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“All I want for Christmas” – is Power

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It’s been nearly a week since Typhoon Odette hit the Visayas region of the Philippines. Bringing Cat 5 winds and an ocean full of rain it devastated many parts of the country and was gentler to others. The following are my experiences and general impressions at this point in time.

“What me worry”

Dumaguete rarely gets hit by typhoons. The last one to really hit the area was about 10 years ago. It’s basic geography; we are further sound than the typhoon belt which routinely slams the island of Luzon (where Manila is located), hits the Visayas less often and Negros Oriental, where we live, infrequently. We’ve seen storms heading our way before but invariably they shift enough to miss us, just drenching us with rain. 

But this time the storm tracked toward Negros from the beginning and never wavered. By Monday it seemed likely to hit us. That said almost everyone I knew seems nonchalant about it. Few people were in the kind of panic or preparation mode that you might see in Florida as a hurricane approaches. Everyone seemed to think “what can you do. It’ll either hit us or it won’t.” But as the days approached not only did it not change direction it went from a Tropical Storm to Typhoon to Super Typhoon.

Up until the morning of the storm even Janet wondered why I was worrying and asked why I was so concerned. We had workmen doing a project in our home. Come Thursday afternoon they still were not finished but continued (no doubt wanting to get paid) until after 5:00PM. Getting the cash seemed more important to them than getting home and batting down the proverbial hatches.

Our neighbor has a successful construction supply company. They were preparing for their annual Christmas party. About 5:00 workers arrived for the buffet style meal. By 5:30 the winds picked up considerably and no one seemed worried as they filled their plates; that is until close to 6:00 when power throughout the Province was cut off. The party broke up quickly after that.

Let’s talk about the power for a minute. Our island is fed by a nationally run transmission line. My guess, and I can’t prove it and no one will admit it, is that the line was cut on purpose to save the system and potentially save lives from downed power lines. 

So by 6:00 we had no Internet or power. Our emergency lights kicked in and I turned on my battery powered fan – an essential for me.

Between 6:00PM – 10:00PM the winds picked up to the point of a serious storm; something I had experienced often. At 10:00 Janet and I went to bed determined to at least try to get some sleep. And that’s when the fun began.

I Can Sleep Through Anything

I have always told people that I am such a good sleeper that I can sleep through nuclear war; that night proved it. We had been told that the brunt of the storm would hit early in the morning but apparently Odette was not informed. Between 10:00 – 10:30 our 2 story houses was battered by winds that did not resemble any storm I had ever experienced. And then conveniently I feel asleep.

I woke up at 11: 30 and while the storm was still raging it wasn’t raging as hard as an hour before. I thought, ‘maybe that was the worst of it,’ and fell asleep again. I am told by Janet and friends that between 1:30 – 2:30 it was pretty damn bad. But I was asleep so it couldn’t have been that bad lol.

I must admit that I wish Odette had hit during the day so I could see what was happening. Since I couldn’t see anything, sleep seemed the best thing to do. I woke again at 3:30 and this time stayed awake; not because the storm was so powerful (the winds had definitely tailed off with an occasional big gust) but because I knew that in a couple hours I could see the aftermath and was scared and excited to see.

At 5:30 I went downstairs and checked Facebook, which was down, along with my cell phone service. I waited till 6:00 and tentatively went outside. The house has survived, my shop in the back of our property survived. Literally not a drop of water had seeped into the house or shop. Apparently I had worried for nothing.

There were a few tree limbs down and a neighbor’s tree had fallen onto our wall; the next day it was cut up easily and efficiently.

Rumors started but with no cell service, Internet or power they were just rumors. By the next day my cell service returned (if poorly) and I could see on FB the devastation. While Dumaguete had gotten by relatively well, surrounding towns in Negros Oriental were severely damaged and other islands just to the north had not faired so well. Cebu, Leyte, and Siargao in particular were devastated.

Janet’s home town of Alcoy, in Southern Cebu was hammered. The family’s old house before they moved 3 years ago into a stronger concrete home was hit by 2 coconut trees and destroyed. Flash flooding killed a number of their neighbors from their former home area. Janet’s newest nephew (under a year old) got swept away by the floods and was saved at the last minute. 

The family’s new house was hit by a coconut tree and the roof damaged but fixable. 

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All this took days to piece together. The day after the typhoon I had enough connectivity to contact my sister and children and tell them I was OK. It was another day or two before the real effect of the storm became clear.

Is Modern Communication Really Better?

Back in my childhood storms meant that power might be down and possibly (though rarely) phone service. If there was a natural disaster somehow local newspapers still managed to get printed and distributed. Many of us had battery powered radios which told us what was happening.

But after Odette, with no power, Internet or cell service, life was chaotic and I couldn’t help but wonder if communication’s really better today. OK it probably is but for 24 hours I wished I had a damn newspaper to read.

Disaster Olympics

Perhaps it’s cynicism but I notice that there is nearly a competition to determine who has it worse. “My power will be out for X weeks/months,” people proclaim. There are towns and entire islands where the estimate is many months. Those who chose to live in remote areas are likely to have far more downed trees and will wait much longer for power to return.

In Valencia, where we live, a suburb of Dumaguete, power has returned to part of the town; unfortunately not our part. We have been told maybe this week but I am doubtful. There is a downed and destroyed pole not too far away, surrounded by shattered trees. They’ve put up a metal pole to replace it but for whatever reason have not transferred the lines. 

Get a Generator

I have debated back and forth for two years about buying a generator. It was in our original house budget but when the budget – well, went over budget, that was cut. 24 hours after the storm I had had enough and announced to Janet that it was time to get a generator. I went to the local Honda dealership hoping to find the Honda generator I was wanting two years earlier. They were already down to one remaining generator and not the model I had lusted after. It was actually on sale and I said I would take it. “Cash only,” I was told. “How am I supposed to get that much cash in the middle of this madness? “ I asked. Shrugged shoulders and sorrys.

Janet and I split up to find a working ATM. We found a couple but both had huge lines. My guess is that most people in line were trying to get food, not generator, money. An hour and a half later we remarkably had withdrawn the money for the generator and its needed accouterments (these things suck gas big time). We got it home set it up and fired it up. So for the past 5 days we’ve powered our devices, chargeable lights, my battery operated fan, kept the fridge cold, etc. We can’t run an aircon, but if I get desperate I can go in the car and cool off temporarily.

A Minor Success

Just as bad as the power, was the Internet situation. Our fiber lines were down and I noticed that our box about a block away was destroyed. Now that I had connectivity via phone I went to the PLDT website and waited in a queue for an hour before a representative chatted with me. It was late at night but I was determined to at least put in the request and inform them our box was destroyed. To my delighted surprise about 24 hours later they called me and a pair of technicians came over. What were the chances they would have a replacement box, I wondered? Excellent as it turned out and within less than an hour we had our Internet back – and thus I can post this tome.

Christmas Movies

For years I do nightly Christmas movies as the holidays approach. My list has grown to the point I have enough that I have to start about December 1. There are the classics like It’s a Wonderful Life, Scrooge, and Miracle on 34th Street, the modern kick ass Christmas movies like Die Hard and Home Alone, and the comedies like Bad Santa and Christmas Vacation. This week all the movies are getting watched on my phone. Ah, the sacrifices we make in the Philippines lol.

