my car by the roadside and let him catch up on his sleep till 8.00am. By the time I secured a parking and joined them at the oncology clinic, it was already 8.20am. We got a waiting number for blood tests on liver and kidney function and CEA level.

Dr Ros attended to us and when I told her that the chemo port was not implanted as yet due to the delay from the Surgery side, she tried calling them and fixed the appointment for us. She could not get through the right person so we had to wait for mom's name to be called again. I called Dr Tee immediately after I came out from the doctor's room. He told me he would call me by noon when the doctor who was incharged of roster of the operation theatres came back.

Not long after, mom was called in and Dr Ros told us the appointment for chemoport implantation had now been confirmed on this Friday and mom to get admitted a day before surgery. The 1st chemo cycle is now fixed on next Monday. Should there be any delay again in the surgery, mom must get admitted for two nights and would have to get the chemo through direct IV drips until she had the chemoport ready. Lets hope that there would not be anymore delays and all appointments fixed would be smooth sailing.

Selvi, the staff nurse gave mom and I a lengthy education session on FOLFOX regimen, its side effects, operation of AMBIT pump, telephone number to contact in case of emergency etc. I will write in more detail about this later.

Soon after we left the oncology clinic, I received a call from Dr Tee confirming the surgery on Friday. He has been very helpful from day one and we are really grateful and lucky to have him in mom's team of doctors.

What Is Missing In My Life???

I played this "What is missing in your life" test on Facebook... and the result is F.U.N. Ya, ya .... my heart is crying out loud for Fun, fun, fun!!!!!!

I have been mom's caregiver since she was diagnosed with colon cancer. I spend my days doing internet search, preparing nutritious meals, providing transportation, talking to health care providers and making sure mom gets everything she needs.

Even though there are other family members but I am the only one nearest to her now, I am the one who deals with her medical care and makes the decisions. I feel a lot of responsiblity and pressure. I feel as though I fail miserably most of the time. I try to stay strong for her as this is my mother we are talking about.

Hubby is very caring and gets the burden off me when he sees I need a break. But he is having a hard time with this too and I have to comfort him. I don't feel it's fair to put my thoughts, fears and sadness on him. Fei lou, if you are reading this, please pardon me everytime when I lose my head on you.

Mangosteen Juice

I bought Peel Fresh mixed fruit mangosteen juice drinks for mom as I have heard a lot about the benefits of mangosteens as a good antioxidant but no research has been done on humans yet on its ability to inhibit cancer cell growths. The ingredients consist of juice concentrate of grapes, apple and mangosteen puree with rind and vitamin C contains permitted food conditioner and preservative. Mom drinks a glass everyday and 1 litre only costs us RM4.oo during offer at Tesco.

A friend of mine asked the chinese medicine practitioner that had cured his sinustis about mom's case and he recommended Xango mangosteen juice. A carton of 4 bottles was priced at RM465, a very steep price indeed to consume and 4 bottles can only lasts for 8 days and one must take for a minimum of 21 days to see or feel the effect and thereafter 2 tbspoonful daily for maintenance. I wonder if I should invest thousands of ringgit just on juice consumption alone.

I did a quick search on the internet and here are the findings.

Mangosteen is a tropical fruit native to Southeast Asia that is touted for its antioxidants, especially xanthones, a type of chemical in certain plants. Its fruit, including the rind and pulp, can be pureed together and is sometimes sold as a drink. Mangosteen juice products may also be mixed with other types of juice. Its rind may be dried and made into a powder, and substances are also extracted from its bark. Mangosteen products are also available in capsule and tablet form. They are sold in health food stores, on the Internet, and through individual independent distributors. Despite the name, mangosteen is not related to the mango.

Although there is no reliable evidence that mangosteen juice, puree, or bark is effective as a treatment for cancer in humans, its fruit has been shown to be rich in anti-oxidants. Very early laboratory studies suggest it may have promise as a topical treatment for acne. Early small laboratory and animal studies suggest that further research should be done to determine whether it can help to prevent cancer in humans.

