By Day 5 of Cycle 1 FOLFOX regimen, my dad had enough and wanted to stop chemo, thinking that the pain and discomfort he was experiencing were all the chemo's side effects. With information from my sister (I was back in PJ), I called and talked with my dad. In short, I told him
  • that he had the current symptoms previously (i.e. not during chemo treatment)
  • that the hope was that the chemo would be effective to lessen these symptoms but needed time for it to work
  • to consult the hospice nurse (she was going to visit the next day) and the PCU specialist (appointment was 4 days later); tell them where the pain and discomfort were and how them how often they occured
The hospice nurse brought a doctor with her this time. They concurred that most of the symptoms were existing ones but the chemo probably caused more bloating (and hence more frequent vomiting of gas). The doctor suggested taking the omeprazole 1 tablet twice a day, instead of 2 tablets once a day. They also encouraged dad to be more positive. Other patients were in significantly worse conditions than he was.

We also borrowed a adjustable reclining bed and a wheelchair from the hospice. The bed worked wonderfully for my dad's sleep. Yay! Yet to need the wheelchair though but good to have it on standby.

Miraculously, dad felt so much better on Day 7, so much so that he could drive to town and do some grocery shopping with my sister's maid. He was taking paracetamol (for his back pain) less frequently and only 1 tablet instead of 2 each time.

PCU specialist was quite happy to continue with the current medication and its dosage but did suggest upping Oxynorm to 10mg to see whether that helped his back pain or not (instead of relying on paracetamol). If not, revert back to paracetamol. He also said that if paracetamol is sufficient, it's better not the substitute it with Tramadol (as advised by the ward's doctor).

By Day 10, he didn't need to take paracetamol and Oxynorm. This is almost miraculous! I hope it'll only get better for him.

A (lucky?) walk-in

My mum tried to follow the psychogeriatric's advice. She managed to successful stop taking benzhoxol but still couldn't go without clonazepam. The dizziness worsened and so, upon Dr N's advice (she kindly responded to my text), we decided to consult GH's psychiatrist as a walk-in patient.

Turned out that there was no clinic day that morning and so my mum was attended quite quickly by the stand-by psychiatrist. We were a little worried that she would be asked to go through the outpatient clinic first because there was a sign stating the procedure for walk-in patient but the doctor, later on while we were parting ways, assured my mum that she could go straight to the clinic.

We briefed the doctor on the situation and also told her of the psychogeriatric's plan. After consulting a senior specialist, she suggested the following:

(1) Cut off the day time olanzapine for 2 to 3 days and observe whether mum's still ok. Incidentally, previously mum tried (without consulting anyone!) cutting the night time dose from 10mg to 5mg for 2 nights and apparently it did ease the dizziness a little.

(2) If ok, then cut clonazepam to 0.125mg (quarter tablet) once every 4th night. The first try is probably going to be a little stressful as the body is trying to adjust without the usual dosage (it's a sleeping tablet after all). It doesn't help that currently she napped a lot because of the dizziness and so that would make it difficult for her to fall asleep at night. If really cannot take it, then take the missing dose.

(3) If ok for 2 to 3 rounds, then repeat the cycle with quicker cut i.e. once every 3rd night for 2 to 3 rounds, alternate night for 2 to 3 rounds, every night etc.

Mum was given a much earlier appointment (about 2 months earlier) so that they can assess the effect of these changes.

In the meantime, the doctor advised mum to get her eyesight checked after she knew that it hadn't been checked in years. Much later, the optometrist confirmed some changes (relative to the spectacles she was wearing). Most seem minor to me (short-sightedness, astigmatism, axis line) but the significant increase was her long-sightedness.

Oh, also, upon query, the psychiatrist explained that the referral to ENT specialist was to rule out vertigo.

Let's hope mum can wean herself from clonazepam and that these changes to the medication, as well as the new pair of glasses, would at least ease the dizziness significantly.

Singapore Aug 2018

Ban and I were in Singapore earlier this month. He was there on volunteer work related stuff while I took the opportunity to do some important errands (I'll probably blog about this later) and to meet friends, ex-colleague and the actuary I'm currently working with.

Here are some photos I took:

Andes by Astons 1

Andes by Astons 2

Andes by Astons 3

One of my favourite Western food restaurant. Cheap and good. Surprisingly its price wasn't hiked up at its Changi Airport's outlet.