It’s Christmas

Some of Janet’s siblings and nieces had planned to travel to Dumaguete for Christmas. This was a big deal since with the pandemic they haven’t been here in two years. Unfortunately Odette changed that plan and so while the family cannot come some of our friends can and we intend to have a great Christmas Eve feast. Of course we decided that lunch would be more practical than a dark dinner. Hopefully Santa will understand.

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Family History (or Is It Herstory)

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I have been into my family genealogy for the past several weeks, using a popular online portal. I’ll get into some of the why’s and wherefores in a minute.

The portal is amazing at linking you to obscure family members using billions of records worldwide. And once you find one family member, that opens the door to dozens of others. Yesterday I was fooling around on the portal, found a new family member (a cousin of a cousin of a cousin), looked at his birth and death dates and thought “died in his 30s. Didn’t live too long.” Then I looked at cause of death. This isn’t filled out that often but sometimes you can see “cancer” or “heart attack” – the usual. But this time the cause of death field listed “Nazi Victim.” The year was 1940 and this obscure relative who lived in Poland was a holocaust victim. Before I was done I found several other holocaust victim relatives. I didn’t know how or what to think. Of course I had always known that I must have had distant relatives that died at the hands of the Nazis, but they were no one I knew or anyone in our American family knew.

This was not the reason I went down the genealogy rat hole.

Like many Americans with immigrant families just a couple generations old I knew nothing about my past. Relatives only talked about their American lives and American relatives. I knew that my maternal Grandfather was born in England and his family came to the US when he was a baby. For 50 years, when asked, I told people I was one quarter English, since that was all I knew.

Not many years ago I said this very fact to my Aunt, the last real keeper of the family history. She laughed and I bristled and said. “Well, he was born in England, so…” “Yes, David” she replied. “He was born in England. Do you know why?” I shook my head. “At the turn of the century Jews escaping Russia and Eastern Europe traveled West and England was the jumping off point to go to America.” There went my fantasy of being a descendant of an English Lord.

My Grandfathers Ain’t What I Thought They Were: I always liked my paternal grandfather’s name – Jack. It was short and sweet and kinda tough – just like he was. Janet and I talked often that if we ever had a boy, we’d name him Jack. Imagine my surprise to see the 1910 census (Jack was born in 1899) and see the family listed with 11 year old Jacob. Other documents of that era also listed him as Jacob. By the 1920 census he was Jack and would never again be referred to as anything else.

My maternal grandfather (the English Lord) was named Sol Criss. Even though I thought of Solomon, no one ever referred to him as anything but Sol. As a kid I speculated that it might have come from the Spanish word meaning sun. After all, he was an English Lord, why not have a cool Spanish name. In the 1910 US census, when he was 7, there it was – Solomon. Other early documents referred to Salomon. After all the family spoke Yiddish, so the English spelling wasn’t consistent. But just like Jack, by early adulthood he was Sol and never anything else. Jack and Sol were Americans, damn it – not Jacob and Solomon.

I found that many of those old relatives changed their names, no doubt to sound more American and less Jewish. We kids all barely knew but loved our Uncle Charlie. He was my Great Uncle and spent most of his adult life working with The Three Stooges. The adults in the family considered him the Black Sheep, but we kids loved the name, Uncle Charlie, and he flat out had the coolest job in the world. Imagine my disappointment at reading the 1900 and 1910 US census and seeing that his name was actually Meyer.

My Great Uncle on my maternal side – Sol Criss’s brother, was named Hyman Francis Criss; my mother called him Uncle Hymie. By the time he got to New York and became a fairly famous New York artist, he was Francis Criss. Not many famous artists named Uncle Hymie I guess.

So why did I go down this rat hole? I’m frankly not really sure. Like most kids I couldn’t have cared less about the past or relatives from far away places who were dead and gone. By the time I was a 20-something adult and kinda interested many of those adults had died, including my mother and grandparents. Once in a while I would travel across the country and see my aunt and uncle; the same aunt who schooled me on why I didn’t have an English Lord grandfather. She would show me pictures and throw out a million names but none of it stuck.

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Now I live in the Philippines where family is the most important thing there is and am married to Janet with her large and close family. And sometimes I feel I have no family. Of course that’s not true. I have a sister and a couple children and two ex-wives. My aunt is still alive and well into her 90s. And there are some cousins. I see a couple of them on Facebook. They’re getting older lol. There’s a younger generation but I know little about them. So I started this process to find out whatever I could find out.

I traced both sides of my family back to my great great grandparents. I found the 1901 English Census listing the Criss family (before Sol was born) waiting to go to America, which they would do two years later.

Other takeaways. All 8 of my great grandparents were born in Russia, or what was then called the Russian Empire. Apparently it wasn’t just little Sol who was trying to escape the pogroms.

People back then got married early – sometimes really early. And they had boatloads of kids. Grandfather Jack was one of 8 children and Grandfather Sol one of 7. In fact Sol’s father had a child fairly late in life; I guess it runs in the family. And BTW, he lived till 95- so I’ve got that to look forward to!

I also found some inlaws from the 19th century who I am guessing were Mormons since they lived in Utah and Idaho, and had a bunch of marriages and more children than you can count.

I’ve traced some branches of the family back to the 18th century and am still hopeful to find Weisbords (although it’s unlikely they were spelled that way) back to Russia.

So the upshot of this is I do have a family. And 100 years from now when descendants look me up and see my history they’ll wonder – how the hell did he end up in the Philippines!

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My PI CAncer Adventure – Lessons Learned

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Part 1

Part 2

Part 3

Part 4

Part 5

Part 6

Part 7

You can all breathe a sigh of relief. This will be my last posting in this epic tome. I’ve been home almost three weeks and my nose is returning to what will be its new normal. My oncologist has cleared me, I’ve seen my dermatologist (as I will every 6 months for the rest of my life) and I visited a cardiologist who said I was fine, with my heart just compensating for – you know, getting old. My energy is coming back. In short I expect to put this ordeal in the rear view mirror soon.

I hear expats all the time complain and worry about health care in the Philippines. So the following are my lessons learned and suggestions. Take them with a grain of salt of course. It’s your body and your money.

Get a Doctor(s): Many guys here just wait till they have a major problem or keel over and then are dragged to the ER where they get whatever doctor is on call. And then of course complain about the care or the costs. So get and visit a General Practitioner regularly. Get a check up and have your blood work done. You’ll not only feel more confident that you are not likely to keel over, you will have an entry point into the medical system who can recommend treatments, medications and other specialists when needed. Yes, you may have to visit a few GPs before you find one you like, but that would be true anywhere.

The same is equally true with specialists. As we age and our little bits and pieces age they need to be cared for. So, depending on what issues you have, find a dermatologist, cardiologist, optometrist, dentist, etc. Typically doctors visits here are cheap – so go to the specialists you need.

And BTW, if you are pasty white and older in the Philippines, you definitely need a dermatologist.

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Get PhilHealth: I am surprised at how many expats here do not have PhilHealth. Yes I understand that a few years ago they raised their rates for expats and guys were pissed off, but unless you have other medical insurance it is still a good deal. If I have done my math correctly, this year PhilHealth covered nearly 100k of my treatments.

