"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.

Updates for the past 3 months

For those who have asked how I've been the past three months — I'm good! Thank you all for keeping me in your thoughts and prayer. 

Also, many have been asking whether there's any more cancer left... Honestly, the doctors haven't explicitly told me that they're gone, but based on the CT scan that I did in June, cell activity has went down (generally cancer cells are crazy active). However, there's still some scar tissue left, which may or may not go away at all. As long as there are no cancer cells and it's just mass left, it's a good sign that I'm on my way to becoming a lymphoma survivor.

However, my heart function hasn't improved the way the doctors had hoped for. My extra accessory pathway (my pre-existing condition) seemed to have hindered my heart's recovery. Also, more problems such as a premature heartbeat and a below than average LVEF have surfaced recently. The doctor gave me two options to consider — to go for a heart ablation (strongly advised), or to continue my medication to try to boost the recovery. 

I have taken the doctor's advice, and would be going ahead for the heart ablation. I don't want to be stuck playing the waiting game again (waiting a few months, going for a scan to check if the medication works...) I kinda have the feeling that I'll ultimately need to go for the ablation anyway. Might as well be now right- to get to the root of it and get rid of it once and for all. The procedure is scheduled to be on 10 September. It is pretty soon, and I think I'm rather prepared. I've done the ablation before, during the period between my first and second chemotherapy. I am less nervous because I know what's going to happen during the procedure, and I believe that this ablation will help my heart heal, and hopefully be strong again.

P.S. My hair has grown... ALOT. Waiting for my hairdresser to be back in Singapore (he's back in Malaysia for awhile) to give it a nice trim and it'll be ready for the world!

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!

Link between my low LVEF and Radiation

Yesterday, I saw Dr Yeoh (radiation oncology) with my mom before I went for my radiotherapy session. Dr Eric (cardiology) was concerned about my weakened heart function with radiotherapy (read more about my low LVEF in my previous post), but Dr Yeoh cleared the air during the consultation.

1. Generally based on long-term research, lymphoma and breast cancer patients will suffer from cardiac problems (if any) only 5-10 years after radiotherapy.

2. Today's technology is so advanced, radiation oncologists are able to pinpoint the area they're shooting radiation at, and calculate the dosage of radiation that a vital organ might be getting. For my case, my mass is in my chest, but Dr Yeoh reassures us that the heart and lungs are only being affected minimally. Some statistics to give you a bigger picture:

- The safety limit which the heart receives radiation is at 10%; and at this level, 1% of patients got cardiac problems. 

- My heart is receiving radiation of 0.16%... so the risk of me getting cardiac problems due to radiation is really verrryyyy low. 

3. Dr Yeoh said that even before I started on radiotherapy, when he was checking the 3D images, I already had a huge heart. 

Me: *chuckles* "What do you mean by a huge heart?"

Dr Yeoh: Imagine working your arms with dumbbells every day, your muscles will grow right? Likewise, a heart is a muscle — it means that your heart has been working very hard with your Wolff Parkinson White (my underlying heart problem), and of course, lymphoma.

---

Dr Yeoh then gave a call to Dr Eric, and they had a 15 min discussion over the phone. They agreed that given that my echo scan was done after 3 radiation sessions, my low LVEF should be the cummulative effect of my WPW, lymphoma and chemotherapy. 

On a separate note, I messaged Dr Eric separately and told him about my side effects after taking the new medication. He told me to cut down the dosage by half, so hopefully everything will be better from now!

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 

4th PET Scan + Results

On Monday, I went for my 4th PET scan. Thank God the wait wasn't as long as the previous one, it was surprising because I thought the hospital will be a madhouse with everyone scheduling their appointments after CNY. 

I got my scan results yesterday, and Dr Lim says "Your lymphoma is in remission". OMG, best 5 words I've heard this year. But but but!!!!! The scan shows that there is still a 'stable' mass left, with less activity compared to my previous scan. Since the scan is done a month after my chemotherapy ended, a decrease in activity = the mass left should probably be scarred tissue, and non-cancerous in nature.

