Day +507 : 500th days Journey

Today, I am fine.

I celebrated my 500th day post bone narrow transplant on Wednesday. We have a lunch , follow by a KARAOKE session.

My family, classmate, friends and colleagues have given tremendous support . Without them, it is impossible for me to make through this 500 days. I have my transplant done in 2008, I used the Day +1 as the first day of my transplant, this week marked 5ooth day of the process.

I would like to thank every one of you , supporting me in facing this challenging episode of life; my family, relatives, friends, classmates, friends, colleagues. 500th day only possible with your support.

Cheer !

Day +329 : Admission

Last week friday, I admitted to SJMC. I chose for admission due to severe cough and tired. I stayed for two days, and discharged on Sunday morning. Dr Alan giving me the IV antibiotic to clear the lung infections. TA and HS dropped by to visit me on the Friday Night.

Now, I am getting better, but physically still weak.

Day +292 : Follow up

I am fine today.Yesterday
I went to SMJC for follow up. The blood test resuts :

My bloods test results on 11 August.Readings in square bracket [] are result from previous test.
Haemoglobin (HB) = 14.4[14.4] (Normal 13-18)
Platelet = 138[126] (Normal 150-450)
Total White Blood Count (WBC) = 9.8[5.2] (Normal 4 - 11)

The total WBC reading elevated due to steroid drug - Prednisolone, which use to control GVHD. Last follow up, I complained the problem of breathless, Dr Alan have ordered me to do X Ray and lung test. The X ray on chest show normal heart size, no evidence of heart failure, no focal lung lesion. However the lung test confirm I have severe obstructive lung defect.

Dr Alan confirm this is due to GVHD in the lung. He said lung is the vital organ, have to monitor closely. He want the follow up on two weeks basic, instead of one month. He changed the drug. I used to take cyclosporin to control GVHD, the new drug called Prograf. The good new is I only need to take two tablet a day, instead of 6 tablet cyclosporin.

Besides Prograf, I also given Thalix 100mg. Previously I take it at alternative day. Now, the dose is daily. It cause drowsiness, I have a better sleep now.

Day +274 : Side effect of Prednisolon - steroid

I am fine today. I spent more time in the office now. Sometimes I spent whole day in the office. I am more actively involved in the daily business.

I have been taking steroid Prednisolon daily since my transplant as a measure to combat the GVHD. Currently the dosage rate has been reduce from 2 tablets to 1.5 tables per day.

• According to document on the Wikipedia, the side effects of Prednisolon includes:
  weight gain
  facial swelling
  depression, mania, or other psychiatric symptoms
  unusual fatigue or weakness
  Mental confusion/indecisiveness
  blurred vision
  abdominal pain
  peptic ulcer
  infections
  painful hips or shoulders
  osteoporosis
  acne breakouts
  insomnia (sleeping disorder)
  severe joint pain
  cateracts

Currently I have facial swelling and acne breakouts only

The doctor start reducing my Prednisolon dosage. It can be life-threatening to stop the drug abruptly especially for those who has taken it over a long period of time. Therefore, I would expect it will take months before I can stop taking this drug.

Day +260 : Dry Mouth

I am not feeling well today, My dry mouth have cause me a great problem in eating. I can only choose soft food. and also it irritate every I chew the food.

Dr Ala Teh told this is due to GVHD, and asked me to put cream to maintain the moisture. I hope the problem will settle down in the next few days or I think my weight will drop again.

Day +240 : Follow Up

I am fine today.

My Blood Count Today: 30 June 09
Readings in square bracket [] are result from previous test.
Compared to the result on 9, June 2009 –
Red Blood Count (HB) = 13.6[12.5] (Normal 13-18)
Platelet = 151[126] (Normal 150-450)
White Blood Count (WBC) = 8.9[6.2] (Normal 4 - 11)

The results is pretty good, in fact it is the best I have so far. Dr Alan have started to cut down the medicine , as the GVHD is settling down, he reduce cyclyosporin from 6 tablet to 5 table per day, and prednisolone from 2 tablet to 1.5 tablet a day.