While PhilHealth only covers in-patient hospital care, many procedures are considered in-patient. My surgery in Manila was in-patient, even though I never spent a night in a hospital. My radiation therapy in Cebu was the same.

In addition, while it is true that my PhilHealth premium increased it also covers Janet. So again, It’s a good deal you should strongly consider.

Do Your Research: It may be harder, but if you know that you need an upcoming procedure, do your research. Ask about doctors, hospitals and the best procedures available. Ask about costs although this may be harder to pin down since the typical answer will be “it depends on what the doctor orders.”

I find that Americans do a little better with this than those expats from countries with socialized health care systems. Those guys are used to “free” healthcare and are less used to a system where healthcare has different prices, just like other services. Americans are also used to being gouged by doctors and hospitals and so are often pleasantly surprised by prices here – that is if they do their research – if they don’t they can get gouged here also.

Know People and the System: The Philippines is a communal society. Everyone seems to know everyone. Most expats do not take advantage of this but you should. Here are two examples:

Last summer, after the pandemic was well underway, but before we knew what we now know (lol) I had a weird rash, unlike any I had ever had. I also was running a slight fever. After a couple of days I wondered, ‘should I get a swab test?’ But we were all still afraid of going to a hospital so I hesitated. Then I remembered that I have a guitar repair customer who is a front line doctor. Apologetically, I contacted him. We spoke on Messenger and I described my symptoms and showed him my rash. He confidently confirmed that it was not Covid and I did not need a test. An antihistamine would help, which it did. I thanked him and apologized again but he reminded me that telemedicine is the present and future.

Second story: Recently I got my 1st Covid jab. I was surprised by several expat friends who didn’t know that it was available here and complained that their local towns or barangays did not come to tell them. Remember, this is the Philippines – a communal society. Everyone knew the vaccine was available for seniors; except my few friends. So, get to know people and get to know the system. Do you know where your barangay is? Do you know your Barangay Captain? You should. Janet and I know ours and we have texted her several times over the years when we had issues and she always got back to us with answers. So know people and know the system.

Have cash and keep it separate: Moving to the Philippines without actual cash in the bank is a disaster waiting to happen and most of us know this. What I am talking about is having a medical or emergency fund separate from your monthly living expenses fund. We have such a fund in the US. In addition, I also keep some cash in a dollar account in my Philippines bank. I keep it separate from my Peso account, so we don’t end up spending it for monthly living expenses. Figure out something similar. It doesn’t have to be huge – just enough so that you can easily access it in an emergency. The same can be true with a credit card. Most (though not all) hospitals will take credit cards, so in a medical emergency having a credit card can help.

Anyway, I hope and pray that this is the end of my medical adventure here. That said, as we get older there is a reasonable chance that there will be other such adventures. I think I’ve learned a little about navigating such adventures. Hopefully, you the reader have also.

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My PI Cancer Adventure – 7 – All the Way Home

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Part 1

Part 2

Part 3

Part 4

Part 5

Part 6

There’s no sense pretending that the 2nd half of my 25 radiation treatments were as easy as the first half. My nose got redder and redder and itched and I applied gobs of aloe on it.

Later I was prescribed some stuff for more severe burning. I applied it and it smelled familiar. Looking at the ingredients, sure enough it was made with sesame oil. I smelled every day like dim sum.

The more annoying aspect was that inside my nose everything dried and clogged up. My oncologist had warned me of the drying effect of the radiation. I sprayed lots of saline solution up there and took plenty of hot showers to soften it up and tried to blow.

But let’s face it, in the end, a red and dried up nose was far easier that what most patients on the Radiation Unit at Chong Hua Hospital were experiencing.

The one surprise to the Philippines doctors and technicians was the nose color. I had been told that near the end my nose would get very dark or brown in color. Janet expressed skepticism “He doesn’t tan. He only gets red.” And sure enough she knew more about her husband than the docs. Only red – no brown.

The last 6 treatments were the toughest. We were sick of the process. There was nothing more to get excited about in Cebu City, other than getting the hell out. The last 3 were like a countdown where I let everyone know, “3 more…2 more…1 more. Graduation!”

Janet and I debated a lot about what to do for the staff on Graduation Day. They had all been so great to us that I wanted to do something: buy lunch, snacks or some token of my appreciation. In the end I went the healthy route and brought a couple dozen Krispy Kremes. The 2 dozen set included a couple of gift donuts that Janet and I consumed. Boy I had forgotten how good fresh, not day or many days old old donuts (like we get in Duma) taste.

I was told that after the final treatment I would meet with my oncologist. Over the last few days I had gotten nervous about this. Based on what little I knew I assumed she would order another CT scan down the road; would that be the last one or would more be needed till I was good to go. Would I have to come back to Cebu City or could I do it in Dumaguete? And what else would I need to prove the monster had gone? I didn’t sleep well the last night and made out a list of questions, as is my nature.

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The doctor handed me two copies of the final radiation report: one for me and one for my dermatologist. She also said that based on the CT scan I should visit a cardiologist since the scan showed an enlarged heart. She got up and started to say goodbye.

“What? What else? I need another CT scan down the line, right?”

“No.”

“i don’t understand. I mean if you say I don’t need it – great. But don’t I need further checking?”

“There was no lymph node involvement; so you’re fine. Visit your dermatologist regularly because you are at future risk. And see a cardiologist. But other than that you’re good to go.”

I broke down for a minute and Janet hugged me. We bid our goodbyes and I told the doctor how much I appreciated everyone on the unit, how great they had all been to me, and how much I would recommend Chong Hua to anyone in the future. And I will!

We went back to our condo and finished packing and under the category of there is always one more glitch, waited patiently for the swab tests results to be emailed to us. We needed them to return to Negros. They didn’t come that day and the next morning when we woke up they were not there either. Finally after breakfast one more time we returned to the hospital. The results were there and they printed them out and then we rushed back to the condo, loaded the car and now 2 hours past our planned departure, finally got the hell out of Dodge. BTW, we never got the emails.

Many hours later on the ferry for home, Janet was happy and I tried to be happy to return. Of course I was happy to go home and happy that this chapter of my life was ending. But still I couldn’t feel completely good about it.

Last night I had a terrible night. With the aircon on as usual I woke up freezing to death. Janet tried to warm me. Not long after I was hot as hell and turned the aircon back. I went through another round of cold and hot, then got up for awhile. Eventually I went back to sleep and slept normally.

For the first 68 years of my life I was in great health and took it casually. A headache was a headache – pop a Tylenol. Now if I get a headache I think, ‘the cancer’s spread – I have a brain tumor.’ If my neck is sore I think. ‘lymph node spread.’

Is this the “new normal” to use that horrible term or will I return to where I was; or be somewhere in the middle? I don’t know but I was home and this morning took my normal walk in our yard and pulled out my guitar and played and prepared to be around for awhile (hopefully a long while) longer.

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My PI Cancer Adventure 6 – Halfway Home

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Part 1

Part 2

Part 3

Part 4

Part 5

I just had radiation treatment #12 with 13 more to go. It would have been #13 but yesterday was a holiday, a newly declared one by President Duterte, so the unit was closed.