Like many other plants, mangosteen extracts have shown in laboratory tests that they can stop certain bacteria and fungi from growing. One laboratory study suggested that mangosteen extract inhibits the growth of acne-causing bacteria. It has not been tested on people to determine whether it can help acne. In the laboratory, it also slowed the growth of certain cancer cells. A small study in rats suggested that the rind of the mangosteen may reduce the risk of cancer cell growth in the bowel. However, the ability of mangosteen to inhibit cancer growth has not been tested in humans. (Source: www.cancer.org)

Offer Letter to Primary one

Ian will be going to Primary one next year and mom in-law has been bugging us to check with the school since we have yet to receive the letter. Yes, mom in-law was even more anxious than the mom as she was afraid that her only grandson would not get accepted to the school of our choice. Ha!

I phoned the school to find out the status and the call was answered by a friendly Malay lady staff. She told me that the offer letter would only be sent out early next week and that all registered students would be accepted as their quota of taking in 400 students had not been met. Phew! We can now breathe a sigh of relief.

Ian's acceptance to our choice of primary school simply means that we will have to move to a place nearer to his school. We will soon move into our condo which was previously rented out to a Japanese family. This will be the 1st time in my life living in a condo and we are actually looking forward to it. As we live in Puchong now, it's been a struggle having to beat the traffic daily to get Ian to his kindy, Juara Cerdik in PJ. Well, I would have to endure the bad traffic and the ordeal to wake up early for another 3 months before we move into the condo in December.

I heard a lot about the homework loads, strict disciplinary actions, caning and all sort of negatives studying in a Chinese school but we still went ahead with the decision because hubby was actually one of the "victims" for being illiterate in Chinese. My chinese is slightly better off than him, at least I can read the Chinese newspaper and coach Ian with his homework with some help from my sifu (the dictionary). *angel grins*

Health Screening Report Out

This is an outdated post.

The physician, Dr Kwan called and informed me that the Health Screening Report was ready on the 4th day after the examination. We went back to Tung Shin Hospital the next day to collect our report.

My result

Mild Hypertension (needs monitoring)
Mild raised cholesterol level
Other blood and urine tests unremarkable
Ultrasound Abdomen showed uterine fibroids
Normal Chest X-ray, Ultrasound Breasts and ECG
Pap Smear normal

I have expected my hypertension to return as I had Gestational hypertension during my pregnancy 7 years ago but never did it cross my mind that it had to be this soon! Yes, I am almost always stressed, whether it be about anything and everything!

My only concern would have to be several fibroids noted within my uterus (uterine fibroids). The largest is noted in the posterior wall measuring 5.8 x 5.5 x 5.8cm. The largest in the anterior wall measures 1.o x 1.1 x 0.9cm. Dr Kwan's interpretation: Nothing to be concerned about. Most women have them and very rarely the fibroids will turn maglinant (cancerous). Advised to have ultrasound scan every year to monitor any growth.

The left ovary measures 3.6 x 2.4cm with a dominant follicle seen within, measuring 0.6cm in diameter. The right ovary is not visualised. No Free fluid noted in the P.O.D.

Dad's Result

Hypertension - Advised long term medication
Mild raised LDL Cholesterol
Mild raised PSA - needs monitoring
Other blood and urine tests unremarkable
Ultrasound Abdomen showed liver cysts
Normal Chest X-ray, Lung Function Test, ECG and Stress Test

Dad is now on amlodipine 5mg (anti-hypertensive drug) once daily. He stopped taking it two years ago since the GP told him his BP level was normal then. Well, it could be the herbs that he took that had worked wonders. He has stopped taking the herbs since coming to KL to be with mom. Well, no one could ever tell if this was indeed the reason.

His PSA (Prostate-Specific Antigen) test showed a slightly elevated result which needs monitoring and another test to be done in 3 months' time as advised by Dr Kwan.

Several simple cysts were noted in dad's liver though the size was too small to cause concern as commented by Dr Kwan.

Gestational Hypertension

Gestational hypertension: Some women just get high blood pressure near the end of pregnancy. They don't have any other associated symptoms. This condition does not cause any problems for you or your baby, but it can increase the risk that you will develop high blood pressure later in life. Gestational hypertension can also turn into PIH.

This condition doesn't need any treatment. But it can be hard to tell this condition from early or mild preeclampsia, so your doctor will monitor you very closely to make sure your high blood pressure does not turn into PIH. Your blood pressure will go back to normal within a few weeks after you have your baby, but you are more likely to develop chronic high blood pressure later in life.

