Wonderfull weekend

Is a very happy weekend.

Got my Sony NEX 5ND at a very good offer, from Boeing Photo, Sg Wang. Twin lens at only RM2599. Sony is selling at RM2999.

Then later on, got my long awaited jeans from Jaya Jeans, Sg Wang too. Unexpected 5 stars services from the sales and boss. I always feel difficult to get my ideal jeans due to the size and cutting. And, I am reluctant to walk into Levis shop due to their unfriendly services. Most of the sales there are not capable to recommend or advice you on the style and models. This sales guy from Java Jeans, has brought me around 10 pair of jeans in different sizes and styles. When I am still trying or just step out from the dress room, he will further take me another style or size to try on again. He is so helpful! Even the boss also a very kind person. The boss order for immediate alteration on the waist even it is only half inch extra. Highly recommended this place if you are looking for jeans!

Sad dream again and again

Like what was happened in the past, again and again, was wake up due to a sad dream...

~
Rushing in sending mother and mother's friends home in several dark nights. After sent, I am walking down alone in dark staircases and driving in the dark roads with fears.

One night after home, policemen come to my door. Wanted to log my statements for a criminal case. Which initially I thought I am not involved in the case, but just there to assist. They found the devices (similar to credit card swiping device) from my house. Which these devices belong to my neighbour, Uncle Loh. I had borrowed these devices from him few days ago. Dunno what reason. And Uncle Loh also promise will tell policemen the truth 1 night before policemen came, which, the devices are not mine, and is someone else doing the illegal work. From their face, I know they are suspecting me when they found the devices. I feel the nervous then and look at uncle. But uncle keep silence this time and didnt realised his promise. I was too nervous, fear and cry...

~
Woke up in the early morning and start work...

Confirm is Dermoid, and not cancerous

Was pushed into operation room at 3.30PM, and was awake around 6.30PM.

When I am still blur, and out of operation room, Dr told me that, operation is smooth and have the cyst removed!

It is confirm a dermoid, because it contains hair in it. Anyway, report will only be out after 1 week time.

I have the picture of the removed dermoid, and the operation video. if any of you interested to watch, can let me know, I can share it out. Just dont wish to post them here as they are quite disgusting if you are not brave enough.

Confusing

This round, dr make me feel very confuse, remove or not to remove.

When I reached clinic at 9AM, I am the second patient in the queue. When dr meet me, dr did endovaginal scan on me.

But again, he could not found the cyst in my right ovary. And I did not expect that will be a scan today, therefore I had my breakfast before the appointment. I can see at Dr's face that he is very confuse and tense too. He explained to me, that he doesn't wanna cut me then found nothing.

I suggested to dr that, let me try to pass everything out (toilet) and we try a  second scan.

After half an hour, I go back to see dr. Dr again did scan on me, and again the same result! Cannot found the cyst. The left ovary is very clear in the picture, while the right ovary is in blur image and cant really see the cyst.

Dr has no choice, but explain to me, that he doesn't wan't to take the risk to operate and found nothing in my right ovary. I told dr, i believe the cyst is there, is confirm there. Yes, I believe. I have been seeing so many drs and i know there are difficulties in finding the cyst and must have some skills. Dr then suggested me 2 options just to confirm the existance of the cyst, 1) do a MRI check, 2) get another dr who is more experienced / professional in doing ultrasound to conduct a scan for me.

I refuse to both options. As i really believe the cyst is there. I told dr that in my CT scan early of this year, it is stated there a cyst is found in my right ovary. And only 2 weeks ago, i had met 3 drs (inclusive this dr), and all confirm cyst is there.

Dr then request to have a look at the CT scan report. But, suddenly, he was being called out to help his patient for delivery. After about 1 hour, dr came back, and meet me again.

With the CT scan report and the image he took from last 2 weeks on my right ovary, he commented that, it is most likely a dermoid, and only 5-10% can be cancerous. He said, "you can leave it and have it monitor." I was shocked!! I told dr, that he also suggested me to remove it 2 weeks ago, as other drs did. After a few seconds he keep silence, then he said, "OK, i agreed, we go ahead for the operation. As i see most cancer patients were tensed by things like this."

