Next phase

Recently, I accompanied my dad at his follow-up appointment with Penang GH's oncologist. Surprisingly, we waited only 1 hour before being called into the room, crammed with 3 doctors @@

(1) Renal function test results seem ok, just below borderline.

(2) Tumour marker (pancreas) level has increased again, from 80+ to 133.

(3) When asked by oncologist, dad said yes to chemotherapy. When asked by dad, the oncologist also recommended that treatment since dad is (relatively) healthy. If the response rate is good, the pain in his leg will likely be gone. I have strong suspicion that that's just a guess on her part.

(4) Will start chemo 2 weeks later. 6 cycles. 1 cycle: chemo on day 1 and 8, and then rest until day 21.

(5) Dad will need to go for blood test on the day before chemo and to bring the results to hospital when going for chemo.

(6) If during chemo treatment dad falls sick e.g. fever, he is to go to emergency ward (of any hospital) and inform doctor he's under chemo treatment.

I forgot to ask which chemo drugs they're prescribing (will it be 1 or 2 drugs?).

Waited for another hour before the palliative care unit specialist met us.

(5) Asked quite a number of questions about leg and history.

(6) Interestingly, there were quite long pause in between (at least 30seconds) where he was seemingly deep in though.

(7) Prescribed morphine, to be taken once every 4 hours and on adhoc basis if pain appears in between; constipation medicine, taken before bed, in anticipation of side effect from morphine; and Gabapentin (painkiller), to be taken at night before sleep.

Waited another 20mins before collecting medicine. Overall, it was quite a fast process especially for a public hospital. The most time consuming bit was traveling in the morning and so our errand took a total 6 hours.

Kopitan Classic

Kopitan Classic 1

I had this chendol (RM4.90) at Kopital Classic while waiting for my sisters, b-i-l, nephew and niece to finish cycling at Occupy Beach Street.

Noticed something odd? It was ice-blended instead of shaved ice. So strange. No large chunky ice for sure. Unfortunately, many other chendol are better than this especially given its price.

Plugged in, not charging: Part 1

(1) From 100% to 40+%, then slowly increased to 53% before plummeted to 3%! Now back to 6%.

(2) Bios: battery operating normally. Dell Support Assist: passed batter test.

(3) Used Ban's laptop adapter. No change.

(4) Dell engineer: changed motherboard and the power input jack.

(5) Dell engineer: changed motherboard and power adapter. Advised to get new battery but he would ask Dell to refund me if that doesn't solve it.

(6) Meanwhile, discovered sound is too low and muffled, similar to previous incident. Informed CSO of this and (5) above.

(7) Then discovered my laptop was performing like a tortoise, similar to what I experienced before. Checked IRST: disk wasn't accelerated. Accelerated it. Still started slow and programme started slow initially but subsequent usage was normal. Saw the RAID cache volume's cache mode is off. Don't know that's normal. Tried to find out but no success. In the end, updated driver of the SATA RAID Controller and it worked. Note that Windows kept saying the driver is updated but the software Driver Easy found the latest version (happened many times before).

(8) IRST app then didn't work. So downloaded directly from Intel. In there, it said that by default the cache mode is off. That's good to know!

(9) Headphone jack now rarely works :(

(10) Dell said they have no battery in stock for my laptop. What?! Also, "Dispatch has got Delayed due to part at backlog" Omg @@.

Japanese rose

One day, many moons ago, after a seafood meal at a rather rural area in Penang, we saw this plant at that restaurant. We are already familiar with it and so my sister (thank you!) decided to...errmm...take some sample to cultivate them at home. Do not need the entire plant; steam will do but make sure there is at least 1 node so that it can branch out.

They have flourished well, taken care by a few people in the household:

Japanese rose plant 1

Japanese rose plant 2

Seeing them always make me feel a little bit more cheery :)

Udon Kobo Min Min

Arata has already closed down years ago and currently Udon Kobo Min Min is operating at that shop lot.

Udon Kobo 1

This is ChaShu Udon (RM19.90). There were 3 slices of chashu which tasted ok. When it arrived, I couldn't smell the soup but I guess it's normal for udon soup? The soup was clear and just right in taste i.e. lightly salted. Unfortunately, the udon was not soft enough for me.

There was yuzu peel inside this dish! First time ever for me. I'm not sure whether it actually enhanced the dish or not but it wasn't bad at all. Certainly different.

Udon Kobo 2

I decided to be adventurous that night and ordered, for the first time, yuzu sherbert (imported). It was aromatic and had yuzu peel in it too. I highly recommend this dessert.

I may dine here again in future and perhaps try a different udon dish. For sure, I will have their yuzu sherbert again :)

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Unexpected advice

About a week after meeting Dr D, my dad had a appointment with the oncologist at Penang GH. Surprising, he did not recommend chemotherapy and instead would continue treating symptoms. The only pain right now is on his left leg. The specialist recommended upping the Tramadol dosage from 3 to 4 times a day. If that becomes ineffective, then small dosage of morphine will be prescribed.

With regard to the tumour at the lymph node, he acknowledged that it has grown bigger but it's still small. Also, there was no further spread of cancer.