Uterine Fibroids

What are fibroids?Fibroids are muscular tumors that grow in the wall of the uterus (womb). Another medical term for fibroids is "leiomyoma" (leye-oh-meye-OH-muh) or just "myoma". Fibroids are almost always benign (not cancerous). Fibroids can grow as a single tumor, or there can be many of them in the uterus. They can be as small as an apple seed or as big as a grapefruit. In unusual cases they can become very large.

Why should women know about fibroids?
About 20 percent to 80 percent of women develop fibroids by the time they reach age 50. Fibroids are most common in women in their 40s and early 50s. Not all women with fibroids have symptoms. Women who do have symptoms often find fibroids hard to live with. Some have pain and heavy menstrual bleeding. Fibroids also can put pressure on the bladder, causing frequent urination, or the rectum, causing rectal pressure. Should the fibroids get very large, they can cause the abdomen (stomach area) to enlarge, making a woman look pregnant.

Who gets fibroids?
There are factors that can increase a woman's risk of developing fibroids.
Age. Fibroids become more common as women age, especially during the 30s and 40s through menopause. After menopause, fibroids usually shrink.
Family history. Having a family member with fibroids increases your risk. If a woman's mother had fibroids, her risk of having them is about three times higher than average.
Ethnic origin. African-American women are more likely to develop fibroids than white women.
Obesity. Women who are overweight are at higher risk for fibroids. For very heavy women, the risk is two to three times greater than average.
Eating habits. Eating a lot of red meat (e.g., beef) and ham is linked with a higher risk of fibroids. Eating plenty of green vegetables seems to protect women from developing fibroids.

Where can fibroids grow?
Most fibroids grow in the wall of the uterus. Doctors put them into three groups based on where they grow:
Submucosal (sub-myoo-KOH-zuhl) fibroids grow into the uterine cavity.
Intramural (ihn-truh-MYOOR-uhl) fibroids grow within the wall of the uterus.
Subserosal (sub-suh-ROH-zuhl) fibroids grow on the outside of the uterus.
Some fibroids grow on stalks that grow out from the surface of the uterus or into the cavity of the uterus. They might look like mushrooms. These are called pedunculated (pih-DUHN-kyoo-lay-ted) fibroids.

What are the symptoms of fibroids?
Most fibroids do not cause any symptoms, but some women with fibroids can have:
heavy bleeding (which can be heavy enough to cause anemia or painful periods
feeling of fullness in the pelvic area (lower stomach area)
enlargement of the lower abdomen
frequent urination
pain during sex
lower back pain
complications during pregnancy and labor, including a six-time greater risk of cesarean section
reproductive problems, such as infertility, which is very rare.

What causes fibroids?No one knows for sure what causes fibroids. Researchers think that more than one factor could play a role. These factors could be:
hormonal (affected by estrogen and progesterone levels)
genetic (runs in families)
Because no one knows for sure what causes fibroids, we also don't know what causes them to grow or shrink. We do know that they are under hormonal control—both estrogen and progesterone. They grow rapidly during pregnancy, when hormone levels are high. They shrink when anti-hormone medication is used. They also stop growing or shrink once a woman reaches menopause.

Can fibroids turn into cancer?
Fibroids are almost always benign (not cancerous). Rarely (less than one in 1,000) a cancerous fibroid will occur. This is called leiomyosarcoma (leye-oh-meye-oh-sar-KOH-muh). Doctors think that these cancers do not arise from an already-existing fibroid. Having fibroids does not increase the risk of developing a cancerous fibroid. Having fibroids also does not increase a woman's chances of getting other forms of cancer in the uterus.

What if I become pregnant and have fibroids?Women who have fibroids are more likely to have problems during pregnancy and delivery. This doesn't mean there will be problems. Most women with fibroids have normal pregnancies. The most common problems seen in women with fibroids are:
Cesarean section. The risk of needing a c-section is six times greater for women with fibroids.
Baby is breech. The baby is not positioned well for vaginal delivery.
Labor fails to progress.
Placental abruption. The placenta breaks away from the wall of the uterus before delivery. When this happens, the fetus does not get enough oxygen.
Preterm delivery.Talk to your obstetrician if you have fibroids and become pregnant. All obstetricians have experience dealing with fibroids and pregnancy. Most women who have fibroids and become pregnant do not need to see an OB who deals with high-risk pregnancies.