Dr is making me very confused now although I have already decided to go ahead for the operation and have everythign booked. I just hope he is just too busy and forgot about my medical history / record before he told me can have the cyst kept and monitored.

He also told me that, if during the operation, and cannot find the cyst, then he will just do nothing but sew the wounds. But if found the cyst is suspicious to be cancerous, then he might need to remove the entire ovary too. Therefore, everything is depends on the situation, where an open method may be needed to securely and safely remove the cyst.

I hope my decision is the right one and benefit me.


Past scanning experiences
Met Dr Patrick Chia from FMGC on 4-July
1) Ultrasound on my stomach, cant see the cyst.
2) Endovaginal scan, cant see the cyst too.
3) Endovaginal scan, with a newer machine, cant see the cyst too.
Then I go out half an hour to pass everything out.
3) This round, with endovaginal scan, found the cyst! Finally.

Met Dr Paul Ng from Pantai Medical Centre on 5-July
1) Endovaginal scan, found the cyst. :-)

Met Dato Dr Alex Mathews from Gleneagles on 5-July
1) Ultrasound on stomach, cant see the cyst.
2) Endovaginal scan, cant see the cyst.
Then I go pass urine.
3) This round, with endovaginal scan, found the cyst!

Another challenge - ovarian cyst

Met few doctors last 2 weeks, to get advices for the cyst on right ovary.

I have met Dr Patrick Chia from FMGC, Dr Paul Ng from Pantai Hospital, and Dato Dr  Alex Mathews from Gleneagles. All of them recommended me to have it removed and send for lab testing. None of them can ensure to me whether it is cancerous or not. Based on the shape, Dato Dr Alex says, only 90% sure it is not cancerous, but a dermoid. Perhaps it is a reliable percentage.

Dato Dr Alex suggested to remove the cyst only (not entire ovary) using Laparoscopic surgery (keyhole surgery, or minimally invasive surgery). But it could ended up with Laparotomy (the open method) if failed to remove the cyst using the first method. Really hope the removal can be completely done using the keyhole surgery, because it is less pain, and can recover faster.

Decided to go for the operation with Dato Dr Alex and appointment was made on coming Tuesday.

噩梦经验

你们可有被噩梦惊醒的经验？
我，时常会发噩梦。今早也是。还没到6点，就扎醒了。应该不能用“扎”这个字，是自然醒，不需要挣扎的。
有时候发的噩梦，半梦半醒之间，你会知道那个是一场梦，你会挣扎的起来，不让自己继续睡、梦下去。
今早的，是，吓到立刻醒过来了！

那里招人？

心头好像被大石压着的感觉，透不过气。

队员一个接一个的离开，找不到合适人选填补离职队员之际，又得不到高层的充分合作，无奈也无策。哎。。。

距离上一个队员离职，已有一年多的时间了，但是到现在还是找不到合适的新队员。
有的资历不符。
也有的薪金要求太高，我们高层不愿意付。
来我们公司求职的已经很少了（可能是地点关系），真的成功被遴选出来的，就更少之又少了，然后，又可能因为高层的不合作，整件事情就告吹了。

新的没找到，留下的也不懂会不会继续留下，会多久？
很累。

幸福

走在mid valley shopping mall里的路上，突然，觉得活着是一种幸福。
更难得的是，能够自力更生，活出自我，做我想做的东西，就更幸福了！

当然的，不能要求太多，满足于现状就好了。

4/25

两位25女。。。

5、10年

这阵子，脑海里时常浮着“5年”、“10年”这两个名词。是有一点担忧、忐忑。

如果在以前，你问我5年后我会怎样，我会回答你说，“应该还是一样”。
但是，现在的我，已经没有以前那么乐观了。
我一直认为这次的病发，都是上天给我一个重新认识自己、爱惜自己的机会。自己还能走多远，就是得看那5年、10年了。

5年、10年，都是医学界对于癌症病发以致死亡或者癌症复发，通用的一个期限。

Diarrhea

Finish 1 roll toilet paper for each day...
Lose 2kg in 3 days...

