This is what I've been looking forward to writing...

... since my last visit with my consultant on 23 December. She was pleased with the rate of my recovery from my second surgery in September although she warned that my blood-pressure is still on the low side. She was happy so long as I am eating well and not anaemic. My last hurdle to clear before I am certified fit to go back to work was the much dreaded colonoscopy; which was scheduled for 4 February. Senna and Picolax - can you guess what they do?  If you have picked up the "lax" at the end of the word then you are right!  The gruesome preparation for a colonoscopy here in the UK starts 3 days before (versus only 24 hours in Asia) the procedure. In fact, the Patient Information handbook urge patients to "follow each step of the preparation carefully" to avoid an unsuccessful procedure, which most likely leads to the scheduling of "another attempt of the procedure"! I'll bet this last sentence was enough to instill obedience in every patient of all ages to follow suit these steps:

1) week up to procedure - stop taking any iron tablets or medications to control diarrhoea till after procedure

2) 3 days before - avoid all high-fibre foods, fruits and vegetables till after procedure

3) 2 days before - stop intake of solid food at 2PM till after procedure (this one was particularly hard when my mum told me about all the yummy food they've been enjoying). Drink 50ml of Senna liquid (tastes like liquorice)

4) 1 day before - drink one packet of Picolax dissolved in a glass of water each at 8am and 4pm "you should experience bowel action within 2-3 hours"

5) Day of procedure - continue to drink only clear fluids up to 2 hours before the procedure, and remain nil by mouth till after the procedure

For the above three house-bound days, Brian borrowed the whole four series of Jeeves & Wooster on DVD from the local library. I nearly developed square eyes from watching them back to back on my computer - as the study is only next to the W.C. vs having to dash downstairs if I watched it on TV in the living room.

During the colonoscopy, I was taken on a guided tour of the inside of what's left of my colon; which was pink and full of bubbles (that explains the frequent farting). A rather fascinating experience to be looking at your own inside and chatting about it. I was glad I had adhered to the stringent preparation, or else we would have encountered a lot of poo along the guided tour! The report from the colorectal surgeon was positive: "Mrs Hitchcock's remaining colon is healthy and the anastomosis widely patent". I AM CLEAR (at least for now).

Thank you for praying with me and for cheering me on in the past 12 months. Your prayers and encouragement in the form of telephone calls, cards, emails, and "survival packs" all contributed to my experience with cancer. I am very grateful for your audience, and I hope that I will have the discipline to organise and compile my thoughts and experience in the near future. You will no doubt hear about it soon enough. I go back to the job I left exactly a year ago on 15 February :)

Hawaii is a magical place ^_^

All I can say is Hawaii does command the highest “wow factor score” – so do go see the sunset for yourself!  Everyone in Hawaii walks around sipping bottled water. Drinking water is mandatory in tropical Hawaii to avoid dehydration. It may even be the law! We quickly got into the habit of drinking WATER instead of cups of tea as we do in England. This, and eating heaps of fresh fruit and salad every everyday, did help settle my bowel movements! ^_^ As I mentioned earlier, I was rather worried about accessibility to the “right foods” when on holiday. I expected the abundance of fresh tropical fruits and vegetables, but I wasn’t sure if I should launch my back-to-normal diet while on holiday. In hindsight, being in a totally different environment is exactly what I needed to kick-start my rehabilitation into normality. Fruits were the easiest accessible food and to have around (both in the car and in the condo), and requires no cooking. At this point, I must stress that everyone who visits the beach must bring their own supplies i.e. drinks, food, towel, beach chair, fins & snorkel, and a book to read. Nearly all beaches do not have a café nearby and the car parks are usually a hike away. Unlike most locals who spend an average of two hours on the beach sunbathing or surfing then pack and go, Jack and I choose a spot and camp there for the day till the sun goes down! And so you can appreciate that we would lug along two gallon-bottles of drinking water, a cooler box packed with sandwiches and fruits, a kit bag with several pairs of fins (don’t ask me why when together we only have four feet!), several snorkels (again – Jack can’t decide if the ones with or without prescription is clearer under water!), and another kit bag with several towels, toiletries and a change of clothes (should we decide to go straight to a restaurant for dinner), AND the all-important beach chairs (essential to keep sand off one’s bum!). Yeap! THAT is a LOT of kit to lug from car to beach. I often utter “why do I feel like a camel?” in the midst of this task. But all is worthwhile when you find a good spot to spend the rest of the day. And a “good spot” will be one that is in close proximity to public facility a.k.a. toilets and showers ^_^

