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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 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.