tag:blogger.com,1999:blog-76631816269360783122024-03-06T13:33:00.102+08:00UpekhaUPEKHA IS A PALI WORD TO MEAN EQUANIMITY. EVERYTHING IS EQUAL.
THIS BLOG CONTAINS THE JOURNALS OF A PERSON WHO HAD STAGE 4 KIDNEY CANCER. IT DETAILS THE EMOTIONAL & MENTAL STATES AND ALSO THE GERSON & OTHER THERAPIES CHOSEN AND PROVIDES UPDATES WHERE POSSIBLE.CT Changhttp://www.blogger.com/profile/11085620064834659684noreply@blogger.comBlogger1001125tag:blogger.com,1999:blog-7663181626936078312.post-41880003879130962212012-10-12T23:27:00.001+08:002012-10-12T23:27:10.855+08:00Thank YOU!!<div dir="ltr" style="text-align: left;" trbidi="on">
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Hi! We are Chang’s daughter.<span style="mso-spacerun: yes;"> </span>First of all we apologize for this message is
long overdue.<span style="mso-spacerun: yes;"> </span>We must thank all the
readers for supporting our daddy’s blog. Your warmhearted comments, wishes and
concerns especially during daddy’s last days, really touched our hearts.<span style="mso-spacerun: yes;"> </span></span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">When our dad posted last entry on 16th August 2012,
many readers had requested us to update the blog so that they can keep tab on
dad’s condition.<span style="mso-spacerun: yes;"> </span>We needed to spend time
with dad and we felt that we are not up to the task. Thank you to Chang’s
friend for updating the blog on his behalf.</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">53 years ago in the year of 1959, our father Mr.
Chang Chee Teck whom you all referred to as Chang was born into this world.
Some of the readers known him ever since he was a child, some might knew him
for maybe, half of his life. There are also some, who just knew him through
this blog. </span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Today, 12th of October is Dad’s 53rd birthday. He
has lived through more than half a century and was blessed with many friends.
We know that many would miss him as we miss him too. This day, we will remember
him, he who fought cancer with all his strength. Even though he did not live until
this day, but today is the day our dad was born. We are grateful for he was
born, we will always remember and miss him.</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Hence, we would like to say thank you again, the
readers for reading the blog and also the comments and support. Thank you friends,
for being there for him: for when he was healthy and for when he was sick. Thank
you Chang's friend for helping dad and write when he couldn't. Chang says that
the blog will not be closed (however there will not be any further update), so
that people can still view the blog for its information and research done by
Chang. This is most probably the final entry for this blog.</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Lastly, we would like to say thank you, dad.<span style="mso-spacerun: yes;"> </span>We will always love you.</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">(updated by Chang's daughters) </span></div>
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CT Changhttp://www.blogger.com/profile/11085620064834659684noreply@blogger.com16tag:blogger.com,1999:blog-7663181626936078312.post-22234723232945533772012-10-06T20:09:00.000+08:002012-10-23T08:36:15.582+08:00<div dir="ltr" style="text-align: left;" trbidi="on">
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<div style="text-align: justify;">
I received many requests from readers to keep
this blog "alive". To keep this blog active so that Chang's efforts
for the past three years will not be wasted. That if I were to stop
posting, this blog would be left idle and no one would tap into Chang's work.
My question to them was, what do you think I should write about?</div>
<div style="text-align: justify;">
</div>
<div style="text-align: justify;">
I did give serious consideration to these
requests. I thought through as to how best to do justice to this blog. Also, what
I can do to allow this blog to continue to be a valuable resource to cancer
patients.To this end, last week I invited a hypnotherapist to contribute an
article on the use of hypnotherapy in cancer and she has accepted. There were
other suggestions as well that I post the story of other cancer patients who
have tried alternative therapies and document their results here. In fact, I
have written to a reader to ask for permission to post her story on this blog.
It looks like these will remain as only ideas. </div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
Anyway, I received an anonymous feedback
yesterday that I should post on a separate blog. Probably, after the aftermath
of the very heated religious debate and the comments made, anonymous said this
blog is being contaminated and readers are putting words in Chang's mouth. And
to leave this blog alone. I don't know what the readers here think. Readers
have argued over religion here in the past, sometimes over a few days. Everyone
gets so heated and then "contaminate" this blog with their comments.
Is that so?</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
I am not sure if you have any idea how much
pressure it is to write on another person's behalf. More so when the article is
posted publicly. It is a huge responsibility. I would not have done it if not
for Chee Teck. And I would not be at this point if not to preserve his memory
and his work. In fact, a reader asked me just this morning if I have stopped
posting on this blog and I said yes. And that it is time to move on. That I
wouldn't want to keep writing about the past unless something fresh and useful
comes along. </div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
The only reason why I wrote about the past here
was to use it as a reference point for learning and sharing. And there is so
much one can learn from another person's life. Also to address readers'
concerns about the dying process, which is very relevant especially for a
terminally ill patient, if not all of us.There is no taboo here, talking about
dying. I just did not want to trigger off an ugly religious debate, which
unfortunately happened. I recognise also that even though we connect via
the blog, we do still grieve for him in our way. I felt a few extra posts
would wrap up nicely the loose ends, answer your questions, grieve
together and move on together. </div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
I created a blog called The Bodhi Circle.. You
may visit me there at <a href="http://www.bodhicircle.blogspot.com/">http://www.bodhicircle.blogspot.com</a>.
