The single greatest mistake I made in financial planning was not buying private insurance when I graduated, got a job and could afford the premiums.

We always think we’re young, at our physical peak, and that nothing is going to happen. And that if anything happens, MediShield is going to take care of it.

The first mistake is in thinking it only applies to one hospitalisation episode. You might have enough coverage or savings to tide you over once. But if you get a disease that puts you on the exclusion list, it’s going to be difficult to get insurance in the future. I’m fine now, but still uninsured because no private insurer wants to take on my case. One illness can affect you for years down the line. Heck, I can’t even get life insurance which only pays out in the event of disability or death. I’m a bit peeved that the insurance companies think I’ll drop dead so easily.

The second mistake is underestimating how high a hospital bill can go. Even with subsidies and a lower ward class, things still cost money. And there will be expenses that aren’t covered by MediShield. I keep using MediShield as an example because most Singaporeans have at least that level of coverage, while I had nothing except a flimsy company plan that was about as effective as an umbrella in a hurricane.

The third mistake is in seeing premiums as wasted money. I use the word “mistake” loosely in this sense. Others might really feel that MediShield is enough, and getting the highest-cost plan from a private insurer is just being kiasi. I wish I had been paranoid, take-no-chances, cover-my-ass kiasi, but you know what they say about wishes and horses.

I’m inspired to write this because one of my colleagues went to the doctor for a funny swelling and the initial tests point to bone cancer. One young person is an isolated case. Two, and you would be foolish not to heed the statistics and buy insurance.

Hope for the best, but plan for the worst.

We were cleaning up our room last weekend – or rather, the boyfriend was cleaning up his side of the room. Among the many little treasures we unearthed was a LIVESTRONG wristband – the yellow rubber things that were so popular a few years back. Well it’s only a shade or two off from my corporate wristband (yes, a wristband is part of our uniform) so I thought I might keep it around to wear.

Then I decided to check out the Lance Armstrong Foundation just to see what it was like. It honestly never crossed my mind to visit the site before. Well, it’s full of good (and free!) resources, and even brochures tailored to your age or ethnic group. You can read the African-American, Asian-American, Hispanic or Adolescent help brochures, among others. That was pretty clever. The Foundation even have Wedding Donations! Now instead of giving out wedding favours, you can make a donation and get cards to inform your guests why they are going home with a wristband instead of cake, chocolate, keychains, shot glasses… Another good thing about this site is that American medical social workers are probably a little bit more advanced than their Singaporean counterparts, because I found some advice on changing priorities that totally matched up with what I remember going through, and yet no one told me anything about it.

From there I got a link to Teens Living With Cancer, which is obviously for young people like me. I am still young okay, never mind that Fernando Torres, who is mere months older than me, said “I’m not old, but I’m not young”. There are a fair number of lymphoma survivors on this community site, because it’s one of the more common cancers among young people. Kids don’t get, like, breast cancer or colorectal cancer. Lymphoma and leukemia are far more common. Only drawback of it being a young people’s community site: The bad typing/spelling! Grrrr. There are even resources for siblings and friends to deal with cancer. Above all, a common theme of the site is encouraging youth to stand up and learn more about their disease so that they can “advocate” for themselves in terms of finding solutions, getting help and making decisions.

Today I went for my PET scan at Paragon Medical, which is a super-uppity place (as if its location didn’t already tell you that). The lab I went to is so posh, they use Apple iMacs at the front desk. But I think they put Windows Vista on them, heehee!

In the cab on the way down, I realised that I have not been to Orchard for months. And today I saw Raffles Girls’ School for the first time. I’ve never had reason to go to that part of Stevens Road, so after 7 years in Singapore, today is the first time I clapped eyes on the building. I noted that its architecture style is almost identical to that of Raffles Girls’ Primary School, but of course.

As we hit Orchard proper, I saw another building for the first time, the monstrous growth of the title. It’s ION Orchard. It’s not just that it’s big. Vivocity is big, and I’ve grown to love its “arterial” façade. Rather, it was the giant “Dior” frontage and other brands that hit me like a crystal-studded Birkin bag to the face. It’s just so ostentatious. All these tai-tai brands screaming out their presence – that’s so pre-recession. Or maybe it’s just the fashion indie in me recoiling from such an overtly mainstream and consumerist display.

Anyway, I did not have to suffer this visual assault for long. The taxi driver turned in at Mount Elizabeth Hospital and I headed up to the 8th floor. While waiting for my turn, I read the information brochure and noted sadly that “a small plastic cannula will be placed in your arm or hand”. Well, at least I had some warning. I’d rather be forewarned and anxious than have an unpleasant surprise. I don’t like that kind of surprises.

