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As soon as we arrived at Gleneagles Parkway Cancer Center, I immediately handed my appointment card to the friendly nurse, hit the weight scale, and rushed to get to my favorite seat in the Day Ward. Not long before I took off my jacket, a nurse was ready to withdraw my blood (from the catheter) for a Full Blood Count check. 

When the tube was filled with enough blood, my sister rushed it to the lab for an immediate check and result. And then there was the waiting game again. I made my seating arrangement as comfy as possible for I was sure that today would be the day.

15 minutes later, Doctor Teo came to visit me with his big smile. Sure enough I knew something good was happening, only it was not going to take place this day. Anyway, the WBC has gone down a bit. Yesterday was 0.3, today was 0.25, so there would be a good chance tomorrow would be lower. Therefore we decided to look what tomorrow has to offer to my condition.

Before we parted, he asked me about the Sop Buntut. And I said,” don’t worry doc, I finished 2 portions yesterday.”

 

 

 

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Arrived at the hospital this morning at 8.45AM, and went straight for a blood test, I was eager to see the doctor and have the transplant done by today. However, that’s not the case for today.

But I was glad to find the blood result. Just as I expected. The chemo drugs still have good effect and that the White Blood Count was even lower. Doctor expected that by today it would have been .5 or .4 before he’s gonna do the transplant. But since this morning’s WBC was at .3 (the lower the better to minimize the chance of complication), I was in agreement with the doctor that we both should wait until tomorrow, hoping that Tuesday’s WBC would even be lower or reach 0.1.

So for today, according to my doctor, my main responsibilities are: eat much more (I’ve lost 3 kgs since I got here, now I’m only 72Kg), drink lots of milk, especially chocolate milk, drink lots of fruit juice, eat lots of boiled eggs (the white part only), stay clean and germ-free as much as possible to avoid unnecessary infection. One of his advice that was supposed to be the best one (for normal person) was when he told me to eat more of red meat. Well-cooked red meat. He said it’s good for blood reproduction. The funny thing was he mentioned to me this word specifically,” eat sop buntut lah…. it’s very good”.

I just wished I had the appetite doctor…..

 

 

 

 

Phew…. finally all the chemo and conditioning stage are done. I must admit that the final chemo day was the toughest one, especially the part in which I had to balance the amount of fluid intake and output. 8 liters went in and they said they wouldn’t let me go home before I had an 8 liters of urine out of my body. Thank God everything went well.

The final chemo was commenced today (Apr 25) at exactly 9AM and we finished at 5.00 PM. But few minutes before I was discharged, my wife Linda, and kids were there already. O how much I missed them already. 

Friday’s blood test showed that my HB was only at 7.9, doctor told me to come in the next day (Saturday, Apr 26) to get blood transfusion. So there I was again, on Saturday morning at 8.45AM, preparing myself for a ‘bloody business’. And sure enough, after drinking 750 cc of blood, I was energized enough to participate in a 10K run.

Doctor Teo came to see me before I went home, saying there might be a good chance that the transplant would take place on Monday (Apr 28 ) but that decision would have to wait until they see my blood test result on Monday morning. On Saturday, the white blood count was at 0.9. They’re hoping that by Monday morning it would have been lower to around 0.5 or 0.4, in which they feel good and ready for the transplant. I personally hope it would be lower than 0.4 by Monday, even though on the other side, I recognize the danger for my body being in that stage. But hey…. anything less than 0.5 is considered to be ZERO, so let’s just get it on.

It’s time to put on my mask … 24 hrs/day

 

 

Time flies fast huh…! Before you realize it, I’m almost done with my chemo, Thank God. The past 3 days have been quite a boring routine for me, you know, got to the hospital at 9AM, done at 11.30AM, went straight home. But I’m grateful that I’ve been able to go through the treatment so far without any difficulties or side-effects which usually haunt every patient undergoing chemotherapy.

Doctor and nurses said the first 4 days would usually be the easy part. However, tomorrow is the real deal. Here’s a sneak preview of what’s going to happen; come in at 8.30AM, do a complete blood test prior to chemo (just in case I need blood transfusion), body weight check (for final adjustment on the drugs volume to be given to me), more oral medicines to take and any other last-minute check ups. 

Roughly about 6 liters of liquid (mostly chemo drugs) will be administered to me tomorrow as the final chemo day. They will monitor very closely on the liquid volume that goes in and out of my body.