Luckily only diarrhea but no stomach pain...

Has been at border for weeks, now finally < 70kg oredi...

Decided therapies

I have been quiet for weeks, because I need time to think about what therapies to go for.

After weighing the pros / cons and my cancer stage, I have decided not to undergo any western therapies that are recommended by doctor. I do understand the good intention of the therapies, and I should not undertreat my disease.

In fact, I will take alternate therapies, a combination of below:
- Consume healthier food, reduce meat and chicken intake
- Chinese medication
- Consume fresh vegetable and fruit juice few times a day

Am going to write emails to update some of the doctors, and am sure they will persuade + advice me further. Will see la...

Side effects after surgery & CT Scan?

Have discovered serious hair drop and dandruff problem these few days.

Are these the side effects after
- the radioactive contrast material that was injected for CT Scan, and
- the electronic wave from the CT Scan machine, and
- the anaesthesia used for the surgery
???

3rd Oncologist Advice

Went to meet Dr Manivanan from Wijaya International Medical Centre, located at PJ.

He first examine my report and body.

Some simple practical rules from him
- mastectomy, no need radiotherapy
- ER/PR -ve, must do chemotherapy
- ER/PR +ve, do hormone therapy

About radiotherapy, IMRT is only suitable for organ or area that is in inner body, like kidney, stomach etc. 3D  CRT is the most common and suitable used for breast cancer, as it is considers located at outside of the body, with minimized radiowave into other body organs. About 1% of lung will get damage, the wave will kill the lung cell; 1cm depth start from the edge that is close enough to the breast. He suggests to do 4 weeks shooting on whole breast and another 5 days for boost. Side effects are similar to what other doctors said, darker skin (temporary), nausea, cough, vomit etc. Dr Azrif from Prince Court told me there will be 3 tattoo dots on my body, but Dr Manivanan says there will be only removable marks but not tattoo. Somemore is invisible marks. Cost is about RM15k to RM20k, Dr Mani give me an estimated figure only.

There are 2 types of drug being used in hormone therapy, i.e. Tamoxifen and something called Armidex (not sure about the spelling, assuming this is correct now). Tamoxifen is a very old medication, which is being used for almost 30 yrs. It is very effective and less expensive. Armidex is being used for 5-6 yrs (most is 10 yrs only), better than Tamoxifen in a way, it reduces the side effects. But is about 5-7times more expensive than Tamoxifen. Less assume Tamoxifen is about RM100 / month, this Armidex will cost RM500 or RM700 per month then. According to Dr Mani, Armidex can cause osteoporosis. These medication will actually stop cancer cell from attaching to ER, but not to stop ER production. This is something I misunderstand about this medication previously.

If cancer come back again on the same breast, definitely it will at higher stage and chemotherapy is a must by then.
I dont have the option to do only radiotherapy but not hormone. If decided to go for therapies, must do both.
It is useless to only start the therapies at 6 months later. He mentioned something like, the therapy must start as soon as possible after surgery, otherwise is not much helpful for the cure. He used one very technical term when trying to explain to me, but, I couldnt catch.

4th Oncologist Advice

Made an appointment with Dr Ho Gwo Fuang from UMSC at 5.30PM, but only able to go into his room at around 7PM.

Before I meet him, one of my fren told me that she did meet Dr Ho at UMMC for her father's disease. My fren says he is a very soft spoken doctor (till my fren hardly to catch his words each time) that makes her dont have much confidence in him. I also feel hesitate to see him after I heard my friend's comment about Dr Ho. But luckily, I met him, and I got some useful information from him. He is a nice doctor and willing to spare me information.

He is scrupulous and smart. He gives me a very good impression for the start!
I passed him the pathology report, he read through. While he is reading, I start brief him about my journey, how I detected the lump and end up surgery in Prince Court. He noticed from the report that I have another lump in right ovary! This is what other doctor didnt noticed, may be except Dr Azrif, since he is Prince Court and can access my CT Scan report easily.

