Tuesday, March 31, 2009

Yay, her kidneys seem to be improving

After Sunday's dialysis, mom has been on constant diuretic with all of us keeping an anxious watch on how much urine she's passing.

On Monday (yesterday) there seemed to be more urine. Toxin level in blood not so high so no need for dialysis. The doctors say that her kidneys may be merely in shock from the UTI, and they may be able to recover once the UTI is gone.

This morning, the nephrologist confirmed that she is definitely passing more urine now and it's a good sign. She may not need dialysis today :) YAY!!!

Sunday, March 29, 2009

Now's a good time to visit

If you've been thinking of visiting mom in hospital, now is probably a good time. She is fresh from dialysis and she's alert. She doesn't speak very much but she hears and understands. And once in a while, she may surprise you with one of her cheeky wisecracks ;)

If you do come, please be prepared : she looks weak and frail, and her mind wanders. She may not know who you are, or she may not say anything to you. Please don't be too disappointed by this. If you are someone close to her, you'll be able to see in her eyes how much she appreciates you.

And don't put on a sad face! This morning, her doctors were very concerned about her kidney failure and very sad that yet another complication has appeared. She asked one of them outright : Why do you look so sad? After he left, she asked me what's wrong with him?! Typical of her to worry about others!

I know people sometimes feel obliged to visit. With mom, there is no need. Come if you feel like seeing her. No need to come if you are busy. She will understand. She has constant companions around her and she can't have too many visitors anyway, it will be a strain on her.

Come with positive encouragement. Be happy to see her. Bring happy vibes :) And she may reward you with a smile!

She is Block C, Room 616, Pantai Hospital. Pls sms me first and I'll let you know when's a good time to come. It's very difficult for me to take calls when I'm with her, and when I'm in office, I'm usually in meetings. Just sms me and I'll reply promptly. Or call Dad, Mike, Phyllis, Wati or Sonny.

Now it's the kidneys... sigh

Mom's kidneys stopped functioning yesterday. Despite the drip and diuretics administered, she is passing only negligible amounts of urine.

The nurses were monitoring it all night, and this morning Dr Rajbans called in a Nephhrologist Dr. Tan. He came at 9.30am and immediately recommended a dialysis session to remove the toxins in her blood.

The cause of her previous nights' fever was a lung infection. The doctors think this may have shocked the kidneys or the infection may have spread. Or it may be the Multiple Myeloma taking its toll on the kidneys.

Poor mom. She's handling it so well. She is alert and aware, cooperating with the procedures. She has no fever now, sleeps well and breathes well on her own. In fact, she looks fine and sounds fine - except that she is not passing urine.

Well, the dialysis may re-start the kidneys. Let's pray for that.

Saturday, March 28, 2009


At 10pm on Friday, mom started shivering and turned icy cold. Her blood pressure shot up to 208/85, then later came back down to 145/70 and stabilised. Gave us quite a scare! We piled blankets, sweaters on her and even used a hot pack to keep her warm. Even after they gave paracetamol, painkiller, antibiotics and nebuliser, it took such a long time for her to settle down. This lasted til 11.20pm.

By the time Dr. Rajbans, the geriatric specialist, arrived, she had finally responded to the meds and was very tired.

At 5am this morning (Saturday), shivering and fever again.

Later this morning, they did x-ray, took blood, took phlegm, to test find the damn infection so that they can prescribe relevant antibiotic.

Meanwhile, mom is getting her milk so hopefully, this will give her the strength to fight the infection. I just saw her at the hospital and she is sleeping soundly. I hope she gets good uninterrupted rest and regains her strength soon.

Pls call me first if you are planning to visit, I'll let you know when is a good time. Janet : 012-385 6435

Thursday, March 26, 2009

The PEG tube was successfully inserted

At 1.45pm today, mom got her PEG tube. Now she has a thick plastic protrusion from her tummy - can almost imagine it's part of a horror/sci-fi movie! Hahah :)

The whole thing took about 20 minutes, then she was wheeled back to her room where she spent most of the afternoon sleeping.

At about 6pm, the sedative wore off and she started complaining of pain. It seemed to come in spasms. She also developed a fever. Dr came and gave paracetamol and painkiller.

The cause of the recurrent fever is still a mystery. Lungs are clear, urinary tract is clear. Doctors still investigating.

By the time I left mom at 8.30pm, she said the pain was much less :)
She's not talking muc today, and still groggy. Hope she sleeps soundly tonight.

Mom gets her PEG tube today

The surgery is scheduled for 1pm today. It's a 20 minute procedure and she will be sedated.

Yesterday, she was fresh and alert. But a blood test showed that her haemoglobin had dropped to 8.5. This is very low. Her multiple myeloma can cause this, and she gets three injections a week to keep her hb at around 10 plus.

She wasgiven a blood transfusion. I quickly informed Dr. Puru who told me not to worry. A drop in hb is to be expected when she has been on antibiotics so long. Phew!

Mom was wide awake whole afternoon and evening, glued to Mr Bean and Hannah Montana :) Hope she got some sleep last night.

Tuesday, March 24, 2009

Mom is exercising!

The speech therapist came and taught mom some exercises. Her problem is twofold : swallowing (muscles in throat) and chewing (muscles in cheeks, mouth and tongue). Great blessing is that mom is alert enough to follow her instructions and do the exercises.

Later on in the afternoon, mom did another round of exercise. I think she REALLY wants to be able to eat again.

A Gastroenterologist came to see mom. He will be the one inserting the stomach tube or PEG on Thursday afternoon. He says it's a simple procedure - only about 20 minutes and she will be under mild sedation, same level of sedation as someone undergoing an endoscope. There will be surgeon and anaesthesist assisting. There is some risk, but very slight.