This will be my last post here.<br />
<br />
(Updated by Chang's Friend) </div>
</div>
CT Changhttp://www.blogger.com/profile/11085620064834659684noreply@blogger.com9tag:blogger.com,1999:blog-7663181626936078312.post-70715367752423269062012-09-29T10:15:00.004+08:002012-10-12T20:11:24.256+08:00Dying Thoughts<div dir="ltr" style="text-align: left;" trbidi="on">
<div style="text-align: justify;">
<b><i>"My religion is simple. My religion is kindness." Dalai Lama </i></b><br />
<br />
<br />
Many readers here hold Chang fondly in their thoughts. This blog seems to be part of their lives already. The day has come for us to move on. </div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
A reader "Anonymous" left the following comment" </div>
<div style="text-align: justify;">
<i>"I wish to know in greater details Chang's thoughts or thought process just
before his passing, if it's possible at all. Did he give much thought
to where he was going / his after-life? Was it just nothingness? Was
he just thinking about what he wished to leave behind without further
thoughts where he was going, or was it that it didn't matter to him at
all?"</i></div>
<div style="text-align: justify;">
<br />
<i><span style="font-size: small;"><span style="font-family: inherit;">From May 2, 2012 post by Chang "</span></span></i><br />
<span style="font-size: small;"><span style="font-family: inherit;">"</span></span><i>One thing about being a Buddhist is that we believe in rebirth. Another
thing I do when preparing my death is to make a wish to be reborn in the
human realm. Although I have not achieved any spiritual attainment, it
is my intent to be reborn in the human realm as a male. After completion
of my university education, I will go forth and enter life as a monk
and continue my Buddhist practice. So I visualise it with intent and
wish for this to happen in my next rebirth".</i><br />
<br /></div>
<div style="text-align: justify;">
<span style="font-family: inherit;">Buddhists believe<span style="color: black;"><span style="color: black;"> that death is not the end of life. I<span style="font-size: small;">t is merely
the end of the body we inhabit in this life, but our consciousness
will still remain. It will seek out through the need of attachment,
attachment to a new body and new life. Where we will be born
is a result of the past and the accumulation of positive and
negative action, and the resultant karma (cause and effect)
is a result of ones past actions. </span></span></span></span><br />
<br /></div>
<div style="text-align: justify;">
In the past, there were times when readers debated with each over their religions. When the discussions were too heated, Chang consulted me about my view. At that time I said that he should focus on the spirit of this blog and what he created this blog for. <br />
<br />
We say that we respect one another, so this respect should also be shown through respect for one another's religions. While all religious prayers, chants and information done in good faith are most welcome, I discourage inflammatory remarks putting down others' religions. We have to deal with our own unhappiness over others' beliefs and take responsibility for our own feelings. True spirituality is about compassion, acceptance and peace, whatever religion we belong to. What is the point in calling oneself a Buddhist, Christian etc when one cannot show genuine compassion for another fellow human being?</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
In his last weeks of life, Chang was struggling to manage his pain. He could not talk much.<span style="font-size: small;"><span style="font-family: inherit;"> As to his thoughts about dying, what
he told me was that he was not fearful of the death itself but the
pain. </span></span><br />
<br />
I encouraged him to "go peacefully, in a positive frame of mind" and he nodded. I asked him how he was coping emotionally (meaning depressed or not, etc) and he said he was okay. The good thing is that he had learned to manage his emotions before he died. Our emotions are a reflection of our mind. <br />
<br />
During our association, I always encouraged him to confront his emotions, dig a little deeper within to find the root cause of whatever he was feeling at the time and deal with those emotions rather than repress them. Later, he told me he had learned this "technique" as he called it, quite well. And I believe it helped him cope when he was dying.<br />
<br />
(Updated by Chang's Friend) </div>
</div>
Unknownnoreply@blogger.com13tag:blogger.com,1999:blog-7663181626936078312.post-58612434459964954262012-09-26T15:27:00.002+08:002012-10-11T17:25:31.480+08:00Thank You Again<div dir="ltr" style="text-align: left;" trbidi="on">
<div style="text-align: justify;">
<i>"The greatest gift is the gift of awareness"</i><br />
<br />
I would like to thank those of you who have written to encourage me. The truth is that I took up this job with the sole aim of helping Chang complete his story. I have not made any plans yet for this blog. Though I have always enjoyed writing, his shoes may be a bit too big for me to fill.<br />
<br />
I have to admit that it was not an easy job he entrusted onto me. During the last few weeks of his life, I followed his physical progress as closely as I could in order to update this blog. And I watched the dying process taking place day by day. The physical changes, the deterioration and the suffering. Watching life unfold, having to process it in my mind and coming home to write about it. The hardest day was on the day he passed on. <br />
<br />
At the end of life, what really matters to you? Is it the money, the job title or career achievements? Would you panic then whilst on your death bed and wish that you had more time to live life differently? Have you been true to yourself, lived up to your beliefs and at least tried to live out your dreams?<br />
<br />
Or is life just one day of struggle after another? Work, work and
work. A life so full of responsibilities and obligations that we have
forgotten what really matters, our heart?<b> </b>What have we done with our lives and the limited time we have on earth to benefit others? Because at the end of the day, nothing really counts but the way we have treated other people.<br />
<br />
These were also some of the questions I posed to Chang then, in 2010, not out of judgment but because I felt these were useful questions to reflect on. He said then that he would try to live differently with the extended time he had. I also encouraged him to live out any unfulfilled dreams, as did many of his friends. Contrary to what many people may think, I believe the process of dying a good death starts now when we are healthy. And, I believe that when Chang passed on, he left with greater awareness and a richer view of life. <br />
<br />
Let us also live in awareness every moment of everyday..<br />
<br />
(Updated by Chang's Friend) </div>
</div>
CT Changhttp://www.blogger.com/profile/11085620064834659684noreply@blogger.com11tag:blogger.com,1999:blog-7663181626936078312.post-14163118813017522362012-09-23T18:10:00.000+08:002012-10-10T22:34:27.479+08:00Conversations with Chang<div dir="ltr" style="text-align: left;" trbidi="on">
<div style="text-align: justify;">
I found out that Chang had kidney cancer almost a year after he was diagnosed. In his usual way, he spoke enthusiastically about the Gerson Therapy, the urine therapy and their benefits. He encouraged me to try out coffee enemas, drink juices and take the Gerson supplements. </div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
After listening to him, I finally asked him whether he had considered that healing could be more than just physical. And that healing encompasses mind, body and spirit. I also asked him whether he loved himself. He was stumped and said "Isn't self-love narcissistic or attachment to oneself?" This turned out to be a really big question for him. </div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
Many people are afraid to love themselves, They somehow feel they are not allowed to. That self-love is self indulgent. They find it much easier to find fault with themselves. And to be harsh and unforgiving toward themselves for their imperfections and mistakes. They do not allow themselves the space to be themselves, to delight in their own company and to pamper themselves. Don't we all deserve a break sometimes? As human beings, we tend to swing to extremes. Does loving ourselves have to swing towards narcissm? What is narcissm? <i>Narcissism is an obsession with ourselves, to the
exclusion of other people -- both their needs, and their gifts
which they want to share with us. Narcissism is not self-love</i>. </div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
Our self-love is a
confirmation that we are lovable; therefore, we eagerly
recognize and accept the love which is offered to us. If we
lack self-love, we reject other people's love, because we do
not recognize it, or we feel that we are not worthy of it. It
increases our ability to love other people. It allows us to understand ourselves and know
ourselves. We are not repressing anything from our own awareness.