Like most unpleasant things in life where I am halfway finished, I think ‘Great – halfway there. I can do this.’ But of course the other side of my warped mind says, ‘OMG, only halfway!’

Janet and I have developed a routine. Our daily appointment is at 11:30. We get there early to get a little bit of paperwork and the payment out of the way, and then hang out in the unit. Often, I am taken early and rarely are we taken late. This couldn’t be the Philippines, could it?

Like with all other patients, an attendant comes out and takes me by the arm to lead me to the radiation machine room. But after a few sessions they realized they did not have to take me by the arm and stopped doing it. In reality I am far different from most of the patients here. Most of them clearly have serious cancer issues and many are doing chemo as well as the radiation. Janet has been asked by others, “What’s wrong with your husband? He seems fine.” And by comparison they are right.

We like to get in and get out as soon as possible and I am not looking to make friends. I knew early in life that a career in medicine was not in the cards for me because, you know, I don’t like seeing sick people.

There is one exception; a little girl is there for her daily treatments. I would guess she is 8 or 9. She is very friendly and greets everyone and calls us guapo/guapa. While we don’t know her exact prognosis, Janet found out from the girl’s mother that she has a brain tumor. Janet fell for her. Janet got her a stuffed dog from Toys R Us; that’s my Janet!

When I am escorted into the room I lie down on the table, they quickly set up the machine for my treatment and bang zoom I am told to stay still, they go to the control room and I get about 30 seconds of radiation. Once in a while I am gently threatened, “If you don’t stay still we will have to use the mask. And remember your eye is close to your nose; we don’t want radiation there.” I stay still! I know the routine like clockwork and am done in 5-10 minutes.

The side effects are minor. My nose is already as red as WC Fields’, for those old enough to know that reference. It itches like hell, as if I had a bad sunburn, which ironically is sort of what I have. I put lots of aloe on the thing. If we were home in Valencia, I could use the aloe plants that Janet raises. Who knew when a couple years back she started raising aloe that I would be a major consumer.

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Let me talk for a minute about my experience at Chong Hua Hospital in general and the radiation unit in particular. It’s been fantastic! The level of efficiency is incredible and everyone is very nice and sensitive to the patients. I have limited hospital experience but I cannot believe it could possibly be any better in an American hospital.

In addition, they seemed very concerned with saving me money. I documented in my last blog piece how PhilHealth discounted the treatment by over 50%. Since I do not have a Philippines Senior Card I could not get the senior discount of 20%. I blew it off at first, happy to get the Phil Health discount. But the office staff in the unit did not blow it off. Somehow (and I am unclear how) after our first couple treatments they did get me the senior discount. At this point the total cost of the treatment which I previously estimated at 60k now looks like it will be 40k. Truth is my daily treatment out of pocket cost is about the same as Janet and I would spend for a very nice lunch in Cebu.

About a week ago I got a call at 6:50AM from someone in the unit saying not to come in for my treatment until I received a follow up call; there was a machine problem and the engineer was on his way. Two hours later I got a callback saying to come in; all was fixed. This is above and beyond service, especially when you consider there are 54 daily radiation patients in the unit.

The other day we were sitting waiting for my day’s treatment. The oncologist approached me. “You look tired.” I was. She examined me and put the stethoscope to my lungs. “Just get more exercise and the fatigue will go away.” And she was right – it did. But again, above and beyond service, especially considering I am far from the most serious patient here.

There are at least two other foreigners getting treated in the unit. I haven’t made friends lol. One funny thing did happen. An attendant approached one day to get the next patient. He had clearly been told it was the foreigner’s turn. He looked back and forth at the two foreigners there before giggling and deciding it was the other foreigner to be taken. Let’s face it – it’s hard to tell the difference.

Our lives are a bit boring outside of the treatment times. So we’ve done some shopping. For those interested in shopping experiences in Cebu City, Ayala Mall was nicely remodeled after the fire of a couple years ago. The new SM Seaside, which is supposed to be one of the largest malls in the world is nice but nothing out of the ordinary, except for its size. We also spent a chunk of yesterday in Landers Superstore, a Costco-like warehouse experience, selling mostly Western goods. It was nice, the cafe food was good and it would be great to have one in Dumaguete. Well, I can dream, can’t I?

I did have a bizarre experience at Ayala Mall. This falls under the category of really, really small world. We were in JB Music looking at strings and demoing an amp. A tall “foreigner” struck up a conversation about guitars. He wanted to tell me that he knows a good guitar tech in Cebu. I told him I am a guitar tech in Dumaguete and we start talking about that. There are so few real techs in the Philippines that I told him I have been contacted by customers from as far as Cebu City willing to bus and ferry to Dumaguete to get my services. I think of one particular guy who contacted me pre-Covid with a 50-year old Martin that needs a neck reset. He was gonna come to Duma but we were never able to connect and then the pandemic hit. Anyway my new guitar friend left and I went back to testing out the amp. About 20 minutes later a Filipino man, perhaps close to my age, approached me. “I hear you are from Dumaguete. I know a guitar guy there – Dave Weisbord.” “That’s me,” I said, completely shocked. That’s right – it was the guy with the 50 year old Martin!

Other than shopping and eating we are a bit bored. We are creatures of routine and I know Janet in particular misses her gardening and Zumba classes. We hit the gym here in the building and use the treadmill. I love to walk and it’s an OK substitute. I also brought my guitar so there is some normalcy for me. Plus we found a really good massage place nearby and Janet has Saturdays penciled in for a massage. Most importantly the liquor ban in Cebu City, going back to last year, was lifted the other day. So drinking just a little bit has become part of my protocol!

The city in general is a little depressing. The energy is less than normal and there seems to be more businesses and restaurants closed than in Duma. Even the hotel next door, one of the best in the Philippines, seems a shell of its former self; simply not enough guests to support it.

So, dear readers, 13 more to go! Can’t wait to go home!

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My PI Cancer Adventure – Part 5

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Part 1

Part 2

Part 3

Part 4

Yesterday I had the first of what will be 25 radiation treatments. Normally I might have waited until all the sessions were done, but I have things to say and I am also using this blog to, in a way, distract myself.

We came into Cebu Province on Saturday. It was the 60th birthday of my MIL and the party was Sunday. It was great that we could coordinate my treatment with the birthday event. Because of Covid I hadn’t seen the family in over a year and it was nice to see them all. The grandkids had grown and it was delightful to play with them and remind them of who I was. At least 100 (maybe 150) people were fed lechon.

On Monday it was off to Cebu City. I debated about going cheap in our accommodations because I anticipated a month there but in the end I know that Janet and I are a bit too spoiled to go completely cheap, so I rented a condo from AirBNB for a month. It’s a nice and secure building adjoining a high end hotel here. We tried to settle in and await the next morning, when I was to meet the first radiation oncologist; I had booked two appointments at different hospitals.

Unfortunately there was no way I could get an estimate as to treatment costs, since there was no way to know what treatment the oncologist would order. So I had transferred money from our US bank to our Philippines bank. I knew that Chong Hua Hospital had the reputation of being one of the top hospitals in the Philippines but I also knew it had the reputation of being expensive – at least by Philippines standards. However I also know that my Phil Health coverage would pay a chunk of the bill. I hoped I had enough money in the bank. Janet assured me we could get more if needed, which is true, but someone has to worry about breaking my retirement fund just for some pesky medical stuff.