How do I know for sure that I have fibroids?Your doctor may find that you have fibroids when you see her or him for a regular pelvic exam to check your uterus, ovaries, and vagina. The doctor can feel the fibroid with her or his fingers during an ordinary pelvic exam, as a (usually painless) lump or mass on the uterus. Often, a doctor will describe how small or how large the fibroids are by comparing their size to the size your uterus would be if you were pregnant. For example, you may be told that your fibroids have made your uterus the size it would be if you were 16 weeks pregnant. Or the fibroid might be compared to fruits, nuts, or a ball, such as a grape or an orange, an acorn or a walnut, or a golf ball or a volleyball.

Your doctor can do imaging tests to confirm that you have fibroids. These are tests that create a "picture" of the inside of your body without surgery. These tests might include:
Ultrasound - uses sound waves to produce the picture. The ultrasound probe can be placed on the abdomen or it can be placed inside the vagina to make the picture.
Magnetic Resonance Imaging (MRI) - uses magnets and radio waves to produce the picture
X-rays - uses a form of radiation to see into the body and produce the picture
Cat Scan (CT) - takes many X-ray pictures of the body from different angles for a more complete image
Hysterosalpingogram (hiss-tur-oh-sal-PIN-juh-gram) (HSG) or sonohysterogram (soh-noh-HISS-tur-oh-gram)—An HSG involves injecting x-ray dye into the uterus and taking x-ray pictures. A sonohysterogram involves injecting water into the uterus and making ultrasound pictures.

You might also need surgery to know for sure if you have fibroids. There are two types of surgery to do this:
Laparoscopy (lap-ar-OSS-koh-pee) - The doctor inserts a long, thin scope into a tiny incision made in or near the navel. The scope has a bright light and a camera. This allows the doctor to view the uterus and other organs on a monitor during the procedure. Pictures also can be made.
Hysteroscopy (hiss-tur-OSS-koh-pee) - The doctor passes a long, thin scope with a light through the vagina and cervix into the uterus. No incision is needed. The doctor can look inside the uterus for fibroids and other problems, such as polyps. A camera also can be used with the scope.

What questions should I ask my doctor if I have fibroids?
How many fibroids do I have?
What size is my fibroid(s)?
Where is my fibroid(s) located (outer surface, inner surface, or in the wall of the uterus)?
Can I expect the fibroid(s) to grow larger?
How rapidly have they grown (if they were known about already)?
How will I know if the fibroid(s) is growing larger?
What problems can the fibroid(s) cause?
What tests or imaging studies are best for keeping track of the growth of my fibroids?
What are my treatment options if my fibroid(s) becomes a problem?
What are your views on treating fibroids with a hysterectomy versus other types of treatments?
A second opinion is always a good idea if your doctor has not answered your questions completely or does not seem to be meeting your needs.

How are fibroids treated?Most women with fibroids do not have any symptoms. For women who do have symptoms, there are treatments that can help. Talk with your doctor about the best way to treat your fibroids. She or he will consider many things before helping you choose a treatment. Some of these things include:
whether or not you are having symptoms from the fibroids
if you might want to become pregnant in the future
the size of the fibroids
the location of the fibroids
your age and how close to menopause you might be

If you have fibroids but do not have any symptoms, you may not need treatment. Your doctor

will check during your regular exams to see if they have grown.

Medications

If you have fibroids and have mild symptoms, your doctor may suggest taking medication. Over-the-counter drugs such as ibuprofen or acetaminophen can be used for mild pain. If you have heavy bleeding during your period, taking an iron supplement can keep you from getting anemia or correct it if you already are anemic.

Several drugs commonly used for birth control can be prescribed to help control symptoms of fibroids. Low-dose birth control pills do not make fibroids grow and can help control heavy bleeding. The same is true of progesterone-like injections (e.g., Depo-Provera®). An IUD (intrauterine device) called Mirena® contains a small amount of progesterone-like medication, which can be used to control heavy bleeding as well as for birth control.