</div>
<div style="text-align: justify;">
</div>
<div style="text-align: justify;">
I reminded Chang that Buddhism teaches the middle path and he could look at self love as compassion towards oneself. If we cannot have compassion towards ourselves, how then can we expect others to have compassion for us? How then can we know how to feel compassion for others. It starts with us.<br />
<br />
And what does self love have to do with cancer? Because self-love is the pathway to healing. We need to learn to have a great respect for ourselves and a gratitude for the miracle of our bodies and minds. The science of energy medicine teaches us that our organs and other
physiological systems sense and store emotions. The immune system’s
intelligence observes feelings we have about ourselves, and can improve
its health when we develop authentic feelings of self-love.<br />
<br />
In the words of cancer survivor, Anita Moorjani, who came back from a near death experience in 2006. <i>"Self love is the best medicine.</i> <i>I learnt from being at death's door that unless I loved myself, nothing else in my life could function at its best.</i>" (Chang posted her story on May 11, 2012)</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<br />
<br />
(Posted by Chang's Friend) </div>
</div>
CT Changhttp://www.blogger.com/profile/11085620064834659684noreply@blogger.com12tag:blogger.com,1999:blog-7663181626936078312.post-34997445327236181432012-09-19T21:49:00.001+08:002012-10-01T16:31:57.156+08:00Exercise Caution<div dir="ltr" style="text-align: left;" trbidi="on">
<br />
<div style="text-align: justify;">
Chang had planned to write a post on his experience with HIFU but he did not manage to. So, I am writing this post based on the little information I have, of what actually happened in order that it may benefit readers as well as those looking for alternative therapies.<br />
<br /></div>
<div style="text-align: justify;">
On November 3, 2011 Chang wrote about the HIFU therapy. He said, "<i>I am quite hopeful because it's minimal or non-invasive form of
procedure. A patient can actually walk as early as 4 hours after the
procedure</i>.", However, the real experience in China was very different. He felt very weak after the procedure, was nauseous and was in quite alot of pain. In fact, he had a really tough time. You may read about his
experience after he went for the HIFU procedure from postings he made
from December 2011 onwards. <br />
<br />
Six months after the procedure, this is what he wrote (ref post on June 29, 2012). "<i>However, my experience with cancer pain only started in the last four
months or so. In fact, it started after my HIFU treatment in China and I
believe it has to do with the dead tumor tissues inside my right
abdominal area and also the healing wounds of the tissues and blood
vessels after the HIFU treatment</i>"</div>
<div style="text-align: justify;">
<br />
<span id="bc_0_6b+seedBTSSD" kind="d">He had also expected that the HIFU procedure would be able to remove the entire kidney tumour. However, it was only able to remove 90% of it. He discovered this fact only when he was there.</span><span id="bc_0_6b+seedBTSSD" kind="d"> </span><br />
<br />
<span id="bc_0_6b+seedBTSSD" kind="d">I</span>t is not my intention here to speculate on what happened. We also have to
bear in mind that after the HIFU therapy, he did not go back to China
for follow up. He said that it was not necessary. He was also not closely
monitored by a local doctor. Without a scan, he had assumed that the constant
pain at his abdominal area was from dead tumour tissues after HIFU. In July this year, doctors discovered that the cancer had spread mainly to his abdominal area causing him great pain and later, breathing difficulties. <br />
<br />
Even though we do our research, there may still be many things we may
miss or be unable to anticipate, just from reading research material
from the internet and books. In his own words. Chang said <i>"<span id="bc_0_6b+seedBTSSD" kind="d">What I want to say is that in theory, it may sound very good but in practice, it may not be so simple.</span></i>"<br />
<br />
I urge readers to take the time to find out more information as well as get feedback from other patients on any treatment which they wish to pursue. Of course, we understand that cancer patients sometimes feel that they are running out of time. As for the HIFU therapy, researchers in Europe are still doing trials in its use for cancer treatment. But they are not sure how well this will work as
yet. <br />
<br />
(Updated by Chang's Friend)</div>
</div>
CT Changhttp://www.blogger.com/profile/11085620064834659684noreply@blogger.com10tag:blogger.com,1999:blog-7663181626936078312.post-34944536974063546392012-09-15T13:12:00.003+08:002012-09-15T23:17:54.240+08:00Free Spirit<div dir="ltr" style="text-align: left;" trbidi="on">
<div style="font-family: inherit;">
<br />
<br />
<img class="l-tk photo" height="250px" src="https://lh4.googleusercontent.com/-kheHvtk85i4/AAAAAAAAAAI/AAAAAAAABEI/TgRLsMG3dhg/s250-c-k/photo.jpg" style="cursor: pointer;" width="250px" /><br />
<i> </i><br />
<i>When I come to the end of the road</i><br />
<i>And the sun has set for me,</i><br />
<i>I want no tears in a gloom-filled room,</i><br />
<i>Why cry for a soul set free?</i><br />
<i>Miss me a little – But not for long</i><br />
<i>And not with your head bowed low,</i><br />
<i>Remember the friendship that we once shared,</i><br />
<i>Miss me – But let me go.</i><br />
<i>For this is a journey we all must take,</i><br />
<i>And each must go alone,</i><br />
<i>It’s all a part of the Master’s plan</i><br />
<i>A step on the road to home.</i><br />
<i>When you are lonely and sick of heart</i><br />
<i>Go to your friends that we know,</i><br />
<i>And bury your sorrows in doing good works,</i><br />
<i>Miss me – But let me go.</i><br />
<i>(poem by Henry Scott Holland)</i><i> </i><br />
<i></i><br />
<i><br /></i>
<br />
<div style="text-align: justify;">
<span style="font-family: inherit; font-size: small;">Chang's ashes will be scattered in
Cameron Highlands today in fulfillment of his last wish. He loved the
Highlands and had planned to spend his time in retirement there. In his
own words, he was a free spirit, happiest spending time in the cool
climate of the Highlands.</span></div>
<div style="font-family: inherit; text-align: justify;">
<span style="font-size: small;">Have a good rest, my dear friend.</span></div>
<br />
(updated by Chang's Friend) <br />
<div style="text-align: justify;">
<br /></div>
<i><span style="color: #2200a1; font-size: large;"><span style="color: #2200a1; font-size: medium;"><span style="color: #2200a1; font-size: small;"><span style="color: #2200a1; font-size: small;"><span style="color: black;"> </span></span></span></span></span></i></div>
</div>
CT Changhttp://www.blogger.com/profile/11085620064834659684noreply@blogger.com12tag:blogger.com,1999:blog-7663181626936078312.post-91596970050689064402012-09-12T15:00:00.001+08:002012-10-11T17:30:06.754+08:00My Message of Thanks<div dir="ltr" style="text-align: left;" trbidi="on">
<div style="text-align: justify;">
<img height="119.60000000000001" id="bigImage" src="http://ts4.mm.bing.net/images/thumbnail.aspx?q=4824378562644479&id=527f8dc8d32afb01c54982da4bbe6e81" style="margin-bottom: 0px;" width="159.9" /></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
</div>
<div style="text-align: justify;">
Very few people, if any at all, knew that Chang asked me to be the custodian of his blog in the year 2010. A custodian is a person whom the blogger has entrusted to take over the blog when the blogger is unable. When he was away for HIFU treatment in China, I helped him with the postings. I asked him to find a substitute but realised that he had not done so after the blog was left unattended to. So, I decided to do my last bit for my dear friend and expected nothing in return. Therefore, I am touched by readers who have taken the trouble to thank me. It was an honour being able to update for him and you. Thank you so much for your kindness and support. You have been great supporters of Chang.<br />
<br /></div>
Chang's Friend<br />
<br /></div>
CT Changhttp://www.blogger.com/profile/11085620064834659684noreply@blogger.com34tag:blogger.com,1999:blog-7663181626936078312.post-69481012221504639602012-09-11T15:59:00.000+08:002012-09-11T16:53:35.837+08:00He is Gone<div dir="ltr" style="text-align: left;" trbidi="on">
<div style="text-align: justify;">
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<div class="MsoNormal" style="font-family: inherit;">
<i><span style="font-size: small;"><span style="line-height: 115%;">He is Gone</span></span></i></div>
<div class="MsoNormal" style="font-family: inherit;">
