Post-Treatment Thoughts

Last Friday 20th March 2015, after 6 cycles of chemotherapy and 17 sessions of radiotherapy, I'm finally done with treatment!!! WOOHOOO. The road to recovery the past 6 months has been tough, but God has gifted me with so many graces to travel this road. Thank you all for soldiering on with me — the visits, prayers, well wishes, kind words of encouragement... they mean a lot! 

Can't believe these 6 months have gone on by so quickly. Not complaining though, just feeling very blessed. This journey has taught me many things, and I thought it'll be nice to share with you guys.

Health is wealth

Growing up, I was always involved in sports — netball, in particular. I've been playing netball competitively, representing my schools since I was 13. In primary school, I was a lazy bum. But a smart one, because I found out that I could list 'piano' as my CCA teehee... so I didn't have to go for any CCA practices etc and could spend more time watching tv at home. But I still liked running, so I was a runner for my House and participated during Sports Day every year. I remember winning my first gold medal in P3 at my first event, and actually slept with it around my neck because I refused to take it off (lol what was I thinking). 

I'm bringing all these up to show that I wasn't the most unhealthy person — yes, I eat McDonalds occasionally (side note: think I'm never gonna have macs again crai), but I exercised regularly too! Especially during netball days, no way was I unfit and unhealthy then. Ok, I admit that I stopped exercising regularly when I graduated, but at least I was still loving my fruits and vegetables?

Truth is, no one expected me to get cancer. Not now, not when I'm 22 and at the start of my career. 

It is so important to treat your body right. I can't emphasize how important it is to eat right — I'm not saying to convert to a vegetarian/stop eating sugar etc but moderation is definitely key. Being young doesn't mean the body is insusceptible to illnesses! Cancer doesn't only happen to old people. Apparently my kind of lymphoma happens mostly in young women... who would have known?! 

Like me, many young people take their health for granted. Not because we don't care... I guess it just doesn't strike us? We assume that our youth equates to health, and then it just disappears in our list of priorities. But we forget that without health, we can neither pursue our paper chase for qualifications, nor climb up that esteemed career ladder. 

"Smile, and you'd have won half the battle"

I am very touched by the comments which say that I've been strong, brave and positive... I really appreciate them — thank you for taking time to write to me, and for keeping me in your prayers. Honestly, what keeps me going is the faith that with God's grace, I will completely recover. Also, I draw my strength from the people around me (especially my family, and my close friends). I wouldn't have done it without them. They have supported me through everything. My parents would visit me twice a day when I was warded, giving me home-cooked lunch and dinner lovingly made by my grandma so that I didn't need to eat hospital meals. I am so blessed to be at the receiving end of such great love.

During my hospital stays, I've always had wonderful roomies (haha) to accompany me. Even though they may be three to four times my age, I enjoyed all our conversations. I believe that God placed these individuals there with a purpose — to keep me company, and make me laugh and be touched by their stories. During the period when I was just diagnosed, one elderly lady in the next bed asked me why I was there, and I started tearing when I shared my story. She then said something which resonated in me until today — "Girl ah... smile, and you'd have won half the battle". 

You can face anything, just do it afraid

I thought long and hard before posting up the photo of me and my baby-hair head. I decided to go ahead with it, because I wanted to show that there is nothing wrong with having less hair. Yes, I cried so much when I shaved it all off. But then I remembered that I wasn't alone. Thousands of other women have shaved their heads to fight hair loss, a distressing side-effect of chemotherapy. I can only wish that I am brave enough to leave out the wig when I'm out. 

I've also read about some women in the US who try to prevent hair loss by using ice caps during chemotherapy. Apparently by reducing blood flow to the scalp, this limits chemotherapy exposure to hair follicles. The thing is, it hurts like mad?!! Imagine having a block of ice on your head 24/7. But by doing this, there is also a concern that this reduces the effectiveness of treatment in that area. If you ask me to choose, I'd rather have my head shaved than all the other nasty side-effects of chemotherapy like vomiting. 

Anyway, I also learnt about the importance of eyebrows and eyelashes... They are SO important to a face's structure omg. The photo that I posted above is considered the 'nicer' version. So here's me, with a few tiny strands of eyebrows, and zero eyelashes. And a shiny bald head. (At least the flush from the drugs gave my face abit of colour haha)

I'll be recuperating at home for the next couple of weeks. I'll update whenever I can! Today, Singapore lost our founding father Mr Lee Kuan Yew. He was a great man who built Singapore, a place I proudly call Home. May he always be remembered. Rest in peace!