After this, she will fast for 24 hours and the nose tube will be gone, gone, gone!

She watched tv all afternoon, reading the subtitles. Then after her 6pm feed, she fell sound asleep until her 9pm feed. For a change, the family all came late so she had nice interrupted sleep.

The little bedsore on her right heel is healing well. To prevent further bedsores, Dr Ridzwan wants her to sit up in a wheelchair for 1 - 2 hours a day. She's taking this well.

Now that she's gaining strength and well-being every day, I pray that she will be strong enough to sail through the PEG minor surgery with grace and ease. Then come home and start eating! For now, eating and drinking is strictly forbidden.

Monday, March 23, 2009

Visiting Mom

She is in Block C, Room 616. Please don't send flowers or fruits - there is no space in the room!

Please visit only during dinner hours (6 - 8pm) as her mornings are busy with treatments and in the afternoons she needs her rest. She has requested for us to let her sleep after her lunch feed (12noon - 5.30pm) as this is the only time when the nurses don't come in so much.

Daily Updates on Mom

Since mom has been hospitalised, I have not had time to make calls and keep everyone informed. The best I can do is to squeeze in a group sms. In the earlier days, I just could not talk about it as she gave us quite a scare and her condition was changing from day to day.

Now that she has stabilised, I've set up this blog so you can keep track of her progress.

First, a little backgound :

She had a stroke in mid 2002. Then a year later, she was diagnosed with Multiple Myeloma, a plasma cell cancer. This is being well controlled by Dr. Puru, a very senior haematologist at Ampang Hospital (govt hospital).

Then in 2007, mom had breast cancer and immediately opted for a mastectomy. She's amazingly decisive and very practical. No self-pity or dramatics.

Last year (about May), the Multiple Myeloma became less responsive to her oral chemo : Thalidomide. Her bones got thinner and developed lesions. A fracture in her lower back made her bedridden :( The wonderful people at HOSPIS came and loaned us a hospital bed and reclining wheelchair. They also taught us to maneouver her in and out of bed. God bless them, they are really providing a much needed service.

Soon after, her right arm fractured. Then her left leg. And all this happened while she was bedridden! Scary!

Can you imagine her discomfort when her right arm had to be bound in a plaster cast? Her left one is immobile cos of the stroke. Now she has no arms to eat, brush her teeth or even scratch her nose. And yet, she didn't complain. Our wonderful maid Bena was at mom's beck and call and attended to her every need.

The nurses warned us that the cast would be itchy and hot, but mom said sheliked it cos it made her arm feel more comfortable. Isn't that just amazing?!

In December, Dr. Puru halted this by adding on another chemo tablet : Cyclofosphamide I think(?). Mom's bones healed!

In January, we got some great news: there is a brand new wonder drug specifically for Multiple Myeloma. It's very new in the market but has been tested with fantastic results for the past 5 - 7 years in the US. Now available in Singapore, it's called Lenalidomide and it's so new that mom will be the second person in Malaysia to apply for it to be brought in. This should arrive in a month or so.

While we were ecstatic at the thought that mom's multiple myeloma will be stalled, and she can regain her strength and mobility... and maybe start going out again (you know how she loves going out to makan at shopping complexes!) there came another blow.

She started developing fever and cough. We admitted her to Pantai where she was diagnosed with pneumonia. Strong antibiotics soon put her right again, in time for her to be discharged and to receive the Henry Dunant Medal from the MRCS.

That was a very moving ceremony, and it was so touching to meet all her old friends and former colleagues who came from near and far to congratulate her. It was beautiful. But it was also tiring. She was exhausted.

A week later, she started coughing again. With lots of phlegm and fever. On Thursday evening (12th March 2009), we had to rush her to hospital again. This time, while waiting for the ambulance to arrive, she started choking on her phlegm and choked. She started turning blue! Thank God the ambulance arrived in time and immediatly gave her oxygen.

She was admitted into the ICU at Pantai and stayed there for 2 nights. Our regular Dr. Ridzwan referred her to a Geriatric Specialist Dr. Rajban. When she came out, she was disoriented, not talking much, not eating much, sleepy most of the time.

On Saturday, Dr Ridzwan called me and told me that her thyroids are defective and this is causing her tiredness. They'll start hormone tablets and she should improve in a weeks' time. Her fever came down but she was still sleepy and not eating. She grew weaker and weaker. She seemed to be too tired to even chew and swallow her food.

On Monday, Dr Ridzwan called and informed me that she is not swallowing her food. He thinks that because she is not swallowing properly, food particles goes into her lungs and causes the recurrent infection and fever. The doctors recommended that she be fed through a nose tube.

This was a severe shock for us. I took it a a sign of decline and was upset cos I know how much she enjoys her food. But no choice. She was too weak to eat, too weak to stay awake, too weak to even recognise us. This was a bad time.

So they inserted the tube and taught us how to feed her.

After we got over the shock, we were happy to see how fast she started to improve. Day by day, she got stronger and became more and more alert. She could recognise us. She could order us around and make her typical cheeky comments. Yay! Thank God!!

Now, she is quite stable. She still has a recurrent fever. Mild and easily brought down with panadol. But the drs don't know what is causing it. They just took a urine sample today for testing.

Tomorrow, she has an appointment with a speech therapist who can hopefully teach her to swallow. This will allow her to eat. Even a bit, just for pleaasure, will be great. They will replace the nose tube with a tube that goes directly to her stomach - a PEG tube. This will probably take place on Thursday or Friday.