Angels Watching Over Her

Through the turmoil of the last 24 hours, we are convinced that God has sent angels to watch over Fiona. Some of these are in the guise of people who amaze us with their compassion and dedication to blessing others.

One such person is Dr Loh Ee Chin, who is one of the very few palliative care doctors in Malaysia. Dr Loh was a true blessing today.

Last night, at about 1.30am, Fiona's breathing worsened. She was put on nebulizer to clear her lungs but she eventually required the oxygen supply to be turned up to the maximum level of 15 litres per minute due to increasing severe breathlessness. This lasted well into the morning, and even at 15lpm, she was experiencing panic attacks. The deterioration was shocking.

When contacted, Dr Loh immediately came to the hospital despite it being a Sunday and having her own plans for the day. After an examination, Dr Loh proceeded to check and clear the catheters coming from Fiona's lungs, and drain whatever fluid she could. This was a long procedure but made comfortable by Dr Loh's gentle and caring touch. Within a couple of hours of the procedure, Fiona was able to reduce her oxygen intake to about 4lpm.

At the time of this entry, she is sleeping well, after having had a simple but tasty late dinner of porridge and papaya (which she enjoyed immensely). She is on 3-4lpm and is comfortable. All praise and thanks to God for the angels He sends in different guises to remind us of His love and faithfulness.

No Words

The doctors believe the cancer has infiltrated the lungs, as evidenced by the way Fiona is breathing.

She is resting now, under some sedation by drugs meant to clear congestion in her chest. She will remain partially sedated for the next 3 days in an attempt to help her regain her strength. Her breathing remains very laboured. We hope this will improve with medication.

At this time, she remains under close watch by Jeff and his sister Marianne. We would ask for no visitors for the next few days so that Fiona has 100% chance at rest and recovering her strength. Thanks for understanding.

Rough Seas

The past two days have been very tough for Fiona. She started Chemotherapy as planned, a long series of IV drips. It has caused a fair bit of discomfort, but she seemed to ride through it fine.

Last night, however, Fiona went into a series of panic attacks where she had great difficulty breathing. As this entry is posted, that dificulty continues, even with greatly increased oxygen supply. Observing her effort to take each breath, it looks as if she is fighting for her life. The doctors are speculating as to the cause of this but we do not yet have a clear answer.

Please continue to pray for relief from this difficulty.

Busy Rest

Even as Fiona seeks to regain her strength at the hospital, many things are happening.

On Monday afternoon, the procedure to insert catheters into both lungs took place as planned. We give thanks that it went well. Much fluid was extracted and the catheters are staying in for up to a week to allow the lungs to fully drain.

The planned CTPA scan took place on Tuesday. We are very thankful that Fiona's lungs and heart looked fine. However we are much concerned that the radiologist believes that there may be small lesions in the liver. The oncologist believes that this is consistent with recent liver test results which have not been good.

As a result of the continued breathlessness and liver findings, it has been recommended that Fiona starts a new round of Chemo sooner rather than later. We expect the first cycle to begin Thursday.

Day to day, Fiona is getting good rest at the hospital. She is sleeping much better now. We continue to hope that the breathlessness will cease. Right now, she continues to be dependent on the oxygen supply. While she is awake, we continue to be very thankful that she is being well looked after. Thank you again to all those who are spending time with her or cooking for her. You are a great blessing to us.

Please continue to pray hard. Pray for the breathlessness to clear, and for the chemotherapy to work well without causing side effects. God bless.

Still Running

With the weekend over, Fiona is pretty much where she was on Saturday afternoon i.e. breathing on less oxygen, but still dependent on it. She is able to come off for short periods (a minute or two), but any exertion, such as taking a few steps, or even coughing, and she will need relief from the oxygen supply.

Later today, she will undergo another procedure to insert a "pig-tail catheter", ultrasound guided, into her right lung to drain more fluid. We're hoping that this helps the breathlessness sufficiently to allow her to go off the oxygen. A CTPA scan (CT Pulmonary Artery) is also planned tomorrow to rule out the possibility of a pulmonary embolism (blood clot).

When she strengthens, we will restart chemotherapy, probably on Gemcitabine+Cisplatin. The disease is progressing, and the doctors suggest that we need to address that as soon as Fiona is strong enough.

Either way, Fiona will have to remain in the hospital until at least the end of the week.

For those who have called to find out her progress and/or have visited, thanks for your concern and prayers, they are much appreciated. Many thanks too to those who have already provided help in so many ways, from taking care of the kids to sitting with Fiona while Jeff dashes home for a bit.

We also great appreciate Jeff's colleagues and clients who are so understanding when he needs to take time off to be with Fiona. The flexibility they have exhibited is unprecedented and a real blessing.

If you plan to visit, Fiona is at UH, Menara Timur, Ward 7TE, bed 6. Do call Jeff first to check on Fiona's condition. There may be days when she requires recovery time from one procedure or another, or just tired. Visits should not exceed 9pm, as she does need her rest badly. (And if you are not well, it would be better if you didn't come as she can't really handle any further problems at this time!)

In terms of help, we are so blessed to be getting lots of it. Our family members and church friends have covered Fiona's needs completely for food and company. They have our unending thanks.

If you do call or SMS and do not get a response, please forgive us. As you can imagine, we have been fairly inundated with these and may miss out responding to some. Check this blog and please tell others about it. We will keep it updated every couple of days or so. It would be a lot stressful than having to individually respond to every message and missed call.

Above all, thanks for your prayers, and don't stop praying.

The Calm after the Storm

It has been a tumultuous few days but there is a calm after the storm and for this we are so thankful.