Another Bump in the Road

One Direction, On The Road Again Tour SG

I went for the One Direction concert on Wednesday!! It was my first time at the new National Stadium, and it was huge?! There were 33,000 people but there were still many empty seats behind the stage. Pretty impressed with the good crowd control — I could even find seats on the MRT on the way back. Aaaand... it was my first time taking public transport in 6 months haha I was pretty nervous and apprehensive but I think taking the MRT back would be even faster than finding a cab at the stadium.

Yesterday (13th March 2015) marks the 6th month mark since I got diagnosed. Happy 6th monthsary? Hahaha. Has it been half a year already?!

I had an appointment with my heart doctor, Dr Eric, yesterday as well. Not so good news. The recent echo scan that I went for showed that there's a fall in my LVEF. I have done 3 echo scans — it went from 50%, to 48%, and most recently, 36%. Here's more info, from here:

With each heartbeat, the heart contracts (or squeezes) and relaxes. Every contraction pushes blood out of the two pumping chambers (ventricles). When when heart relaxes, the ventricles refill with blood. The ejection fraction (EF) refers to the amount, or percentage, of blood that is pumped (or ejected) out of the ventricles with each contraction. This percentage, or EF number, helps your health care provider determine if you have heart failure or other types of heart disease. 

A normal heart pumps just over half the heart's volume of blood with each beat – a normal EF is 50 to 75 percent. 

A low EF number is an early sign of heart failure. This is a condition where the heart does not pump enough blood to the rest of the body. With treatment, many people live well with heart failure. 

So I've been put on two medications — Enalapril (5mg bd), and Bisoprolol (2.5mg bd). He says that with early treatment, there's a high chance of recovery. These two will decrease my blood pressure, and I have already felt some side effects last night. When I got up from watching tv, I got a bit dizzy and then my heart went into crazy racing mode (150 beats/min) for 5 minutes. 

Dr Eric says that the decreased function of my heart is due to the combination of chemotherapy and radiation. He even tried to call my cancer doctors to see if my radiation can be stopped as it's evidently weakening my heart. But... they didn't answer their calls sigh. Hopefully my body will be able to tolerate the medications! Will be doing another scan in the middle of April to see if they work.

I'm left with the last 5 sessions of radiotherapy! Lezzgo!

How Does Radiotherapy Work?

/edit @630PM

To Uncle J and Aunty AK (pretty sure you both will be reading this hehe):

Thank you so much for the lovely flowers, they were a wonderful surprise. Very touched by the handwritten note as well; really appreciate your kind words of encouragement and support. Would love to thank you both personally next time. God bless!

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Radiotherapy means the use of radiation, usually X-rays, to treat illness. X-rays were discovered in 1895 and since then radiation has been used in medicine for diagnosis and investigation (X-rays) and treatment (radiotherapy). 

Doctors have a lot of experience using radiotherapy in medicine. About 4 out of 10 people with cancer (40%) have radiotherapy as part of their treatment. It can be given in various ways, including from outside the body as external radiotherapy, using X-rays from linear accelerator machines, electrons, and more rarely other particles such as protons. 

Radiotherapy destroys the cancer cells in the treated area by damaging the DNA within these cells. Although normal cells are also affected by radiation, they are better at repairing themselves than the cancer cells.

Source: Cancer Research UK

I have gone for 3 radiotherapy sessions so far, and it has been really manageable. It is always at the same treatment room, with the same staff. That's really good because patients feel comfortable. Also, when you look up at the ceiling, there's a giant projection of a mountain and the sea. Makes you feel like you're on top of a mountain!

Did I mention that they play pop music too? It's great as it feels as if time passes really quickly. The second session was as long as 2 Bruno Mars songs, and 1 Capital Cities song. The third session played the extended version of Justin Timberlake's Mirrors... and as soon as the song ended I was already done! For one of the sessions, classical music was being played for another man who had treatment before me. Before my session started:

Me: Eh what happened to the pop music?

Radiotherapist: Haha, you like ah? Ok play for you.

Teehee now I use songs to have an inkling of how long every treatment takes.

In total, I'll have to go for 17 sessions. My last one will be on 20th March (my sister's birthday!). I was told that the first 4 sessions will be abit longer (~15 mins), and I'll have a doctor's appointment every Monday after treatment. Treatments will usually only last 5-10 minutes. As mentioned in the previous post, during treatment, I'll have to fit myself in the body mould and have my arms over my head. Most importantly, I can't move! I'll wriggle my fingers from time to time so that they won't freeze. 

