Monday, August 27, 2012

Hanging On

In his last post titled "The End Is Near", Chang has said that he no longer has the energy to continue updating his blog and that his August 18 post would be one of his last. The response from his readers and friends have been overwhelming, many requesting to be updated on his condition.
During my last visit to him, he said that there are no more stories to tell his readers. Instead of just waiting for more stories, I believe all of us just care.  We wish to know how he is doing and we wish to provide our continuing support, prayers and love to him during this very, very difficult time. As his friend, I shall endeavour to provide some updates about his health and well being.
He checked into UH on Wednesday, 25 August to get an abdominal tap done.

What is an abdominal tap?
An abdominal tap or paracentesis is a medical procedure in which a small tube is inserted through the abdominal wall to remove fluid from within the abdomen. Inside the abdomen is a membrane called the peritoneum. The peritoneum covers the organs inside the abdomen and produces a fluid which lubricates these organs and helps them to glide smoothly over one another. Sometimes too much of this fluid can be produced causing discomfort. This is known as ascites. 


 There are several possible reasons for this build up of fluid:
• If cancer cells have spread to the lining of the abdomen they can cause irritation, leading to the build up of fluid.
• If the liver is affected by cancer it can cause a blockage in the blood circulating through it, leading to a build up of fluid in the abdomen. Alternatively liver damage can change the body’s fluid balance, causing fluids to build up in the body’s tissues, including the abdomen.
• Cancer can also affect the lymphatic system. This is made up of the tissues and organs that produce and store lymph, as well as the network of vessels carrying lymph fluid throughout the body.

What are the symptoms of fluid build up?
The symptoms of this build up of fluid include:
• Swelling of the abdomen, with associated pain or discomfort.
• Difficulty in moving or sitting comfortably.
• Breathlessness.
• Tiredness.
• Nausea and vomiting.
• Indigestion.
• Reduced appetite.
• Altered bowel habit

Abdominal tap is usually done under local anaesthesia. It is an outpatient procedure, which means you can go home after it is done. An ultrasound is sometimes done to locate the area where the fluid has collected and a mark is made on the skin where the paracentesis tube is to be inserted. A small tube is then inserted into the abdomen and is sometimes secured by stitches. The fluid (ascites) will drain through this tube into a drainage bag. You will be able to move around whilst the fluid is being drained into the drainage bag (Sometimes doctors also put an internal tube under the skin to permanently drain the fluid and prevent this from constantly happening). 
However, for Chang, what was supposed to have been a 25 minute procedure turned into a 25 hour ordeal. He was told that there was a shortage in manpower at the hospital that day and and ended up putting up a night at the hospital. The next morning he was wheeled to the operating theatre. There was initially no bed there and Chang was wondering if they were intending to perform the procedure with him in the wheelchair. After that was sorted out, they administered the anaesthetic but horror of all horrors, before the anaesthetic had time to take effect, they jabbed the needle into him. He screamed in pain. It was, all in all, a nightmarish experience for him! He came back home on Thursday evening.

He spends most of his time resting in bed. He is weak and has lost quite alot of weight. However, he has an army of well wishers and commented that he received more visitors during the recent Hari Raya than the Chinese New Year.

(Updated by Chang's friend)


  1. Thank you to this friend of Chang, who took the trouble to update Chang's condition to all his caring readers. Appreciated!

    John Tay

  2. Thank you for your updates. Chang is lucky to have friend like you. Maybe you would like to identify yourself?


  3. Yes, I agree. He is lucky to have a friend like you.
    Very appreciated indeed!
    CT will need lots of care from friends and family.


  4. Dear Chang's friend

    Thank you very much for doing what you are doing. I have been waiting and waiting for Chang to update and finally read your writing. Send our love to Chang and I am sure all of us who have commented on his blog are praying for him. Thanks once again for your work.

  5. Hello Chang's friend,

    I don't know Chang personally but his blog gave me & my family a connection to him some how or the other. By posting update, I am grateful that Chang has a friend such as you who is with him even at this difficult times.