When the time comes for chemotherapy, he would recommend 6 cycles but with only 1 type of drug (rather than the 2 types that have been consistently recommended by the other 3 oncologists) so that it's less harsh on the weaker organs.

He asked dad to go for tumour marker tests and to meet him again in a few weeks time to look at the results as well as to get an update on my dad's left leg.

Currently I have reservation about this because we've been following Dr D's advice and knowing how much she prioritises quality of life, I put lots of weight on her recommendation of chemotherapy. I hope my dad understands that the risk of delaying this treatment is that his health may deteriorate even further when he finally goes for it and so he may even feel worse.

Family vacation on Penang island

My youngest sister surprised us by saying that there was another family vacation planned for the next weekend after the trip to Ipoh. This time it was a two-night stay on Penang island (we spent 3 nights in Ipoh).

Here's a summary of what we did on Penang island:

(1) Had curry mee made by the Two Sisters, and the famous asam laksa next to the market, both at Air Itam. Both are good. The former was unlike any curry mee I know (not that I had many though). The latter was not as spicy as I expected.

(2) Had oh chien (oyster omellete) Joo Hooi Cafe (I had some egg and no oyster haha), and the famous Teochew chendol just beside the shop. Love the egg part of the former (not an oyster fan) and, as usual, love the chendol.

(3) Had kway chap with duck meat and pork innards at Kimberley Street. Delicious! Later, had soupy dessert and bought some Nyonya rice dumpling. Both were good although the latter lacked some spices.

(4) Took funicular train up to Penang Hill. Fun fact: cheap entrance fee at night. Didn't spend too long there as it was getting cold for parents and we didn't wear shoes for walking.

View from Penang Hill

(5) Shared a bowl rough mee hoon soup with prawns, a bowl with pork and its innard, a separate bowl with pork and bittergourd and 2 bowls of yam rice at Hon Kei. Quite delicious although I wouldn't request a trip there for myself.

(6) Went to 1st Avenue and Prangin Mall for a variety of reasons. Fun fact: there is no supermarket in either of these malls @@.

(7) Went to D'seafood Paadise (first time trying, first-choice shop closed) and had ikan bakar (bbq-ed fish), soft-shell crab deep-fried with flour, stir-fried belitung (obtuse horn shell), bbq-ed cockle and stir-fried mixed vegetables. They were all delicious. The best was the soft-shell crab which was hardly greasy. The stir-fried belitung was too spicy: burnt lips, burnt tongue. This despite us choosing black-pepper over chilli (we were given only these two choices when ordering). Looked too red for black-pepper. It was much later we were told by a waitress and the cashier that there were other non-spicy options. The least satisfactory was the vegetables: too expensive for its portion. Still, it's the best dining experience of this trip for me.

(8) Went to Occupy Beach Street. Had delicious coconut ice-cream while some family members rented bicycles and cycled the kids around.

(9) Had Chinese dishes with rice at Tek Sen Restaurant. Pretty good, especially the claypot tofu with mixed vegetables.

Leg, kidney, CT scan

Two months after the radiotherapy, the pain in my dad's left leg came back. This time, the pain was a little different (I forgot what's the difference). It started very mild but become increasingly more painful such that he needed to take painkillers 4 to 5 times a week. The pain also started to spread.

Naturally we suspect it could be due to the growth of residual tumour there. We consulted her. After asking some questions and checking my dad, she discussed a couple of options and ended by recommending a CT scan. Since dad was going to have an initial appointment with Penang GH's oncologist in about a week (his aim was to have chemotherapy there when the time comes), she recommended an almost whole-body CT scan so that the results could be used by Penang GH's oncologist immediately (rather than ordering one for an update).

Firstly, she ordered blood test to check his kidney function as he has only one kidney now. Unfortunately, the indicator has fallen from 64 and 53. Hence, she ordered hydration for 2 hours before the CT scan and another hydration for 4 hours after it. The hospital would charge us a full day stay at its ward regardless of whether he wished to stay overnight or not. Since it would be late at the end of it, he stayed overnight and Dr D would see him in late morning the day after with the CT scan results.

This was unexpected and so we didn't make any preparation for the overnight stay. It takes about 55mins to travel from Butterworth to the hospital and so it's not practical to go back and forth. Poor dad.

The next morning, my sister and I arrived and waited with my dad for the discharge process to be completed. Then later, we waited to see Dr D to discuss the results of the CT scans, once she received them.

Good news: there's no discernible growth in his leg and so it's the pain is unlikely caused by tumour. He's advised to tone down his walks substantially e.g. start with half and hour gentle walk before increase its intensity and/or duration gradually. Meanwhile, use Tramadol to manage the pain.

Bad news: the tumour at the lymph node has grown. Dr D said this might be a good time to have chemotherapy given that dad is still healthy and before he experience more pain (probably referring to his leg). So the next step is to see the Penang GH's oncologist, with the expectation that he would recommend chemotherapy. 

3 meals

Simonlover: It's actually better to eat 5 meals a day but in smaller portion. People usually have normal meals 3 times a day.

Ban: Huh? 3 meals? *started counting on his fingers* Lunch, dinner and ... ?

Derek: Breakfast lah! You wake up late, that's why you don't have it.

Everyone laughed hahaha.