Other drugs used to treat fibroids are "gonadotropin releasing hormone agonists" (GnRHa). The one most commonly used is Lupron®. These drugs, given by injection, nasal spray, or implanted, can shrink your fibroids. Sometimes they are used before surgery to make fibroids easier to remove. Side effects of GnRHas can include hot flashes, depression, not being able to sleep, decreased sex drive, and joint pain. Most women tolerate GnRHas quite well. Most women do not get a period when taking GnRHas. This can be a big relief to women who have heavy bleeding. It also allows women with anemia to recover to a normal blood count. GnRHas can cause bone thinning, so their use is generally limited to six months or less. These drugs also are very expensive, and some insurance companies will cover only some or none of the cost. GnRHas offer temporary relief from the symptoms of fibroids; once you stop taking the drugs, the fibroids often grow back quickly.

Surgery

If you have fibroids with moderate or severe symptoms, surgery may be the best way to treat them. Here are the options:
Myomectomy (meye-oh-MEK-tuh-mee) - surgery to remove fibroids without taking out the healthy tissue of the uterus. It is best for women who wish to have children after treatment for their fibroids or who wish to keep their uterus for other reasons. You can become pregnant after myomectomy. But if your fibroids were imbedded deeply in the uterus, you might need a cesarean section to deliver. Myomectomy can be performed in many ways. It can be major surgery (involving cutting into the abdomen) or performed with laparoscopy or hysteroscopy.

The type of surgery that can be done depends on the type, size, and location of the fibroids. After myomectomy new fibroids can grow and cause trouble later. All of the possible risks of surgery are true for myomectomy. The risks depend on how extensive the surgery is.

Hysterectomy (hiss-tur-EK-tuh-mee) - surgery to remove the uterus. This surgery is the only sure way to cure uterine fibroids. Fibroids are the most common reason that hysterectomy is performed. This surgery is used when a woman's fibroids are large, if she has heavy bleeding, is either near or past menopause, or does not want children. If the fibroids are large, a woman may need a hysterectomy that involves cutting into the abdomen to remove the uterus. If the fibroids are smaller, the doctor may be able to reach the uterus through the vagina, instead of making a cut in the abdomen. In some cases hysterectomy can be performed through the laparoscope. Removal of the ovaries and the cervix at the time of hysterectomy is usually optional. Women whose ovaries are not removed do not go into menopause at the time of hysterectomy. Hysterectomy is a major surgery. Although hysterectomy is usually quite safe, it does carry a significant risk of complications. Recovery from hysterectomy usually takes several weeks.

Endometrial Ablation (en-doh-MEE-tree-uhl uh-BLAY-shuhn) - the lining of the uterus is removed or destroyed to control very heavy bleeding. This can be done with laser, wire loops, boiling water, electric current, microwaves, freezing, and other methods. This procedure usually is considered minor surgery. It can be done on an outpatient basis or even in a doctor's office. Complications can occur, but are uncommon with most of the methods. Most people recover quickly. About half of women who have this procedure have no more menstrual bleeding. About three in 10 women have much lighter bleeding. But, a woman cannot have children after this surgery.

Myolysis (meye-OL-uh-siss) - A needle is inserted into the fibroids, usually guided by laparoscopy, and electric current or freezing is used to destroy the fibroids.
Uterine Fibroid Embolization (UFE), or Uterine Artery Embolization (UAE) - A thin tube is thread into the blood vessels that supply blood to the fibroid. Then, tiny plastic or gel particles are injected into the blood vessels. This blocks the blood supply to the fibroid, causing it to shrink. UFE can be an outpatient or inpatient procedure. Complications, including early menopause, are uncommon but can occur. Studies suggest fibroids are not likely to grow back after UFE, but more long-term research is needed. Not all fibroids can be treated with UFE. The best candidates for UFE are women who:
have fibroids that are causing heavy bleeding
have fibroids that are causing pain or pressing on the bladder or rectum
don't want to have a hysterectomy
don't want to have children in the future

Are other treatments being developed for uterine fibroids?Yes. Researchers are looking into other ways to treat uterine fibroids. The following methods are not yet standard treatments; so your doctor may not offer them or health insurance may not cover them.