<span style="font-size: small;"><b><span style="line-height: 115%;"> </span></b><span style="line-height: 115%;"> <br />
<i>You can shed tears that he is gone, <br />
Or you can smile because he lived, <br />
You can close your eyes and pray that he will come back, <br />
Or you can open your eyes and see all that he has left. </i></span></span></div>
<div class="MsoNormal" style="font-family: inherit;">
<i><span style="font-size: small;"><span style="line-height: 115%;"><br />
Your heart can be empty because you can't see him <br />
Or you can be full of the love that you shared, <br />
You can turn your back on tomorrow and live yesterday, <br />
Or you can be happy for tomorrow because of yesterday. </span></span></i></div>
<div class="MsoNormal" style="font-family: inherit;">
<i><span style="font-size: small;"><span style="line-height: 115%;"><br />
You can remember him and only that he is gone <br />
Or you can cherish his memory and let it live on, <br />
You can cry and close your mind, be empty and turn your back, </span></span></i></div>
<div class="MsoNormal" style="font-family: inherit;">
<i><span style="font-size: small;"><span style="line-height: 115%;">Or you can do what he would want: smile, open your eyes, love and go on.</span></span></i></div>
<div class="MsoNormal" style="font-family: inherit;">
</div>
<div style="text-align: justify;">
<br />
<i>(poem by David Harkins)</i><br />
<br />
<br /></div>
<div style="text-align: justify;">
Today is the third anniversary from the day Chang discovered that he was suffering from Stage 4 kidney cancer. Exactly three years, after that fateful day, Chang has passed away peacefully surrounded by his family at 12.10 pm this afternoon. His family wishes to inform that you may pay your last respects at: </div>
<div style="text-align: justify;">
<br />
<b>Wake: 11 & 12 September 2012 </b><br />
<b> </b> Time: 7 pm onwards</div>
<div style="text-align: justify;">
Gui Yuan Funeral Parlour <br />
Room 1 </div>
<div style="text-align: justify;">
Jalan 229 Section 51A,</div>
<div style="text-align: justify;">
Petaling Jaya<br />
46100 Selangor <br />
<br />
<b>Funeral (cremation): 13 September 2012</b><br />
Time: 2pm<br />
Venue: MPPJ crematorium (next door)<br />
<br />
<br />
<br /></div>
<i><span style="font-size: small;"><span style="line-height: 115%;">May the roads rise to meet you,<br />
May the wind be always at your back,<br />
May the sun shine warm upon your face,<br />
The rain fall soft upon your fields<br />
And, until we meet again,<br />
May the Lord Buddha hold you in the hollow of his hand</span></span></i><br />
<br />
<i>(adapted Celtic blessing)</i><br />
<br />
<br />
<br />
(Posted by Chang's friend)</div>
CT Changhttp://www.blogger.com/profile/11085620064834659684noreply@blogger.com40tag:blogger.com,1999:blog-7663181626936078312.post-57686424164065387372012-09-10T22:59:00.001+08:002012-10-01T16:33:35.508+08:00The Final Days<div dir="ltr" style="text-align: left;" trbidi="on">
<div style="text-align: justify;">
<span style="font-family: inherit;">It's hard to be prepared for death, be it our own or a loved one's. Too much is unknown about what dying feels like or what, if anything, happens after you die to ever feel truly ready.</span></div>
<div style="font-family: inherit; text-align: justify;">
<br /></div>
<div style="font-family: inherit; text-align: justify;">
Health professionals speak of “dying trajectories” that suggest how
persons with specific diseases will die. For example, those with a
terminal illness, such as advanced cancer, will show a steady decline
toward death. Those with serious chronic illnesses may have peaks and
valleys that sometimes give the impression of recovery.</div>
<div style="font-family: inherit; text-align: justify;">
<br /></div>
<div style="font-family: inherit; text-align: justify;">
Dying involves a process in which the body gradually shuts down. There are signs of dying, some of which are as follows:-</div>
<ul style="font-family: inherit; text-align: left;">
<li>Decreasing level of consciousness, possibly entering a coma<span style="font-family: inherit; font-size: 12pt;"></span>
</li>
<li style="font-family: inherit;">Decreasing ability to communicate<span style="font-size: 10pt;"><span style="mso-list: Ignore;"> </span></span></li>
<li style="font-family: inherit;">Loss of ability to swallow</li>
<li style="font-family: inherit;">Loss of ability to close eyes- whites showing<span style="font-size: 12pt;"> </span></li>
</ul>
<div style="font-family: inherit; text-align: justify;">
</div>
<div style="font-family: inherit; text-align: justify;">
As the person moves closer to death, he sometimes slips into a coma. Coma is a state of unconsciousness lasting more than six hours<sup class="reference" id="cite_ref-RR_0-0"><a href="http://en.wikipedia.org/wiki/Coma#cite_note-RR-0"></a></sup>,
in which a person: cannot be awakened; fails to respond normally to
painful stimuli, light, or sound; lacks a normal sleep-wake cycle; and,
does not initiate voluntary actions. The person is still alive, but the <a href="http://kidshealth.org/kid/body/brain_noSW.html" id="link0" name="link0"></a>brain is functioning at its lowest stage of alertness.</div>
<div style="font-family: inherit; text-align: justify;">
<br /></div>
<div style="font-family: inherit; text-align: justify;">
I was told that Chang stood up and hugged his mother three times yesterday. Then, during the early hours of this morning, he slipped into a coma..</div>
<div style="font-family: inherit; text-align: justify;">
<br /></div>
<div style="font-family: inherit; text-align: justify;">
Pain medication (morphine) continues to be administered. Apparently, comatose patients still feel pain because their brain is still functioning. (<span id="intelliTxt">Belgian doctors discovered that some comatose
patients develop the same "pain matrix" in the brain as healthy
individuals do when subjected to pain stimuli. This gives further
justification to medics administering painkillers to patients previously
believed to have had no functioning pain receptor). </span></div>
<div style="font-family: inherit; text-align: justify;">
<br /></div>
<div style="font-family: inherit; text-align: justify;">
<span id="intelliTxt">He is breathing on his own and resting at home surrounded by his family, parents, brother and sisters. We continue to speak to him and his Buddhist friends were at his home, chanting to him.</span> While we do not know what unconscious patients can actually hear, extrapolation from data from the operating room and ‘near death’ experiences suggests that at times their awareness may be greater than their ability to respond.</div>
<div style="font-family: inherit; text-align: justify;">
<br /></div>
<div style="font-family: inherit; text-align: justify;">
The time is near. Let us pray for a peaceful journey home for Chee Teck.</div>
<div style="font-family: inherit; text-align: justify;">
<br />
(Updated by Chang's Friend)</div>
</div>
CT Changhttp://www.blogger.com/profile/11085620064834659684noreply@blogger.com13tag:blogger.com,1999:blog-7663181626936078312.post-6677820176382673032012-09-09T21:51:00.000+08:002012-09-10T12:08:33.968+08:00Not Good<div dir="ltr" style="text-align: left;" trbidi="on">
<div style="text-align: justify;">
I visited Chang this evening with the intention of reading your messages to him. He has deteriorated since last Friday. He did not open his eyes or make any sign of acknowledgement of my presence (which he used to when he got visitors). In short, he does not respond much. He tried to communicate with his family using the little whiteboard but no one could read his writing. Seeing his condition, I was worried that your messages may go unheard. But I know he can still hear though he does not respond. So, I sat and waited for the opportunity to arise. </div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
And I am relieved and happy that it did. I have read your comments on this blog as well as the messages sent to upekahblogspot@gmail.com. I received one more email message after I left at 7pm. If I have the opportunity, I shall continue to read to him. I thank all of you who have written in. I am very grateful to you for sharing the kind words about Chang. I believe that the beautiful, positive words you wrote will help him in his journey forward.</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
I feel very sad but that is life, as he puts it. As I start to process what happened this evening, I realise that I had not written him my own message (except for the brief message thanking him on the post "Death and dying."). </div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
I really do not know what else to say. Goodnight.<br />
<br />
(Updated by Chang's Friend)</div>
</div>