The radiation oncology department at Chong Hua looked and felt impressive from the moment we entered. It was clearly upscale, as was the entire hospital. Just the general environment reminded me of an American hospital, if that’s important to you. Hell, even the aircon in the radiation unit blasted lots of cold air. First impressions are important.

Several staff at the unit’s front desk, including the woman I had been communicating with online, took great care of us. After paperwork, we waited in the waiting room for the arrival of the radiation oncologist. I looked around at the patients there, many of whom seemed to be dealing with much more serious cancer issues than me. It did selfishly panic me; would I look like this in a month, I wondered?

We met the radiation oncologist, a no-nonsense middle-aged woman. She agreed with my surgeon, that a round of radiation was needed. She also wanted another CT Scan, despite the fact that I had one a week before in Dumaguete. This one would focus strictly on the lymph nodes in the neck, since that would be the place where any spread from the nose would have to start. I started panicking. She explained the radiation treatments if it only turned out to be the nose or if it turned out to have lymph node involvement.

Now in all fairness to me, I well remember my grandfather who had oral cancer and had his lymph nodes irradiated and eventually surgically removed. So I had a genuine reason for a little panic.

At that point I apologized to the doctor but said, “I am an American so forgive me but I need to ask this question. Why should I use Chong Hua for this treatment.” She and Janet giggled a bit at the arrogant foreigner but she actually explained why and it made perfect sense. We were sold.

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The doctor also described a mask that would be created to lock my head down so they could get a perfect CT scan. She said they might or might not use the mask to immobilize me for the actual 25 radiation treatments. This caused me concern but after all I have never been claustrophobic so I could handle it.

The radiation oncology unit has its own CT Scanner and technicians. In fact everything in the unit is self-contained, unlike most medical places in the Philippines where you go from one place to another to order treatments, pay for treatments, and have them performed. It was all done in the unit, which I really appreciate.

Apparently at 68 years old I have now discovered I am claustrophobic! They showed me the mask which is wetted and then the tech pushed it against all parts of my face to mold it to me. It then snaps down, making my head completely immobile. I began to hyperventilate. My heart rate shot up as no doubt did my BP. I pulled my arms out of the restraints they were in and began pounding my fist against the table, trying to distract myself. The technician asked, “Do you want me to take it off?” “Yes!”

She unsnapped me and remarked that at least the mask mold was dry. She was actually very nice, calming me down with soothing words. After a couple minutes she asked if I was ready for the mask again to perform the CT and that she would go as fast as possible. I agreed.

The mask was snapped down and she said “three minutes.” I could hear her running to the control room to do the test. I pounded my fist on the table again and just said, “Hurry.” She was a real pro and gave me a countdown. “One more minute.” OK, I thought, I can do this for another minute. “Thirty seconds – last scan.” “Ten seconds.” Then it was over and they rushed to get me out of the mask. I tried to pretend that I had gotten used to the mask a little bit the last minute or so but who was I kidding.

I came out of the CT Scan room and still hyperventilating tried to explain to Janet what had happened. The technician came up and explained to Janet in Visayan that they would not use the mask for my treatments and would have to go to Plan B. I was whisked to another room where I stood face to face with the radiation accelerator. I lay down and was surrounded by 5 people, including the radiation oncologist. Everyone was quickly speaking in Visayan moving the machine to get the correct angle. The doctor marked my nose with a permanent marker to create a target and I was told not to wash it so that they could use the target the next day for the first treatment.

There was a reason for all the rushing. I had had the required swab test in Dumaguete last week and the doctor told me if they didn’t actually start treatment by the next day I would have to be re-swabbed.

I stumbled out of the room and Janet and I went back to the front area for the bill. Another form of panic; financial panic. What was all of this great treatment going to cost? Lots of discussion about my Phil Health coverage and lots of questions about whether I had a Senior Discount Card. Now this is a sticky subject with foreigners in the Philippines. A Senior Discount card gives you a 20% discount on all sorts of services, including here at the hospital, but foreigners aren’t suppose to have one. That said, I know a number of foreigners who have been able to get one but it’s a controversial issue and I have never bothered to try.

The estimate came and I was shocked. I had to read it a couple times to convince myself it was real. PhilHealth, which I spoke positively of before, discounted my bill by well over 50%. My grand total for that day’s CT Scan, the treatment plan development, and 25 radiation treatments was out of pocket about 60k. This couldn’t be right; I had budgeted triple.

Now I realize this might not be all of the cost. I would expect another CT Scan or some kind of testing at the end of the radiation series to make sure I’m good. But basically I am getting complete treatment at one of the best hospitals in the Philippines for the equivalent of under $1300.

The next day we confirmed that there had been no lymph node involvement found and therefore only the nose would be zapped. I went through the first round with no problems. I think I can do this!

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My PI Cancer Adventure – Part 4

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Part 1

Part 2

Part 3

Part 5

Part 6

Part 7

It’s been two months since my last blog posting and a few readers have asked for an update, which I really appreciate.

Last night was a sleepless night. I spent part of it thinking of my mother and grandfather and the cancer treatments they went through. I know why this all came up last night.

Two months ago I came home from my surgery in Manila. Janet and I were allowed to quarantine at home and I started the process of healing. For five weeks I had a large scab covering my surgery and the skin graft. But at five weeks the scab came off, showing that what was left behind wasn’t too bad. Better still, the remaining wound began to heal rapidly. I sent my surgeon a weekly selfie of my nose progress.

The progress was important for the obvious reasons but also because the surgeon had told me that once the nose was 100% healed I was to get a CT Scan, MRI and a round of radiation for any stray nasty cancer cells left behind. So while I was happy to see rapid healing I was perfectly fine to delay things for a few more weeks.

But last Monday I got a message that I was good to go and ready to proceed with the CT Scan and radiation; she said to forget the MRI. One thing down – I liked that.

The truth is if you look at my nose now you would have to know that I had cancer surgery two months ago otherwise you’d see nothing but a less than beautiful old nose. Skin grafts are amazing!

I’d enjoyed the last month. I’d come to the conclusion that the nose was healing and yet I knew I had time until the next medical stuff; so I relaxed, at least a little bit. But now I was back into reality. I had to make an appointment with my local dermatologist, find an oncologist to order and evaluate the CT, and find a radiation oncologist for the radiation step – the part I was most scared about.

So last Thursday I walked into Silliman Medical Center for an appointment with an oncologist. The doctor was at least as old as me – maybe a bit older (Janet estimated she was close to 80 but I’m not sure about that). Now I am not an agist – considering my age that would be silly. But still it gave me pause; I know how good my memory is nowadays. Worse still the doctor pulled out a magnifying glass to read the order my surgeon had written. Still she seemed pleasant enough as I told her the details of my surgery and after all I just needed her to order the CT Scan and imaging medication.

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The next day Janet and I came back to have the scan done. Now I’ve seen the large CT Scanners on TV doctors shows but that’s about all I knew. We paid for the scan (about P8.3k) then wandered around trying to find the pharmacy for the imaging medicine, designed to light me up for the chest scan. We found the place, got the bill, then had to go back downstairs to the cashier to pay for it, then return upstairs to pick it up. Cost? A less than modest 5k.