One day, Jack chose a rather secluded beach (with no public facilities) known to be a great for spotting dolphins and quite often, enjoy the company of green sea turtles (known as “honu”, who waddle onto the sand on the beach for a snooze. For these duo attractions, I couldn’t say no. We could have limited our stay on the beach but the attractions were far too tempting, and so I made sure I didn’t need to poo by not eating between breakfast and dinner. I drank lots of fluids and that kept me running behind a bush frequently. Soon after we had dinner that evening, I felt the urge to make room for the food I’ve just eaten. And so you see – this simple exercise helped me understand that I CAN control my output to some extend ^_^

November came and went

The day before we left for Hawaii, I had an appointment to see my oncologist for the scan results of the cyst on one of my ovaries. Apparently, it is normal for some to have an enlarged cyst before a menstrual cycle. The cyst has since subsided and everything seem to appear normal now. Praise God! That was one less worry, for I had several on my mind.  I have never been on a 3-week holiday in my life. With no agenda nor purpose i.e. dropping in on friends enroute or participating in some form of sports event, I was not sure how I would cope mentally. The thought of sand between my toes made me cringe (those who know me well will know this is a fact). When I am on panic-mode, all sorts of scenarios came to mind - what if: 1) the "fasten seatbelt" sign is on when I need to use the toilet? 2) the inflight toilets are occupied and there is a long waiting line to use one? 3) Jack chooses to visit a remote beach where there are no (toilet & shower) facilities? On top of all that, my second wound was still sore - sneezing and coughing will still make my eyes water :(  In short, I lack self confidence.  Aaaaaaaaaaaaaaaah!

I remember coming home from my appointment with my oncologist and making myself a cup of tea for myself. As I sat nursing my cup of tea, the words on my mug caught my attention. It read "Stay Calm and Carry On". Well, there you go! Life is too short to start worrying about what may be, or not. I have never wasted my time on worrying about things beyond my own control and I reckon I shouldn't start doing that now. It is realistic to be aware of one's own short-comings and I was determined not to let fear overcome me and spoil our long-postponed holiday. And on that very positive note, I threw a couple of t-shirts and some shorts into a bag and off we went on our transatlantic flight to Kona, Hawaii, that took a total of 32 flying hours (excluding waiting time for connecting flights) with FOUR transit stops. We made the best use of our time stuck at airport terminals to freshen up in those numerous and HUGE toilet areas, and set loose our "shopper-saurus" instincts as we stuck our noses in every shop that was open :)

And I can honestly say now that being in a totally different environment offers independence.  There are too many (good) distractions that make you forget own fragile condition, and no one to remind you of your situation. Back in Topsham, nearly everyone I bump into in town would ask about my condition and remind me to "take it easy". I am sure it is all out of concern from their good hearts. But I often feel I mustn't be too chirpy because I am aware of some families with a cancer-victim in their midst. My seemingly remarkable speed of recovery can cause polar reactions and unnecessary emotional stress :( I will write more about this later.

Recollections of my first chemo infusion treatment on 4 may 2010

Jack took the day off to be with me (but that often means more rushing around as he tries to pack more in for the day).

We arrived on time at Cherry Ward, RD&E Wonford. Upon checking in with the receptionist and paying 20 pence for my special chemo-treatment parking permit, Jack was sent off to display the permit on the car dashboard while I made a cup of tea at the self service counter and helped myself to the complimentary chocolate biscuits. Nervous munching.

A few minutes later, with a mouthful of chocolate crumbs, I heard the matron call my name. She showed us into the room where two other patients' treatments were in process - an old gentleman in a reclining chair for chemo, and an old lady lying in a bed having a blood transfusion. Before my seat was warm, the old gentleman had finished with his treatment. After the nurse removed his intravenous tube, he promptly stood up, walking stick in hand and marched out of the room. Wow! I told the matron that I’d like to finish my treatment today just like that old gentleman! The matron smiled. Very diplomatic, I thought. She took my "appointed" arm and examined for a "good vein". In fact, she had been eyeing both my arms for as long as we've met! She said I've got generally good veins and she's looking for the straightest stretch of the vein to stick the needle in, and it is very important that I KEEP STILL. (Uh oh! Might I be dealing with a matron with shaky hands here.)? I decided the safest thing to do at this moment was to look away. Jack sat up from his chair next to me and pulled him closer to have a better view of the process ... You would never have guessed - the "straightest stretch" of my vein is half way up my arm towards my elbow! Thank goodness - her first attempt was successful and I was spared the trauma of multiple pricks! I was surprised that the matron had used a yellow needle contrary to my understanding that the smallest one (pink/red to my understanding) will be used. When I tried to verify that, the matron explained that surgery ward staff always tell patients they have used the smallest needle on them just to ease the patient's anxiety ... and because the needle has to cater for emergency situations, all surgery patients are given the biggest red/pink needle as a precaution - which was what I had :0 (mental note for future hospitalization: Never trust what those hospital staff says again!)