Changi Airport

Something new to me, at Changi Airport.

Chew Kee 1

Chew Kee 2

Chew Kee 3

Chew Kee 4

Still the best dumpling noodle ever. Delicious soup too.

MRT station notice

Well, I guess "major" disruption happens sufficiently frequent that they had to put this notice up at the MRT station.

Cute plastic bottle

So cute the bottle.

Intercontinental High Tea 1

Intercontinental High Tea 2

High tea at Intercontinental Hotel. There was also self-service ice-cream. There was a chef who could make pancake to go along with the ice-cream.

Fantasic yong tau fu selection

Wide selection of yong tau fu (ytf) at Changi Airport. In fact, it's the norm in Singapore and almost all non-fried. Usually can ask them to fry on the spot if you want. Malaysia's ytf pales in comparison.

Uniquely SG beef noodle

Unfortunately, this beef noodle was worse than the norm. So sad. Cannot get such beef noodle in Malaysia. It's one of my favourite uniquely Singapore food. Another is their Fried Hokkien Prawn noodle, which I had it for my first dinner, which was also lousy :(

Start of second line

The consultation with GH's onclogist, 2 weeks after the insertion of chemo port, was a breeze: it took about 5 minutes. What took longer, apart from the waiting time of course, was the date of the first cycle chemotherapy. There was some confusion on their part. When it was finally sorted out, we were told that for the first cycle, my dad had to go to a ward because the staff there would teach us about the process. Subsequent cycles would be done at the usual daycare oncology section. The date was 1.5 weeks later.

On the day itself, we were told that the chemo drugs would be ready only at around 3-4pm, which means that dad had to be in the ward until about 6pm. I wished someone told us this earlier. Haiz. In addition, it was only on that day itself they asked us whether we brought a sling bag to place the chemo bag in it. How would we know this if no one told us? It was our first time going through this regimen.

However, I appreciated a nurse's initiative to quickly check availability of a bed nearer to the toilet, after my dad was already assigned another bed. She probably assumed, and rightly so, that my dad would prefer that bed since he was using a walker. That was so considerate of her.

I went back to my sister's place to have lunch, nap and work for a bit before going off for dinner with Ban. Then we went to get my dad at the hospital. All in all, including travel time, it took 13 hours @@. The infusion of 3 drugs plus pre and post hydration took about 5.5 hours.

Then the last thing was to attach a bag of chemo drug to the chemo port. It was a 48 hour infusion and then we were supposed to have it detached at the hospital. The best way was to just have it detached when the infusion was completed, determined by visual inspection of the bag i.e. it shrunk. Hence the periodic measuring of its circumference.

The next two days, my dad felt weak, sweated frequently and felt like vomiting, which are common side effects. At times, he vomitted "air/gas". Fortunately, his appetite wasn't too bad.

There was no problem in detaching the chemo bag at the hospital. Unfortunately, we were told that the daycare oncology was full for 2 consecutive weeks and so my dad's Cycle 2's date is nearly 4 weeks after the first :(

A dizzying problem

During the two-month period since the last appointment, my mum was gradually getting better. She could drive again. Woohoo! Her range of facial expression had increased. Her taste bud improved (previously, it was "ok" for most food, which wasn't her "norm"). The only constant problem, something that had been happening since the time she was warded, was her dizzy spells. It occurred from the moment she woke up and lasted until at night. Only its intensity varied.

The geriatric psychiatrist said that this may or may not be due to the medicine. Three medicine could cause dizziness: benzhexol, clonazepam and olanzapine. Clonazepam was already on its minimum dose (it seems) and so the next step was to cut it off but mum wasn't keen on that because when she tried that (it was like 3 months ago though), she couldn't sleep. So the doctor asked her to stop benzhexol and stick to that as long as her tremor doesn't interfere with her activities. If not, take it on a ad hoc basis. If that fails to stop the dizziness, then next step is to reduce olanzapine.

Later, after I discussed with my mum, she agreed to try without clonazepam but to take it if she cannot fall asleep by midnight.

So let's hope this works. If it turns out that adjusting these medicine doesn't help, then, according to the doctor, mum needs to consult ENT specialist.

Atlas Reactor: Titus

One defining feature of Titus is his dash. His dash's range is the longest of all freelancers, in a straight-line. In a non-linear path, Asana's and/or Celeste's can easily surpass Titus's dash's range. It's a useful ability to get away from enemies.

