The severed nerve

P6150076.JPGWhen I was going through cancer treatment, I followed a few blogs of other cancer patients. When the blog ended abruptly, I feared the worst. In some cases, I was right, but in at least one case, the person was fine but had just stopped posting. So, in case anyone undergoing cancer treatment follows my blog, I want to encourage them by posting at least a few times each year, so they know all is well still.

While at my one-year check up this past February at MD Anderson in Houston, my doctor asked me if I had any unusual symptoms to report. I mentioned that I huffed and puffed a lot, and that it had started almost exactly one year earlier. I had mentioned it to several other doctors during the year, but no one had been able to detect a cause.

One doctor had sent me to a cardiologist to see if it was due to congestive heart failure, but it wasn’t that.

The inability to breathe was especially concerning to me because vigorous exercise can help ward off cancer recurrence. I could only use my elliptical machine for about 3 minutes before I doubled over in pain and couldn’t breathe. I tired easily from simple tasks and needed naps. I couldn’t climb stairs or walk far, and I certainly couldn’t jog. Even tying my shoes made me breathless. It wasn’t like that before. I knew that radiation gave people long-term fatigue, but fatigue and breathlessness are not the same thing.

My doctor ordered a chest x-ray.

The radiologists discovered that my right phrenic nerve had been severed, and it almost surely happened during neck surgery the previous year. A severed right phrenic nerve paralyzes your right diaphragm. Instead of laying flat, the paralyzed diaphragm juts up into your lung in the shape of an upside U, and keeps your lung from filling up with air.

It is medically irreversible. They can do surgery to pull the diaphragm out of the lung, but it isn’t able to repair the diaphragm itself. Plus, it is risky surgery and no one seems to think I should do that.

My newly-enlisted pulmonologist at MD Anderson suggested I try to live with it, and stick to light housework and office work. I can’t run, but he hopes I can build my strength by walking. He said I can’t lift weights because of the nerve damage to my right shoulder and the tightened muscles/tendons in my right neck. (The whole upper right side of my body is abnormal and gives me pain.)

I huff and puff tying my shoes because when I bend at the waist, I am cutting off what little air supply my right lung has. Certain sitting and lying positions work better for me than others.

I’d lived overseas with it for a full year before it was diagnosed. Knowing what the cause is sure makes life easier though. I know how to work around it better. For example, I know not to go jogging. Seriously. I cannot.

Overall, I have some challenges, but it is, as always, good to be alive! I am amazed and grateful that God spared my life.

For your name’s sake, Lord, preserve my life;
    in your righteousness, bring me out of trouble.

— Psalm 143:11 (NIV)

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Time for my one-year check up

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One year and two days ago, I finished my cancer treatment. Praise God for His care and for this victory in my life! I was able to move back overseas nine months ago, and I am slowly but surely increasing in strength as my body recovers from the chemo, radiation, and nerve damage suffered during my neck surgery.

In early February, just a few weeks from now, I will travel back to the U.S. and have my one-year check-up. I have 10 appointments at MD Anderson, will have at least two road trips from my parents house to there, will have one surgery on February 15th, and will have two procedures that involve anesthesia.

I knew last year that this surgery was going to happen. It is not a cancer surgery, just a reparative surgery.

Please pray:
–Pray there will be no cancer in my body for the doctors to find.
–Pray for protection during surgery.
–Pray for protection from the dangers posed by anesthesia.
–Pray for safe travels both in the air and on the roads.
–Pray for my brother J who will have to take days off work to take me to Houston. It is pretty inconvenient for him, yet he is willing to give up his time to help me. Pray that things will work out for his good in regards to his work and time off.
–Pray I will quickly recover from the flu that I sadly obtained three days ago. I’m not famous for quick recoveries from respiratory problems. I need to be completely well before I have surgery.

Praise:
–Thank God that my brother and I have friends in Houston who will let us stay with them. Also, I am thankful this was not scheduled a week earlier, as Super Bowl attendance the previous week has maxed out all hotels and things will be a mess. MD Anderson is very close to the stadium.
–I am thankful because, even if I use all my vacation time for surgery and recuperation, it is still not enough (since 4-6 weeks is the norm for recovery), but the medical department of my work has allowed me a little extra time back home to fully recover before flying back to Asia. They are so helpful and kind and have blessed my life tremendously in recent years.

Thanks for your interest, prayers and love!

Two years ago today

Two years ago today I got on a plane and flew back to America. I knew I had cancer but I didn’t know what kind or how severe it was. I didn’t know if I’d ever see China or my Chinese friends again. I left my dog behind in China on that day and hoped I would be successfully reunited with her. I remember wondering if I’d make it until Christmas, and now it has been two years. It feels a little surreal. Of course I am very thankful for all that God has done for me. Everything in life seems different now though. There is nothing good about cancer.

I had a PET scan

From my very first diagnosis in Hong Kong, I knew that my cancer had “spread.” But the doctors never did a PET scan (full body scan that looks for cancer anywhere in your body) to see exactly where it had spread to. Instead, they did CT scans, X-rays and MRI’s on different body parts. I think insurance company restrictions were the reason for this piece-meal approach.