Dr Ho requested the scan report from me if I have. I passed him the CD (soft copy) of the CT Scan, I myself also never open it. I thought it is definitely something I will only get ??????? in my brain when I open it. It is an interesting CD . It contains a software which can open a series of images saved in the CD. These images are the images took by the machine during the scan. I can see all my body organs, lumps etc clearly! Dr Ho also shows me where my ovary and breast lump is.

I only discussed radiotherapy and hormone therapy with him, as I told him that whether will or will not he recommend chemo to me, I will insist NO to chemo.

He started with me discussing the ovary lump, which is something not in his scope . By using the images in the CD, he shows me that my lump is "light" color inside. He says this tumor is undecidable on the type as it is not something "dark" color like the edge of the tumor which can classified as a cyst. He recommended me to see Dr BK Lim from UMSC. He says he is a nice doctor.

About radiotherapy
- 3D CRT
- Commonly 5 weeks shooting for whole breast, and 1 1/2 weeks for boost. But studies shows that 3 weeks whole breast shooting is also efficient enough for the cure. Therefore he recommended 3 weeks and follow by 1 1/2 weeks boost for me. This treatment will be conducted in SJMC.
- Lung damage, about 1cm depth, starts from the edge closest to breast. But this damage is not significant to us, but yes to a marathon runner.
- Without radiotherapy, it is about 25% to 30% local recurrent. With radiotherapy, it reduces to < 5%.
- Use marks but not tattoo. There is option for me to choose. Mark is fine and good enough for breast.
- Treated breast is firmer, tends to be long term. But degree is patient dependent.
- Treated breast will be swollen.
- Treatment course will take 4 weeks in SJMC, and will meet Dr Ho once a week or once every 2 weeks.
- Treatment must starts within 6 weeks after surgery. Therefore I must decide before end of February.
- Cost is a little bit cheaper than other hospital.

About hormone therapy
- When consuming Tamoxifen, cannot get pregnant as it is harmful to baby.
- < 50 yo women get more benefits from chemotherapy.
- >= 50 yo women get more benefits from hormone therapy.
- http://www.adjuvantonline.com, a website that shows me some statistics about the relapse and alive rate. This is the tool Dr Harjit is using that day!
- ovary ablation will stop ER production, but not Tamoxifen.
- Tamoxifen is to stop cancer from attaching to ER.
- AI, another name (?) of Armidex that was told by Dr Manivanan, is more effective for women in post menopause. AI can be prescribed following by ovary ablation. But the result is not significant for women > 30 yo. The result of Tamoxifen as compare to ovary ablation and follow by AI is the same.
- AI will cause osteoporosis.
- Something new to me, Tamoxifen will pause menses, uterus lining get thicker after some times, could then cause uterine cancer, especially to post menopause women. But reported case is only about 1%.

Before I leave his room, Dr Ho told me Dr Azrif is his best friend.

2nd Oncologist Advice

Went to Prince Court Medical Centre to meet Dr Azrif today.

Unexpectectly, he is a nice guy, and give me confidence to undergo my treatments with him.
He anwered all my doubts, like, some ppl says radiation will cause recurrent of cancer in another breast etc.
He also explained to me, about the radiation methods that I have learned online, 3D CRT, IMRT and IGRT.
IMRT - Low dose wave shoot into our body from every angle (front, side and back), and only high dose focus on the breast. Therefore, lung will also receive a lot low dose wave.
3D CRT - Low and high dose shoot front ftont and focus on the breast. Therefore, only the top layer of lung will receive the low dose and high dose wave.
IGRT - is type of technolgy that is also used in the above 2 methods.

