Chronology - Part 1 of 3

Of primary concern to all of us is news of Fiona`s relapse. I know that many of you have only heard of the many bits of news in snippets here and there. As you can imagine, it has been very difficult and tiring for us to cope with the situation, let alone repeat the news to the 20 or 30 concerned callers who try to reach us in a day. Thank you for being patient with us during this trying period. Let us try to give you a clearer picture of how things unfolded:

Monday, Aug 28, 2006 - Fiona complains of a shooting pain in her left leg, running from her hip to her feet. A friend recommends that she visit a Physiotherapist.

Tuesday, Aug 29, 2006 - In the morning, the session with the Physiotherapist doesn`t do much good, and she recommends that we visit an Orthopaedic Surgeon to verify that she doesn`t have anything like a slipped disc.

Tuesday, Aug 29, 2006 - In the afternoon, we visit the O.S at SJMC. He doesn`t think much of the pain initially, until we tell him of Fiona`s history with cancer. He immediately recommends a X-Rays, a Bone Scan, and MRI, and a CT Scan, to rule out a relapse. Fiona is admitted so that the tests can be done quickly.

Wednesday, Aug 30, 2006 - Instead of ruling out a relapse, the scans confirm that the cancer has returned and spread to 4-5 sites in Fiona`s bones, mainly in the pelvic bone, the spine, and the sternum. Of even more concern is the detection of fluid in the right lung, which is indicative of a spread to the lining of the lung. Due to the poor visibility caused by the fluid, there can be no certainty that the cancer has not penetrated the right lung. We quickly call Prof. Yip, who asks us to see her the next morning, despite it being the National Day holiday.

Thursday, Aug 31, 2006 - Prof. Yip confirms the initial diagnosis offered by the O.S. and outlines 2 possible approaches for treatment: Hormone Therapy (starve the cancer), Chemotherapy (directly attack the cancer, but potentially bad side effects). In addition, if the cancer is HER-2 positive, a new but expensive drug called Herceptin could be used. We decide that a Bone Biopsy would be best to confirm that the cancer would be responsive to Hormone Therapy or Herceptin. Prof also tells us of the options to strengthen Fiona`s bones to counter the weakening caused by Hormone Therapy.

Friday, Sep 1, 2006 - We return to SJMC to do a Bone Biopsy. Despite the assurances of the O.S., it turns out to be a painful procedure for Fiona. Results are only expected by the following week.

Friday, Sep 8, 2006 - The results for the Bone Biopsy finally arrive, and they indicate that Hormone Therapy is still viable, and that the HER-2 amplification status is normal (meaning Herceptin will not work, but also that the cancer is not as aggressive).

Monday, Sep 11, 2006 - We see Prof. Yip at the UH Oncology Clinic where we decide for Fiona to do an Oophorectomy (removal of ovaries) as the best solution to starve the cancer of the Hormones which promote its growth. We later see Prof. Paul Tay to schedule the surgery. He also recommends a Hysterectomy to remove any risk of cervical cancer. And we also decide that Prof. Yip should put in a Chemo Port to facilitate administering of I.V. treatment. The surgery for all 3 procedures is scheduled for the following Monday, Sep 18.

... to be continued.