When I get home, I'll apply lavender essential oil on the affected area, so that the skin will not be too dry. So far so good, no red patches whatsoever. 

Aaaaaand... I have to update everyone that my hair has been growing!!!! Eyelashes and eyebrows too. My eyebrows are actually growing so much I have started tweezing the stray ones lol. My head now is filled with baby hair hahaha I feel like a giant baby

Tadah!!! Shadow of my baby hair 

Pre-Radiotherapy

Last Wednesday (11th Feb 2015), I went for my pre-radiotherapy session. It was supposed to take 45 minutes but it felt like ages. I reached National Cancer Centre pretty early, changed into the gown, and waited for my turn. As they were going to run a 'contrast' in my blood (from their screens, my lymph nodes will light up once the contrast is in my system), they inserted a plug at the back of my palm. I have very small veins, so when they're searching for veins to poke they always choose the most visible, i.e. it's always the same one! Also, chemotherapy causes my veins to shrink, in turn, causing the entire area to swell after every plug insertion. 

Before heading into the theatre, one of the radiotherapists gave me a briefing. The usual procedure process, things to look out for etc. I casually nodded my head in acknowledgement until she said....

Radiotherapist: You do know that you'll be having parmanent tattooed dots inked on you right?

Me: HUH WHAT? And by permanent do you mean... forever?

Radiotherapist: Um, yes. It'll be with you for life. It's just gonna be 4 small dots, pretty much like little moles.

Me: (My mouth was open for 5 seconds before I said a word) Ok... You sure there's no cream to remove it?! 

---

The main purpose of me going for this pre-radiotherapy session is to do my body mould (again, for accuracy). This mould will be with me for the next 20 sessions, and I'm supposed to lie in that exact position everytime I go for treatment. Even my fingers had to be in the same position! Hence, it was imperative that I lay still and try to feel comfortable. Sucky thing is that my hands have to be above my head — I had to lie in that position for almost an hour, naked, in the freezing cold. Halfway through, my fingers were so numb I couldn't feel them anymore. I couldn't take it, I asked to rest. It was so bad, I couldn't bring my hands down on my own? The nurses had to massage them for the blood to flow. It was horrible!!! 

I can now say that I have been tattooed... FOUR DOTS. They were being serious, they used the needle/ink method. Haha it actually sounds ridiculous when I say it like this. But it isn't too bad, each dot is a size of a 0.38 uniball pen dot? It's on the top and bottom of my ribcage, and on each of my sides. These dots will help guide the laser, so that the procedure will be done accurately.

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On a happy note, I have had a very busy Valentine's Day weekend catching up with friends, family and Joel. We avoided the crowds and had an amazing affordable lunch at The Naked Finn on Friday. 

Will be doing another PET/CT scan next Monday to confirm if I'm going for radiotherapy. Praying for complete healing!

Yesterday's scare

Had an appointment to see Dr Lim yesterday, and as usual, did my blood tests and the flushing/cleaning of my PICC line. There are two lumens on my line... one was alright but the other was not!!! There was no back flow, and worse, it couldn't be flushed. This meant that no liquid could flow through the tube as there was a clot somewhere, most probably due to fibrene. At that point, there were only two scenarios:

1. They'll inject some medication into the line, leave it there for an hour to unblock it, or;

2. If the above doesn't work... They'll remove the entire PICC line, and schedule me for surgery to re-insert it.

Honestly, I was so sian and heavy-hearted when I heard the second part.

But this morning, the moment of truth — when blood started gushing out into the syringe as it pulled back (the backflow)... The clot is gone! With God's grace, the medication worked!!! So thankful yay. Will be starting chemotherapy this afternoon, it'll be my 5th and second last cycle. It's a bit early this time round so that I'll be home just in time for Christmas :) Here we go!

Realized I haven't posted a photo of the line without it being wrapped up in dressing... For those who are interested, it looks like this! (p.s. Not for the faint-hearted hehe sorry it looks kinda gross)

Post-chemotherapy Round 4 / What goes on in the Ward

Can't believe I'm done with my 4th cycle, just 2 more and I'll be done! Pretty busy this week with 4 appointments — 2 blood tests, a CT scan, and a Heart Echo Scan. Went for my first blood test yesterday and I had a bit of fever (37.7). I was feeling really tired but all's good now!

Mind Your Body (The Straits Times) always has freebies to give out every week. Two weeks ago it was rosehip oil products and I asked my mom to join too to up my chances... AND WE WON!!!!! I have been using rosehip oil for my scars (esp from ablation), stretch marks etc and it works wonders. Plus it's organic, what's not to love!