MRI-guided ultrasound surgery shrinks fibroids using a high-intensity ultrasound beam. The MRI scanner helps the doctor locate the fibroid, and the ultrasound sends out very hot sound waves to destroy the fibroid. The ExAblate® 2000 System is a medical device that uses this method to destroy uterine fibroids.

Some health care providers use lasers to remove a fibroid or to cut off the blood supply to the fibroid, making it shrink.

Mifepristone®, and other anti-hormonal drugs being developed, could provide symptom relief without bone-thinning side effects. These are promising treatments, but none are yet available or FDA approved. Other medications are being studied for treatment of fibroids.

Dominant Follicle in Ovaries

Roughly a week before the midpoint of the menstrual cycle the dominant follicle develops in one of the two ovaries. This grows faster than the other tertiary follicles and prepares itself for ovulation. It reaches a diameter of up to 25 mm and is also known then as the graafian follicle.

A dominant follicle just means that it is not quite big enough to call it a cyst. You can have a dominant follicle if you are still in the reproductive ages. A lot of women have these on their ovaries.

Protein Powder

PROSURE
Per 100 g Protein 21.29 g, fat 8.2 g, carbohydrate 64.9 g, dietary fibre 3.1 g, fructo oligosaccharide 3.52 g, moisture 2.4 g, taurine 64.1 mg, carnitine 32 mg, vit A acetate 430 iu, β-carotene 2,241 iu, vit D3 218 iu, vit E 14.6 iu, vit K1 32 mcg, vit C 110.2 mg, folic acid 138 mcg, vit B1 0.81 mg, vit B2 0.92 mg, vit B6 1.09 mg, vit B12 1.58 mcg, niacin 7.99 mg-NE, pantothenic acid 3.52 mg, biotin 16 mcg, choline 163.4 mg, ash 3.2 g, Na 480 mg, K 640 mg, Cl 487 mg, Ca 474 mg, phosphorus 336 mg, Mg 90.6 mg, Fe 0.35 mg, Zn 7.99 mg, manganese 1.34 mg, copper 236 mcg, iodine 51.1 mcg, selenium 25.3 mcg, chromium 32 mcg, molybdenum 44.7 mcg. Energy: 392 kCal.

NESTLE NUTREN OPTIMUM
Per 100 g Fat 17.5 g, protein 18.4 g, carbohydrate 58.2 g, vit A 1,800 iu, vit D 130 iu, vit E 13 iu, vit K 23 mcg, vit C 65 mg, vit B1 0.92 mg, vit B2 1.1 mg, niacin 13 mg, vit B6 1.8 mg, folic acid 250 mcg, pantothenic acid 6.5 mg, vit B12 3.7 mcg, biotin 180 mcg, choline 210 mg, taurine 37 mg, carnitine 37 mg, Na 402 mg, K 573 mg, Cl 551 mg, Ca 307 mg, phosphorus 307 mg, Mg 123 mg, manganese 1,239 mcg, Fe 5.5 mg, iodine 46 mcg, copper 0.65 mg, Zn 6.5 mg, selenium 18 mcg, chromium 18 mcg, molybdenum 55 mcg. Energy: 461 kCal.

I got mom a tin of Nestle Nutren Optimum 400g after trying out few samples hubby brought back from a newly opened pharmacy in Puteri IOI, Puchong. I got the first tin from Guardian at Ikano Power for RM29.90. I then hopped over to Tesco nearby and was shocked to see the price tagged at RM36.80, if I remembered correctly. My impression was that prices at the supermarkets should be lower than that at the pharmacies, right, well, I was wrong.

While doing my marketing with papa at the Tropicana City, PJ the other day, I walked into Caring Pharmacy and the price gave me another shock, only RM19.90 per tin but that was a promotion pack larr. I quickly grabbed the 2 tins on the shelf and asked the shop assistant to check if they have any more stocks available. The remaining stock on the shelf was their last batch of stock available.

I initially wanted to get Prosure by Abbott but ended up with Nestle Nutren Optimum after comparing the ingredients, they were almost similar and Prosure had lighter weight content by 20gram and priced at RM45++ per tin, almost doubled the price of Nutren Optimum. Guess the higher price contribution was from branding and Abbot's aggressive advertisement and emphasis on special fomulation mainly for cancer patients.

