Day +115

I am fine today. Now continue my story at UH…

It was coincidence that my eldest sister came from Kuching, Sarawak on that night. She is a government school teacher teaching in Chinese primary school and she took half-paid leave to come here. I thanked God that she came at the best time because I needed most help during fever. My wife was about seven and half months pregnant at that time, so she could not stayed in the hospital overnight to take care of me. Since the nurses have to look after many patients, to have someone to lend a hand during fever is really helpful. She stayed in the hospital day and night to take care of me.

On 6 March 2006 (Day 15), my creatinine level in the blood reached 165 µmole/L, which is way above the normal level of 121 µmole/L. This reading serves as an alarm that my kidney function was degrading. Because of this, the doctor replaced the anti-fungus drug Amphoteracin B with Cancidas which has much fewer side effects compared to Amphoteracin B. I did not have to be given sleeping drugs before receiving it and it took only one hour to complete a dose. The creatinine level also dropped to normal level after a few days. However, the drug was not without side effect. The biggest side effect was it made me poorer because it was so expensive. The first dose which was called loading dose cost me RM1000 and the subsequent dose cost RM785 each.

I was discharged on 13 March 2006 (Day 22) and I stayed in the ward for 27 days. I managed to compete the very long novel “天龙八部”(The Demi Gods and Semi Devils) by Jinyong (金庸). During the period I was also given intravenous antibiotic called Tazocin, a few platelets and red blood transfusion, potassium infusion and other drugs. I also experienced water retention which made my stomach looked like a pregnant woman :-(

Since then, I never stopp taking anti-fungus medication until now. Initially I was given expensive drug called Sporanox in liquid form. After the bone marrow transplant, I take a less expensive and less effective Sporanox pill.

See you next post :-)

Day +114

I am fine today. Now continue my story at UH…

On Day 12, my blood’s creatinine level rose to 137 µmole/L. The normal range should be somewhere between 50 and 121 µmole/L. Creatinine is a chemical waste produced from muscle metabolism. The kidney filtered it out from the blood stream and disposes it through urine. A high level of creatinine in blood indicates that the kidney is not functioning properly. The high level of creatinine level in my blood showed that my kidney function had been affected by Amphoteracin B.

I experienced fever on 4 March 2006 (Day 13). This was within my expectation because based on my experience, fever would normally occur on someday between Day 13 and Day 16. In the evening on that day when I just about to feel the “heat of fever”, I complained to one of the nurses who came to administer drug to me, “Susahlah saya berdemam lagi” (It is unfortunate for me to have fever again). The nurse was so kind to offer me a more isolated room which was partitioned for two beds with a common access door. Each partition has its own attached bath room and more importantly, patient could limit the visitors to avoid visitor-carried infection.

The ward supposed to limit the number of visitors because many patients were having very low immunity. Thus unhealthy visitors can easily spread diseases to the patients in the ward. Considering the risk of infection of myself and other patients, I declined many visitors during my chemotherapy. However, I was once “amazed” to see a total of 15 visitors coming to the ward at the same time to visit a patient. Due to reasons unknown to me, the ward failed to limit the number of visitors even though the staffs tried to do it.

After the nurse put me to sleep to receive Amphoteracin B at about 8:30pm, they moved me and all my belongings to the isolated room.

See you next post :-)

Day +113

I am fine today. Now continue my story at UH…

After a worry-full night, I returned to the same operation table and felt even more worried to find out that the same radiologist was going to fix the line for me. “How come she becomes her own teacher today? How could she learn from herself?” but I dared not question her. The only thing that I could do was to pray, to recite Bible verses and to shiver harder.

The PICC line was successfully inserted only after three attempts. This added another two holes on my right arm :-( The radiologist encountered the same problem while trying to fix the PICC head. After many attempts, another radiologist came to help, but failed to insert the head either. Finally, a more experienced radiologist took over the procedure. Fortunately, she managed to push in the head in the end. A half an hour procedure took one and half hour to finish. What a procedure!

When I returned to the ward, I raised both arms proudly to show the nurses the new and old PICC lines. Indeed I was the only one who had two PICC lines at that time. The old PICC line on my left arm would only be removed if the new one could perform well. I encountered many patients experienced inflammation, leaking and blocked or punctured PICC line just a few days after the line was fixed. The line had to be removed if patients experienced these problems. Fortunately, the new PICC line worked well and the left PICC line was removed on 3 March 2006 (Day 12) after serving me for about 3 months.

See you next post :-)

Day +112

I am fine today. Now continue my story at UH…

Just after I was admitted to the ward, I informed the hematologist who treated me in Kuching that I was infected with Aspergillus fungus. He warned me that the treatment could be tedious and my PICC line might need to be removed as part of the treatment. As mentioned in my Day +57 blog, this PICC was installed on my left arm after much difficulty during my first chemotherapy in NMSC, Kuching. The removal was necessary in case the fungus infection was caused by fungus growing in the PICC line.

After a few days I received the warning, the chief hematologist in UH “demanded” my PICC line be removed. The appointment to install a new PICC line was fixed on the afternoon of 1 March 2006 (Day 10). I was very nervous to go through this procedure due to my bad experience while installing the first PICC. I was shivering, praying and reciting Bible verses on the operation table while the radiologist inserting the line into my right arm. I experienced great pain initially. The radiologist said the pain could be due to blood clot in the vein. And I believed that the clot might be resulted from the failed attempt to fix the PICC line on my right arm during my first chemotherapy.