I realized I hardly document what's it like during chemotherapy itself... So here's a sneak peek to what goes on during the 5 days I check into Ward 78 in SGH. Very specifically Ward 78 because it's the only ward which can administer chemotherapy drugs (there are only 4 in the whole hospital), and have the equipment to monitor my heart (i.e. the telemetry) together. 

The nicest view that I have got so far

These are my chemotherapy drugs — I will usually be hooked to two of these machines which control the flow of the drugs into my body. The flow is extremely slow, there will be one at 11ml/hour and the other one at 21ml/hour. Both will flow via my PICC line, a central line that is semi-permanent. I have had it since October and will only be able to take it out in January after chemotherapy. It can't touch water so when I shower it becomes a bit of a hassle because I'll have to wrap it up nicely. Dressing and flushing are changed and done once a week — if I'm home, my (super)mom does it. Otherwise the nurses at the hospital will take care of it. 

Anyway back to the drugs, the sequence for the 5 days usually goes like this:

- 1x of 4-6h drug

- 4x of a pair of 24h drugs

- 1x of a 15 min drug

Whoops I don't even know the names (I get very confused when I try to remember, all I know they make up these letters R-EPOCH hehe)... but the main gist of it is the 24h pair of drugs. For my safety, I'm not really allowed to move from my bed because if I do, I'll have to lug these machines around. 

Here's the telemetry that I was talking about! It is at least 1kg and there are 5 wires connected to my chest. Apparently from a giant monitor screen in some heart lab, there will be people monitoring. They'll know of any extreme dip or soaring of my heart rate because there will be an alarm, and they'll call the nurses immediately. There was once my heart rate was 34 (the 3rd chemotherapy) and they woke me up in the middle of the night to check on me... I didn't feel a thing but at least the machine is working and the people are very alert? Haha

#fromwhereIstand #hospital #ootd #telemetry #wires #havaianas #rolex (actually barcode scanner for medicine) 

Chemotherapy Round 4

Happy December everyone! I just got admitted for my 4th cycle of chemotherapy on the 1st, and just started the first round of drugs today. It usually takes a day for them to prepare the drugs. I've been trying to rush them... but I learnt that alot of people are involved in the process — the doctor will first calculate the concentration of the drugs from my height, weight, and BODY SURFACE AREA (which is 1.6 m2 btw lol), and then fax it over to the pharmacy lab to prepare the drugs, and which they will finally send it over to the ward when they are done. So I guess I can understand why they take so long every time!

For the next chemotherapy cycle, I am really hoping that it won't clash with christmas or new year's. Dr Lim says he'll try his best to push it forward so that it will end just before christmas but this will only happen IF my blood counts rise up in time after this 4th round... or there's a back up plan of coming in on boxing day, and going home on new year's eve. Don't wanna be in hospital on neither occasions, that'll be a major mood dampener but I know health comes first, so fingers crossed!

Anyway, here's some mid-week organic pasta cheer! Salmon (marinated with terriyaki sauce) with aglio olio, handmade chia meatballs (really proud of this one — second time making this, and the chia seeds make the meatballs so moist!) with tomato pesto fusilli, and a ~fusion~ miso salmon with miso pasta haha #domesticated

Chemotherapy Round 3

I'm almost midway through!! In terms of both this cycle, and for all 6 cycles as well. I think my body is getting more used to the chemotherapy drugs because I have been coping pretty well. 

Plus, even more great news- Dr Eric (my cardiologist) came by the other day and said that my ECG this week didn't show anymore irregular heartbeats! Previously one day after the surgery it came back, but apparently that's because the heart is in the "healing process". Hopefully these irregular heartbeats will be gone forever!! But he mentioned that they'll only be able to confirm it after a few months when everything stabilizes. 

On a sidenote, the oncology team who visited me this morning told me that there's another girl (in her late 20s) who just got admitted in the next room with a similar condition as me. She just came over, and I was glad to be able to share my experiences. I hope I managed to make her feel more at ease - it's always comforting to know that you're not alone... I pray that she'll have a smooth recovery too!

Only time will tell

I've been back home resting since Thursday — so glad the doctors allowed me to return home for the weekend before  heading back on Sunday to get ready for my 3rd round of chemotherapy starting Monday. 

