9-11 Jan 2018 ~ 9 Jan

It's easy to slip into having too many thoughts, too busy distracting oneself and letting go writing here.

9 Jan 2018

The day that should be significant as every 'check-up' usually is. Somehow, time passed and despite my original intent, I reached late by 3 minutes. I note this visit was not like previous, in that I would get calls the day before confirming that I would be coming, and even 15 minutes before the appointment. So the lack of persistent reminders was missed.

I gradually saw Prof Low about 1230. Chicken Soup series on Cats was a good way to keep occupied on mrt and waiting. Many thanks to Gerlynn. I also fix my mind on lunch thereafter with Sean and Lakshmi. When Sean visited on 30 Dec, I mentioned this appointment. Both of them happened to be attached at nuh and he remembered the date. I appreciated that and messaged me yesterday to have lunch together. Sometimes in teaching, you never know which student would be the one that after years passed, remember you and stretch out a compassionate hand. Lakshmi and Visha, Sean....they have actually been a comfort over these past 17 months.

With Prof Low, its basically a conversation. Without any diagnosis data, all is a standstill, as I expected. It was a good conversation. He says he respect my decision, to have things as natural as possible. I think he actually recorded that down from the previous appointment. For those are my very words. He did not make any negative statements of my decision. Remain objective in that statistics are arrived by data from a large group of people. No one knows if they are in the majority or minority. As to symptoms, there are those that do not have significant symptoms. Survival outcome, possible 1 to 2 years. Abdominal colic issue, watch what is eaten. Avoid hard fibre. In my case, it was that chunk of kwei teow taken over too short a time, at least too short for me. I am used now to stretching eating even to hours, not that I was ever the fastest eater. I would rather not eat. I asked if I could see him if I needed to, and he replied, I may not be here. My records are there, I can see any consultants. When urgent, there is A and E. He did try to say if he was, he would see me. Somehow I sensed he was more pensive. I asked if he thought I was unwise. He replied that everyone has their reasons for their decisions, and no one can say which is better. Statistically, it does say, the treatment plan offers a longer survival outcome, but it is not absolute. He gave the analogy of heavy smokers. Statistically, many of these get lung cancer. But there are those that would boast that despite being heavy smokers, they are free from it. The minority. But who knows who is in the minority. I did prefer to have a date set for next appointment, in 3, 4 months time? But even as I asked, i know all is too iffy. He asked what for, it would just be for a chat. He had earlier saw why I declined to do another ct scan within 6 months after having already two in June and Sept respectively. I asked any point in doing ca marker. To which he asked whatever the result, would that change your course of action? These diagnostic tests would only be useful if i intend to change my course of action and if not, radiation from ct scan is not without some negative impact on the body. Actually all that he said was what that I had arrived at months ago. I credit him for being neither positive, nor negative, neither discouraging or encouraging. Few can remain so neutral. The doc at kk always had a smugness about him somehow, and like to talk about the many cancerous scenarios. One would not know much of Prof Low's experience safe that he must be, being both head and by his age and credentials online. I have this feeling I wont see him again at nuh. He gave me an open date appointment. I asked if palliative care support would be there, he said yes. When should I see them again? When all that I have done now, diet, tcm etc is not working anymore and pain, discomfort cannot sustain normal living. Usually abdominal discomfort. He did not elaborate beyond bloatedness and constipation. This made him better than the kk doc. Conspicuously, he said twice, no one knows. Only God knows. I respect him for acknowledging that.

I walked out of the clinic, feeling like crying. It feels like finalising a divorce. I have been walking this path, and by not going for the recommended treatment, this has got to be the outcome. It is almost like finalising a divorce paper. My aversion to the ways of treatment in modern medical sciences and much vaunted researches claim of success could not but lead to this. Holding on to appointments for a kind of 'security' when in actuality, I could not go along with it is really a farce. And the truth is, recurrent ovarian cancer is not curable. Treatable, but survival outcome could be lenghened/shortened by treatments with corresponding side effects that is part of the package.

I felt like a string cut off, and as one floating in the air. Its not that I am now totally cast onto the Lord. Whatever course I take, I am cast onto the Lord. He has been my stay, my staff, my guide, my comfort. I did not take this path without feeling that this is the way for me.

Prof Low also said, whatever is suited for me may not be for others. This, I have always known to. My constitution is extremely sensitive and actually frail. I have never been one that feels in good health. Ironically, there had been times even over the past months, that I felt healthy. I just knew for myself, the hospital setting is not for me. If I have to go through, I will grit my teeth and do so, as I did in my last operation. I am fully aware that every path chosen has its cost. And for mine, it may mean lesser days. But, I cannot envisage that a longer timeframe means a much longer stay at hospital, the corresponding pain from the surgery etc, and a continual chemo treatment till it no longer works....I cannot face that.

If I live past these months and managed to cross 2018, I give thanks to God. No, I do not want to prove anyone right or wrong. Seriously, whilst I may have preferences, I have learnt to respect every doctor. The arduous training they go through, the high demands of their job, the pain and suffering they see, and they being human, their errors, misjudgment are very costly. Its all so easy to make criticisms because we do not like what we hear, but actually its not their fault that our bodies are afflicted with illnesses. Of course, as in every situation, the personal touch makes the difference. But do we have it in all we do?  I have nothing but thanks for their taking time to see me.

Tcm has maximise my personal 'strength', for nature to take its course. I somehow feel I have also reached optimum here. I will keep up, for maintenance. Zh also seemed to reach the end of the road with encouraging me. He had always stressed any way that my own frame of mind is important. He is tired himself.

Yes, I am planning toward going to UK. Not to prove the other Prof wrong. He meant well. In October, I did look a wreck. I have since progressed well. The lurking discomforts are there. I take my food conscientiously, treating each meal as a duty, my medication to fight the continual battle within. Tcm has helped secure better sleep pattern and bowel regularity. I kept up 3 km walk almost daily. I realised how much teaching 2nd sem last year had helped me. This lack of direction each day I have to fight. The good thing is it does give me time for miscellaneous. But too much time for the mind to meander into melancholic grounds.

It was good to meet S and L for lunch. I did feel bad thereafter cos coming from the clinic with all my thoughts, I just shared what was in my mind. Usually, I would be able to couch it better with afterthoughts. Nevertheless, it was good company. I did send my apologies and both graciously remain kind and patient. Before we parted, I asked them to always remember 20 Jan. I do not know how many 20 Jan I will pass through. But as long as I can, I would always want to remember the boy that was so lost, he chose to lose his life 6 years ago. I do not want him to be forgotten. I hope his classmates wont.  Every child is important. I am glad both of them understood even without my explaining. In fact, S remembered so many things I said/ posted that he had read. I am gratified.

I thought of cancelling tcm thereafter, but decide not to change based on mood. I admit I also was uncertain what zh comments would be. He was for keeping up continual appointment. Whilst he could not possibly understand the wealth of thought within my mind, he did see the sense in what Prof Low said and respected him for being forthright. That is zh strength. He is able to grasp key points (when he is not in a low mood) and succinctly expressed his own. That was what that I admire him most for. He seemed pleased that I said I would be going UK in June, and that he would also confirm their dates.

Family dinner was the way it always were. sk asked, and I just said I was given open date to go as and when I want. I guess there is no point talking about all my fears and thoughts.

So 9 Jan is an eventful day without events.