To get much value out of it, however, you (as a Titus player), should dash and hit enemy(ies) which will then reduce the ability's CD by 2 i.e. half it. That's significant. To help him survive better in case enemies anticipate the dash towards them, I like to take the healing mod. In fact, I use the "Holy trinity" build (not my term):
(read this wiki for details on abilities and mods)

(1) Overhead Slam: Battlefield Triage (2 loadout points)

Healing mod. If you prefer a more damage-focused build (then you better hope your support can help you), then Power Hitter is a good choice

(2) Berserker Charge: Harvest (2 loadout points)

Healing mod.

(3) Thundering Road: Rallying Cry (2 loadout points)

Healing mod.

(4) Dirty Fighting: Flurry of Daggers (2 loadout points)

This is a great mod if you have allies who can consistently trigger the explosion. Reduction in CD is great because this ability is a Prep phase ability and so can be used to reveal enemy who plans to dash and/or be invisible.

I used to equip Rapid Follow-Up, which is a good mod if you intend to make sure that at least you'll be around to trigger the explosion next turn.

(5) Deathblow: Battle Rage (2 loadout points)

Choice of mod is due to leftover points. So it's this or Executioner. I don't like the latter because it's too conditional and at times can make players predictable. Nix has a similiar mod too and often such Nix player will wait for the condition to trigger before using its ultimate ability.

One thing I learn about Battle Rage is that, except for knockbacks, it seems that it's the last Blast phase action to be executed. This means that Titus can be hurt by enemies first and thus lowering his hp and increasing damage from Deathblow.

Below is a recent gameplay that shows the power of healing mods :)

In different shapes

Coca-cola in all shapes

Atlas Reactor: Frontline with triple accolades

At the end of a match, game will show who get which accolade from a selection of 4 accolades. There was a few times I got all 4 and if I remember correctly, that was through playing Support freelancers. I believed one of those times was with Helio.

For Frontline freelancers, it may be possible to get all 4 if there's no Support freelancer in either teams, or the player is bad at supporting if there's one. Still, getting 2 or 3, for any freelancer, is already quite impressive.

Recently, I got this:

Gary triple accolades triple threat

Oh yes, my Garrison got Cornerstone too lol. I believed there was at least a support and so it's surprising. Not only that, I also got silver Triple Threat badge. Amazing.

Then shortly later, followed by this:

Rask triple accolades triple threat

This is more believable. Also, bronze Triple Threat here.

A Matter of Honour (or is it?)


A Matter of Honour

Let me summarise the main conflict of the story:

In late 19th centure, Russia (still ruled by Tsar then) needed money while US was interested in purchasing Alaska but the former wasn't keen on losing the land. So someone on the US side proposed what he thought was a brilliant idea: Russia can redeem the land in 99 years by paying 99 times of the the purchase price (paid by US) i.e, a total of $712.8 million in gold bullion.

Of course in 1966, that redemption amount was considered cheap. Power of inflation. Russia easily came up with the required gold bullion.

Russia needed to present the original signed agreement in order to redeem the land. The problem was that it was hidden within a national icon: something that only very select few people on both sides know about. This icon was, indirectly, bequeathed to a British guy. Coming from a rather poor family, this guy, in fulfilling his father's last wish to take care of his mother, wanted to auction off at Sotheby, for a potential price of 10 thousand pounds.

For obvious reasons, US wanted to prevent Russia from getting hold of this icon.

If you're Russia, what will you do? I thought that one simple thing to do is to talk to this British guy, telling him that the icon is Russia's national treasure (they did this but way too late) and then offers him more than 10 thousand pounds to purchase it. This should work because this guy wanted to do the honourable thing (due to what happened to his father and also due to his father's last wish). Even if Russia wasn't aware of this "code of honour", they knew about him wanting to auction it off. They knew his background. Not only that, they could also provide him an official document that would clear his father's name (again, they did this but way too late).

Instead, Russia sent their ruthless KGB agent who killed the British's girlfriend, a taxi driver (he forced the girl into the taxi because he thought the icon was in the bag she was carrying) and a British Air Force pilot who was helping the protagonist. This agent also killed other people but nothing to do with the pursuant of the icon.

Why? Why??? This is so stupid.

The power of marshmallow