CT Changhttp://www.blogger.com/profile/11085620064834659684noreply@blogger.com14tag:blogger.com,1999:blog-7663181626936078312.post-64817863245284614002012-09-07T20:03:00.000+08:002012-09-09T22:09:10.369+08:00Message for You<div dir="ltr" style="text-align: left;" trbidi="on">
<div style="text-align: justify;">
How is Chang? In his own words "very bad" and "very tired". He has stopped taking porridge. Now, he is on dextrous intravenous drips administered by the hospice nurse. He sips ice water, takes some watermelon and sometimes, a bit of yoghurt. </div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
He is mentally alert but is too weak to read updates on this blog. So, I offered to read the previous two posts to him. He listened closely as I read and gave a slight nod here and there I also noticed him wiping away what I suspected were a few tears. After I finished, he scrawled the following message on the little whiteboard, in response to your comments:-</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<b><i><span style="font-size: small;">1. My daughter has technically graduated. She will receive her scroll</span></i></b></div>
<div style="text-align: justify;">
<b><i><span style="font-size: small;"> in September</span></i></b></div>
<div style="text-align: justify;">
<b><i><span style="font-size: small;">2. I am touched by the readers' comments. </span></i></b></div>
<div style="text-align: justify;">
<b><i><span style="font-size: small;">3. I will miss all of you but that is life.</span></i></b></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
I enjoyed reading for him and I hope he continues to take an interest in this blog. I would also like to invite readers to start talking to him especially those who have been keeping silent. If not now, when? If you want a message read to him privately, you may send it to upekahblogspot@gmail.com</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
Recall his good deeds and how he has contributed, touched you and how his life has made a difference and benefited yours. He is still contributing in his silence albeit in a different way.</div>
<br />
(Updated by Chang's Friend)<br />
<br /></div>
CT Changhttp://www.blogger.com/profile/11085620064834659684noreply@blogger.com22tag:blogger.com,1999:blog-7663181626936078312.post-64169332548684313622012-09-05T21:58:00.001+08:002012-10-01T16:32:29.587+08:00Death and dying<div dir="ltr" style="text-align: left;" trbidi="on">
"<i>We are alive, therefore we will die</i>." This is the simplest, most obvious
truth of our existence, and yet very few of us have really come to terms
with it. <br />
<br />
<div style="text-align: justify;">
Although intellectually we all know that one day we shall die, generally
we are so reluctant to think of our death that this knowledge does not
touch our hearts, and we live our lives as if we are going to be in this
world forever. However, to cancer patients, death is never far from their minds.</div>
<div style="text-align: justify;">
</div>
<div style="text-align: justify;">
</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
It was in July that Chang told me that his condition had deteriorated and that he was preparing for death. At that time, I didn't want to encourage what I assumed were negative thoughts. (which he battles with now and then). We all do not wish to hear our loved ones or close friends tell us that they will be leaving us. It is hard to imagine a world without them in it. We sometimes forget that our loved ones' wellbeing and wishes are paramount. And when the time comes, to let them go peacefully and without guilt.<br />
<br />
Chang told me that he had to counsel a few friends who came to
visit him over the Raya holidays. These friends had told him to "hold
on". Though, these friends may have meant well, Chang was obviously
irritated.<br />
<br />
Yes, talking about death is taboo to many people. Yet without talking about it and facing it honestly, how can we prepare the dying as well as ourselves for the process of dying? How do we help the dying to die well?<br />
<br />
We do not know what the future holds but Chang has been mentally preparing himself since he discovered he has cancer. He said that he has no regrets about his efforts. To quote him in an earlier post titled The Joy of Dying in Peace, "<i>While, I would certainly like to find a cure for my cancer, there comes a
time I will recognise that it's no good. I have tried all that I know
(of course, you can say there are many more I have not tried) which I
think will work for kidney cancer. I am satisfied with my actions and
prepared to move on".</i></div>
<div style="text-align: justify;">
<br />
<i>"I take a different view. I am actually preparing for this day so that I
can die peacefully. To this end, my doctor loaned me a book called </i><i>The Joy of Living and Dying in Peace by
His Holiness, The Dalai Lama. To approach death without fear or regret
and welcome our passage of death. To live peacefully you must also learn
to die peacefully."</i><br />
<br />
I will miss him dearly if he goes, But I also wish him, what is best for him and a peaceful journey ahead. And I ask for forgiveness for my imperfections and thank him for his generosity, support and being my wonderful, wonderful friend.<br />
<br />
(Updated by Chang's friend) </div>
</div>
CT Changhttp://www.blogger.com/profile/11085620064834659684noreply@blogger.com8tag:blogger.com,1999:blog-7663181626936078312.post-79753688852020747372012-09-04T17:02:00.002+08:002012-09-09T22:09:42.507+08:00Update<div dir="ltr" style="text-align: left;" trbidi="on">
<div style="font-family: inherit; text-align: justify;">
<span style="font-size: small;">Yesterday, when I visited Chang, he complained that he has little energy. He had barely eaten, saying that his throat feels blocked. He had written instructions for his wife to inform the Hospis Malaysia nurse to administer intravenous glucose drip (to boost his energy levels) when she visited later in the evening.</span></div>
<div style="font-family: inherit; text-align: justify;">
<span style="font-size: small;"><br /></span></div>
<div style="font-family: inherit; text-align: justify;">
<span style="font-size: small;">When I saw him again today, the glucose drip had already been administered. I was told that the nurse would be visiting again this afternoon regarding his constipation problems.</span></div>
<div style="font-family: inherit; text-align: justify;">
<span style="font-size: small;"><br /></span></div>
<div style="font-family: inherit; text-align: justify;">
<span style="font-size: small;">He cannot sit for long periods. There's not enough flesh on his backside. After some time, he would stand for a minute to change position. Today, I saw him stand up and put his arm around his mother's neck for support. T</span><!--[if gte mso 9]><xml>
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<![endif]--><span style="font-size: small; line-height: 115%;">hen </span><span style="font-size: small;">he leaned his head toward her</span><span style="font-size: small; line-height: 115%;">, like a child seeking comfort from his mother. </span><span style="font-size: small;"> In that moment, I saw so much tiredness and weariness on his thin face. Anyone watching would feel for this man.</span><br />
<span style="font-size: small;"><br /></span>
<span style="font-size: small;">He likes alot of gentle massages as a relief. Today, his sister massaged his swollen feet with medicated oil. Then, he asked his mother to give him "guasa". Guasa is Chinese language. Gua means scrape. Sa means poison or disease that will appear when scraped, like red rash or bruise. The Chinese believe that it helps to detoxify and eliminate wind from the body. </span></div>
<div style="font-family: inherit; text-align: justify;">
<span style="font-size: small;"><br /></span></div>
<div style="font-family: inherit; text-align: justify;">
<div>
<span style="font-size: small;">I agreed to update this blog on his behalf because I always thought that this blog holds alot of meaning for him. It is a documentation of the most difficult and lonely period of his life. Yet, it has also been a period of growth and awareness. He has mustered all his knowledge and skills in trying to heal himself, an area totally new to him.. He has put hours into research and poured his heart into writing this blog, On his busiest days, he made time to provide updates. It would be such a waste. So many people still wish to reach out to him and send him their prayers, I shall continue for as long as there is information for me to go on with.</span></div>
<div>
<span style="font-size: small;"><br /></span></div>
<div>