When my turn came, they gave me a gown and led me to the locker room. Once changed, I went into a room with a bed, and the lady gave me a capsule. She kindly poured me some water to glug it down, and when I tasted the water I looked at her in horrified realisation. It was contrast material, the same yucky stuff I had to drink before my CT scan. The horror is not only due to the taste – I knew that there was more yucky liquid in my immediate future. They make you drink 3 big cups of it before they scan you. *sigh*

I lay down on the bed for a while, then the nurse came in to insert the cannula. “Which arm do you want?” I asked. The right arm was more convenient for her, so she tightened the tourniquet around my upper arm. Alcohol swab, and then the poke. Ow! I hadn’t expected her to go for my wrist! Man, that hurt. But at least she got it right the first time, so I didn’t suffer unnecessarily as compared to my last CT scan.

She dimmed the lights and left me in the room after she injected the radioactive tracer. You have to wait 1 hour for the cells to pick up the tracer, you see. I lay there, alone with my thoughts and a throbbing pain in my wrist. 20 minutes later I downed another cup of contrast material, following which I had to visit the toilet. When I came back they gave me the 3rd cup and ushered me outside. Finally, time for my scan.

I lay down on the moving bed with my arms raised above my head. Then they moved the bed into such a position that there was a wind blowing directly into my face. Not in the way a nice breeze blows across your face, this one was literally in my face and it was making me panicky, the way it interfered with my breathing.

“Hello?” I ventured softly. No answer. I waved my feet. No reaction from the people inside the room. But then the bed moved and I got away from the horrid wind, and they never moved me back into that position.

The scanning machine is like a CT scanner, doubled. There are 2 giant donuts instead of just one, and the wind was coming from a rubber pipe in the second donut. Anyway the scan’s pretty boring, it’s brief periods of moving through the donuts followed by long periods of not moving at all. Finally they released me, and once the doctor confirmed that the images were good, they served me Milo and Khong Guan crackers. I put aside the sugar crackers and had the cream crackers instead. The nurse removed my cannula, and I was good to go.

The reason why I had to go down to Orchard for a PET scan is because NUH is in the process of acquiring one, it’s not standard hospital equipment. Also, PET scans are apparently not subsidised by the government, making them very expensive for most patients. Anyway, my ordeal is almost over – I have a blood test on Monday and they will have to poke me for this one since the PICC line is gone. But, you know, I think cannulae are worse.

In the usual scheme of things, today would have been the beginning of another chemo cycle. But no more! Instead, today I had some blood drawn for a blood count and then I had my PICC line flushed and its dressing cleaned.

I shouldn’t have bothered, because Dr Koh ordered that my line be removed as it’s a potential source of infection. He actually said I wouldn’t be needing chemo any more, so out the line comes. Flushing and dressing costs money, you know, and I’m a bit peeved that we spent that money pretty much for nothing.

The nurse called me into the treatment room, where the outpatients get their chemo, and I sat there waiting for the doctor to arrive. I got the young lady doctor who calls me “little princess”. She’s not that much older than me, she told me so when she asked my age.

She cut the stitches (a rather tuggy affair), picked up a stack of swabs and positioned it over the site. And WHEEEE! Out came my line. The actual part that’s inside my vein is even thinner than indicated by the bit I could see coming out of the site. And unlike the removal of my femoral line, this time I couldn’t feel anything. There was a piece of suture thread left and she had to pull it out. It probably got stuck over the 4 months that it was in my arm, so she had to pull with some force. A bit icky, but not painful.

The nurse sprayed some permeable dressing over the site (yes, a sprayable dressing!) and I marvelled, “Oooh!”. The doctor commented that I had a lot of sound effects. Like that only fun mah! Then a pressure bandage went on. End of procedure.

So now I don’t have to worry about people gawking at my PICC line when I go out in public. The stares don’t hurt but it’s just annoying to catch people looking, because most of the time I don’t remember it’s there. But I’ll miss my PICC, especially when it comes to drawing blood! It is the return of the needle pricks!

Oh, the memories. Remember when I had it put in, and I swore when the anaesthetic needle went in? I have a perfectly good justification for that now! This article from Scientific American (another old buddy from my JC days) basically states that proper use of swearwords for situation where they are warranted actually reduces pain! I love science.

On Monday I went to see the doctor for my check-up, as usual.

