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Showing posts from March, 2019

Increasing pain

Within a week of the pamidronate infusion , dad experienced severe pain twice (5 days apart). He attributed it to the drug's side effect, which is possible, but there was much uncertainty because he had such incidents previously. Despite the increase in dosage of Oxycontin and Oxynorm, dad was still taking Oxynorm about 6-8 times a day :( Source of pain: the lumps in his right abdomen, and the sides of his legs stretching from the knees to the shins. When the frequency increased to 9 times a day for 3 consecutive days, we decided to do a walk-in on a clinic day. We learned that constipation can reduce the effectiveness of the opioid and so dad should aim to pass motion everyday. More importantly, to my shock and annoyance, dad once again unilaterally adjusted medicine: Gabapentin twice daily instead of 3 times a day. Grrrr. This is highly relevant because Gabapentin is suppose to relieve nerve pain, numbness and tingling with pins and needles, all of which increased in frequen

Asenapine, audiologist, neurologist

Fortunately, asenapine  worked at least as well as clozapine in terms of managing my mum's emotional and mental health, as well as getting decent sleep.  Also, her dizziness is overall better i.e. the intensity oscillated between bad and less bad about twice a day, whereas previously it was just bad throughout the day. The psychiatric doctor continued the same medication but we told her of a problem: I called a few private pharmacies and none of them had asenapine in stock. The fastest we could get hold of it was 2-3 working days after ordering it specially. Hence, we needed a few tablets to tide over before it arrived. We were lucky but embarrassed that the doctor then gave us their last sample strip of the medicine @@ The next appointment was with an audiologist at ENT, who conducted hearing test. She strongly recommended hearing aids for both ears. After some discussion, it was decided that at the next appointment, mum would try 3 sample hearing aids, all different brands bu

Contradiction

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To wash or not to wash?

Pamidronate

Finally, it was time for dad to go for appointment with orthopaedic oncologist (nearly 3 weeks after end of 2nd line chemotherapy ) to plan for the surgery. This time, as we found out later, we were seen by a more senior specialist. After looking through the the X-rays taken that morning, he concluded that there was no need for surgery. We were surprised and stated that we were told that the femur was going to fracture  any time, based on MRI done previously. Dad: Oh, but Dr Y said... (interrupted) Snr specialist: She's a medical officer and she works for me. (much later) Me: Dr P said... (interrupted) Snr specialist: He's ranked below me. Oh, wow. What arrogance. We were confused and just wanted to reconcile the difference. Giving the response "I'm ranked higher" does nothing to address our queries and is condescending. Fortunately, he called Dr P in and through their exchange, I surmised that the difference in opinion is that he placed more emphasi

2nd Line Cycle 12

On Day 1 Cycle 12, dad told the doctor that he had been taking Oxynorm 5-6 times daily and so the doctor increased dosage of Oxycontin from 30mg to 40mg (still twice daily), and Oxynorm from 5mg to 10mg (ad hoc as usual) For the next few days, the frequency of ingesting Oxynorm remained the same as before but the level of pain lessened. The frequency, 5 to 6 times a day, remained the same, unfortunately but I managed to discover that 4 of those times were due to knee pain, rather than the pain in his hip. Gosh, I really hope the orthopedic can help him with this knee pain. In the meantime, he's still taking glucosamine + chondroitin + MSM and restarted applying Flexisec: these were stuff that helped with his knee pain many years ago. During the 14 days of the cycle, there was a couple of incidents of vomiting or wanting to vomit and also swelling in his legs. Hopefully these are just side effects of the chemo drug (as we had been told many times by different doctors) and w

Share investment Mar 19 Part 2

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Here are the average dividend yields on cost for shares that have paid out dividends: Share counters (7 of them) with no dividend yields just means that I have yet to receive at least a year's worth of dividends from these companies. The overall dividend yield on cost weighted by invested amount is 5.5%, excluding the 7 share counters mentioned above. There are 10 share counters with dividend yield (on cost) less than 5% (number of consecutive years of this low yield in bracket): Boustead (1) Keppel Corp (3) Kingsmen (5) SATS (4) SPH (3) ST Eng (5) Sembcorp Ind (5) Silverlake (3) Sing Shipping (4) UOB (1) It's probably time time to sell Kingsmen and Sembcorp Ind. Except for bank's shares (4% is good enough), I need all other shares to provide dividend yield of at least 5%. Here is the average cost of each share counter compared to its then prevailing price as at 9 March 2019: Share that had increased significantly is Venture (53%) and th