After reconfirming who I am (to ensure that I haven't transformed into someone/something else between the waiting room and the treatment room), the matron and a staff nurse go through a dual-control procedure that made me laugh. OK. It is important to avoid giving the wrong medication to a patient, but isn't now a bit late for this? The matron said it isn't as she has only started flushing my vein with glucose and the second was a bag of anti-sickness. No medication has been administered as yet. (Hmmm .... "glucose"? Goodness! Aren't they supposed to sedate me rather than get me bouncing off the wall!?!)

The staff excused themselves for some reason and I jumped at the opportunity to say a little prayer with Jack. We committed the time to God and trust in Him that this is the process He has planned for me. And that we accept that if we cannot conceive in future, it is also His perfect plan for our marriage. We left our hopes at His feet.

1:00PM: The point of no return. Poor Jack had to put up with my crying when the matron plugged the Oxaliplatin to my intravenous tube. So, you see, I'm not that brave after all. So much went through my head (ouch!), I was hyperventilating! One thought was a death sentence scene from a movie (been watching Prison Break with Jack the night before). Not a good start ... I shall remember to reboot my mind to think of something else next time. But the main thought was around the possible damage to my ovaries :( As a healthy individual, I was sitting there helplessly waiting for this bagful of poison to flow inside me and cause havoc and destroy the very life form that constitutes to my well being now. I had this huge urge to pull the intravenous needle out of my arm. The thought was quickly quashed - you should have seen the way the matron had criss-crossed tape over the needle to ensure it stayed where it should! Darn!

For the past weeks, I had put aside all the bits that I was to take with me on my chemo treatment. Guess what? As we rushed out of the door, I totally forgot about the bag with my lemon-flavored ginger preserves (courtesy of my Hong Kong friends), my iPod (soft, soothing music was highly recommended but I think I'll stick to ACDC), etc. Useless. Just as I NEED them most HERE & NOW! Thank goodness Jack managed to find some Polo Mints at the hospital newsstand. I scoffed them up like I've never before to overcome a horrible taste of metal that came on so quickly in my mouth! Blah! Yurk! :(

As the Oxaliplatin has to be packed in an ice sleeve to stay cold, it is very cold when it entered my vein. The freeze seized the muscles of my entire arm :( A little electric blanket to offer a bit of relieve is wrapped around my scrawny arm. However, my arm was ceasing up all the way up my shoulder during the whole process that took more than two hours. Although there are no bruises from the process, my whole arm feels like it's taken a few hard punches even at this time :( (mental note for next treatment: offer other arm!)

And you must know what nervousness makes one do? Yeap. Go to the toilet. Picture me dragging this wheeler-pole with a big bag of drip along a corridor THREE times (that's a total of six trips)! The other patients must think I have a terribly weak bladder ... Brian was expressionless on my third trip. Not surprised.

Just after 4PM, the pump box on my wheeler-pole bleeped. That means the process has completed. Hooray! The matron came and replaced the tube with another bag of glucose to "flush" my vein again :) (Ha! This one is to boot me up like it did that old gentleman earlier!) She also took the opportunity to brief me on the bagful of boxes of tablets I am to take when I get home. I was too anxious to get out and nodded to everything she said and hoped that Brian was listening.

I felt fine so as we were walking through the hospital, I was saying to Jack perhaps we might take a drive to Budleigh Salterton beach for a stroll before we went home. The instant I stepped beyond the automatic doors of the hospital on to the road towards the car park, a gust of wind brought severe pins-and-needles sensation to my hands and face. While Jack continued to walk ahead of me, I had made a u-turn and walked straight back into the hospital and stood in a corner, crying in shock! It was nearly a whole minute before Jack came looking for me and found me. I huddled up to him and he held me tight and walked briskly towards our little car. The pins-and-needles just won't go away no matter how I rubbed my hands to warm them :( When we got home and I tried to open the door, I got "zapped" again. (mental note: gloves!!!) Soon, nausea set in and I was not much company the rest of the evening. Jack made mash from scratch and we had my favorite Birds Eye fish fingers with it. Swallowing was difficult and Jack sat with me for a long time after he had finished his meal, just to make sure I finished mine too.