I never made it into his office. While waiting for my turn at the blood draw (Monday mornings are always crowded at the Cancer Centre), I started seeing stars before my eyes.  The receptionist pointed me in the direction of a recliner chair, but I fainted before I made it there.

In fact, my mum says I had a fit, and the doctor confirmed that I was rather rigid when they got me into the procedure suite. Me? I thought I had fallen asleep and was having a noisy chaotic dream. I actually felt quite content, that I was able to sleep which was what I had been wanting for the past hour or so. Then someone stuck an electrode on my chest, and a voice said “It’s okay, she has a pulse.” Of course I have a pulse, I’m right here aren’t I? And then I started waking up.

I have a history of fainting, as my former schoolmates will attest, but I’m pretty sure I’ve never had a fit before. Most times I just go limp. And it wasn’t due to a sudden drop in blood pressure due to standing up suddenly, I was sitting down when I started feeling giddy. I just had a severe lack of blood, that’s all.

They admitted me into hospital for a blood transfusion, and now I owe the NUH blood bank a total of 4 bags of blood. (Actually no need to “pay back” wan, but I don’t feel nice la, blood is a precious resource you know.) The transfusion finished around midnight, the doctors came to see me in the morning and sent me on my merry way home. Now that I have a normal amount of blood and hemoglobin and red blood cells, I feel much better.

The regularity with which I collapse on checkup days makes it look like I’m some sort of drama queen who loves the attention, but it’s just a fact that my blood count drops in cycles, and the drop always coincides with checkup days. Also, when I’m at home I can lie down whenever I want, whereas I have to sit for prolonged periods in the waiting room. Then my heart has to do extra work to send blood to my brain.

Anyway, now that chemo is over and they gave me blood and my own blood factories should have started up production again, I don’t expect any more fainting in the future. It’s very tedious to not have enough blood – I always know when it happens because I get very tired very easily. No more chemo means no more unexpected collapsing means no more surprise hospitalizations!

Also, no more chemo and a normal blood count means I can eat pretty much anything I want now, yes yes? KFC relaunched the Bandito Pockett (sic) just in time. I am looking forward to eating it again, nyam nyam.

Yay! Chemo finally finished today! My doctor’s quite sure he doesn’t want to do more chemo, so I can confidently bid goodbye to being tied to tubes that deliver deadly drug dosages into my frail little body. 6 f87king rounds of chemo, each round lasting 6 days. Ugh. Some days I feel more like chemo gave me a beatdown, rather than me giving cancer a kick in the arse.

I’m just glad it’s all over, and looking back, one can say “well that went pretty fast” although I know it was anything but over too soon. The first round was okay, the second a novelty in the new private room, and at least the third round had the saving grace of being the halfway point. The fourth round was absolutely AWFUL because of the nausea – practically nothing helped, and the neutropenic fever compounded it AND delayed my chemo by a week. Round 5 went pretty well, no nausea, and this final round was much the same. I had some queasiness, and went to the bathroom in preparation for some Merlion impersonation, but it wasn’t to be. Just as well. I’ve gained back some of my lost weight, so that should be good news.

When I started chemo, it was March, and we were gearing up for more students at work, I had plans to do this and that, and the football season was in full swing. Now June is almost out, we’re swamped at work, and there’s not much football to watch. Although I am looking forward to seeing the Liverpool team on their tour of Singapore. Nothing barring jail, hospitalization or some other form of incarceration will stop me from going to see my beloved team! Although I am a bit concerned about the timing and how it will clash with the imminent arrival of Fernando Torres’ baby. His wife is due very soon, and I’d hate for him to miss his child’s birth just because he had to go on tour. I’m nice that way. *grin*

On Tuesday I go back to the hospital for my injection to boost white blood cells, then the week after that, I go in to see the doctor and have my usual blood count done. Instead of planning for the next chemo round, we’ll be scheduling a PET scan, so it’s like a pass/fail exam for me *eeeps*. Dr Koh informed me that the PET scan technicians are not allowed to use my PICC line so they’ll have to inject the radioactive material the old-fashioned way. Sigh. This PICC line has been a good friend to me, okay. Saved me a lot of pokes, especially for blood draws. Hasn’t spared me from them entirely, but my left arm has been poke-free since my admission for neutropenic fever, which is rather a record for that arm.

126 days divided by 7 is precisely 18 weeks! Which is how long my chemo was supposed to take. Although my original figure DID include the 2 weeks of recovery time, but the very first week of my hospitalization plus the delay in chemo round 5 ate up those 2 weeks.