Puteri Mart, Puchong

Papa and I like to go for our weekly grocery at Puteri Mart. We will have our breakfast first at the foodcourt where we get to choose our food from a few stalls that open in the morning. The place starts getting into full swing by noon time when most of the stalls are opened to cater for the lunch crowd and it gets even busier during dinner time.

1st Visit to UMMC's Oncology Clinic

We went for mom's 1st appointment at the Oncology Unit last Friday. We reached there around 8.30am, got a waiting number and filled up a form and mom's name was called not long after for taking of body weight. It was finally our turn after 2 hours waiting. Dr Ros, the MO under Dr Ho's team (the oncologist incharge of mom) attended to mom. Mom was asked to lie on the bed and had her wound checked. Dr Ros commented that mom's wound was healing well and I gave her the CT Scan for review. We were then asked to wait for mom's name to be called again while she discussed with Dr Ho and Prof. Dr Chin (the surgeon operated on mom). While waiting, I observed the patients around us. Most of them were seen wearing head scarves and hats to hide their balded head. I later found out they were mostly breast cancer patients and had undergone few chemotherapy cycles and the balding was due to its side effects and not all cancer patients undergoing chemo treatment would get the same side effects due to different types of drugs used.

There were three breast cancer patients seated a row behind us and they were discussing about life after getting this deadly disease and the dieting regimen they followed while on chemotherapy. I took life for granted and lightly and never bothered to get myself checked by the doctors before mom was admitted to the hospital and diagnosed with colon cancer even though I was previously in pharmaceutical sales for 5 years where I got to see doctors every day. During mom's twice admission to UMMC for a total of 10 days, I realised one could not take one's life lightly or ignorantly. In mom's case, should she had seek treatment when the symptoms like, dark coloured stool, abdominal pain, no appetite, fatigue arose three years ago, things would have been easier to manage today. But let bygone be bygone. The whole family had actually agreed not to ponder on this again as they would only make mom feel more guilty, the guilt of being a burden to the family.

Mom's name was called after another 1 hour waiting time. Dr Ros then told us that they had called Prof Dr Chin and he said that “almost” 100% of the tumour and infected colon were removed. Dr Ros briefed that due to the perforation (a tear or hole) of the tumour, they planned to put mom on a more powerful chemo drug called oxaliplatin combined with FU5 and Folinic Acid (a type of vitamin) also called FOLFOX regimen for 8 to 12 cycles every 2 weeks. The whole duration of chemotherapy would take at least 6 months depending on how well mom responded to the drugs. The cost of full cycle of FOLFOX regiment would be in the range of RM21,000 for the drugs alone and not included other expenses. She suggested a chemoport be implanted to reduce the pain mom had to endure everytime looking for veins for IV drips of the chemo drugs.

Dr Ho, the oncologist incharge of mom, came in and greeted us. I asked him about the side effects of this FOLFOX regimen and the possibility of moving mom back to Sandakan to continue with the treatment as mom has always wished to be to be in her hometown at this difficult part of her life journey. Dr Ho said some of the side effects would be neuropathy (tingling of the fingers and toes, nausea or feel like nauseating, touching or taking cold drinks would get an even worse effects to the nerves) though it would not cause hair loss due to the drugs used. He continued that he could refer mom to an Indian oncologist in KK but wasn't sure about any oncologist available in Sandakan.

He then observed mom and told me that mom looked very worried. I then asked Dr Ho if he could converse to mom in Cantonese and repeat what he had told me so that she could be more at ease than just staring at both of us not knowing what we said. He did that and mom looked very calm though a bit shocked and that gave me slight mental relief. All this while, I had been thinking chemotherapy would not be necessary on mom as one of the surgeons, Dr Tee reassured us that chemo might not necessarily come into the scene. I did not ask many questions as I was still recovering from the shock and wasn't prepared to this. I have had no idea what the hell this FOLFOX was and what damage it would bring to my already fragile mom with only 48kg left from the previous 60kg!