At that point we went to the Imaging Department. The imposing machine looked just like it did on TV. Where was Dr. House to run this thing? I met the young technician and asked her what would be happening and what possible problems or side effects I might have. She ran through a long list of effects the medicine might cause. I am sure the blood drained from my face. “So how do we avoid those side effects?”

“We will give you a test dose and wait five minutes to see if you have a reaction. If not we will proceed with the scan.”

“How long is the scan?” I asked. “Less than 20 minutes,” she said.

I got on the CT Scan table and they ran a machine test. The machine pretty much yells at you to “Take a deep breath and hold it.” Then after a moment “Breathe normally.” The thing was so loud Janet could hear it all from outside the treatment room.

The technician asked if I was Ok and I admitted I was nervous. I think this made her nervous. Janet speculated afterwards that she was intimidated because I am a foreigner. Not sure if this is true but she was very nervous about installing the IV for the imaging medication. Eventually she brought in someone else to put in the IV. She injected a small amount of the medicine to see if I would have a reaction. When I had no reaction we were ready. While I am not claustrophobic I was bracing myself for the 20 minutes under the machine. The table slid under the machine, the machine yelled at me to “HOLD MY BREATH” which I did, the table slid back out and the technician said over the microphone,”the test is over.” “What! That was it?” 30 seconds tops.

Later I realized that when I had asked her and she had said 20 minutes she was talking about the entire process, not the test itself. The communication gap strikes again.

After the test the technician asked me to wait for 20 minutes in case I had a reaction because “we’re right here at the ER.”

So I’d survived the test and was told I wouldn’t have the results until the following Wednesday. And now on Tuesday night I couldn’t sleep. What would the test – a test ordered to see if the cancer had spread – show?

Testing of all sorts in the Philippines is different. When the results are available you pick them up and then make an appointment with your doctor. So after picking up the results Janet and I scanned the papers to see what the results were. Yes there were several concerning issues – issues not uncommon for a 68 year old – but my medical eye saw nothing about spread.

At that point we went to the oncologist’s office and waited. She and her assistant were late; pretty common here. Eventually she arrived and began reading the report to me and explaining it, and surprisingly without the use of her magnifying glass. Yes, she wants a couple of follow up tests, which can happen during or after the radiation. And yes, we will probably do another CT in a few months to compare. And yes, she said at my age I should visit a cardiologist regularly. But nothing seemed to worry her too much.

So at that point, feeling more confident, I asked her about the radiation and admitted that my notion of radiation was what they did to my mother and grandfather over 50 years ago. She told me it was just like a light and I would feel no pain. Soon I will find out whether this is true or not.

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My PI Cancer Adventure – Part 3

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Part 1

Part 2

Part 4

Part 5

Part 6

Part 7

We returned to the doctor’s office three days later to have the bandages replaced. I had thought plenty about whether I was ready to look at the results, knowing it would be swollen and nasty looking.

Surprisingly it was not that bad. OK, it was bad but not as bad as my crazy brain was fantasising. After the doctor replaced the giant bandage with a more modest one I looked like Jack Nicholson in Chinatown. In fact I jokingly mentioned the reference to the doctor, who admitted she was not familiar with the movie but would watch it.

After the bandage change she wrote and handed me a quick order. “After about a month when the surgery has heeled I want a CT Scan and an MRI. Even though we got all the cancer, spread is possible.” I freaked and saw my life flash before me. I went to the darkest place.

The next couple of days I spent sleepless nights and Janet wonderfully tried to calm me down and said “we’ll get through this.” I was planning the funeral.

My mind has always been strong or so I’ve told myself. But this week my rational mind had come apart. It started the day of the surgery when the doctor showed me the photo of my nose. I literally thought “there is a giant hole in my nose going all the way through. Hole in the nose plus CT scan plus MRI means the end.” I thought this completely and believed it absolutely.

It was a couple days before I could express this to Janet. “No – there wasn’t a hole in your nose,” she said confused. “Yes they dug but did not through it. Go look.” She dragged me to the mirror. “Feel inside – they didn’t go all the way through.” It took a lot of convincing because I was sure of what I saw. But finally I was convinced and realized that my mind had made it up and I was incapable of expressing what I thought I saw. All I could say at the time to my doctor and Janet was, “OMG is that my nose?” “Well of course it was your nose,” Janet said. “Whose nose was it?”

Once I realized that my mind had fooled me, I saw that I had taken everything to the darkest place possible. OK, this is sort of my nature but never like this. Part of it is that I have been so healthy with literally nothing major and very little minor ever occurring in my 68 years that the shock of something serious made me more than a little crazy.

So it took two days for me to decide, ‘maybe it’s not the end yet.’ Sounds crazy and it is but for nearly 48 hours I thought this completely. I came to this changed realization just in time for us to arrange to return to Negros Oriental.

We got up Monday morning and tried to perform what we needed to do to leave Manila and return home. We found the local Barangay, the one nearest the hotel, and got a Barangay clearance. We proceeded to the City Hall and submitted documents for the medical clearance. This included a certification from my doctor as to what surgery had been performed and that I could travel. It also included negative swab tests for both of us.

Unfortunately I had done my swab test the day before the surgery, so technically that was a day or two too early for the clearance. I neither wanted to stick something way up my nose again nor could we afford the day another test and results would take. Janet asked (begged) for a special consideration. I pointed to the giant Jack Nicholson bandage on my nose and they agreed.

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However we were told that the police clearance could take 2-3 days. We took the Barangay clearance and medical clearance to the police station. Again Janet begged, saying we needed the police clearance that day in order to return home. I realized that in this crazy age begging is an important skill. She pointed to me and said “cancer,” I did my best to look pathetic, and they agreed. Within a half hour we had the police clearance.

Now, we could send all that documentation to Valencia and get permission to return. At the same time we asked for permission for me to quarantine at home. This is rare and unusual but we needed to try. We attached my doctor’s letter and to my pleasant surprise they agreed – contingent on a check of our home. “But where will Mrs. Weisbord quarantine?” they asked. “No no. I need her to quarantine with me. She is taking care of me,” which was certainly completely true.

Let me take this moment to state the obvious; that Janet has been incredible throughout all of this. If I ever made a smart move in my life it was marrying her. She stuck by me completely, helped in every way possible and remained a ray of sunshine when all I saw was the blackest of clouds. I love her more than ever!

Let me take another moment to describe the Covid response in Manila. Not only are face masks ubiquitous, so are face shields. You simply can’t enter anywhere without both. This included our hotel. And it seemed like most people complied though of course often the faceshield was propped up on people’s forehead.

Communication is nearly impossible. You have a mask and faceshield on and so does the other person. And there’s a good chance the other person is behind a sheet of plastic. At 68 with poor hearing I yelled “what?” a lot. Trying to communicate important information, such as surgical stuff or getting back home details was an effort in frustration. No wonder most people just use their phone to text or IM.

Signs throughout Manila encourage people to do the right thing. “Mask is the new smile,” one read. Yet the Filipino people are resilient and they seem to manage. Interesting that nearly everyone in Manila was aware that Negros “was strict” because we still maintain a 14 day quarantine. The quarantine in Negros is strict but the faceshield orders – not quite as strict.