8 o'clock is no longer a time I want to see on my clock anymore. This is the appointed hour, day and night, for taking my THREE ENORMOUS 500gm chemo tablets, The XELODA pill, Capecibabine, that MUST NOT be broken up to smaller pieces for easy consumption. The matron said it is important to take them whole within 30 minutes of having food :( (now why did I remember THAT part of her lengthy instructions?). There are two different types of anti-nausea tablets to confuse things further. It took me nearly twenty minutes to swallow all those tablets. Each one seemed to rock down my throat in the bumpiest way possible - much like trying to slide down a tunnel lined with crumpled newspapers! Like I said in my last email, I have to tilt my head back and stretch my throat to attempt to create a straighter path (like the giraffe at Longleat safari park!), and stroke my throat with one hand to ease the tablets down. I vaguely recall the matron also mentioned that the tablets must not be taken with some kind of fruit juice. Well, I can't remember if it was grapefruit or cranberry juice. To avoid disaster, I took the tablets with warm water. And right now, water tastes like custard gone bad :( (mental note: must find a safe place to store these poisonous tablets away from our usual meds in case Jack reaches out for the wrong thing in the middle of the night!)

My highly exaggerated sensitivity to cold means no ice-cream treats :( (And I had just stocked up on tubs of my favorite Haagen Dazs flavors the day before! Boo!)

Concentration - nowhere to be found. Could hardly read five sentences and my eyes start to blur. The connection from eye to brain (ouch!) seem to be disconnected ... It has taken me many attempts to write this email.

Hands and feet - thank goodness it is only the cold I am ultra sensitive to. Can't imagine having to miss my daily hot shower ... standing under a hot running shower has been the highlight of my days post surgery. I miss having a bubble bath. But I'm not about to risk it with my stoma. Jack treated me to a hand massage in the evening after my tablets. A tube of some form of cream came with my tablets and I'm supposed to apply it twice a day on my hands and feet to overcome possible flaking! :0 (at the time of sending this email, my hands have started to flake)

And speaking of stoma - for the first time, I'm grateful to have stoma. Diarrhea is a common side effect during chemo treatment. Imagine the number of loo trips I'll be making through the night and day if not for my stoma bag!

Sleep - The good thing about lying in the bedroom means I can hear the local church bells ringing last night (Thursday)  :) Bless my fellow bell ringers, who must have put in extra effort to ring those melodious changes. All this sleeping in the day is causing me to be awake by 4AM :( We woke up this morning (Friday) wondering if we have a proper new government. No such luck. :0

Quick update after first chemo infusion

I know you must be anxious to hear from me. I will write in detail (from my notes I'm taking along the way) when I feel better but right now, I can only muster this much...

In a nutshell - I survived my first chemo infusion on Tuesday. A total volume of 542 ml of an Oxaliplatin and glucose concoction infusion was successfully administered intravenously over just two hours. The ice pack cover over the infusion bag was dubiously labeled "CAUTION CYTOTOXIC DRUG - Vesicant". They may as well have simply put the pirate's skull-and-cross-bones sign across it! I'm currently experiencing the worse end of the possible side effects described in the literature:
1) Severe pins-and-needles sensation in both hands (versus "tingling at finger tips"). Hands are very stiff - I can't curve my fingers over my computer-mouse. I'm typing only with my index fingers!
2) Extremely sensitive to cold - touching a doorknob or cup is like holding a block of ice in my bare hands! Sensation is HIGHLY exaggerated.
3) Throat seems to have shrunk at least half in size and the membranes seem to have wrinkled up like crushed paper - apart from liquid, everything I try to swallow seems to get stuck just two inches behind my throat :( I've come up with a solution - think giraffe!
4) Appetite nowhere to be found - actually forgot to have lunch yesterday 'cause didn't feel hungry at all :( Sad when you think how much I love my food...
5) fatique, Fatique, FATIQUE - this needs no elaboration. Branson must be annoyed to have to share the bed with me ALL day versus the norm of having it all to himself during the day!

Will be interesting when the rest of the possible side effects set in i.e. memory loss! Hahahaha! Might be a good idea 'cause I won't even remember the reason for popping those huge tablets!

Please continue to pray for Jack. I've not seen him so worried...

p.s. Buddy should be completing his Topsham tour and leaving the UK to embark on his world tour beginning with the USA by mid next week.