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.

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!