In addition, as our 11 days in Manila progressed, more and more locations required a contact tracing app to enter. This was annoying but there was no choice. I know that a few paranoid people speculated at one point that the purpose of the Covid vaccine was to implant a tracking chip into everyone. How ridiculous – there is no need. All they need to do is track your smart phone and I worry that it will never end.

On the positive side, in addition to lots of mall shopping for both of us we ate great. The restaurants at the Shangri-la are excellent and the mall and surrounding areas had dozens of options. In additional I got New York pizza at SBarro. Now back in the US no one would consider SBarro to be excellent New York style pizza but for me it was close enough. In addition, I got to Subway and Wendys to complete the junk food trifecta.

Three days later we were back at the doctor’s office to remove the stitches. She removed the stitches and the truth be told, while there’s lots of healing left to go, the nose did not look that bad.

And the hits keep coming: She gave me my final results, confirming that all the cancer had been removed but there were cancer cells discovered that needed addressing. So after the nose heals in about a month I will need a round of radiation as a precaution.

But the best news within a series of difficult news events is that the City of Valencia gave us permission to quarantine at home. We’re homeward bound and I can’t wait!

Clearly 3 parts to this saga is not enough.

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MY PI CANCER ADVENTURE – Part 2

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Part 7

Once the decision had been made I acted as quickly as possible. I had an online meeting with the surgeon in Manila. She explained the procedure, quoted the success rate and her staff scheduled the surgery for the following week. This relieved me a little bit since the thing on my nose was noticeably growing almost by the day.

Since Janet had already had one experience leaving Negros Oriental during this pandemic, we were familiar with the process: permission to travel from the Barangay Captain, sign off from the Mayor and the police, and a health document. We had it all in a day or two and I booked a flight. Then the unexpected fun began.

I had promised Janet (and promised myself too) a nice hotel, great restaurants and shopping to compensate for the ordeal. I went onto Agoda and booked a hotel close to the hospital. The next day I got a message from the hotel that they were currently allowing quarantine guests only – guests coming from out of the country and required to quarantine – and therefore my booking was rejected.

I quickly discovered that many hotels in Manila were quarantine only. I was annoyed that none of the hotels published any such information on their websites, nor did Agoda. Others were government approved for “staycations” but those staycations were only available to residents of Metro Manila. I emailed a bunch of hotels and one by one they apologized but would not allow our booking.

I then got the bright idea to book an AirBNB. Perhaps they wouldn’t have the same restrictions. But one by one they too got back to me that they could not accept my booking for a variety of reasons. I was panicking and not thinking straight. Finally I contacted an upscale hotel, the Edsa Shangri-la, and they asked for documentation from my doctor confirming why I had to come to Manila. I submitted my doctors orders and they approved me. I nearly cried in relief and will forever be grateful to the Shangri-la, which is the best damn hotel in Manila!

Janet and I flew to Manila. The process at the Dumaguete airport wasn’t too horrible; just submission of the documents giving us permission to travel. BTW, the Dumaguete airport has never looked so clean! Normally it’s a shabby, dirty little airport. OK it’s still a little shabby, but pretty spotless. The flight to Manila was at most half filled.

Contrary to my usually cheap ways, we paid for the car service from the airport to the hotel. Upon arrival we were escorted to what used to be the hotel’s Spa (now closed), where a rapid test was performed. It was only after our negative test results came through that we were allowed to check in and go to our room.

The next day the real fun began. I was required to have a swab test to perform the procedure, as well as 3 other blood tests, an ECG and a chest X ray, followed by an exam by a cardiologist. I guess they want to make sure that, you know, you’re not going to kick off during the surgery.

The testing procedure at The Medical City in the Ortigas area of Metro Manila, was surprisingly efficient. Fall in line, show the doctor’s orders, pay for the tests, and then get the tests. Within a couple hours I’d had the swab test plus the 5 others completed.

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However I was then told that the cardiologist, whose approval I required, would not be able to see me after 12:00. This meant that we rushed back to the testing area and begged for the results to be given to us early. Fortunately I was able to get all the results (except the swab test) and rushed back to the Cardiologist’s office at 11:45. Naturally blood pressure had to be taken first. “You gotta be kidding. I’ve been running all over for 4 hours. My BP will be off the charts.” And it was! But 5 minutes later, after closing my eyes and breathing deeply and slowly to calm myself, it was closer to normal and the cardiologist saw me. Cool guy who acknowledged when I asked that his practice was way up. “There are Covid deaths and non-Covid deaths caused by the pandemic,” was his simple statement of fact. He certified that my heart was fine for the next day’s procedure, and we breathed a sigh of relief.

At that point we did what anyone unable to travel for a year would do; we hit the local mall! SM Megamall, right around the corner from our hotel, is the 2nd largest mall in the Philippines and 9th largest in the world. This place makes Dumaguete’s Robinsons Mall look like a 7-11. Significant shopping, followed by a nice Japanese dinner occurred, keeping my mind a little bit off the next day’s surgery.

Are we having fun yet?

The next morning we went back to Medical City and proceeded to what was called the Wellness Institute, a suite within the hospital. It was pleasant and upscale and could easily be confused with an American counterpart.

After paperwork, the doctor and her nurses arrived. We asked a few questions and the work began. I am certainly no expert but it all appeared very professionally done. The US-trained doctor had performed thousands of these procedures and it showed. She was very attentive to my comfort and must have asked a dozen times whether I was OK. BTW, the surgery was done with local anesthesia – lots of it.

The surgery was performed and the tumor sent to the lab, which is the advantage of MOHS micro surgery; they can get the results between 30-60 minutes and then decide whether to cut more. In this case I waited over an hour; I was to find out why later.

After a lot of waiting I just padded out to the waiting room in my surgical gown to be with Janet. The doctor arrived and told me she proposed using the skin under my eyes, aka the bags, for the skin graft. Basically I’d be getting two surgeries for the price of one; essentially an eye job. Lol.

What I found out later from Janet was that the doctor was unhappy with the samples the lab sent back and yelled at them over the phone to do it again and do it the way she wanted. Janet told me, “she’s tough.” When the revised samples came back the doctor found a small amount of additional cancer left, requiring another cut.

My doctor then showed me a photo of where the graft would go. I was stunned and for the first time scared and muttered, “Oh my God.” There was a nearly dime-sized circle on the right side of my nose. The reality of what had occurred set in. Janet was wonderful and calmed me down, reminding me that we had acted quickly and done everything possible.

“We won’t be able to use the eye skin. It’s too thin. We’ll have to be a bit creative,” said the doctor, scaring me again. So I got more anesthesia and another cut. That sample came back quickly and the doctor proclaimed there was no more cancer.

The doctor proposed taking skin from under my arm where she said “the skin was a bit sagging.” “I used to have more muscle there, doctor. But my weight lifting days are over.” So more anesthesia, a cut for the graft from the arm, stitching up the arm (first stitches in my life) and stitched the graft to my nose. The doctor proclaimed that the shape of my nose (never a particularly pleasing shape) had been saved.

A gigantic bandage was placed over my nose and the doctor gave us prescriptions and general orders and said she’d see me in 3 days.