Doctor said my cancer is stage 4, it is quite hard to cure, the most critical period is the first two years where the relapse chance is high, and declare cured after 5 years. Doctor said I am lucky in the sense I have match bone marrow from my sister, and undergo the transplant on the right time. ( I am in remission after the 7th chemo and immediately I did my bone marrow transplant). I cann't complain much, at least I have gain back my life at this moment, I don't suffering pain, I feel the life quality is getting better and better. 自足长乐

Day +230 : Happy Father's Day

昕怡，锦濠

作为你们的父亲，我感到非常骄傲。你们带给了我们很多的快乐。

Day +219 : Follow Up

I am fine today.

My Blood Count Today: 9 June 09
Readings in square bracket [] are result from previous test.
Compared to the result on 26, May 2009 –
Red Blood Count (HB) = 12.5[11.6] (Normal 13-18)
Platelet = 126[159] (Normal 150-450)
White Blood Count (WBC) = 6.5[4.7] (Normal 4 - 11)


The blood count results are considered OK . Dr Alan Teh said the drop in platelet was due to the GHVD, which is good to prevent re-lapse of the deasese. Now, I am not too particular about the test figure, the most important is I feel better. I still have to take the Ciclosporin, the immunosuppressant that was used to treat GVHD. I have started taking this drug after bone marrow transplant about 7 months ago

I asked for advise how to reduce the dumbness of my foot. Dr Alan recommend to eat more banana and oranges to increase the potassium level.

Day 207 : Follow Up

I am fine today.

Follow-up at SJMC on 26 May 09
My Blood Count Today:

Readings in square bracket [] are result from previous test.
Red Blood Count (HB) = 11.6[12.4] (Normal 13-18)

Platelet = 159[178] (Normal 150-450)

White Blood Count (WBC) = 4.7[4.7] (Normal 4 - 11)

All the blood count considered OK. For the HB, as the donor is from female, it is OK as long as HB above 11.5. The most important things is , physically I feel comfortable. Don't too particular about the figure.

The result of the transplant is a change of blood to my sister's in my body and since our immune system is provided by the blood as one of its functions, effectively, I got a brand new immune system. But the new immune system is not exactly the same as my sister's, so it may fails to recognize some of my organs and starts to attack them. This is what we called graft-versus-host disease (GVHD).

The main challenge after the bone marrow transplant is the management of GVHD. Whenever there is sign of GVHD, the patients' immune system have to be suppressed through certain medication to avoid organ damages. On the other hand, suppressing the immune system too much defeat the purposes of transplant as the immune system might become too weak to clear the remaining cancer cells in the body. Therefore, this is a game of balance. A good haematologist must be a good game player in this field.

I am "fortunate" enough to have GVHD, therefore, my immune system needs to be suppressed by taking immunosuppressive drugs such as Prednisolon (steroid) and Ciclosporin. With this, I found a very good and friendly reason to turn down any products that offer a boost to immune system.

Day +176 : SUSAN BOYLE

Photo : Susan Boyle


Teck Ann email us about this 48 years old woman SUSAN BOYLE sings "I DREAMED A DREAM" in a UK talent show . If you are tired of Jay Chou, Michael Jackson or Madonna, then try Susan Boyle. Frankly, I was impressed by her voice and courage. More than 10 million visitors viewed the video clip.


http://www.youtube.com/watch?v=9lp0IWv8QZY&feature=related

Day +172 : EPF

Today, I am fine.

Yesterday, I asked Boon Tiam drove me to EPF at Jalan Gasing at PJ to submit the form for medical withdrawal. The process is faster than I expected. Within half an hours we settled the application. The payment will be bank in directly into applicant 's account within 3 weeks times. We went for tea break at the famous Ipoh chicken rice at Jalan Gasing. We ordered steam kampug chicken, meal ball, oil rice ad grout beans. Usually Boon Tiam don't finish his portion, but this time I saw him clean the the whole plate. He said the food taste good and good customer service as well.

Last year, I did the same EPF application , but the bill was submitted later, that was during the bone marrow transplant. As I must avoid crowded area at least 3 months after the transplant to minimise the infections, Teck Ann help me submit the bill. EPF' staff is helpful.