    Please tell Chang that we will flood God with our prayers, to give him healing (both physical and spiritual), and so he may be free from pain and further complications. And for his family, that they may have strength in accepting what lies ahead for Chang.

    God be with him.


  6. Dear Chang,

    I am jotting down my thoughts and feelings as I know I don’t have the guts to say all these to you in person. You see, my greatest regret in life is not saying what I needed to say to people in your situation. I couldn’t say it to my mother, my father, my sisters. I guess I am trying to absolve myself by saying it to you. So please hear me out.
    Firstly, I pray that, while you are waiting to make the transition from this realm to the next, God grants you calm and peace. He knows you have fulfilled your obligations as a son, sibling, husband, father. You have discharged your duties as a citizen, friend and colleague. You did your best to carry out your responsibility as a man, aware that you are one creature out of His many creations and that you stood to be counted. Rest assured that you are leaving your mark here on Earth.
    Thank you Chang, for blogging, which enabled many to benefit from the research that you did into various aspects of the cancer journey. You have been generous with the knowledge that you gained and many of us can claim that you are our teacher. Terima kasih, cikgu! for showing us the changed our perspectives, our mind sets and you made us realise that it is ok to move the goal posts as and when necessary. Nothing is permanent anyway. We accept and then we adjust ourselves accordingly... and we move on, after learning from the experience.
    And I find that the part that is most stressful is saying goodbye to people you have come to know as a friend, colleague, fellow-traveller... I wonder if I will ever learn how to do it right cos' most times I just fail to say goodbye. But after reading "Not the Last Goodbye" by Servan-Screiber, I know that the French are right in saying "We can say goodbye many times" and you can do that in as many ways as you want to. C’est acceptable. So I suppose in my own way I have said goodbye to you. Did you realise that?
    And Chang, I pray that you make the crossing from HERE to THERE confidently, without fear or doubt. When you were given this cancer assignment, you took charge of the situation without a second thought. You did all you could within your means, without neglecting your duties as a son, sibling, husband and father, and I might add, as a fellow human being. How many can look back and say that they have shared their experience with fellow travellers and benefitted them in the process… you did well, Chang! It is not about the Destination, it is about the Journey! I pray that God grant you the wisdom to accept His decision, His will. We are told that life here on Earth is just a segment of a long journey back to Him. You had an eventful Journey. May you arrive at your Destination safe and sound. And, if God permits, please be there to welcome us when our time comes. Amen!

    With love and respect,

    1. A beautiful piece by Khadijah! And Chang, thank you once again for sharing your thoughts as you journey on!

  7. To this very compassionate friend of Chang, thank you very much for this update. Please tell Chang he is always on my mind, whatever turn out to be in this very trying stage of his life.

    Being a very knowledgeable Buddhist himself, Chang obviously knows what to expect in his journey ahead. He knows where he is heading to. To me, Chang has no regret to lead his life this far, sharing his experience in his blog, an inspiration to many of us, and having true friends in you, Khadijah and others of different faith.

    All in all, this proves to us, love and compassion are what matter, not faith or belief that each of us supposedly attached to. These virtues are what emphasized in Buddha's teaching. Each of us can learn from Buddha without regard yourself as a 'Buddhist'. In a nutshell, this is what Buddhism is, and this is what Chang illustrates to us.


    Gary Kang

    (It would be great if I can meet you people. Chang knows how to reach me)

    1. Whoever you are, I thank you for the update. Like others I have been opening this blog more frequent than ever. Please do update us now and then, appreciate this.

      We pray that he is out of this suffering moment and getting his strength back gradually.


  8. Thanks for the update. Please send Chang my well wishes.

  9. To Chang's friend,

    Thanks for your time in updating us, what is your name? We just want to show our appreciation.


  10. Thanks for the update..
    CT, you're always in my prayers... Love and peace to you...