After the last visit to see the doctor, Fiona's breathing had steadily deteriorated and breathlessness started with less and less exertions. On Wednesday, this looked so bad that we contacted Prof Yip to get us connected to Hospis Malaysia. This connection took place very quickly and we were able to pick up an Oxygen Concentrator to assist Fiona in her breathing.

The machine seemed to become a double-edged sword as Fiona immediately was able to breathe better, but also quickly became dependent on the oxygen supply, so much so that she quickly became distressed without it. Rather than allow her to grow stronger through better rest, it seemed to worsen her ability to breathe independently. Worse, her sleep quality did not improve as her continued and repeated breathless episodes at night prevented her from getting any real rest.

This all came to a head on Friday morning when we realised that the worsening of her condition needed intervention in the form of another visit to the hospital. Even the trip to the hospital was difficult, as it required Fiona to use a portable oxygen tank. Upon arrival at the hospital, we realised the extent of the deterioration of her condition when she was not able to make the walk into the hospital but required a wheelchair and a continuous supply of oxygen.

A quick X-ray revealed that the amount of fluid in both lungs had visibly increased. And Prof Yip's assessment of her condition was that she needed immediate hospitalization. So Fiona was admitted on Friday morning. With an acute shortage of space, Fiona was given a bed in an open ward rather than a preferred single room. Still, it was a peaceful ward, and the environment seemed alright.

Arriving at her bed, Prof wasted no time and began the procedure to extract the liquid from Fiona's right lung. After a painful 30 minutes, some 700ml had been extracted. This was followed by a painful few hours of recovery, as the local anesthesia wore off and Fiona experienced the full pain of having had a thick needle in her back. After the pain had dimmed to a bearable level, it became apparent that there was little effect on Fiona's breathing. She was still as dependent on the oxygen.

Still, the night bore some good fruit. Fiona was able to get more rest than on previous nights.

In the morning, Prof decided to repeat the lung tap, but this time on the left lung. This procedure, as painful as the first, extracted some 900ml of fluid. Worse, this was followed by terrible coughing spasms lasting 90 minutes, an awful experience. When this finally ceased, Fiona was able to rest, but it seemed that the second procedure also had had little effect on Fiona's breathing and dependence on oxygen.

We then decided that she should stay in the hospital for at least a few more days as it would be very difficult to cope at home without medical care. After this, Fiona rested.

Things were very different in the afternoon. Waking from her sleep, she declared that she felt better and decided to try weaning herself off the oxygen supply. Amazingly, she was able to stay off for 20 minutes when she could barely have managed 20 seconds earlier that day! However, because her blood oxygen levels were measured to be below normal, we decided to put her back onto the oxygen supply, but at no more than half the previous flow rate.

Things only got better from then on. She was able to have dinner with little oxygen assistance, she was able to make a trip to the bathroom (something we so easily take for granted), and she was able to speak to visitors (when breathing would previously have caused breathlessness). Her energy levels were clearly picking up, and smiles were more forthcoming and frequent.

Even as this entry is posted, she sleeps soundly, breathing smoothly and seemingly effortlessly, something not seen a while.

There is little to say except to praise God for His mercies and His quiet miracles to remind us that, even in a storm, He is still a sovereign and faithful God. Thank you Lord.

And for all your prayers and kind thoughts and wishes, thank you and God bless you.  Please keep praying.

Tough Going

Fiona had breathing problems in the last day or two, especially at night. We paid a visit to Prof Yip today and her assessment is that the disease may have spread into the lungs, thereby causing even greater problems than just the water alone. She suggested that we restart some form of treatment right away. We agreed on Aromasin (a form of Hormone Therapy) and that will start today. She has also suggested that we look to a Hospice to get a tank of oxygen for Fiona should she need it. This is not someplace we wanted to get to. Please keep praying.

Slow Recovery

Hi all. This is just a quick update on Fiona's condition.

Wish we could report that all is well. Unfortunately, Fiona continues to experience breathlessness and coughing. The coughing comes and goes, but the breathlessness has not shown any improvement. If anything, it might be getting a bit worse.

The coughing also got especially bad yesterday. A quick visit to the local GP revealed that she has developed a throat infection. It's back onto antibiotics for now. Will be contacting the doctors at UMMC to see if anything can or should be done about the breathlessness.

Directions

Our visit to UMMC yesterday revealed possible reasons for Fiona's slow recovery as well as some new options for treatment.

Firstly, a chest X-ray revealed a penumothorax (a pocket of air outside the lung) and a partial collapse of the right lung. These are likely the cause for Fiona's continued breathlessness. (She is able to move about well, but gets breathless after climbing a flight of stairs or walking a short distance.) The doctors say that this should improve over time, maybe a few weeks. Please pray that this happens quickly.

There is also the possibility that the Pleurodesis procedure was not successful, which means that, after all the effort, it will not stop the increase of water in the lungs.

We have been asked to consider restarting some form of treatment soon. It has been suggested that Fiona starts another course of Hormone Therapy, either Aromasin (Exemestane) or Faslodex (Fulvestrant). While these are less toxic than chemo, they still have their side effects. Please pray along with us for wisdom in this decision.

Our next appointment will be on September 2.

On The Road to Recovery

Hello all!  Thank you for the many messages expressing your caring and concern.  It has been good hearing from so many of you and we appreciate your fellowship.  We have also received some suggestions for persons to contact regarding Oncologists in Singapore.  Thank you for those, they are very helpful.

As a quick update, we are glad that Fiona is recovering from her last procedure.  The recovery is a bit slow.  She continues to cough and the pain in the ribs and back are still there, albeit reduced in intensity and frequency.  Her gastric pains are also significantly less but not all gone yet.  Of greater concern is that she still has a tendency to get breathless after minor exertions like climbing the stairs.  Our next appointment with Prof Yip is on Tuesday.  In the meantime, we would appreciate your prayers for a complete recovery from these and regaining of strength.