I always wondered if they had checked everything thoroughly enough though.

The doctors in America seemed satisfied that the cancer had only spread a few perilous inches into the danger zone, all in my neck, rather than spread throughout my entire body.

The question mark remained in my mind though. Every cough and every stomach pain made me wonder if I should get checked.

I went to visit the expat oncologist in Shanghai when I got back overseas. He, an Israeli, was shocked to hear I’d never had a PET scan with my type of diagnosis. (He’s worked in America before, but apparently he’s forgotten the joys of working within the parameters of American health insurance.)

So he sent me to the best Chinese-run hospital in the city to get a PET scan. Those machines are expensive, so not every little place can own one. The cost of doing this in Asia is still much, much cheaper than in the U.S. though.

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The day of the scan

On the day of the PET scan, I had to get up early. I couldn’t eat or drink anything. I took my e-bike to the subway, rode the subway to the train station, waited a bit, rode the train to Shanghai, waited in line for a taxi, and ended up at the expat doctor’s office. Then the English-speaking Chinese nurse accompanied me to the Chinese hospital across town by taxi.

I get car sick easily, so on an empty stomach, I was feeling pretty queasy by the time we arrived and had a migraine headache (no coffee that morning).

They gave me an injection of radioactive isotopes (radioactive liquid sugar, basically), then made me down 7 cups of water in a short period of time, on a queasy stomach with a splitting headache.

I made it to the ladies’ room to throw up the first 4 cups of water.

I was in the PET scan room when I threw up the next round of water. And when they asked me to roll over on the bed I threw up everything else. At least it was clear water and nothing smelly.

From the pathetic glances I received, I’m pretty sure all the Chinese people waiting to get PET scans thought I was on death’s doorstep and wondered how advanced my cancer was. They would never guess that a cup of coffee and a breakfast burrito might have kept all this from happening.

But once it started, I couldn’t stop. After my PET scan, I vomited at a restaurant and in a taxi on the way to the emergency room. After a few IV’s and a couple hours of napping, I was well enough to return home.

If it wasn’t the worst day of my life, it was certainly in a tie to be the worst day of my life.

Results

They emailed me my results in English. I got them Monday after the PET scan on a Friday.

I expected to read something like, “all clear.” Instead, they found five things wrong with me. A doctor would have to evaluate the results and let me know what’s going on. One item gave me concern that I was going to have to pack up and head back to America.

I sent the results to my doctor at MD Anderson at his personal email account and he wrote back on the 4th of July (his holiday) with his take on the situation. I love those MDA doctors and their helpful, dedicated service. His note put me at ease.

I couldn’t get an appointment with my Israeli doctor until ten days later, which was fine because I was gone on a week-long trip anyway.

Of the five things wrong with me, none of them are cancer, and none are life threatening! Yea! So the best news I got is confirmation that the cancer has not spread throughout my body, not to any part of it. For breast cancer patients, it is most likely to spread to lungs, brain, bones and liver. They said my brain was quite clear … haha!

I will have to follow-up on some of the five things they found wrong with me. For example, the PET scan showed I have chronic lung inflammation, and there is nothing that can be done about it to improve it. A few things may require follow-up ultrasounds. A few things were not easily explained, but neither doctor thought it was cancer spreading.

I’ll have future PET scans that can be compared to the one I just had. This one is the baseline one.

Who did this

I believe that God stopped the cancer from spreading to other places. He heard my cry for help.

So I want to say: Thank you God for all You have done for me, for sparing my life, for giving me hope to replace my despair. No one could do this but You.

May the Lord be praised,
for He has heard the sound of my pleading.
The Lord is my strength and my shield;
my heart trusts in Him, and I am helped.
Therefore my heart rejoices,
and I praise Him with my song.

Psalm 28:6-7 HCSB

Prayer request

Continue to pray for my damaged right arm and neck that restrict my daily activities. Day-to-day I get by okay, but when anything unusual comes up, like a trip, I need extra strength and medicine to feel up to the same level. I have a major trip approximately once a month.

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As far as my doctors in Houston can tell, my cancer is gone. But the war against that beast left me battle weary and scarred. Literally. I have Frankenstein-ish scars and scar tissue on my neck and upper body. I can’t turn my neck much, can’t raise my arm but a few inches, and live in a degree of post-surgical pain. The doctors say I may have to live with it forever. I also have fatigue from radiation that has vastly improved from this time last year, but still has a ways to go before I feel fully human again. If I have to live in pain, I’d rather do it overseas where I feel a purpose, rather than back home where I never could find a suitable one.

Some of you may think that because I returned overseas, I am back to my old self. But since I’m not, I’ll give you some things to pray about if you feel inclined to remember me.