Day + 155 : Condolences

My deepest condolences and heartfelt sympathies to Cheng Yoong and Family on the demise of their beloved father.

Day +154 : Still weak

I have not written any message in my blog for the whole last week. I am having a heavy cough, it make me weak and tired. My energy level is extremely low during morning times. Sometimes after breakfast, I will sleep from 10am to 1pm noon. The cough syrup always make me drowsy.

last week , Teck Ann accompanied me for the follow up. The lung is clear. The next follow up will be in two weeks times. Over the last 5 months, the follow up was on weekly basic.

My condition is improving, I feel better now.

Day +146 : Fever

I admitted to SJMC on last Sunday for high fever, 39.5C. Dr Alan said statistical show transplant patient used to get infections at 2 weeks interval. So , I am doing alright, as I only get once a month. I was discharged on Tuesday morning. This time the treatment is simple, Panadol 3 times a day + infusion of normal saline.
I am still recovering from the flu and cough. Hope the situation will improve in the next few days.
Chen Yoong 's father have stroke and currently still in Columbia Hospital. We pray for his father to get well soon.

+Day 137 : Namo Tassa Bhagavata

Today, I am fine. Getting better energy.

妈妈赠印一百本地藏菩萨本愿经， 祝我早日康复.

Let me know if you want a copy.

Day +135 : Visit

I feel better today, recovery from flu, the coughing is still persist.

Last Thursday, my colleagues, Johnny Chiou (Regional GM), Eddie Neo ( AP HR manager) , Tee and Ronald Wong drop by to visit me. Like to thanks for their caring and blessing. Grace staff from Singapore, Shanghai, Malaysia and Hong Kong have donated some fund for my on going follow up. Would like to thanks them individually when back to work.

Yesterday, I asked Teck Ann to accompany me for the weekly follow up, instead of driving myself. The blood counts drop as expected due to GVHD and flu. Dr Alan is OK with the results.

Day +130 : Coughing

Today coughing very frequent, and feel tired. I decided to see Dr. Alan today. Alan said my lip is getting too dry due to GVHD, prescribed me the Protopic Ointment. Alan also prescribed the new antibiotic.

Hope thing will get better in the next few days.

Day +128 : So far so good

I am well today. Now, I wake up even earlier, at 6am, to catch up the Chi Gong at Taman Wawasan. The event was organised by two auntie who had started since 1999. They start at 6:30am, with warm up exercise, follow by Tai Zi 24, Tai Zi 18 , 健身舞。We have the music accompany to these Chi Gong, the member able to follow the step more promptly. We will start learning the 太极伞子舞 next month.

I take part most of the activities, except the light dance, as the sun is getting out. Exposure to the sun can trigger chronic GVHD.

Day +127 : Follow Up

I am fine today. I have a follow up today, and this is the first time I drive myself to SJMC since my first Chemo March 08.

The blood count on 10 March 09:
Haemoglobin : 11 ( Nortmal 13 to 18)
Platelets : 131 ( Normal 150 - 400)
Total WBC : 4.8 ( Normal 4 to 11)

Overall the results is about the same compared to last week. This few days, I am doing more exercise, this may be the reason Haemoglobin raise. I have gain weight from 47kg to 48kg. I have asked Dr Alan Can I back to work by May, the answer is Yes. Alan said generally patient able resume work after 6 months.

I visited Hiap Soon's father at SJMC this afternoon. His father had recovered speedy from very minor stroke, discharged today. His doctor have asked a dietitian Ms Bee to explain how to lower down the cholesterol. It is very useful information. To control our cholesterol, eat more vege, more fruit, less meat, less egg, less sugar ( all cholesterol come from animal meat), Regular exercise and quite smoking.

Day +122 : Tai Zhi at Taman Wawasan

I am fine today. Yesterday Hiap Soon and Teck Ann drop by. Hiap Soon brought me Wisley series book.

This morning, I started to learn Tai Zhi at Taman Wawasan. the activities was organised by the local community. member required to pay RM5 per month. Start from 6:30am to 8:30am. They also teach light dance. I quite enjoy doing exercise here. However my current energy can't allow me to attend the full course.