"I don't have the best news..."

My doctor came into the room this morning and shared with me that my irregular heart beats returned at midnight. My second ablation procedure wasn't successful after all.

I felt sad, frustrated, fearful, nervous... It was the second time for the procedure, a re-do; it was supposed to be a success. Was this second ablation for nothing?

Prof Tan sat down by my bedside and took time to explain everything clearly, going through the different considerations he had to take.

1. Difficulty of the procedure

- Extra pathways (at birth) can be found at different parts of the heart, and mine happens to be at a relatively tricky position

- What makes it even harder is that my heart continues to beat/move as the doctor tries to aim the catheter at the extra pathway; the doctor has to make sure that the powered catheter doesn't hit the good parts of the heart (which can cause even more riskier complications)

2. Minimal level of risk

- Taking into account the above difficulties, Prof Tan did his best to damage my extra pathway at the least level of risk

- He could have powered the catheters at a higher amount of watts, but the trade-off was that he'll be doing it at higher risks (eg burning a hole in my heart), which would have dire consequences in terms of complications... And Prof Tan was not willing to do that "to a young heart"

3. Two options, moving forward

a) Going for a third ablation- which he advised against, due to the above reasons

b) Continue with my medicine, and hopefully with given time, the function of my heart will improve. Another plus point to consider is that the damages from the two ablations would have gotten rid of the palpitations completely (an earlier problem which I had during chemotherapy)

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In essence, the ablation was to improve my lower than average function of the heart (measured by LVEF). This could have been caused by my Wolffe-Parkinson-White syndrome, and/or the negative impacts of chemotherapy. We went ahead with the procedure, thinking it would at least eliminate one of the reasons for my low heart function.

But my extra pathway has been so stubborn- even with two ablation procedures, it just did not budge (and even if it did, it was only for a few hours). With it being so stubborn, as well as the addition of the increased risks in getting it ablated the third time... we decided against it. We would be patient, and I would continue to take my medicine and we'll see how it goes.

Prof Tan said that he had a patient who took 2 years to increase her heart function (and hers was really bad, at around 10%; they even considered doing a heart transplant). Mine's hovering around 40-45%, while the normal range is from 50-60%. It's just a bit more to go!

It is not the best news after everything, but God is still good. With no more palpitations, and with more time- I have faith that my heart will be strong again.

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!

The Budwig Diet

Based on the information from here:

The Budwig Diet is also known as the Cottage Cheese & Flaxseed Oil Diet created by Dr Budwig  — purported to be an alternative treatment for cancer and other chronic disease. A mix of these two ingredients is one component of a protocol involving additional types of alternative therapy, and generally avoiding conventional treatment such as chemotherapy and radiation.

Budwig said that the blood of cancer patients was deficient in some essential components, including phosphatides and lipoproteins. This affects the proper balance between the electrically negative cell membranes and the electrically positive nutrients, causing stagnated healthy cell growth. A balance could be restored through diet over three months, resulting in better health.

Eating a specific mix of cottage cheese and flaxseed oil is said to help resolve stagnated healthy cell growth and cause tumors to dissolve. This is due to the essential electron-rich unsaturated fats in flaxseed oil and the sulfur protein of cottage cheese. The chemical reaction between these two makes the oil soluble in water, so it can permeate cell membranes and produce healing effects.

To make the cottage cheese and flaxseed oil combination, I use the immersion blender to blend 2 or 4 tbsp. of cottage cheese to 1 or 2 tbsp. of oil. To make it more palatable, I will add fruits, chia seeds etc as seen in the photo above. That one has strawberries, chia seeds and lime zest (extras from my key lime tart).  

I have been having this 'diet' multiple times a week — not sure if it works because I'm under chemotherapy as well; whereas those under this strict diet are usually patients who are seeking alternative therapy. In any case, I hope eating this will be a supplement!

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In other news, yesterday I was getting out of the car at Eastpoint Mall... when my heart palpitations came back again :'( CRAI. Spent almost 30 mins sitting at Tori Q in the basement instead of exploring the newly renovated mall. Tried my best coughing hard to get my heart back on track but to no avail. When I got home, my heart rate was around 146. Lay on my bed and didn't move an inch cuz I was afraid my heart rate will go up (dinner in bed!). My mom managed to contact Dr Eric, and he asked me to take an extra dose of my heart medication. Past 10pm, my heart rate finally slowed to 100+, I think it's due to the combination of both the medication and the effect of blowing the syringe (the cardiologists taught me this method to reverse my fast heart rate). 

Well, at least it went down and saved us a trip to the ER where I would have been kept for at least a night. So thankful. 

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) 

Post-chemotherapy Round 3

I have been resting really well at home the past few days! As usual, after the first 24h of post-chemotherapy, I would have to inject myself with the 'booster jab' to up my white blood counts. If anyone is wondering how it looks like... I took this photograph for Joel in my moment of panic when I couldn't remove the top needle cover. Some sort of weird suction/pressure ALWAYS makes it stuck. This one injection costs $510 and I don't understand why they have to make the user assemble it on his/her own?! A teeny weeny bit of the liquid was coming out as I tried to pull the cover off, didn't wanna waste it so I rubbed it on my stomach, hopefully it gets absorbed haha. But I think I finally managed to figure a way! Hopefully it'll work the next time. Lol sorry please excuse my polka dot pants

After one week of chemotherapy — we realized that my irregular heart beats will come and go. There were a couple of times when my heart rate was 38/hovering around 40... But I felt well/non-dizzy so it's not really an issue. Doctors say that they would rather my heart rate be low than high, but of course not too low as well. Just have to continue monitoring! 

Went for my first my post-chemotherapy blood count today; the next one will be on Friday. It took me by surprise when the receptionist recognized me, and she even realized that I didn't go for my previous blood count after my second chemotherapy. Told her I was re-admitted then (due to my heart palpitations), and that I had my bloods taken while being warded. She wished me well — how thoughtful of her. I was really touched! My cardiologist Dr Eric also dropped my mom a private whatsapp message asking if I was ok as he was overseas when I was discharged. The docs and nurses so far... really grateful to be treated by the kindest souls around.

I turn 22 tomorrow — not sure how I'm feeling about it yet, but I think I'm pretty excited!

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

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!