At that point, since this is the Philippines, we were left with the need to pay. For those of you who want the numbers, this was not an inexpensive procedure. The doctor’s fee was 70k Pesos. The hospital and lab fees for Medical City were about 39k Pesos. BTW, my doctor also has privileges at a hospital in Makati and I was told that hospital’s fees would have been about double. I have PhilHealth coverage and while many expats complain about the price increase for expats that started a few years ago, PhilHealth paid about 30% of both the doctor and the hospital fees. In addition, the day before, PhilHealth paid for most of the swab test fee. So you will not hear me complaining about Phil Health! In the end I paid out of pocket about 79k plus a little more for the tests from the previous day. Thank goodness the stock market’s climbing.

More to come…

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My PI Cancer Adventure – Part 1

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Part 2

Part 3

Part 4

Part 5

Part 6

Part 7

Early in the pandemic last year I speculated to several friends, “What if you got genuinely sick with something other than Covid? What would you do?” You see, the way the heath care system works in Dumaguete (and similarly throughout the Philippines) is that the local hospitals handle the basics, and so far I have been reasonably impressed with medical care in Dumaguete. But if you need something major – heart surgery or sophisticated cancer treatments, for example – they send you to Manila or Cebu City. No big deal; a quick flight or longer ferry ride. So that was my plan when I moved to the Philippines. Who could have imagined when I made those prognostications, that they would impact me so directly?

I just turned 68 and have been pretty damn healthy my whole life. Not a broken bone or a stitch on my body. Never a surgery other than something that was done to me when I was an infant.

For these reasons it was easy to be somewhat cavalier about my health. Sure, I started going for an annual physical before age 50 but generally in the US that is little more than blood work and taking your vitals.

Nonetheless there are three things I keep some track of and worry a bit about. My PSA test, which checks prostate health (my father and uncle both had prostate cancer and survived it). Secondly, colonoscopies; those fun little things that I have had 4 times already, mostly because I have a brother who died of colon cancer. I am due for my 5th one of these later this year – can’t wait. BTW, if anyone watched the AFI Lifetime Achievement Award given last year to Diane Keaton, Woody Allen did the greatest joke about colonoscopies ever. Go watch it on YouTube. https://youtu.be/S8AAYTDf87Y

And the final area of concern is – my skin. I’m fair skinned, used to be red-headed, and burned often as a kid. As an adult I discovered that sunscreen actually works and became addicted to the highest SPF I could find; usually 100 or more. Because of burns I hated the beach as a kid. Ironic that I would move to the Philippines and now very much like swimming in the ocean.

Nonetheless when I had my last physical exam in the US before moving to the Philippines I asked the doctor about the spots on my face and whether they were just age or what. I don’t think he would have said anything if I hadn’t asked, but I did so he recommended a visit to a dermatologist. So, for the first time in my life I went to a doctor who I believed mostly existed to cut off moles and pop zits. The dermatologist explained that the small spots were pre-cancerous and could readily be removed by freezing them off with liquid nitrogen. It was quick and not too painful. The doctor also took a small sample for a biopsy which came back negative. When I told the doctor that I was moving to the Philippines she recommended finding a dermatologist and getting an annual exam and freezing.

About six months after I arrived in Dumaguete I found a dermatologist and went for a checkup. The office at Tru Dermotologie was clean and upscale, the staff bright and knowledgeable. The doctor, trained in Canada, had me strip and examined all my skin. After that she froze off spots on my face and top of my head, where the red hair used to protect me. All quick and professional, though by Philippines standards a bit pricey. I have come back annually.

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Last year I noticed her office opened and closed often because of Covid. Finally they re-opened in November and I decided I’d better go before they closed again. The routine was the same: strip, examine and freeze off those pesky spots. The total price, between the examination and the spraying, was somewhere close to 7k. Nonetheless I felt good about doing the right thing for myself.

Now, once the spraying is done the spots scab over and the highly attractive scabs take 7-10 days to fall off. But this time there was one on my nose that didn’t seem to want to come off. It looked weird and felt weird for a scab and it grew out of a small bump on my nose that I’d had for perhaps 5 years; something that I’d previously been told was common and not to worry about.

But after a few weeks I did worry and returned to the doctor. “This scab isn’t falling off and seems to be growing,” I said. “It’s not a scab,” she said and gave me a Latin term for what it was.

The next day I returned to have the thing suctioned out. Because of Covid the doctor was dressed in an outfit that covered her head and was sort of a cross between a bee keepers mask and something NASA would have invented. The devices used to suction were modern and sort of reminded me of what you might see in a dentists office. No cutting – just suctioning and then cauterizing the wound left behind. The doctor took material to do a biopsy but touched the area and told me she was pretty confident based on feel that it was not cancer. A sample was sent to the lab and I was told 4-6 weeks to get the results. That didn’t concern me because I was so confident it was nothing.

I should have known that something was very wrong when the results came back in 2 weeks. I went back to the doctor only to be told that the results were inconclusive; it might or it might not be a squamous cell carcinoma. The doctor was torn with whether to ask the lab to do another test. She actually was worried about spending my money or perhaps worried that I would think she was taking advantage of me. I assured her I could afford the tests and to please do whatever was best. In the end she decided I should come back in two weeks by which time the scab would be gone and she could examine the wound and perhaps take another sample of the affected area.

But in 2 weeks the scab was not gone. I had soaked it a couple times a day as asked and even rubbed it to get the scab off. Some of it did come off but then to my dismay it grew back. When I returned in 2 weeks and showed the doctor my nose she knew it was skin cancer. “Don’t we want to get another biopsy?” I asked. “I’m 99% sure,” she said.

We discussed the options. I could get it cut out by a plastic surgeon and perhaps that could be done in Dumaguete or I could go to Manila and have modern microsurgery, called MOHS. “Manila? There’s nowhere else?” I asked. “No.”

The outpatient procedure was explained to me. They take a small slice and exam it under a microscope right then and there. They continue to take tiny slices until there is no more cancer. This is much more effective than the cut off a bunch and hope for the best procedure which a plastic surgeon would do.

The doctor knew I did not want to go to Manila since it would mean quarantining upon our return and poor Janet had just gotten out of quarantine. One thing that is good about me is that when it comes to major decisions which are unpleasant, I don’t hesitate. “I guess we’re going to Manila. What do I do?”

This is Part 1 and there will be more to come. I debated about whether to share this now, when it was all over, or not at all. In the end I opted to share because I fear (and have felt this throughout the pandemic) that there are millions of people who will avoid going to doctors or hospitals and have necessary medical procedures, treatments and tests done. In my jaded opinion this is due to the geniuses telling us what not to do and scaring the crap out of us so we don’t take care of other health concerns. And in some cases doctors and hospitals are flat out closed or not available for non-Covid treatment. Thank goodness my dermatologist was open. My encouragement to all of you is to take care of your health and not just your Covid health!

BTW, I am gonna make this Manila thing a fun holiday with a great hotel and the best restaurants and a serious mall shopping budget. So Janet and I expect to have fun!

Addendum: My purpose here is to: document my experience; describe medical experiences and costs here in the Philippines; and perhaps encourage people to take care of all their health issues. It is not to do a “woe is me” – so if you hear me doing that give me a gentle kick in the ass. Nor should anyone else proclaim “poor Dave and Janet” – or I’ll give you a gentle kick in the ass!