<span style="font-size: small;">As a friend, who has seen him go through some of the ups and downs during his cancer journey, I am learning each day. Sometimes, he write a few lines on a little whiteboard using a marker pen for me and I have an idea what he wants me to post. On other days, I would like to hear him talk but he does not have the strength anymore.</span></div>
<div>
<span style="font-size: small;"><br /></span></div>
<span style="font-size: small;">(Updated by Chang's friend)</span></div>
<div style="font-family: inherit; text-align: justify;">
<span style="font-size: small;"><br /></span></div>
<div style="font-family: inherit;">
<span style="font-size: small;"><br /></span></div>
<div style="font-family: inherit;">
<span style="font-size: small;"><br /></span></div>
</div>
CT Changhttp://www.blogger.com/profile/11085620064834659684noreply@blogger.com8tag:blogger.com,1999:blog-7663181626936078312.post-60413987914375402102012-09-02T22:39:00.000+08:002012-09-09T22:14:14.940+08:00Managing The Tough Times<div dir="ltr" style="text-align: left;" trbidi="on">
<br />
<div style="text-align: justify;">
For the past few days, Chang has been eating little and not sleeping well. Besides pain, he is also struggling with severe constipation. He has not had a bowel movement for the past 14 days.<br />
<br />
(Before writing about this topic, I asked him if he really wants me to post about his constipation problems and he said yes, so here goes....)</div>
<div style="text-align: justify;">
<br />
Constipation is a common and frequently troublesome symptom in patients with advanced cancer. Despite its prevalence, constipation
can still be an overlooked symptom, which often receives little
attention until significant problems occur. Often, multiple causative factors are present:-</div>
<div style="text-align: justify;">
<br />
<b>o Reduced food (including fibre) and fluid intake</b></div>
<div style="text-align: justify;">
</div>
<div style="text-align: justify;">
Patients with
advanced cancer often have a reduced appetite for a variety of reasons,
with fibre in particular being difficult to tolerate: </div>
<div style="text-align: justify;">
- Some tumours produce chemical substances that suppress appetite.</div>
<div style="text-align: justify;">
- The slowdown of many bodily functions including gastric
emptying, which results in early satiety and decreased hunger; </div>
<div style="text-align: justify;">
- Nausea and/or vomiting are associated with an aversion to food; </div>
<div style="text-align: justify;">
- Oral pain when attempting to eat and drink. Possible causes include oral thrush, mouth ulcers, mucositis; </div>
<div style="text-align: justify;">
- Only able to tolerate a low residue diet and are too weak to chew for any length of time </div>
<div style="text-align: justify;">
</div>
<br />
<div style="text-align: justify;">
<b>o Reduced abdominal and pelvic muscle power</b></div>
<div style="text-align: justify;">
Patients with advanced malignancy who are too weak to give the push
necessary for defecation. </div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<b>o Reduced mobility</b></div>
<div style="text-align: justify;">
<b> </b> </div>
<div style="text-align: justify;">
<b>o Constipating drugs</b><br />
(e.g. opioids, drugs with anticholinergic action, antagonist anti-emetics, iron). Opioid use is strongly associated with constipation in patients with
advanced cancer. Opioids have a constipating effect whether given orally,
sub-cutaneously or transdermally, although the incidence of
constipation may be reduced with non-oral administration<br />
<br />
<b>o The cancer itself</b><br />
<div class="MsoNormal">
If a tumour is pressing on the nerves in the spinal cord, it
can slow down or stop the movement of the bowel and so cause constipation. Tumours
in the abdomen can compress, squeeze, or narrow the bowel and rectum making it
difficult to have a bowel motion. Or a tumour in the lining of the bowel can
affect the nerve supply to the muscles and cause constipation</div>
</div>
<div style="text-align: justify;">
<b>o </b><b>Environmental factors </b></div>
<div style="text-align: justify;">
Environmental factors should not be overlooked. Patients unable to get to the toilet
unaided may be reluctant to ask for assistance due to embarrassment or a
desire not to bother their caregivers. </div>
<div style="text-align: justify;">
</div>
<br />
<b>Treatment of Constipation</b><br />
<div style="text-align: justify;">
Oral measures such as laxative therapy are usually the firstline treatment of constipation. However, rectal measures such as suppositories and enemas can bring about quick results. An enema is a liquid that is squirted into the rectum and colon via the anus whereas a suppository is an easily melted pill or capsule inserted in the rectum.<br />
<br />
In Chang's case however, laxatives have not worked. In cases of constipation it is important not to wait if there is no bowel movement for a few days. He told me that he was too embarassed to accept help during an earlier visit to the hospital. (when a nurse asked him if he wanted an enema administered). So, during his recent stay at the hospital last week, he asked for assistance and this time, the nurse administered the enema for him but it was unsuccessful. Back home, he has tried what he calls the "tin mining approach" ie using water to spray up the anus but has still not been successful.<br />
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The Hospis Malaysia nurse will be visiting tomorrow. Hopefully, there will be a breakthrough.<br />
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(Updated by Chang's friend) <br />
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CT Changhttp://www.blogger.com/profile/11085620064834659684noreply@blogger.com7tag:blogger.com,1999:blog-7663181626936078312.post-51458244779674701082012-08-30T23:37:00.000+08:002012-09-09T22:11:58.989+08:00Back Home Again<div dir="ltr" style="text-align: left;" trbidi="on">
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Chang was discharged from the hospital today. He did not sleep well last night and ate little today. However, he enjoys eating watermelon and was having some when I visited him.</div>
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There have been offers to help from readers, Tan Ai Wee and Anonymous. Actually, Chang needs to replace the 3 pints of blood given to him at the hospital. If you are able to donate blood at the hospital during office hours, Monday to Saturday (except public holidays), please contact me at upekahblogspot@gmail.com. Thank you, thank you to all of you for your kindness.</div>
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Chang has also read your comments and wishes to thank all of you for your prayers, words of comfort and help. A reader asked whether he is able to walk. Yes, he is able to make short trips to the restroom with assistance.<br />
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Happy 55th Merdeka Day to all Malaysians! It is a long weekend. Rest, relax and rejuvenate! <br />
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<span style="color: black; font-family: Helvetica, Arial, sans-serif;"><span style="font-family: inherit;">(Updated by Chang's friend)</span><br />
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CT Changhttp://www.blogger.com/profile/11085620064834659684noreply@blogger.com5tag:blogger.com,1999:blog-7663181626936078312.post-10143606999856467452012-08-29T21:43:00.000+08:002012-09-09T22:13:05.928+08:00A Strong Man Indeed<div dir="ltr" style="text-align: left;" trbidi="on">
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Yesterday, Chang decided to go to the hospital because of breathing difficulties. He was thinking that the problem could be due to a buildup of fluid in his lungs and that a thoracentesis or pleural tap would help. A pleural tap is similar to an abdominal tap in that it helps drain the excess fluid out but instead of the abdomen, its from the lungs. However, the latest findings from the hospital is that his breathing difficulties are not being caused by fluid buildup but by tumours which have displaced his liver and pushed his diaphragm up. </div>
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He is still in the hospital for another day of observation. He has
been given another 3 pints of blood since last evening when his red
blood count dropped to 5.3. </div>
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He is currently on 20 mg (or 10ml) liquid oral morphine five times a day and also wears a 25 mg morphine patch. His family helps him keep a record of the morphine he takes. Morphine has its side effects so he has been prescribed with laxatives and drugs to manage these side effects. Despite taking laxatives, he is still having quite bad constipation.<br />