As mentioned in the previous post, I underwent cardiac ablation on Wednesday morning. It usually takes 1 hour, but for my case they took almost 3 hours. The cardiac doctors say my case is unique — those who have Wolff-Parkinson-White syndrome usually have their extra electrical pathway on the left side of the heart; mine's on the right. And for these people, theirs will be found at the bottom; mine was found at the top area. Doctors wouldn't know exactly where the extra pathway is until during surgery, that's why my procedure took so long. My doctor said they had to "look high and low for it" haha. 

With local anesthetic, they inserted three ablation catheters through my groin area, and these are guided to my heart through the blood vessel. From the tip of these catheters, radio waves produce heat to destroy the heart tissue (i.e. my extra pathway). They also gave me sedation... twice. Sedation was meant to make me drowsy, but not enough to sleep. I felt that it didn't really work?! Thought I was awake 98% of the time. It was quite entertaining actually.

Surgeon: "Standby... eh standby, did you guys hear me? Can y'all focus please"

Surgeon: "30 watts... 35 watts... 40 watts... Hold. 20 seconds... Ok stop!"

When the electric current was introduced, thank god there wasn't any pain. But for 40 watts, there was a slight metallic taste in my mouth? Anyway towards the end, they gave me some drug that tingled my entire body and made my face flush. I was like, "What did you guys give me! Am I supposed to feel hot!!" 

And my doctor simply smiled and replied, "A sprinkle of magic dust".

Post-op, they took my ECG and it was, for the first time in my life, normal. No extra long lines means no more extra pathway! Woohooo success! Just had a pressure bandage wrapped around my groin and leg. 

BUT...  I was greeted with not-so-good news the next morning. ECG taken again showed that my irregular heart beats came back :'( My heart really sank. But Dr Eric remains hopeful... during the ablation, the amount of watts they applied were minimal — enough to scar the pathway, but I guess not enough to get rid of it entirely. Hopefully my heart will be smart and try to use the main pathway more since this extra one is slightly damaged, this way I think I'll have less palpitations/fast heart rates?

For now, it's a wait-and-see approach. We'll need to see how it reacts when the chemotherapy drugs are introduced next week. Gotta have faith!

Happy news and a change of plans

Happy news

The PET scan results are out, and I was so happy to hear that after 2 chemotherapy cycles, the tumour has shrunk by half!!! *\o/* (cheerleader emoji)

It used to be 13.5cm by 8cm, and now it's 6.5cm by 3.5cm. 13.5cm is MASSIVE I didn't even know?! 

Also, the level of activity of the cancer cells has gone down by 70%.

It's great that my body is receiving treatment well. Can't wait to get rid of these nasty ugh things!!! 

Change of plans

Yesterday evening when I was just about to check into hospital, my heart started racing again at dinner and instead of going to the admissions office, I ended up at A&E. 

Tomorrow I'll be going for ablation, a minor surgery to remove my extra electrical pathway in my heart. My 3rd chemotherapy cycle will be postponed to next week instead. This was really sudden and only decided this evening. At first we thought of only having this procedure done next year when I was done with chemotherapy, but the cardiologist team and my oncology doctors were getting worried about the recurring episodes of my palpitations and high heart rate... And my parents and I agree that this is the best option at this point in time. The pattern so far is that with each chemotherapy cycle, my palpitations get worse :( A worst case scenario is when an emergency ablation is needed during chemotherapy. 

The cardiologist said that this procedure has a 85-90% chance of success. But there's also a 1% risk of burning the main pathway, or even causing a hole in my heart... Which is TERRIBLE. But I trust God to be guiding the hands of the two senior consultants tomorrow.

Cardiac ablation is a procedure that is used to scar small areas in your heart that may be causing your heart rhythm problems. This can prevent the abnormal electrical signals or rhythms from moving through the heart. During the procedure, small wires called electrodes are placed inside your heart to measure your heart's electrical activity. These electrodes may also be used to destroy the bad areas of your heart.

Heart strikes again

/edit 630PM
Sigh, my heart acted up again when I got up to use the toilet. The series of events followed this morning's. This time my heart rate was 165, not as high but still fast and very uncomfortable. I'm stuck in the high dependency ward again - they'll probably keep me here for now.

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I was all ready to go home today... Until my heart decided to go wonky again while I was in the toilet. I walked slowly back to my bed, praying so hard it'll disappear within 10 mins. That was the time I gave myself before telling the nurses... cuz I knew that I wouldn't be going home once they got to know about it. And I really wanted to go home :( Tried all the maneuvers that I was taught by the cardiologist - blowing into a syringe etc. But all of them didn't work, so I pressed the red call button with a heavy heart (lol).