That being said, taking my age into consideration, Dr Lim still feels the strong need for radiotherapy because it will kill the tiny possibility of any cancer cells lingering behind undetected by the scan. I guess that's the best way forward now. 

Radiotherapy starts tomorrow, let's go!

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Yesterday after the appointment, we were about to turn into MCE, when Joel and I made a spontaneous decision to go to Gardens by the Bay! Even paid to get up on the Giant Supertrees hahaha it was a wonderful time getting some fresh air and scenery.

So thankful.

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!

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?!

Dealing with Hair Loss

(L-R) Bob, Pixie, Just before going to the salon, Shaving halfway (couldn't resist taking a photo teehee I look so badass)

I have been keeping this blog post on hold because it means so much to me. Since my chemotherapy sessions have come to an end, I thought it would be a good time to share it here — not for the purpose for others, but rather, more for my myself to remember.

I shaved off my hair on 20th October 2014 after my second chemotherapy. In the mornings, my pillow would have collected strands of hair, and I will continue shedding hair throughout the day around the house. Honestly, it was getting frustrating, and emotionally draining whenever my hair dropped in clumps (especially when I showered!). 

I remember it being either the first or second day that I was back home after my second cycle... It popped up while I was talking to my mom, and it was rather impromptu I'd must say. I took half an hour to decide if it was the day to shave — I stared at the mirror, prayed for strength, and thought, sooner or later right?

The next important question: Which salon should I go to? 

I didn’t want to trouble my hair stylist to come down to my place (like how he came to SGH to cut my bob, and for my pixie style I actually went do to the salon at Siglap), and since I thought shaving didn’t need much skill; I did a quick google search and settled for the most random salon on the second floor at Elias Mall near home.

My mom accompanied me, and when I walked into the salon… “I would like to shave my hair, please”. The hairdresser asked softly, “all of it?” I nodded, and there weren’t any more questions.

Army boys have different ‘levels’ of shaving, so I thought this was the best thing to describe how short I wanted my hair to be. “Number 4!” … It turned out messy, and worse, patchy. Unfortunately, hair loss from chemotherapy is horribly uneven. For me, most of my hair loss is at the crown of my head, compared to the back. So from Number 4, it became Number 1, and then it just became 0 (i.e. the shortest the shaver could go).

—

I’ve always thought that those who shaved for Hair for Hope were really brave. I even remember having this conversation with a group of friends jokingly: “Maybe if you pay me $10,000 I’d go for it. Actually maybe $100,000??” 

Well, the joke’s on me now. I don’t know how to put this nicely… I guess for young males with shaved heads, people go, “oh, army boy”. For females, if it’s not during Hair for Hope, first reactions would usually be, “oh no, she has cancer”. It's like no matter how brave you are, it's just so damn hard to walk along the streets bald. 

I think my worst fear is for a kid to see me and to ask his/her mom, “Mummy, why doesn’t she have hair?” WAH I think I’ll cry. Thankfully, my mom thought well ahead, and brought me to buy my wig right after my first chemotherapy when I wasn’t shedding as much hair yet. True story: We were in the lift heading to the car park, when this boy (carried by his mom) PULLED MY WIG!!!!!! Um… Lucky it didn’t drop? The mom kept apologising, and I’m pretty sure she didn’t know it was a wig, but still?! Could the boy really recognise the fake hair? (Actually my wig is made of real hair haha but ok, not the point!)

—

Hair loss hasn’t been limited to my head — I’ve lost ALL my eyebrows and eyelashes too. I used to have longer than average eyelashes so I was quite sad when my last old eyelash dropped during my last chemotherapy (I really had the hope that it'll be the last one standing haha). But thank God they've been growing out pretty quickly such that it’s not fully bare at once. To think of it positively... at least it’s like a full body IPL? Hahaha

I’ve gotten used to my new (hair)style the past few months. It is definitely breezier and makes showering a whole lot easier. I have been reading Joyce Meyer’s Living Courageously — “You can face anything, just do it afraid”. I know I wouldn’t be able to walk around a mall without a wig (sorry this one really too extreme), but I thought I took a baby step forward when I walked around the hospital on two occasions au naturel. 