Share investment Mar 19 Part 1

It's been less than a year since the last update . I decided to update this in March because usually I'm busier in April with actuarial projects (although that may change soon). These were the companies I first invested in since the last update (I'm ignoring additional purchase of existing share counters): (1) CapitaLand From Motley Fool SG: " Singapore’s CapitaLand stands tall as one of Asia’s largest real estate companies. The company has a presence in over 30 countries and develops, owns, and manages integrated developments, shopping malls, serviced residences, offices, homes, real estate investment trusts (REIT), and funds. Why Buy: CapitaLand has a vast and diversified property portfolio. It has a solid stable of investment properties that provide recurring income (read: dividends) CapitaLand’s shares are priced at a discount to book value " (2) DBS From Motley Fool SG: " Established in 1968 as the Development Bank of Singapore, DBS G

Clozapine?

For the week that mum stopped taking clozapine   she couldn't sleep or even nap :( She was worried about relapse and consequently hurt herself. She's been managing such feeling via distraction by doing some activities. On the appointment date, the doctor confirmed my suspicion that mum's white blood cell count was low and hence the suspension of clozapine. After getting the above information from us and discussing with the specialist, she said that they needed to wait for the results of the blood test before telling mum to either resume clozapine or take a substitute. I guessed that the blood test result was still not good because late afternoon they called to inform us of the change in medicine i.e. from clozapine to risperidone (1mg per night). The following week's appointment remained. For the next 6 days days, mum managed to sleep but not of good quality. Better than when not on clozapine but worse than was on it. However, finally sleep quality reverted to clo

Minion Masters: first time on leaderboard!

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The in-game leaderboard shows the top 150 players, for each mode. Being a Grandmaster isn't enough to get on it. Hence, I'm proud to have done that in solo mode (ranked 145), on the last day of February :) Once I hit GM in solo , I had more losses than wins. I normally switch deck once I have 3 consecutive losses (or even at 2 if I am frustrated with the deck). Then when it was time to use one of my favourite decks, Stormbringer 'Guild', I decided to try something for the first time ever: Laser Turret. This was insipired by Xiniu who use it in his Stormbringer deck. (1) Illusory Cleaver (2) Screaming Scrat (3) Wall (4) Daggerfall (5) Plasma Marines (6) Xiao Long (7) Whirly Scrat (8) Laser Turret (9) Cleaver (10) Crossbow Guild Let's try to use the  checklist provided by Edelweis s to look at this deck: Average mana cost of around 3.5: Yes, it's 3.4. 8 minions + 2 spells: 7 minions, 1 building, 1 spell Counter to (a) Flying, (b) Swarm, (c) Big

Minion Masters: Grandmasters!

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I finally got to Grandmaster tier. Got it first in Team mode: Deck build is entirely copied from a player, Shin, who was in the top 10 in solo mode but I found it still potent in team mode. (1) Scrat Pack (2) Shock Rock (3) Plasma Marines (4) Xiao Long (5) Defenso Chopper (6) Dragon Ball (7) Morgrul's Ragers (8) Cleaver (9) Wolf Among Sheep (10) Shars'Rakk Twins The key card is Morgrul's Ragers, which in turn needed sufficient number of Voidborne cards to make it work. Let's try to use the checklist provided by Edelweis s to look at this deck: Average mana cost of around 3.5: No, it's 4.3. 8 minions + 2 spells: Yes Counter to (a) Flying, (b) Swarm, (c) Big units: (a) Plasma Marines, Xiao Long, Defenso Choppers (only vs Propeller Scrats), Dragon Ball, Succubus (if Shars'Rakk Twins' condition is triggered) (b) Shock Rock, Defenso Chopper, Dragon Ball (c) Cleaver, Dragon Ball Specialised cards: Morgrul's Ragers Win condition:

2nd line Cycle 11

Just before start of this cycle, I was informed of two pieces of information that was new to me: the lumps starting to hurt but manageable with the opiod shortness of breath, started a week before (and now only I got to know and that too because I overheard my mum telling my dad to inform the oncologist) The doctor said the shortness of breath was due to accumulation of chemo drug. As for the numbness , she prescribed Neurobion. Earlier, my dad said that, unlike previous times, he felt uneasy about this cycle. Fortunately, it turned out to be the best Day 1 of any cycle thus far. This was because he had the company of two other patients. The three of them chatted throughout the session, without napping :) When I came back to pick him up, he looked notably better. I suspect that this was at least partially responsible for his really good sleep that night. Over the next week, his numbness lessened but the lump's pain getting more frequent i.e. 4 - 5 times a week and up to