The following happened in 15 minutes: Nurses went into an emergency mode, doctors were called in. Heart rate was 185. Poked a new IV line. 30 wires across my chest connected to the heart monitoring machine. Rolled into the high dependency ward. Given the same drug they gave me at A&E. 

Because it's the second time I was administered this drug, I was calmer and could feel the way my heart reacted. It's like someone taking your heart, and squeezing it so hard it almost stops. Something like a scene out of The Vampire Diaries when Damon Salvatore threatens a vampire by semi-pulling his heart out... and then putting it back. My heart rate dropped to 110.

Admission to SGH

I had high heart palpitations for 6 hours before being admitted to hospital on Thursday. My heart rate was 195?!! Usually it would go down on its own but this time it didn't... A&E doctors had to inject me with a drug to slow down the heart rate. The effect was pretty immediate - it actually had the feeling of my heart stopping... and then I became slightly breathless, similar to the feeling you get when you're running for the bus haha. It slowed down to around 110/min, but with my medical conditions they decided to keep me for observation. 

The blood test also showed that my potassium level was slightly lower, so the doctor decided to have me on potassium chloride via the IV drip line. IT WAS THE MOST PAINFUL EXPERIENCE EVER. I would like to think that my tolerance for pain is pretty high... But this potassium drug was really no joke. It was so bad I cried twice through the night and tried to beg the nurses to take it off. But the only thing they could do was to lower the infiltration speed. It felt like the drug was burning my veins :'( so terrible!! 

It was such a relief when the bag of potassium was fully deflated and finished... Until the nurses told me there was one more. Utter despair. But this second one was inserted through the PICC line instead of the IV drip line... And it was SO MUCH better! No pain at all?! Turns out that the PICC line is a central line that is connected to the bigger vein to the heart, while the IV drip line was a peripheral line. Faints they could have done that earlier!!!

So far they've taken me off the tele machine (a device that measures my heart conditions 24/7) and even allowed me to go for a walk! Both very good signs that I can go home tomorrow yay. 

Sidenote: My "walk" also involved having a flat white while my mom ate her sandwich hehe

Post-chemotherapy Round 2

I was discharged on 18th Oct, so I'll be resting up at home for the next 3 weeks. The second chemotherapy went by smoothly — I was amazed at how 5 days went by so quickly! During this cycle they increased the dosage, and this will continue as long as my blood counts remain good enough. There were no nausea side effects this time, just fatigue. All I do is sleep and eat, I wasn't even allowed to walk to the toilet! Total nua mode. The nurses were really kind, one even bought me a madeline from flor patisserie :')

Remember how I was saying that the PICC line that was inserted before this cycle was so troublesome...? Well, it will remain inserted till the end of ALL my 6 chemotherapy cycles. My parents were taught how to clean the area once a week, it'll have to be super clean, dry and germ-free. Looks like I'll be in long-sleeved loose cardis when I go out for the next few months!

The past couple of days I've been slightly feverish (37.7-37.8 deg), although I feel not serious enough to go back to the hospital. Actually had high palpitations today for 5 minutes too sigh. Anyway, the doctors and nurses once cautioned that once there's a fever, I'd have to return to hospital — "a fever to others may just be part of a passing flu, but for you... it can be life-threatening!" But then again, body temperatures post-chemo are known to be abit higher too. I promise that I'm not acting tough or anything ah... but really, I think it's important to know your own body. I still feel the same as with a lower body temperature, so all's good!

Also, instead of the 7-day booster jabs that I needed to inject myself post-chemo, they gave me a 1-day one this time around! Apparently previous blood counts have shown that my body is pretty strong... so this one time jab actually has a few "layers" - it will self-activate every day without me injecting myself. Hurray!

Meanwhile in SGH

3rd day of my second cycle of chemotherapy! Have been getting my daily dose of homemade cold-pressed juice in mason jars, delivered with love by my family members. After all the vegetable (cabbage, carrots, broccoli, asparagus etc) juices, I made a request for a fruit juice! Tonight I was presented with an avocado milkshake (unsweetened soy milk) with a dash of organic maple syrup. Yum!

The ward I'm staying in now is the only one in SGH which is CARPETED hahaha. Just that I wish there was abit more sunlight in the room - my wing is unfortunately facing another building so there's not much sunlight as I'd love to have. But other than that, I've been very well taken care of! 

Although last night I gave the nurses abit of a scare when my heart rate was 38... This isn't the first occurrence, and it wasn't physically uncomfortable - as compared to my high heart palpitations which raced my heart rate to 160 before in the last chemotherapy round. There are two reasons that the doctor thought could trigger these abnormal heart rates - my Wolff-Parkinson-White syndrome (an abnormal electric pathway in my heart) and one of the chemotherapy drugs that I'm on now. Was up at 5am doing ECG checks... Thank God that when I woke up my heart rate was normal again!