According to him:
- Breast cancer can mainly categorized into 3 groups, i.e. ductal, lobular and misc. About 75% of breast cancer is ductal cancer, and 20% for lobular, and 5% for misc. Tubula, Mucinous, Papillar, Medullary are some of the rare type of breast cancer under misc category.
- My cancer type is rare type, and is not as dangerous as the ductal cancer, therefore he suggests me to undergo radiotherapy and hormone therapy only.
- Radiotherapy will last 4 weeks, 3 weeks for entire breast shooting and last week is boost shooting which focus on the lump area only.
- About 20% of young breast cancer patients that undergo radiotherapy will still have recurrent of cancer on the same breast, but it reduce to 10% only after boost shooting.
- He suggested 3D CRT for me, which he think this is best for me as it minimize the low dose wave to other organs in the body, especially the lung. Which indirectly to minimize the damage to the lung.
- Sample of side effects: Redness, peeling expecially underarm and breast, skin darker (temporary) and breast becomes firmer (permanent).
- Tamoxifen will cause irregular of menses cycles, or in worst case, will cause menopause.

1st Oncologist Advice

Today, I met Dr Christina Ng at Sunway Medical Centre, to discuss about the treatments that she will suggest to me if I decided to undergo the treatments under her supervision.

She made a call to Prince Court Medical Centre. After getting the detailed lab result of the tumor, that was not printed in the pathology report, she suggested the 3 most popular and common therapies to me, as expected. They are chemotherapy, radiation, and hormone therapy. Therapy will be carry one one after another. Chemotherapy will start first. Chemotherapy is suggested due to I am fall into young age category.

The discussion, somehow is a bit disappointed me, although this is the expected result. Some online articles and information gave me hopes that I might not need chemo and radiation base on my pathology report. But the result of discussion is in opposition.

Chemotherapy
6 cycles, 3 weeks once.
Will finish in about 4 months time.
The quality of drug that they are using will not cause much nausea, but hair lost is confirm.
Will cause < 1% heart damage.
In most cases, other organs will recover after chemotherapy.
Should start on 16 or 17 Feb 2011.
Total cost is about RM20K.

Radiation
25 sessions, finish in about 5 weeks, from Monday to Friday.
Using external beam.
The good radiation machine / chemical material will not cause damage to lung and other organs.
Focus on the whole breast.
Total cost is about RM12K.

Hormone Therapy
Tamoxifen will be used, which to stop the body from making estrogen.
Menses will be stopped.
Side effect similar to menopause.

Shortlisted oncologist

With frens' help and online information, I had shortlisted 3 oncologists and I am going to meet them to get consulation about the treatments. They are Dr Christina Ng from Sunway Medical Centre, Dr Ho Gwo Fuang from UMSC, and Dr Azrif from Prince Court.

Tomorrow is the first meet up with Dr Christina, and then Dr Azrif on Saturday, lastly Dr Ho on 7th February.

My surgical pathology final report (partially)

Clinical Information
Mucinous carcinoma right breast.

Source of Specimen
A. Right breast tumour with additional superior margin.
B. Right axillary fat and node.

Microscopic Description
A. Sections show the mass is a mucinous carcinoma, 2.3cm in largest diameter, composed of small groups of malignant cells with mild nuclear pleomorphism within pools of mucin. Lumina formation is seen in some cellular groups. A few foci of cystic ducts are seen in the breast lobules of thew surrounding breast tissue. All margins are free of malignancy. The other piece of breast tissue also shows a few cystic ducts and is free of malignancy.

B. Sections show fibroadipose tissue with a few nerve bundles. Lymph nodes are not present.

Diagnosis
A. Right breast tumour with additional superior margin: Musinous carcinoma with clear surgical margins.
B. Right axillary fat and node: No lymph nodes present.

Addendum Report
Immunohistochemistry Report
Estrogen Receptor : Strongly Positive
Progesterone Receptor : Strongly Positive

Anti Her2/neu (clone 4B5) for CerbB2 oncoprotein: Negative (score 1+).

My 1st analysis on the pathology report

The lump is confirm a mucinous cancer, namely Mucinous carcinoma.

There are few therapies which oncologist will normally recommend:
Radiation therapy, chemotherapy, hormone therapy and targeted drugs.
http://www.mayoclinic.com/health/breast-cancer/DS00328/DSECTION=treatments-and-drugs

Radiation therapy - Looks like this is a must for lumpectomy surgery, which only remove the breast cancer, but not the entire breast (mastectomy).