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His taste buds have also been affected. Foods which used to taste so delicious to him before, taste radically different now, probably as a result of these drugs. For example, plain water tastes sour so he adds ice cubes. Carrot juice tastes like ginger root juice. He is able to tolerate apple juice and lemon juice. His diet consists mainly of vegetarian porridge, Enercal and foods he tries and finds palatable.</div>
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To say that it is a tough time is really an understatement but he has been very, very strong. I salute him and admire him immensely. I think many of us do.</div>
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(Updated by Chang's friend)</div>
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CT Changhttp://www.blogger.com/profile/11085620064834659684noreply@blogger.com5tag:blogger.com,1999:blog-7663181626936078312.post-90090073060894379072012-08-28T23:32:00.001+08:002012-09-09T22:12:18.928+08:00Friends <div dir="ltr" style="text-align: left;" trbidi="on">
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During his cancer journey, Chang has made many new friends as well as received the support of so many across the globe, both through this blog as well as through his daily life, Some have written to him asking for information and advice. There have also been offers to help from readers in countries such as New Zealand and Hong Kong, to name a few. He has been touched by many, just as many people with loved ones or friends in similar situations have been touched by him.</div>
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On a daily basis, there is a beautiful lady who cooks and delivers to him delicious porridge. His friends from different faiths, ex-colleagues, Khadijah, Yeong and many more have been there for him. I am honoured to contribute but a small part. Names are not important at this stage. Chang is.</div>
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He has been having breathing difficulties. He is spending the night at the hospital and has received a pint of blood. As you already know from previous posts, he has low haemoglobin levels. Hopefully, he will be discharged tomorrow. </div>
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Let us all dedicate our prayers and thoughts to him, that his suffering may be minimal. And that his mind remains strong and steadfast.</div>
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(Updated by Chang's friend)</div>
CT Changhttp://www.blogger.com/profile/11085620064834659684noreply@blogger.com7tag:blogger.com,1999:blog-7663181626936078312.post-65120747971791142662012-08-27T18:04:00.002+08:002012-09-09T22:13:22.783+08:00Hanging On<div dir="ltr" style="text-align: left;" trbidi="on">
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<span style="font-size: small;">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.</span></div>
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<span style="font-size: small;">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</span><span style="font-size: small;"> provide some updates about his health and well being.</span><br />
<span style="font-size: small;">He checked into UH on Wednesday, 25 August to get an abdominal tap done.</span></div>
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<span style="font-size: small;">What is an abdominal tap?</span></div>
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<span style="font-size: small;">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. </span><span style="font-size: small;"> </span></div>
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<span style="font-size: small;"> </span><img alt="" class="rg_hi uh_hi" data-height="244" data-width="207" height="244" id="rg_hi" src="https://encrypted-tbn3.google.com/images?q=tbn:ANd9GcTiBx_KnBn2yw3wbf4iVeMR2L2EG0wN1_lm9DkSOAal4DdjLndP" style="height: 244px; width: 207px;" width="207" /><span style="font-size: small;"> </span><br />
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<span style="font-size: small;"> There are several possible reasons for this build up of fluid:<br />• If cancer cells have spread to the lining of the abdomen they can cause irritation, leading to the build up of fluid.<br />• 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.<br />• 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.</span></div>
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<span style="font-size: small;">What are the symptoms of fluid build up?</span><br />
<span style="font-size: small;">The symptoms of this build up of fluid include:<br />• Swelling of the abdomen, with associated pain or discomfort.<br />• Difficulty in moving or sitting comfortably.<br />• Breathlessness.<br />• Tiredness.<br />• Nausea and vomiting.<br />• Indigestion.<br />• Reduced appetite.<br />• Altered bowel habit</span></div>
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<span style="font-size: small;">Abdominal tap is usually done under local anaesthesia. It is an outpatient procedure, which means you can go home after it is done. </span><span style="font-size: small;">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</span><span style="font-size: small;"> around whilst the fluid is being drained into the drainage bag</span><span style="font-size: small;"> </span><span style="font-size: small;">(Sometimes doctors also put an internal tube under the skin to
permanently drain the fluid and prevent this from constantly happening). </span></div>
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<span style="font-size: small;">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.</span><br />
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<span style="font-size: small;">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.</span><br />
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(Updated by Chang's friend)</div>
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CT Changhttp://www.blogger.com/profile/11085620064834659684noreply@blogger.com13tag:blogger.com,1999:blog-7663181626936078312.post-72246644285055119392012-08-18T22:17:00.000+08:002012-10-01T16:32:58.286+08:00The End is Near<div dir="ltr" style="text-align: left;" trbidi="on">
This will probably be one of the last few postings I will be making unless my condition improves.<br />
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I am really very very tired and I realised writing even for a post takes up a lot of energy.<br />
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I thank all of you being there to support me especially during this most difficult time of my life.<br />
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I will end this post with the following thoughts:<br />
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<i>Clinging to life against the inevitable is to create more suffering</i><br />
<i>There is no life without death</i><br />
<i>The good and bad comes to decay</i><br />
<i>All things shall come to pass.</i><br />
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<i>Do not waiver your mind when the test is near</i><br />
<i>Hold steadfast in your believes</i><br />
<i>When the road forth is no more</i><br />
<i>Embrace with grace that the end is near.</i><br />
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May all of you be free from danger, free from mental and physical suffering. May you all be well and happy always.<br />
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(Last Post by CT Chang) </div>
CT Changhttp://www.blogger.com/profile/11085620064834659684noreply@blogger.com57tag:blogger.com,1999:blog-7663181626936078312.post-47443419365534675262012-08-11T07:43:00.002+08:002012-08-11T07:46:06.438+08:00The Show Must Go On<div dir="ltr" style="text-align: left;" trbidi="on">
I wanted to update two days back but due to the pain on my abdominal area, I am unable to sit for long. My condition has not improved. Many of your have contacted me and I am sorry to have kept all of you in the dark.<br />
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The abdominal abstention is really giving me a lot of problems. Not being able to eat and also pain all over the body and constipation. Last Tuesday, I did a tapping at Hospis Malaysia and the nurse managed to draw out 2.7 liters of water. But by the next day, my abdominal area is about 70% full back. Looks like I may have to do daily tapping and I will be discussing with my doctor about this and select a hospital to implant a tube on my abdominal area.<br />