It’s going to be a whole-day process and they said that I would feel really tired and weak by the end of the day. Well, let’s bring it on. After all, tomorrow noon my wife n kids will be arriving in Singapore and would go straight to visit me. So, the day they apply great destructive force to my body, just happens to be the same day when my reinforcement of joy and happiness come. Coincidence…??? No way lah!!!

Judging from the oral medicines and pre-medications I’d have to take tomorrow morning, I just know tomorrow is the real heavy stuff. What worries me a bit is they will administer drugs whose side-effects I’ve not come to know yet. The doctor has used them several times of course, it’s just in my repertoire yet. But hey, I guess I’ll pray even harder and hit the bed much earlier tonight so I can have more energy.

Matthew 6:34 (NIV); Therefore do not worry about tomorrow, for tomorrow will worry about itself. Each day has enough trouble of its own.

 

That’s exactly what I felt on Monday morning (Apr 21) as my cousin’s car was about to find a parking spot at Gleneagles Hospital. It took us extra long to get to the hospital that morning as there was a little accident in the highway plus the hard rain surely slowed people down. The appointment was 8.30AM and we made it just in time. Having experienced the process for several times before had somehow made me very calm. In fact I was so eager to get it all done ASAP.

I went in straight to their procedure room (it’s actually a big hall separated with partitions so they can accommodate 10 patients at the same time). After picking my favorite spot, took off my shirt, lying down on a cold leather mattress, I began to try to get a short nap while waiting for the doctor to install the catheter. My brother Jacob was about to get some pictures of me, but as soon as he got the camera out, the nurse said,” no picture please. There’s going to be a procedure on him, so please wait outside haa…”.

The doctor came in with a big smile and asked me,” have you had a catheter installed on you before?” I pulled down my blanket to reveal the scars I had from previous catheter while saying,” too many times doctor….too many times already. Let’s hope this is the last time.”

Before long, he finished the job perfectly. I couldn’t help but to compare his work with my previous procedures, and this guy by far has beaten the work of more senior Indonesian doctors, in terms of speed, smoothness, tidiness, and practically pain-free.

I thought I’d get the chemo right away, but since I was coughing a little when I came in, doctors wanted me to have an X-ray and some blood test first. So it was a delay of about 1 hour which we used to get brunch.

As soon as I finished my food, we went back to the centre only to find that they were ready to start the chemo on me. Thank God X-ray and blood test results were very good. As the chemo drugs (yes…there are 4 items) were administered to me, they went thru the detail of everything, and I mean literally everything. Which of course made me bored and sleepy as I’ve known most of them, but since it is the procedure, I let them continue and tried to stay focus on what they’re saying.

It took about 1,5 hours to get the chemo process done. Good thing the sofa is nice (kind of a Lazy-Boy type) and I get to enjoy personal TV. But this time, because not so many patients and nurses were around, we’re able to get pictures from my cell-phone.

Time to pack-up and go home.

And all the nurses said,” bye Doodoh…..see you tomorrow morning at 9.”

 

Ready, Set, Success.

It is a very normal situation for those who have never been admitted to an Operating Room / Theatre in their lives before, to have fears, worries, anxiety and other uncomfortable feelings. My sister Rina was no exception despite her strong determination to give her healthy stem cells to me.

At precisely 6.00 AM, Singapore time (Apr.19) we arrived at Gleneagles Hospital. (My cousin picked us up at 5.40 AM). We immediately went to the Admission to take care of all necessary paperwork and upfront payment. Good thing we still had ample time for my sister to get a quick rest and final check-ups prior to being taken to the OT. We tried to use this 45-minute time period as best as we could (we’re not allowed to enter the OT) to support her spirit, cheer her up and get her attention away from the process she was about to experience. Why we did this to her? Because even though she said nothing to me, or managed to conceal her feelings, her blood pressure measurement told me everything that’s going on in her head and heart. But again, like I said in the beginning, everybody, including veteran like myself, would have worries and anxiety. Even the nurse said,” in my entire life, I’ve never seen a person who has not worried at this stage”.

Before they begun to push the bed, I told my sister that she’d be okay, and that nothing to worry about. While trying to muster a smile, she said,” wish me luck”. I just smiled back and said nothing to her. But in my heart, I was saying to myself,” no, you don’t need luck, your operation has been guaranteed by God to be a smooth and successful one. Nothing can harm you or jeopardize the process”.

Why did I have such confident? Simply because all of our family members, friends and even you have been praying for the whole process.

The process turned out to be a very quick and smooth one. Doctor Teo only needed exactly 30 minutes to finish it off. He came to us to say that my sister was okay, and that he managed to extract 2 full bags. He was extremely happy with the volume extracted, it’s just that we had to wait for several days before they’d be able to know the exact counts of stem cells that were collected during the extraction.