So how does it feel to finally finish chemo? Well, obviously I’m just glad I don’t have to look forward to the nausea and the general discomfort any more. Also, hospitalization is a blessing because I have nurses to take care of me and my mum can have a break, but I can’t say I really like wearing hospital pajamas and eating hospital food. AND the hot water doesn’t reach scalding levels, unlike my water heater in the apartment. Seriously, I’ve been scalded by the tap when brushing my teeth, that’s how hot the water can get. Now get off my case about electricity consumption.

I don’t know how common this sentiment is among cancer survivors, but anyone who dares to say that “cancer is a blessing in disguise” will just get a big fat NO from me. NO. It is in no form a blessing, not even a blessing wearing 10,000 disguises. The diagnosis, the surgery, the chemo, the radiation – all of them SUCK. They don’t make you stronger if you’re not already strong enough to get through them. Sure they show you what you’re made of, but I can think of better ways to test my mettle than to contract a deadly disease – like, say, crocodile wrestling. So, no. I wouldn’t wish cancer on anyone, not my worst enemies, not terrorists, not animal abusers. Cancer is a curse, and that’s all I have to say about it.

Maybe I’ll feel differently after I’ve crossed the 5-year mark and my illness is just a footnote in my autobiography. Maybe I’ll look back and say, “Hey, having cancer changed me in some good ways”. Um, I can think of only a few, very trivial ways: I lost some weight, I got to try out a new hairstyle, and I’m well-versed with hospital terminology. I think I was pretty awesome to start out with, so nothing cancer can do to improve on that. ;D

So yeah, if my PET scan comes in with an all-clear, I’m going to get back on with life, blood count permitting. It’s going to be a bit jarring having to go back to work after so many months of slacking off – even during university vacations I never goofed off for so long. But it’s okay, I have a plan to ease myself back into a routine, and I am actually looking forward to being back at work and being surrounded by my kiddos. And the new kiddos I haven’t met yet. And the fish. Hello feeeeesh!

Since the PET scan is a pass/fail, and I do so love predicting my grades, let’s have a prediction now. I’m not really superstitious, and whatever the result, I’m prepared for the next step, so I don’t think I’m jinxing myself. R-EPOCH has a very good record of remission without radiotherapy, according to the ONE journal article I could find. Hey, cancer trials don’t come along every day, okay? Plus I’m young and didn’t have any major issues before, all of which work in my favour. And frankly, I think the chemo makes me feel shittier than the cancer does. I’m pretty sure the cancer’s all gone now. I mean, I myself barely survived the chemo, so I don’t think the cancer had a chance. I’m leaning towards a clear PET scan result.

But hey, if there are still some tenacious bits left, I say we zap them to kingdom come, so I can get on with my life without worrying about a recurrence. Do it once and do it good, right?

Okay! That’s it for this report. I don’t expect to have much more to say on the matter, since treatment is on hold for now. I’ll get back to blogging about more mundane things, like learning to cook properly, and watching the Liverpool team, and how very hot I find Draco Malfoy in the upcoming “Half-Blood Prince”. I’m waiting to hear from you people!

I checked into the hospital on Monday, as I always do. They had trouble finding me a single room because NUH had closed down my regular ward 86 for A(H1N1) patients, so I ended up in a 2-bedded room on ward 66. And because it was such a chaotic rush just to get me a room, I didn’t manage to get my Rituximab on Monday. I like getting it on Monday because it’s only 2-3 hours on the drip, then I’ve cleared 1 day of my cycle. But inefficiencies in the system (thanks to the flu-induced chaos) delayed my Rituximab to Tuesday.

On Tuesday afternoon they informed me that they would be shifting me to ward 58, where I had my very first chemo cycle, because the nurses on Ward 66 aren’t trained to handle my very complicated R-EPOCH regimen. So I waited and waited, and they finally moved me. At 9pm. By this time, visiting hours were over, so the nurses had to assist me with all my stuff. And believe me, I have a lot of stuff. 1 bag of clothes and food, 1 bag of toiletries, and 1 more bag for my electronics. Hey, I gotta entertain myself, being in hospital isn’t a novelty any more, and hospital food doesn’t cut it so I have to bring my snackies from home.

Wednesday morning my regular doctor comes in to see me. He just returned from being away on MC so he joked “I’d better stay far away from you.” Basically everything was okay, because they hadn’t started me on the orange stuff yet. My PET scan will be scheduled 2 weeks after I complete chemo, so we won’t know till mid-July whether I’ll need further treatment.