I have been refusing to wear a beanie cuz I think I look very sickly and weak, and I have horrible scarf tying skills… So the wig has been the best option for me. Of course, there are still a few days when I scroll through Instagram and feel sad when other girls caption ‘bad hair day’ when they still look gorgeous anyway. 

—

To be honest, it didn’t come easy. I curled up on my bed and cried like a baby when my first clump of hair came off in the shower. Hair loss has taught me many things — I know it may seem like a trivial side effect of chemotherapy because ‘hair can always grow back’, but I’m glad, and proud, that with God’s grace, I have learnt to slowly overcome this.

Yet having said all these, I’m still a girl, so… hair quickly grow back please!!!

Post-chemotherapy Round 6

Hello, I am back and I HAVE FINISHED ALL 6 CYCLES OF CHEMOTHERAPY!!!!!! I was home on 14th Jan, just in time to celebrate my mom's birthday on the 16th. I was fit enough to head out for her birthday dinner at Dempsey on the 2nd day post-chemo, so I was quite happy because usually the first 2 days I'll be having body pains (muscle/bone aches). 

Initially I thought my PICC line would be removed right away after my chemotherapy ended, but the doctor said he'll only take it off when I meet him on the 29th... just in case. My PET scan will be on the 26th — this scan will check if there's any more cancer-active cells left after these 6 rounds (TOLONG please no more ah). 

The doctor says the results will be classified using a scale of 1 to 5-

- 1 and 2: confirmed cancer-free 

- 3: unconfirmed, and a second scan will be needed 3 months later

- 4 and 5: still some cancer cells left, and the oncology team will need to discuss with the radiologists for potential radiotherapy

Praying really hard that it'll be a green light from the doctors on the 29th! *crossing fingers and toes*

Hello 2015!

Have been pretty busy the past week — celebrating Christmas and New Year's, and even catching up with my ACJC classmates, as well as Clare & Faith. It has been a while since I have went out with friends, so I was abit apprehensive at first (what if my heart rate goes up? what if it's too crowded?)... But I'm glad I did! Always great to spend time with friends that I hold dearly to my heart. On another happy note, Joel is home from his exchange in Copenhagen!!! 

2014 was a rollercoaster ride for me — I graduated with a BA in Sociology, went on an ultimate grad trip to Korea, Cambodia and Europe, started work at a PR firm... but it was also the year that I was diagnosed with lymphoma. It was unexpected, shocking, and a blow to what I deem as my smooth-sailing life. Rather than a 'battle', I would like to call the past 4 months a learning journey. Looking back, I've so much to be thankful for. There has been progress in my treatment, and I'll be ending my last chemotherapy the following week (probably 13th Jan!). A great start to the new year!

I don't know what 2015 holds, but that's what's exciting isn't it? That way, we'll make the most out of it.

Happy New Year!

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Here are some happy food photos to end 2014:

Our Christmas roasted duck stuffed with orange turned out pretty awesome!

Linguini with mackerel at Spathe Public House 

Spaghetti in organic tomato sauce, with spinach and feta cheese at Real Food (Clarke Quay)

Strawberry cheesecake for New Year's Eve

Scare No. 2

I'm home for Christmas!!! Really glad I managed to push forward this round's chemotherapy. The ward was getting pretty quiet too... I guess people would want to hold off any treatment until after the festive season. There was even one night where I had the entire room to myself! 

On the last day of chemotherapy, while the nurse was cleaning up and flushing my line... My PICC line decided to throw me a second surprise this week- ONE OF THE STITCHES HOLDING IT DOWN DECIDED TO COME OFF???!! Sigh. Thank God that the ward on-call doctor was pretty efficient and did the stitch rather quickly. Since I was on local anesthetic, there wasn't any pain so I decided to look at how it was being stitched hahahaha had always been curious! 