Chemotherapy - HIghly recommended  in order to control the spread.

Hormone therapy - Use hormone blocking pill to reduce the hormone production or to block hormone to attach to cancer cells. Because of I am strongly positive in both Estrogen Receptor (ER) and Progesterone Receptor (PR) positive, therefore I am suitable for hormone therapy. For those patients with ER/PR negative, they may only rely on chemotherapy and radiation therapy to kill those cancer cells. In other words, I have averagely  30% success rate after for each therapy but those iwth ER/PR negative, is 50% on chemo and radiation. I personally think, if i skip chemotherapy, I still can rely / put hope on hormone therapy + radiation.

Targeted drugs - I am not suitable for this therapy, as mine cancer cells is Her2/neu negative. Lucky me, I heard this treatment costs about RM100K.

*Not very sure about all the information in the report.*


Some additional information about Mucinous Breat cancer, which is quite match to my report.
Information from:
http://www.breastcancer.org/symptoms/types/rare_idc/mucinous/symptoms_diagnosis.jsp

There are some other key features of pure mucinous carcinoma:

• Hormone-receptor-positive: Studies show that pure mucinous carcinoma tests positive for estrogen receptors 90-100% of the time and for progesterone receptors in 50-68% of cases.
• HER2-negative: Mucinous carcinoma usually tests negative for receptors for the protein HER2/neu.
• Negative lymph nodes: Pure mucinous carcinoma rarely spreads to the lymph nodes, especially if the tumor is 1-2 cm or smaller. Larger tumors may involve spread to the lymph nodes. Sometimes, cancer in the lymph nodes indicates that the tumor is actually a mixed mucinous carcinoma, with invasive ductal carcinoma cells present.

About recurrent of cancer

Early conclusion
Lesser chance of recurrent.

Supported statements from report
"All margins are free of malignancy", and "Musinous carcinoma with clear surgical margins"

References
http://www.mayoclinic.com/health/recurrent-breast-cancer/DS01078/DSECTION=risk-factors
Which describes a few factors that will increases the risk of recurrent, either local recurrent (same place) or at other areas (spread)
Lymph node involvement - Mine does not
Larger tumor size, more than 5 centimeters, or about 2 inches - Mine is 2.3cm
Positive or close tumor margins - Mine is margin clear
Lack of radiation treatment following lumpectomy - Still under consideration to go or not to go, lets say i go
Younger age. Women under age 60, particularly those under age 35. - Considers a

Some statistics (source from Dr Harjit)

Dr Harjit showed me some statistics on the day I met her for the pathology report.

A. Alive rate in 10 years, with or w/o therapy
B. Alive and w/o cancer rate in 10 years, with or w/o therapy

Alive rate
Decision: No additional therapy
88 / 100 women are alive in 10 years.
4 / 100 woman die because of cancer.
8 / 100 women die of other causes.

Decision: Hormone therapy
1 / 100 women are alive because of therapy.

Decision: Chemotherapy
Less than 1 / 100 women are alive because of therapy.

Decision: Combined therapy
1 / 100 women are alive because of therapy.


Recurrent rate
Decision: No additional therapy
74 / 100 women are alive and without cancer in 10 years.
18 / 100 woman relapse.
8 / 100 women die of other causes.

Decision: Hormone therapy
4 / 100 women are alive and without cancer because of therapy.

Decision: Chemotherapy
2 / 100 women are alive and without cancer because of therapy.

Decision: Combined therapy
6 / 100 women are alive and without cancer because of therapy.

Gather opinion abt the therapies

Frens, I need your opinion now...

Perhaps you guys can spend some time help me read the information posted below.

My father ask me not to do any therapies, but put hopes on chinese medications.
Of course I won't reject chinese medication. Furthermore, it is in my initial plan of treatments too.
Looking at the risk, if I don't go for radiation, it increase my risk on recurrent of cancer.