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I have not given up yet. I am just doing what I can and the focus now is to control the stomach abstention. When this is done, the next step is eat, at least have enough body to mount a fight back. Three days back I developed an instant sore throat and now, I even have problems drinking water. I have stopped all medications since June 2012 and now only on Hospis palliative care.</div>CT Changhttp://www.blogger.com/profile/11085620064834659684noreply@blogger.com10tag:blogger.com,1999:blog-7663181626936078312.post-34744628685366917712012-08-06T09:50:00.000+08:002012-08-06T09:53:26.339+08:00Feeding Frenzy<div dir="ltr" style="text-align: left;" trbidi="on">
Since discharging from the hospital one week ago, I have been on a feeding frenzy. I have lost so much of weight because of the abdominal distention that physically I look like a 12 year old buy but with a stomach of a seven month old pregnant women. I have been taking all kinds of nutritional foods, especially liquids ones since I still have a limitation of taking in solid foods. I have lost my sense of taster about two months ago now and my food either taster sour, bitter, salty or sweet. When I closed my eyes and you give me food to eat, I won't be able to tell what food you just gave me. They all taste lousy and hard. So, it's been very challenging to gain back some weight. Even drinking water taste sour!<br />
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My swellings on my legs have improved a little with the new medication that I am taking but it's still too slow. My abdominal distension is getting bigger back and I need to go for another tapping this week, hopefully, I can a get a slot tomorrow. It's painful and uncomfortable.<br />
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I am still suffering from cancer pain because I am not taking the optimal painkillers because of the side effects of opioid drugs. It's a trade-off I got to live with for now if not my stomach functions will be severely impaired.<br />
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Thanks again to Khadijah and Yeong for bring me some herbs and medication to deal with the legs swelling and stomach distension. What a friend to have when I needed help most. They have been constantly by my side encouraging me on.</div>CT Changhttp://www.blogger.com/profile/11085620064834659684noreply@blogger.com6tag:blogger.com,1999:blog-7663181626936078312.post-65684544455324448252012-08-04T07:43:00.001+08:002012-08-04T07:46:38.652+08:00Getting Rough Ahead<div dir="ltr" style="text-align: left;" trbidi="on">
I have been plagued with fatigue the last few days so much so I am sort of spent most of my time lying on the bed, immobilised. Although the hospital managed to drain about 3 liters of fluids from my abdominal area, my doctor has warned me that it will be refilled and I will have to come back for draining or tapping a few more times. Yesterday, I was so tired that I have very little strength, much like a diabetic patient suffering from lack of sugar. So, immediately I made myself a honey lemon drink and managed to get some energy back.<br />
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This morning I will be doing a follow-up with my doctor at Tung Shin Hospital and will request that she write a recommendation letter for me to do the tapping so that I can do the procedure at other hospitals. In view of the cost involved and the frequency that I need to do tapping, I am thinking of going to Government hospitals for the procedure. Subsequently, I also found out the Hospis Malaysia also provide such service. In my case, I think I need to do another tapping this coming Tuesday to relief the pressure of the fluids in my abdominal area.<br />
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I don't have the energy to write longer post now days, so what I will do is to write shorter updates. I like to thank Khadijah and Yeong for baking me a carrot cake and also making the very aromatic Gomito pasta. I had a very good dinner last nite.</div>CT Changhttp://www.blogger.com/profile/11085620064834659684noreply@blogger.com4tag:blogger.com,1999:blog-7663181626936078312.post-61360965197150857422012-07-31T22:04:00.001+08:002012-07-31T22:33:05.107+08:00Trusting My Instinct<div dir="ltr" style="text-align: left;" trbidi="on">
It's good to be back home after spending 2 days and 2 nights at the hospital. Originally, I planned to get admitted to KL General on Monday morning but on Sunday night as I was going up to my room to sleep, I felt shortness of breath. I was feeling half dead. I got uneasy as if something bad was going to happen to me and I spoke to my wife and mother about checking in to a hospital on that very night itself. Finally, after some discussion, I decided to go Tung Shun Hospital for better service and cut the waiting time for treatment. Upon arrival at the hospital at about 1.30am, I was wheeled into the observation room and the nurse amount other things took an immediate blood test. It was found out that my hemoglobin count was at a low of 6.3 and contacted the specialist doctor who immediately ordered 2 pints of blood for transfusion. The transfusion started at 5am and ended about 2pm later the day. Come to think back, my fatigue and unclear mind that I have been experiencing was due to the lack of blood. Last Saturday, I was crawling on my bed when my hands suddenly became powerless and I collapse on my bed faced down. A day after the blood transfusion, I felt like a new person, so much more energy, less tiring and the fatigue that has been haunting me seems to have gone! I have been monitoring my blood levels regularly but I did not expect such a drastic deterioration in July itself.<br />
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Anyway, there are some good, bad news and an important lesson that I learned from this episode. In my next post, I will give you more details. As for now, the nurse managed to draw out about 3 liters of water from my abdominal area. I am so relieved of the pressure from my abdominal area. Suddenly, I can eat without obstruction, no incidence of vomiting and no indigestion though constipation is still a problem. I am much more alive now but wait, there are still so many more things I need to do.</div>CT Changhttp://www.blogger.com/profile/11085620064834659684noreply@blogger.com3tag:blogger.com,1999:blog-7663181626936078312.post-31050163018460436832012-07-27T10:00:00.000+08:002012-07-27T10:54:14.898+08:00There Is Hope<div dir="ltr" style="text-align: left;" trbidi="on">
I would like to thank my friends for coming to visit me during the last week or so. In particular, thanks to Jasmine for bringing the lovely organic porridge. One of the best I tasted in a long time and also to Yeong and Khadijah for bring me some Koren made organic nutritional cereals drink to supplement my liquid diet.<br />
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My doctor has started me on liquid morphine as the new painkiller. Liquid morphine taste like cough syrup and is very effective for immediate pain relief. Theoretically, each dose of 2.5ml which supplies up to 5mg of morphine is set to last 4 hours but in my case, it can only last 2 hours. The plan was to take 10ml (20mg of morphine) during the daytime and 5ml (10mg of morphine) during the night and in total, 15ml should be sufficient for my whole day needs. However, I needed to almost double the dosage to get the relief. In particular at night, I am awaken by the pain and then have to take another dose. This is quite disruptive. More that that, I think I may actually end up taking up to 30ml (or 60mg of morphine) to manage my pain. This amount of morphine intake is more that what my body can bear and I believe the side effects will be as bad if not worst than what I am experiencing. So, just after trying for half a day on liquid morphine, I have to stop and revert back to morphine sulfate instead. At least at 40mg, I can get reasonable pain management throughout the day and occasionally supplement it with tramadol to ease breakthrough pain. At this dosage, I can tolerate the side effects and have a decent meal with minimal vomiting.<br />
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Earlier, I thought I had stomach bloating but it's more than that. It's abdominal distension with the complication of tumors. Or more correctly called Ascites, which is a gastroenterological term for an accumulation of fluid in the peritoneal cavity. So, I am planning to be hospitalised this coming Monday at the KL General Hospital to undergo direct removal of the fluid by needle or paracentesis (which may also be therapeutic). My brother has been pestering me to undergo this procedure when the symptoms started appearing but I wanted to try other less invasive methods of treatment first. Strangely enough, none of the urologist and gastroenterologist that I consulted proposed this procedure. </div>CT Changhttp://www.blogger.com/profile/11085620064834659684noreply@blogger.com5