Christmas this year will be a simple homemade dinner with the family- we are going to be roasting a duck instead of the usual turkey because it'd be too much! Fingers crossed it'll go well! 

Merry Christmas xx

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)

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 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!

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.

Lifestyle changes

My typical kind of breakfast nowadays

I believe that chemotherapy alone will not be able to treat cancer. There's also a need for a change in mindset, and with that, a change in lifestyle — especially in terms of diet. I think it is essential to feed your body the right way so that it remains strong and well-equipped enough to fight these nasty cells. Plus, it doesn't help that chemotherapy kills BOTH good and bad cells. So the more it is important for the body to get as much nutrients and anti-oxidants as possible to cope with the battle!

My parents and I have been reading quite a fair bit online. Cancer cells feed on certain sugars... so I've been staying away from artificially sweet food. It's a big change for me because I have a mega sweet tooth and I love my desserts! Thank god for natural sweeteners like honey and fruits which keep these sugar pangs at bay haha but of course, everything in moderation.

I've also learnt about the importance of organic food! Especially since my immune system is lower than normal, and with chemotherapy, I feel that I should limit the unnecessary chemicals going into my body as much as possible. I used to personally think that there was little need for organic food because we have been eating normal food our whole lives and our bodies should have adapted right? Plus it's so expensive here in Singapore! 

But after everything now... imagining the amount of chemicals and pesticides that go into our everyday food — it just isn't natural for our bodies to take in so much nasty stuff!

Realistically I don't think there is a need to have a 100% organic lifestyle. For me, I just believe that if you're eating something raw/juicing, it'll be good that the fruits and vegetables are organic so that you know that your body is absorbing all the wonderful nutrients without any compromise. 

And it doesn't stop at organic food! I've also switched to organic skincare — using Kora Organics by Miranda Kerr now. Pricey, but I think super worth it! My skin remains less shiny throughout the day and I haven't had pimples in the last 2 months! I read on the Kora Organics blog that an average woman puts at least 200 chemicals on her face everyday?! I think this is pretty accurate because I was looking at my other products and true enough... I did not recognize any ingredient (all chemical names) except for "aqua/water". 

Ok I sound like an organic maniac haha but for my case now I really don't want any more unwanted and unnecessary chemicals to be in my body. Also, chemotherapy has caused my skin to be extra sensitive and dry. Decided to try Kora Organics because y'know... look good to feel good! Hehe

Anyway I've been really blessed to have my dad and his friends flying to organic paradises like USA and Australia to buy organic produce for me. Because it's locally produced it's so much cheaper and easily available! LOOK AT THESE BEAUTIFUL CARROTS AND BEETROOT FROM AUSTRALIA!!!! The carrots look exactly like the kind that Bugs Bunny eats. Like WHUT?! Honestly I haven't seen carrots and beetroots being sold like this with their leaves in Singapore... ever. Felt like a citygal noob when my dad showed them to me. 

There are a couple of organic stores in Singapore that my parents have gone to as well. As an alternative to dairy milk, I've been drinking unsweetened almond milk (prefer it to soy milk). One carton costs $8?! Madness. But my mom bought 4 for me to try anyway. So glad to have found it on iHerb.com at half the price!! I have another 4 cartons on the way to Singapore now. Just bought another bunch of stuff as well — organic pasta, organic granola... It's a great site to buy healthier products. 

They seriously stock everything organic/gluten-free/vegan, and products range from groceries to household items! And the best part — shipping is only SGD4 for max 6kg worth of stuff! Plus there's $10 off for your first order, and an extra 10% if your order's >$40! You may use my referral code BJS904. Good things must share! (Thanks Clare for recommending this site to me!!)

Wow that was a lengthy post — but just thought I'd share on how things have changed for me. There are soooo many articles on how people have changed their lives drastically (e.g. no meat diet, juice-only diet) to cure cancer. So much information and perspectives it was quite overwhelming. But I strongly believe that every individual copes differently. It's good to have all these information on hand, and from there, adjust accordingly to make it work for yourself. 

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!