I told you it’s going to be okay, didn’t I?

We had to wait another hour in front of the OT before my sis could recover from her ‘deep sleep’

So what exactly did we do during those waiting hours in front of the OT?

We talked about Indonesian government and its policies (what…??? At 7.30 AM???…), hot gossips, we commented on patients, nurses and doctors who passed us by, and we even played SUDOKU at our cell-phones. In short, we’re having fun lah…!!!

What happened to my brother-in-law Jacob? Well, he took some pictures of us and then slept thru the whole process. He needed that because he’s the care-taker of us all while in Singapore.

After my sis has been placed in recovery room, we all went to the food court at the hospital lobby to get our brunch. We then went upstairs again only to find that my sis had finished her hot Milo and small serving of bread. Didn’t matter to us, as long as she got her consciousness back. Slowly she’s able to sit upright from her bed, then at a regular chair and finally walk on the hospital isle. Great, she’s good to go then.

At about 11.30 AM, she was discharged from the hospital.

We went to the food court again because she was thirsty and hungry. How else would you feel after a 7 hour fasting (prior to the operation) and after almost 800 CC of your blood sucked out? So she had a fresh apple and carrot juice plus (not so delicious) Chicken Rice. But it was enough for her.

So her part is done. She has reached the finish line successfully.

Next is my turn……

 

How exactly do you extract someone’s stem cell from the body? It’s easy to answer but tough to explain, especially to people who are not used to medical terms. What makes it harder to explain is because, even up until now, this is still quite a rare topic for people to discuss. 

In a nut shell, the process is similar to any blood donor activity, however, there are several ways to get this done. First and the most simple one is thru our vein. Very small amounts of stem cells are available in our vein. We can extract the stem cell with exactly the same process as regular blood donor. I heard the medical term for this process is PBSC (Peripheral Blood Stem Cell). This may be the most preferred way to donor your stem cell, however, this is NOT the way doctors want to collect them. They always want to be able to get the most stem cells available from each donor within a single extraction process, and to achieve that, doctors always go to the source…..bone marrow.

Bone marrow is like the factory of stem cells, so whenever you tap into the main source, you are guaranteed to get abundant supply. And since in every Bone Marrow Transplant (a.k.a Stem Cell Transplant) you need both quality and quantity of the stem cells, heading straight to bone marrow seems to be way to go. I’ve also heard that you can go for the hip bone. But either way, it’s a fast but a bit painful process for the donor.

From preparation to the finish line, doctors would only need 1 hour max. Most donors will be put under general anaesthesia if the cells are to be extracted from the bone marrow. Why? because when they start to suck your blood out, you will not be able to withstand the pain. If they extract only 10 cc, then you can survive (I’ve been there before several times), more than that, your scream will wake people up from 5 blocks away. My doctor say that he will extract maximum of 800 cc of my sister’s blood.

Ok…. enough with medical terms. Now what’s happened to my sister Rina lately?

Since last Tuesday (Apr. 15), after the blood test declared that she’s virus free, HIV free, Hepatitis free (Thank you Jesus), she’s been taking few oral medicines as well as Nepogen. Nepogen is a medicine which promotes your marrow to produce much more stem cell, however it is not administered orally. It must be injected under your skin. She needs to take 5 Nepogen prior to extraction, each with 12 hour interval. As this writing is made, she has 1 injection left to go. Doctor also said that her marrow, based on the test result, was in a very very healthy condition. (Coincidence? I call that grace from God)

Tomorrow early morning at precisely 7.30 AM (Singapore time – Apr. 19), she will be admitted to Gleneagles Operating Theater for the extraction. It would be a 1-hour process, but overall she would have to stay in the hospital for 4 hours before being safely discharged.

Any sign of hesitation, fear, doubt from my sister? Not a bit. She’s one tough individual. Doctor has previously explained in detail to us of the whole process, including how huge the needle is…. (you won’t believe how big and long that needle is), but again, she is one very determined and focus donor, she’s a strong woman, and above all……… she is my sister. She has made the whole family proud by knowing that she has made any necessary preparation and disciplined herself from the day she was declared to be a perfect match for me.

What has been the driving force behind all of her actions? Simply….. love. You can call it family love, a sister love, or whatever it is, for me, basically it is love. Love conquers all, right?

Everybody has been praying for her process tomorrow. We are more than confident that everything will be okay and smooth. God is with us.