My initial plan is, I will go for radiation, considering on hormone (pro and side effects), then NO for chemo, together with chinese medication.

Now, I need your opinions to help me decide.

Side info: I met a patient who is also diagnosed with breast cancer stage 2 yesterday in hospital. She told me that, after her first chemotherapy in Glenneagle, her hair was dropped (now she shaved all her hair), and nausea for 4-5 days.

Got my surgical pathology final report

Frens, knowing everyone is worrying about me and care about how my report is. Just want to let you all know, report shows positive result. I will post the report here later. But, still not clear about what type of treatments will be undergo. Am going to meet oncologist this coming Saturday to discuss and get information about radiation, hormone and chemotherapy. Basically I guess these should be the 3 treatments that he will suggest to me on this coming Saturday.

RIP 谭家荣

Heard from old friend that Tham Ka Weng 谭家荣， my primary schoolmate has passed away during his sleep on Saturday. Age only 36, same as me. Still so young. Heard from fren he even got stroke before this. Health already start alerting at such a young time.

Appreciate every moment of living! Just like what my blog's title means.

Swelling breast

Operated breast become bigger than normal. I think it is swelling, the breast! Not sure why. Did some studies online. Some articles say it is common after operation especially if I had axillary dissection. But I did not. Some even says this situation may continue for months. Underarm also still feeling numb. Hope it will get back to normal very soon.

Wound Bleed

May be move too much, causing the wound bleeding and pain. Have to take pain killer to stop it.

Now like "orang cacat", avoiding using right hand, and need to use the other hand to hold the breast while walking or moving, to avoid stretching the wound.

home

finally, home with little pain on right hand.
will be on mc for 1 month temporary.

frens, sorry cant type too much and reply some sms and calls. i hope i am left-handed.

"Coma" for the day

Frens, I will be undergo a surgery at 8.30am today. I forgot to ask doctor how long it takes. I guess it could take about 2 - 3 hours. I will not able to update anything here, as I guess I will be keep sleeping and sleeping for the whole day.

Good night.

Btw, Dr Harjit says, radiation and chemotherapy will only be started about 3-4 weeks after the operation. So, I still have time to make some studies on it.

Operate liao...

Nurse pushed me into operation room at 8.05 this morning. I stilll actively looking around. He told me his name is "Koh Wah", and he is the one in charge of anaesthesia jab. He told me i will going into sleeping mode in 1/2 minutes. I remembered my last sentence is, "I am getting blur." Then I really sleep for 3 hours.

By time, I start having little feeling and awake is at 11.30AM. I can see the clock on the wall.

Go back to wad and sleeps till 12.30PM, woke up by fren. Till now, I am totally awake liao.
My friend keep telling me most people will be sleeping and blur for the entire day. But I feel OK wor... nothing. May be 箭猪粉 really helps?

OK, about operation, 2 leading lymph nodes were took out and tested, no infection. So Dr Harjit only removed the tumor from my right breast, no further lymph nodes were being removed. They are safe!

When I just go back to my wad, the wound is pretty pain. So nurse gave me pain killer. After then I am ok, dun feel anymore pain (may be due to pain killer is taken). The wound still got little pain now. Cannot type keyboard too much, cannot stretch my right hand also.

Full report will be out on Thursday or Friday. I will be seeing dr on Monday for the report. Probably will discharge from hospital tomorrow, and continue rest at home.

Another Shock - Cyst / Lump in Right Ovary

In hospital today. Done the CT Scan in the morning, about noon time.

After the scan, I did not wait for the result, but I went out to take lunch with fren. After 1-2 hours, hospital called me, and ask me back to meet a gynae doctor. I was shocked. I asked whats the matter over the phone, but the nurse was not sure about it.

I met Dr Tan, the gynae that Dr Harjit refers me to. Dr Tan told me, they found a cyst in my ovary during the CT Scan. Argghhhh!!!!! Another breaking news. He did a scan for me again, but cant see the cyst clearly as compare to CT Scan. End up he did a scope for me. Saw the cyst!