An appointment was fixed for blood test and day after, starting of chemotherapy on 20 & 21 July. I was then asked to get an appointment from Surgery Unit to have the Chemoport installed but due to the fact that I could not get a date as Prof Dr Chin's team would only be at the surgery clinic on Thursday, the oncology side postponed the dates to 27 & 28 July to allow sufficient time for chemoport implantation.

I told my sister about the oncologist's plan to put mom on chemotherapy and she was so upset over the fact that at this age mom would have to suffer yet again after the major surgery 3 weeks ago. Apparently, my sister has always been our messenger in the family to avoid having to repeat so many times on the same issues. My two elder brothers would always call should they want to know more about mom's case. I started my search on the FOLFOX regimen and my focus would definitely on its side effects.

Health Screening at Tung Shin Hospital

After having done some price comparison and research on the type of health screening available at private hospitals, I have finally chosen Tung Shin Hospital in Jalan Pudu, Kuala Lumpur.

Comparison with other private hospitals
Tung Shin Hospital - Comprehensive Health Screening Package

Physical Examination by physician Hearing & eyesight test/ Resting ECG / Chest X-ray / Ultrasound Abdomen & Pelvis / Stress test / Lung function test / lab profile 44 tests:(Haematology Profile / Fasting Blood Sugar / Renal Profile / Liver Function Test / Lipid Profile / Diabetic / Thyroid / Hepatitis B Screening / Urine Analysis / Blood Grouping / Venereal Disease (STD) / Tumor Markers for CEA & AFP) / Medical Report / report interpretation by specialist

Cost: RM630 (senior citizen), RM665 (public)
Sunway Hospital - Platinum PackageSame as above with additional diet counselling but minus the stress test and 2 tumour markers

Cost: RM799 (all)

I called the specialist clinic to make an appointment a day before going. We were then advised to fast at least 10 hours before the health screening process.

The next morning, after dropping off Ian at his kindy, off we went to Tung Shin Hospital. We reached the hospital around 9am and I took the Intermediate package with breast ultrasound and pap smear added in (total cost) while Papa took the comprehensive package with a PSA test added (total cost).

A friendly Malay nurse brought us to a room where our weight and height were taken and we were then asked to lie on the bed with all wires were hooked up to our chest for ECG.

We then went to see the physician, Dr Kwan Eng Keong for physical examination, we had our eyesight tested and Dr Kwan checked my blood pressure and found that my bp was a bit on the high side, same with papa. We were then asked to lie on the bed to check on our sensivity toward the hammer knocked on our knee and ankles. I was sent down to the X-Ray Department to have my chest x-ray and ultrasound on my breast, abdomen and pelvic while papa was having his stress test on the 1st floor. I was asked to change into a blue loose gown to facilitate the chest x-ray scan and was given a basket for keeping of my blouse and belongings. I was then sent to a dim lit room with the ultrasound machine just next to the bed, I lied on the bed while waiting for the radiologist, Datin Dr Ranjit Kaur to do the scan. A transparent gel was applied over my breasts down to the pelvic area and Dr Ranjit tole me there was no lumps found on both my breasts and they appeared normal.

My liver, spleen, gallbladder, blader were all normal except she found 5 fibroids in my uterus, especially the one at my posterial wall, it was as big as an orange. She assured me there was nothing to be concerned about as very rarely the fibroids would turn maglinant and most of them would disappear after menopausal. She advise me to have a pelvic scan at least once a year to monitor if there is a growth in size of the fibroids.

I then went to 6th floor to get my blood and urine samples done. I was a breeze and painless when the nurse took my blood. I would have to go back to 1st floor for Pap Smear to complete the whole health screening process.

It took a while before I was attended by a lady Indian doctor as they had an emergency case prior to that. It took a mere 5 minutes for the doctor to take some sample out from my vagina for the test.

Not long after I have completed, papa walked out from the X-ray department and he told me that the radiologist, Dr Kaur told him that there was some water trapped inside the stomach. I was doubtful though not very sure if an ultrasound could ever get through any gas or air let alone the stomach. Papa was very concerned about stomach as he has been having stomach discomfort ever since he can remember.

It was 12.45pm when we completed the whole process. We then looked for the canteen in the hospital and had mixed rice there. We paid RM11.00 for two plates of mixed rice and two cups of hot drinks, reasonably priced I would say that.