after 6 months

It has been 6 months now from my transplant day. I remembered one transplant survivor told me, time flies faster than you think when everything started to become 'normal' around us.

For now, I still visit the hospital for follow up. The wound on my chest has further shrunk in size. I positively think that this wound problem will finally over, and completely heal in another month or so.

Last weekend, me and my family went back to our hometown, the last trip that we had was 8 months ago. We spent the whole period of school holiday at both my mom and in-laws house. It was a great time for me. I managed to visit my friends also.

Starting back to work? Yes, I am going back to hospital (as a doctor) next week. Anyway, its going to be an 'office' job first, as assured by my boss, at least for a couple of weeks, when I completely stop taking immunesuppresive medicine.

The last 6 months had given me a colourful experience, eventhough not as tough as other patient. I had encountered many people and also spend a lot of times and in many ways, I hope, will help me to be more patience.

the much awaited result

As usual I went to the hospital yesterday. First, for my post transplant follow up and secondly for wound dressing.

The much awaited blood result sent to Singapore was ready and it showed that I do still have very, very minimal residual 'tracing' of this cancer marker. However, it is very much below the acceptable value and should not raised any unnecessary worrisome. I still feel so much thankful to God. However, yes, I would be more than happy if the result showed that I do not even have any 'tracing'. Having said that, the next possible plan is to get my brother to again donor his white cell (lymphocytes) for me. These lymphocytes can act as another troop of army to take out those remaining potential cancerous cells. The harvesting procedure is very much similar for him and the infusion process on me is very much minor if compared to the normal transplant process. Albeit, the consequence of GVHD is not something to be considered less seriously. The procedure will be planned after I completed the Cyclosporin, i.e. after 6 weeks times from now.

By the way, the wound on my chest has shown a lot of improvement but still a long way to completely closed. I just hope that it will be sooner so I could resume working in April.

after the third surgery

The third surgery went smooth but I was shocked when I first saw the second wound. It was much bigger than the first wound and obviously much uglier, sitting at the base of my neck. For a moment, I just sat and couldn't believed that the problem could ended this bad. I have nothing to regret, only a feeling of a 'lost'. A lost of something that you used to have. People says, if you want to gain some, you have to lose some. I became more aware of having and appreciating good health lately. Having repeatedly admitted and repeatedly felt how it was being a patient, talking to other patients (not as a doctor) has kept me reminded to be as wise and empathy.

Today, after spending 5 days in the ward, I was discharged home. I still have to go to the hospital everyday for wound dressing. I must tell how good it was to be home again, at least it is still the best place to feel good spiritually.

I guessed the wound will get better, in the end. Just be more patience, even though it has make my daily movement limited and restricted.

*I hope I don't pick up a nasty 'bug' on the wound.

the third surgery

I just got called from the hospital. The surgeon has reviewed the scan and they feel the sinus is quite simple and just lied under the skin. Not extending in to the deeper structures on my right chest. I developed another small abscess along the tract of Hickman's tunnel, just above the collar bone. I guess the infection is still active and trying to find its way out through another door. That was the other reason I keep reminding the surgeon on what is their next plan when they seem to 'lost'.

I will get admitted today and hope this would be the last surgery for this quite distressing problem.

the good and not so good news: no. 2

For the whole last week, I was admitted. It was not a preplanned decision as I was supoosed to be discharged soon after the daycare surgery. The surgeon felt that I should have the daily 'aggressive' dressing in the ward. The sinus ( i.e the persistent Hickman's tract ) still and even larger than before the first surgery. Now I have an even larger and longer (about a little finger length tunnel) under the skin of my right chest. It has been more than a week now and the team feels that I ought to have a special dyed scan to see the extent of the 'not so SMART' tunnel. Oh.. I just got informed that it is going to be next Friday. The further plan depend on the scan findings. I just could not imagine what surgery I am going to face next...

Anyway, despite all those painful news, I am still in joy when the F.I.S.H (Flourescent In Situ Hybridization) test showed a negative signal. In a more simple meaning, I do not have anymore potential blood cells that carry the cancer signal, at least from the standard test. I am still waiting for another more sensitive test result which was sent down to Singapore about 2 weeks ago.

not another surgery

Not long after I was so much excited, the wound over my chest that I thought would have completely closed by now, does not happened. It has gone down to the smallest size but failed to dry. On that moment, I knew that the problem is not going to settle at anytime. So I went to see the surgeon again and as I had expected, I need to go for another surgery and hope this will be the last one.

Tomorrow I will be admitted as a day care patient and going home as soon after the surgery.

after 4 months post transplant

I went to the hospital yesterday. Now the follow up is once in 2 weeks. My blood results were good.

The wound over the chest is still there but it has so much contracted and I am doing the dressing my self every two days. I just wondered why the previous tunnel tract became thickened and hard and I could feel a tightness everytime I turn my head.

I have lose about few kilos since a couple of months ago, but I am still above my usual body weight. My hairs getting more appreciated but it still thin and as I can still see the scalp underneath.

I have been calculating on when is the best time that I could go back to work. The best time could be when the antirejection pills (which now on tapering dose) completely stop in another 2 months or maybe I can use the "hair test" i.e. when the hair is thick enough and completely covered the underneath scalp, then, that could be the best time. Hahaha..... Hopefully eveything will go as planned.

Any better ways?

2 weeks after the surgery

The wound over my chest became smaller after 2 weeks of everyday dressing. I guess it will completely closed in 1 week or so. The previous Hickman's line tract is still hard and at certain area became a nodule-like mass. Just hope that it is not another collection of infection. The whole last week, I went to the hospital where I work to have the dressing done and I took the chance to meet my colleagues in the department. Some of them suprised since it was their first time we met each other after almost 4 months. Great to meet again the people that you used to work with and it makes me so excited to come back to work...

the surgery

I was admitted in the surgical unit last week. The surgery to explore the wound on my chest went well. There was an infection over the previous Hickman's line scar and the surgeon had to debride (clean) and removed the opening and extend the wound. Now I have about a 5 cent coin (but deep) size wound on my chest and get it cleaned and dressed everyday.

Otherwise, I feel much better. My blood count was steady except that my Hemoglobin still low making my stamina a bit low......

good and not so good news

My last medical review revealed that the virus was not detected on the last blood checkup. This was the effect of daily anti virus that I got for 2 weeks. Good!... in the sense the it will not interfere with the blood cell production anymore. Now my platelet count continue to rise, whereas the white cell count stabilize within the normal range.

My kidney function has return to normal. I was not on steroid anymore and my full moon face has been less appreciable and my weight started to reduce also.

Now, the not so good news is that I have my previous Hickmans line tunnel infected. I noted that the previously completeled healed wound started to break down and continously 'wet' and when I compressed the area it was painful and pus started to come out. I took a course of standard antibiotic but it didn't help. I guess either the germ is more aggressive or the infection took deeper.

Anyway, I saw a general surgeon today and she advised for a minor surgery under daycare tomorrow. I will be admitted tomorrow morning and the operation will be under general anesthesia. The site still painful and I guess the low grade infection had caused me a bit lethargic past few days. I hope it will not become a chronic problem. My appetite? Still catching.....