Dr Tan says that is hard, not soft as a cyst, not suspicious on cancer, because my CA125 test result is good, not so high (high means cancerious). But all are based on "guess". Will need to cut the cyst out and send to lab for test to get the actual result. If it is only a cyst, then should be fine. Cut out and thats all about it. But if it is something not good, and  may need to remove one side ovary. And worst case is remove the entire uterus.


Sigh...

Dr Tan says he can do the cut in the same operation. But I told him I want to think about it first.

Found Prince Court with SNB

While waiting for my surgery day to come, I spent some time on breast cancer studies online.

I still have some doubt and can't believe that I really have breast cancer. So, I was still thinking if I sould go down Singapore to do second biopsy test. I emailed Prof Dr Yip about some questions, like the accuracy of the biopsy test and a new technology called Sentinel Node Biopsy (SNB). Dr Yip is really a good and responsive doctor. I never seen a doctor that can share her personal info, like HP number with patients. She told me from the ultrasound is very suspicious of cancer, and the fine needle biopsy test is very accurate. She told me that, UMSC does not has the facility to do SNB, and the only one has it in Malaysia is Prince Court Medical Centre. And she also wrote that, "Perhaps you can meet Dr Harjit Kaur if you go there."

So, I end up appearing in Prince Court today. And Dr Harjit also a very kind doctor. She explained things to me clearly, about SNB, did ultrasound again for me on the day. Her schedule is actually full with appointments, but she still meeting me as I told her nurse about the urgency of my case.

I then decided to take the surgery in Prince Court under Dr Harjit. The surgery is to remove the tumor, and together Dr Harjit will do SNB for me, which will then further decide whether to remove the other lymph nodes or not.

The surgery is scheduled on next Tuesday, 18-Jan-2011. But have to admit to hospital on Monday, to do a thorough CT Scan.

Detected Lump -> Mucinous Breast Cancer

I detected a lump in my right breast few months back. I did some researches online, and some recommended to wait for at least 2 months after menses. To see if the lump is actually caused by the menses cycle.

I waited for months, and it does not get smaller. So I decided to go for a scan. I went to Sime Darby Megah Centre located at Taman Megah there.

I met Dr Evelyn Ho, recommended by Yvonne Loh. Yvonne has few frens working in medic line who can really recommend good doctor. Dr Evelyn Ho is a radiology specialist. She has lot experiences in detecting breast lumps. She did ultrasound and mammogram for me. Result is, both my breast are full of water cysts, but not harmful. Except, one, on my right, which is the hard one. I remembered she said, “Something not very good.”

She recommended and referred me to Prof Dr Yip Cheng Har from UMSC. Dr Evelyn also said that, I should meet a specialist in breast cancer rather than gynae. She made call to Prof Yip immediately and squeeze me in to meet Prof Yip the next day.

When I meet Prof Yip the next day, she did a biopsy test for me. Which the result will only be out after one week. May be my case is quite serious, so Prof Yip ask me to call her for the result after 2 days. When I call her on Monday, she already told me is confirm a cancer. It is Mucinous Breast Cancer. When I met her yesterday, the full biopsy report is not out yet. She actually call to the lab and get the result. She keep ask me to seek second opinion if I doubt and encouraged me to discuss with frens.

You can get information about these 2 doctors from these links:
http://www.breastcancer.org.my/cms/index.asp?menuid=18
I got this link when I try to google some of the doctors’ info.

Ok. I booked the operation to be done next Monday. It is going to be a “minor” operation (according to doctor ). But to me, it is a major one. It is going to remove the lump and some normal tissue from my right breast, together with the full lymph nodes. Radiation therapy is a must after operation, which will be 30 days continuously and about 5min daily. Chemotherapy is required if determined is stage 2. To determine the stage, they will send the tumor and lymph nodes to lab after removed. Breast after operated will have scar, and in smaller size than normal.

The Journey Start

There are many things happened recently. And since I have to update frens who are very care about my condition, therefore I decided to update my condition here. So everyone can read the updates from here.