  1. I feel blessed that there are several western-trained, English-speaking doctors in my city. Most are Singaporean, at least one is Filipino. They helped me find my cancer in the very beginning back in 2014; they know me quite well. My favorite doctor, Dr. L, has been able to help me with medication since I got back overseas. But the medication available here is slightly different from what I was able to get in America, and I haven’t yet found the right balance. Some of the stuff she gives me makes me groggy. I require extensive napping, which is fine if the need comes around on weekends! If I try not to take the medicine, my arm and neck pain are the only thing I can think about. I wouldn’t bother to mention this to you if it was just a little annoyance, but it is at the front and center of my life every day. I want to feel pain free, alert, and human. Please pray my doctor and I can strike the right balance. Pray that eventually I won’t need any meds at all.
  2. When I first went to MD Anderson in the fall of 2014, to the emergency room, they ran all kinds of CT scans and MRI’s trying to locate my cancer. The most horrifying thing was to get an exam, wait for the result, and then have the doctor stand in front of me with his/her mouth about to open with words that could change my life forever. I wondered if the next ten words I’d hear would herald life or death. It’s not a position you want to be in often. I haven’t had any of those kinds of exams in quite awhile, but I’m having a PET scan in July that should be able to detect cancer anywhere in my body. I’ll have the exam, then be gone on a week long trip. I won’t know the results until I get back. Please pray that no cancer is in my body for the PET scan to find. Ask God to clear away any remnants of disease and make me whole. ASK FOR GOOD NEWS! By the way, the PET scan will be in Shanghai. China’s only (as far I I can tell after doing research) western-trained, English-speaking cancer centers is there. The doctors there are compassionate and experienced.

Sometimes I worry that by talking about doctors all the time, you think I depend on them for my health. I do think they are a blessing. I believe God can and does use them. I also believe that God can do all things, including heal me, with or without the help of doctors or medicine. I love to read the stories in Matthew, Mark, Luke and John of the Bible, and see how God’s heart was always inclined to bring life to those who were sick. When we see the heart of Jesus, we see the heart of God. I never want anything I say about medicine and medical professionals to take away from what our loving Father can and wants to do in our bodies. Sometimes I struggle with how to express it well. But I know God and His work are more important than anything else, and that’s why I ask for prayers. My requests almost look like news bulletins, but in fact they are my way of seeking the intervention of God in my life, the type of intervention that surpasses human involvement. Please ask God to bestow His favor in my body and in my life.

I also realize that these past couple of years, I’ve had to think about myself a lot, while many of you were facing your own struggles that I heard little or nothing about. What can I do for you? How can I pray for you? Please let me know. You are my friends, and I want to be there for you in your time of need as you have been around for mine.

Trip to the doctor’s office

Seems like it should be an easy thing to take the 21-minute bullet train to the next city over to see the doctor and physical therapist. So why was I having such a hard time? I finally sat down to calculate, and discovered that from the time I walked out my door until I arrived at the doctor’s office, 2 hours 45 minutes were gone. Round-trip was 5-1/2 hours, only an hour of which I was seated. The humidity in this mostly un-air-conditioned country was as thick as molasses, up until massive thunderstorms rolled in to break it up. Either way, the weather conspired to keep my skin and hair miserably wet all day. I traveled by electric scooter, subway, train, subway again, and bus no. 11 (expat code for “my own two feet”) to get to the doctor’s office. Fortunately for me, a Starbucks recently opened at the local train station, to take away a little pain in the morning hours.  I happily collapsed on my soft bed in my air-conditioning bedroom at the end of the day. What can I say? Life’s not perfect, but it is good to be alive. Really, really good to be here and alive!

(Photos: Starbucks recently opened in both train stations. Unfortunately, on my next trip to the doc, I can’t eat or drink before I get there and have some tests done. The little pics above are within a few blocks of my doctor’s office. It’s a lovely, lovely area.)

It was a Sunday, but not a fun day

image (45)TODAY – I couldn’t keep my breakfast down and my head was throbbing. This happens 2 or 3 or 4 times a year. I knew I’d better get to the ER fast.

Of all the places to have need for an ER, this is the best I’ve found. I’ve had this ailment in America, Thailand, and China over the past 8 years. Once I went to a Chinese-run ER in the city where I live now, and it was pretty horrendous. But in this city there is also a medical practice operated by western-trained Singaporean doctors. They are open on weekends and evenings, they know me well, and I get immediate service. On top of that, the whole thing probably costs less than a hundred bucks. They file directly with my insurance too. Can’t beat the service or the price!

The doctor who saw me today is the same one who first found my cancer in August 2014; at that time, he sent me to another big city to get it further diagnosed (I went to Hong Kong). When I walked in today, he looked as if he was seeing a ghost. I don’t think he ever expected to see me again. It was a joyous thing … except for the part about me holding my head and wanting to throw up.

Three bags of IV’s later, a long afternoon nap and several medications later, I was as good as new. I really hate this headache/nausea combo though, and pray that it will never come back. It is not a good way to spend a Sunday.

I find myself appreciating doctors more and more as time goes by, and I’m also thankful for the generous health insurance plan provided by my employer. Mostly, I am thankful to a caring God who loves me and watches over me.