On another note - recently I also went on a spree on iHerb.com... Will blog more about that soon (probably a post on my lifestyle changes). Have been snacking on healthy sweet potato and coconut chips, which are really delicious - and supposedly healthy too! 

Gearing up for chemotherapy Round 2

Went to SGH this afternoon for my appointment to insert the PICC line — a similar line to the one that I had at my groin (the femoral line) previously. 

The doctors had to use local anesthetic to numb the area, and then ultrasound scan to make sure that they're poking into the right vein (or artery?). Ended off with two stitches to fix the entire line down. 

Rested for an hour before I was allowed to go home. After the anesthetic began to wear off, wahhh the pain! Hurts more than the femoral line. Maybe cuz my arm is more active and I have to keep moving it? Hopefully the pain will be gone when I wake up tomorrow!

Not sure if this is gonna be semi-permanent/lasting for more than one chemo session, but it's so zuo-dang (best translation would probably be 'in the way')! Plus, it's on my dominant right hand. Guess this will train my left hand abit — shall start by brushing my teeth tonight!

1st week post-chemotherapy

Today marks the end of the first week after my first cycle of chemotherapy, which means that I'm done with the 7 booster jabs as well. At the hospital, the nurses gave a heads-up that the booster jab would abit painful... but for me, thankfully it turned out to be almost painless. I think the Clexane (the blood thinner) is worse! Yay this means I only have two injections to do

Went to the hospital to do a blood test today — cross fingers that my blood count will be alright. The next time I'll be seeing the doctor will be on 7th Oct!

Flashback Part 2

Monday, 22nd September 2014

Snip, snip! Apparently I made history when I asked Lucas (my usual hairdresser) to come down to give me a haircut. Decided to go for a bob because pixie's too badass for me. The last time I had short hair I was 15?!

How's my new hair?

Wednesday, 24th September 2014
Ended my first chemo cycle on Tuesday night 1030pm, so it was finally time to go home! Got rid of the femoral line (the one at my groin area) so it's definitely much more convenient to walk about.

Throughout my stay at Ward 48, the nurses and doctors were so genuinely wonderful. They took time to talk to me, to make sure I was alright. So blessed and grateful to have my friends, colleagues and family visit me as well. Thank you for the love, concern, gifts (especially the flowers and fruits haha I have week's supply of fruits in my fridge now)... You guys are the best!

Flashback: While in SGH

Saturday, 13th September 2014

At Changi General Hospital, A&E

Only 2 weeks ago, but so much has happened. It was a Saturday morning, and I had woken up with a swollen face/neck and a terrible cough. I have been coughing (with on and off fever) for 3 weeks, and my face has been swelling for a week as well. After 3 trips to 3 different GPs, I wanted to go to see the sinseh (Usually that's what people do right? If western medicine doesn't work, TCM to the rescue!). That morning, my dad returned from a flight and was still shocked that I was still having 'flu' — and worse, with a swollen face. I was sent to A&E at Changi General Hospital after breakfast.

The doctor could not figure out what was wrong with me — could it be a drug allergy? But she ruled it out because I've been taking normal cough mixtures and panadols... If it were to be a drug allergy, surely it would have sprung up at least once the past 22 years. So I was sent for the full checks — X-ray, urine and blood tests.

I was on drip, resting on a corner couch, almost sleeping. And then I was gently shook awake... "Amanda, the X-ray shows a mass in your chest. Do you smoke/drink? Do you have a family history of cancer?"

The rest was a whirlwind. I was transferred to Singapore General Hospital in an ambulance — lying in the stretcher, I was breathing through a portable oxygen tank, having a drip, and clamping my legs over a mega machine which was apparently able to keep track of my heart condition (side track: I have Wolff-Parkinson-White syndrome since young, an abnormal extra electrical pathway of the heart).

I stared out of the window as the trees along ECP swooshed by. When I awoke, I was being admitted into SGH already.

Monday, 15th September 2014

In the operation gown, face still as swollen as ever

Major test day! I was going for a biopsy to find out what exactly the mass in my chest was. It was scheduled to be at 9am, and I had to fast from midnight. As they wheeled me from my ward into the waiting area, I was so nervous I teared.