In the end, the radiologist managed to put the PICC line in place. When I was just about to feel relieved, the radiologist told me she experienced difficulty to fix PICC head into my arm. She said my skin became very tough after chemotherapy. The procedure was finally abandoned after many attempts, even with different types of head. She said she will ask her teacher to fix the line for me early in the morning the next day. Only then I realized that the radiologist was a student who was learning to fix the PICC line :-(

See you next post :-)

Day +111

I am fine today. I would like to continue sharing my third chemotherapy experience at UH.

My chemotherapy was completed in the morning of 24 February 2005 (Day 5) and as usual, I had to wait for the blood count to drop and then pick up again before I could be discharged. Since it is almost impossible to avoid fever when the white blood count dropped to a level almost equal to zero, we always tell people that we were “waiting for fever” after completing the chemo drug.

A CT scan was performed on Day 8 to check the condition of my chest and abdominal region. This scan was necessary to check whether my lung and other organs such as kidney and intestines were infected with fungus. I was asked to fast after the breakfast. The doctor set up an intravenous line on my hand for the injection of a solution into my vein. According to the nurse, the PICC could not be used for this purpose because the solution was too thick to be administered through the PICC and it might block the PICC line. Just before the scan was carried out, the nurse asked me to drink a glass of yellowish solution. I was happy because I thought the nurse “belanja” (treats) me with nice orange juice, but I was nearly vomit on the spot as the drink tasted like iodine solution. :-( In the end, they asked me to lie down on a table-like structure, hold my breath, and then let a big noisy rotating cylinder run across it. When I returned to the ward, I vomited and experienced stomach upset. Of course, I had no appetite to eat any food on that day.

It was very fortunate that the CT scan result showed no sign of fungus infection; or else I might need to be treated with Amphoteracin B for three months.

The doctor also started to give Neupogen (growth factor) injection to me on Day 8, hoping that it would stimulate my bone marrow to produce white blood cells faster.

See you next post :-)

Day +110

I am fine today. I would like to continue sharing my third chemotherapy experience at UH.

I developed fever, cold and chill on 16, February 2006, one day after I received Amphoteracin B. The nurse told me this could be due to reaction to the drug and it should be alright if the fever did not persist.

I planned to enjoy reading a novel called “天龙八部”(The Demi Gods and Semi Devils), which is written by Jinyong (金庸). This novel is very long, but I could not make much progress because I was sleepy all day long.

My third round of chemotherapy started on 20, February 2006 (Day 1). The first two rounds of chemotherapy were called induction chemotherapy. If a patient managed to enter complete remission after the induction chemotherapy, he/she will be given a few rounds of consolidation chemotherapies which uses two types of drug called VP16(Etopside) and Ara-C over a duration of four days. VP16 was given once a day and each dose took one hour to finish, while Ara-C was given twice a day with each dose took three hours to finish.

During the first 4 days of chemotherapy, I was very busy receiving different types of drug. You might think that those who were busy should be the nurses, not me because they had to prepare and administer drug to me. Yes, I supposed to relax but I worried bubbles generated within the plastic tube would go into my vein which would result bubbles in my blood stream. These bubbles might be generated when the drug reacted with the plastic. So I had to “jaga” (monitor) all tubes that were connected to my PICC. If I spotted bubbles inside them, I would knock them off immediately before they went into my vein. I am now as good as the nurse in knocking off the bubbles :-)

See you next post :-)

Day +109

The doctor told me that the blood culture of blood sample taken on 23rd, January 2006 grew a type of fungus called Aspergillus. They were going to give me a type of drug called Amphoteracine B for four to six weeks. The drug could cause reactions such as chill, cold and fever. I was given a test dose in the afternoon to see if I could “tahan” (stand) the drug and I passed the test.

The first real dose of Amphoteracin B started at 8:00pm. The nurse mixed the drug in a 500ml normal saline solution. The resulting solution was yellowish in color and it was covered with a black envelop to prevent exposure to light. The solution was then administered to the patient intravenously through a flow control machine. The nurse would adjust the flow to 30ml per hour first. The speed was then gradually increased to a maximum of 100ml per hour if there was no reaction. They found out that I could tolerate the maximum speed, so it took about 5 to 6 hours to complete a dose of the drug.

The nurse gave two type of “sleeping” drugs called Pethidine and Phenergen through injection before giving Amphoteracin B. These two drugs made me relax instantly and sleep quickly. An auntie who was taking care of her daughter next to my bed told me how powerful these “sleeping” drugs are. She said a patient who received the drugs would fall to sleep before she counted to 10. One night, she complained that she could not sleep. “Ask the nurse to give you Pethidine and Phenergen and let me count for you this time.” I advised her :-)

See you next post.

Day +108

I am fine today. I would like to continue sharing with you my treatment at UH.

As mentioned on my blog Day +91, I was discharged from the hematology ward after second chemotherapy on 1st, February 2006. The doctor did my third Bone Marrow Aspiration (BMA) on 16, February 2006 and scheduled to start the third chemotherapy on 16th, February 2006.

It was important for me to hand over my work to other staffs to make sure that the software development project that we were embarking on will continue smoothly. Therefore I went to work occasionally while waiting for the next round of chemotherapy to start.

While I was busy in the office on the morning of 15, February 2006, the clerk of the hematology ward called me and informed me that the doctor would like to admit me to the ward immediately. I could sense that something was wrong because they used to delay the admission for chemotherapy due to unavailability of bed, but now they wanted to admit me earlier. Why couldn’t they just wait for one day? Anyway, I am a good guy (?), I just “obeyed”, stopped my work, packed my stuffs and went to hospital immediately.

See you next post.