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?! 

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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!

Treatment #2: Radiotherapy?

Supposed to post this earlier but I got lazy hahaha zzz now I have a backlog of updates:

Thursday, 29th January 2015

I had an appointment with Dr Lim to discuss the results of my PET scan done a few days before. This scan was done after 6 chemotherapy sessions, and was supposed to check on any signs of mass/cancer activity left in my body.

My scan showed that the mass has decreased — what's left measures 4.7 x 2.8cm (compared to the previous scan, 6.2 x 4.2cm). But there's a concern over the activity part, because it INCREASED from SUV3.6 to 7.0. This can mean two things:

1. The PET scan is very sensitive, and it may pick up activity from scarred tissue that will slowly go down given more time

2. There's still some disease left which means that radiotherapy is needed to zap it off

They've arranged for another PET scan after CNY on the 23rd Feb to try to make sense of things. But for now, my doctor is more keen on radiotherapy to get rid of the cancer totally. He says he rather 'overtreat' than miss out on something which can be worse.

But on the brighter side of things... I'm off my (blood thinner) injections and PICC line!!!!!! Major hallelujah! I have been injecting myself twice a day for the last 4 months my stomach got pretty badly bruised. I got used to the PICC line but yes, really really glad to get these two out of the way.

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Wednesday, 4th February 2015

Dr Lim discussed my case with other specialists (radiologists, radiation oncologists...) last Friday and he helped to arrange for me to meet Dr Yeoh, a senior consultant in radiation oncology today. I think the consultation was around an hour?! He explained radiotherapy thoroughly — the history, side-effects, my case... 

Honestly I wasn't keen on radiotherapy AT ALL. (HELLO... I WON'T SIGN UP FOR ANOTHER CANCER TO HAPPEN IN THE FUTURE!) I've always thought it was a really bad type of treatment (must be all the horrible stories of old technology radiotherapy). Ok la, then again, chemotherapy is equally horrible!!!! Scientists should find even better cures for cancers ASAP. But I can understand where the doctors are coming from, pros vs cons. Like what Dr Yeoh said, there can only be so much scans I can do. Plus, most of the time, he says that patients who keep doing scans, the results are hot-cold-hot-hotter... In other words, time is of the essence. We wouldn't want to wait and only find out one day that the cancer has deteriorated. *touch wood*

Because I started off with a HUGE tumour (12.6 by 6.5cm), chemotherapy can only do so much to shrink it. Most lymphoma patients will still have abit of cancer cells left because of the tendency that our tumours are naturally larger in the first place. Dr Yeoh described chemotherapy as a systematic type of treatment (i.e. it goes through the whole body), while radiotherapy is localized. 

With modern technology, radiologists are able to blast the radiation at precise locations that only hit the affected cancer cells. But every treatment comes with side-effects and risks right? Since my mass is at the chest area...

Short-term side effects:

- Redness of the skin ("You mean like sunburn?" "No, for sunburn there's peeling. But for this... It's like spending 2 hours walking at the beach")

- Dry cough

- Fatigue

Long-term side effects (20 years down the road):

- Secondary cancers: Skin, bone, lung, breast

- Heart and lung problems 

Dr Yeoh assured us that these secondary cancers only occur to a reallyyyyy small percentage of people. As we grow older, risk of cancer goes up anyway. I ran into Dr Lim at the entrance, so nice of him to say hi and check on me. After balancing the pros and cons, the doctors agree that getting rid of my current tumour entirely is the safest option, and an option that will give me a peace of mind, rather than playing the waiting game.

And since there's a pre-treatment session for radiotherapy for the doctors to decide on how they are going to carry out the treatment (e.g. how to localize the radiation such that it has minimum effect on my vital organs)... I have an appointment booked next week on the 11th. The real treatment begins on 29th Feb (if I decide to go through with it, after my PET scan on the 23rd Feb). It will last for 3 weeks every day (????!!!!), and 15 minutes each time. 

Gah.... why can't SGH be in the east?!

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!

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

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!