I had two major concerns:

- If the biopsy were to be unsuccessful, they would have to proceed with surgery to get a 'sample' of the growth (i.e. cutting my chest open)

- What if it's cancer!!!!! (Yes, I still had the little hope that it was just a benign mass)

The biopsy only started at 1130am. The local anesthesia was injected four times to numb the area for the pin-hole operation. I was on the super flat operating bed, and it became really uncomfortable because I kept coughing... I coughed so hard my chest hurt so badly, and tears started welling up in my eyes (I was in pain because of the cough, and not the biopsy). All these while they were poking me with the biopsy needle.  It was to the extent of not being able to breathe properly, so the doctor decided to take a short break. He gave me the plastic mask (the kind for general anesthesia) to inhale something that managed to suppress my cough for awhile. Thank God the biopsy was done 15 minutes after that, because my coughing kept going on, I felt my chest was going to burst.

The doctor then inserted the femoral line at my groin area — it is thicker than the normal drip line, and needed to be stitched. This was going to be there until the end of my first chemotherapy cycle. This line would allow them to draw blood, insert the drip, insert my chemotherapy drugs etc (basically everything).

I was in a daze lying on the bed face-up, staring at the white ceilings as they wheeled me back to my ward — I only turned to my side when the nurse accompanying me touched my hand and said, "stay strong, okay?"

"Okay."

Tuesday, 16th September 2014

Went for even more scans/tests in the morning... but the afternoon one was the highlight of the day — the bone marrow test. This test is to show whether there are cancer cells in my bone marrow. I've heard from everywhere that it would hurt. Well, thankfully the pain was manageable. In fact, on a scale of 1-10, it's only 2-3! They had to inject local anesthesia three times though. Apparently my bone is VERY hard hahaha the female doctor, Dr Kaavya, had difficulty and had to even get the male doctor to help her out with the pushing of the needle into my hip bone. Well, she says it is a good sign that my bones are strong. It means they are healthy!

On another note, the gynaecologists came to speak to me about the option of taking out one of my ovaries before chemotherapy. There was a risk that chemotherapy would affect my fertility in the future. BUT, the operation for this is major, and requires general anesthesia. If I decide to go through with this, chemotherapy would have to be pushed back 1-2 weeks, as my body will need to recuperate after the surgery.

My first thoughts:

- Having children in the future is important to me — but with this, does my body have the luxury of time to push back chemotherapy?

Thursday, 18th September 2014

I woke up at 4am to go to the toilet. The lady at the next bed was struggling for her life. Through the 2-3 days that she was here, I have gathered that she has brain cancer. The whole nurse team and two doctors were by her bed — they even pushed a trolley with orange sides and an orange box. I have never seen this trolley before... it meant that it was serious. I turned on my side and managed a glimpse of her.

At 5am, I stirred from my sleep and saw that family members were already gathering at the next bed, saying their last goodbyes. I couldn't help but tear. When the nurse came by to draw my blood, she decided to move me to a private room for the morning until everything was over. That was very thoughtful of her — I don't think I would have been able to take it. Not right now. 

Have been taking steroids, which suppressed the cough and got rid of the swelling!

Anyway, they forgot to take my breakfast order the previous day... so I was eating oatmeal and bread (definitely not my first choice). Breakfast was supposed to be muffins! I tried my luck, and asked one of the nurses to check if there was any extra left in the kitchen. Well, there weren't any left — so after her shift, she kindly surprised me with a pack of 3 muffins from the bakery downstairs. Nurses are the best people on earth!

Highlight of the day: Joel is finally home for 10 days!!!!! So so blessed and grateful that he's back. I know I initially told him that I was gonna be okay on my own — but he flew back anyway. Besides my family, he's my other pillar of support and with him going through the first phase of chemotherapy with me, I won't be going to battle alone.

Decided that I would be starting treatment the next day. Dr Tiffany said that chemotherapy would have an extremely low risk on my fertility — this confirmed my decision to go on with treatment immediately and to forgo the removal of one of my ovaries. The surgery is complex, and there was even a risk of my heart stopping?! I don't need that! Plus, any form of surgery would definitely weaken the body, and I wouldn't want to fight a war that way. My first priority is to kill the cancer cells!

Friday, 19th September 2014

Chemotherapy starts today! Chose to go for the R-EPOCH treatment rather than R-CHOP. Well, it was created to reduce recurrence, and to diminish the need for radiation. CANCER CELLS BE GONE!!!

Have been looking and reading at what to eat (e.g. antioxidants), what to avoid... 

Also, used pinterest for hairstyles (pixie? bob?)... I contacted Lucas my hairdresser, and he was going to come on Monday to cut my hair! Pretty excited.