Later on as I was sleeping, a doctor came in to tell me that ward 86 had a discharge, did I want to upgrade? Yeah do I ever! the 4-bedded room in ward 58 is comfortable enough, but the bathroom and toilet were separate so each was rather small, and it made life a bit difficult because I had to squeeze my IV drip inside with me. Also I felt shy about watching TV and playing computer games because I had to take the other patients into consideration. And most of all, there is no desk in the shared rooms so I have limited space for my laptop and meals!

They finally moved me into my lovely single-bedded room at 5pm. Yay yay single room. I guess I’ve been spoilt by having single rooms all this while, and it’s not as though I’ll die if I stay in a shared room. But I just like having my own space, you know? This way, I can turn up the volume on the TV and sing along with the contestants on “Don’t Forget The Lyrics!”. Best of all, the nurses here are familiar with me and my needs, so it’s like my hospital home.

By the way, this is cycle #6 of my chemo, so it’s the last one. Don’t celebrate yet – the cancer hasn’t gone into remission (at least until we get a PET scan to confirm), so it’s not necessarily the end of the road for my cancer. But it IS the last chemo, which means no more drips and nausea and my hair can start to repopulate my scalp again. Radiotherapy isn’t a walk in the park either, but at least its side effects aren’t as severe as those of chemotherapy.

Oh yes! Today the teaching doctors who have medical students attached chose me to be interviewed by the students because “I speak English well”. How flattering! I got a final-year medical student who was given 15 minutes to get a complete history of my illness – how I ended up in hospital, what was the diagnosis, what’s my treatment, and whether it ran in my family. After his time was up, his instructor sent him out for a short while so we could discuss his performance. Basically the instructor is looking to train the student to stick to a systematic manner of questioning, but also to train his listening skills in order to pick out details in my story that he may have missed out if he just focused on getting answers. It was very interesting for me as well because I got an insight into how doctors are trained to get a history, and how I should give more details to doctors in future so as to help them with their work. The instructor also requested politely that my aunt and boyfriend leave the room while the student got a history. It’s standard procedure, both to preserve confidentiality and also to get a clearer story because some patients may not be as forthcoming if family and friends are around. By eliminating any reason for patients to hide details or lie, doctors get a more complete history, which is essential to their practice.

Cycle #5 of my R-EPOCH regimen is now finished, and I’m resting at home. I didn’t have much nausea this time around – the only time I puked, it was first thing in the morning and only bile came up. At least, I think it was bile – yellow and bitter-tasting.

But in exchange for no nausea, I got a new side-effect: falling down. It happens when I get up from a sleeping position to go to the toilet or something. The first time it happened, it was pretty dramatic.

Saturday night and I’m on my last bag of the orange stuff. I get up to use the toilet. I make it there all right, but I collapse on the way back to bed. One moment I’m stumbling back to bed, the next moment I’m on the floor as though I were a wind dancer and someone turned off the blower. I lie there for a while, calling softly for help. Of course no one comes. But it doesn’t matter. Lying down is precisely what my blood-deprived brain needs, and I haul myself back into bed.

If it were a one-off incident, I wouldn’t have paid it much heed. But there are signs that my blood pressure is insanely low – probably because I don’t have enough red blood cells to start with. They all died in the crossfire of the chemotherapy.

Sunday afternoon, I have been discharged and gone home. I walk out to the kitchen to give the boyfriend’s phone charger to my dad. The effort of standing up and walking is apparently too much for me, and I wave the charger at my dad while mumbling incoherently. My mum completes the task and I go back to the room to lie down. I don’t even have enough blood to run my brain.

Sunday night, I get up to use the toilet. I make it into the bathroom, but I don’t make it out. I open the door, call for my mum, and fall down.

Flop.

I spend most of the next 10 hours lying down. Lying down is safe. Nothing can happen to me while I’m on a bed. I won’t hit my head, scratch myself, or break anything. I don’t even have to support my own weight. I can retreat into nothingness.

The doctors saw this coming – they booked me for a blood transfusion next week, pending the results of my blood count. It’s kinda weird to think about someone else’s blood being pumped into your body.

Some days I don’t have a lot to say, or rather, I have many little things to say and not much detail to go with them. I know Twitter was made for situations like this, but I don’t like Twitter! I don’t want to join Twitter! Also, if I join it now, I’ll look like I’m hopping on the bandwagon. I don’t hop on bandwagons. I’m one of those pretentiously-indie people who like to “go my own way” and “be quirky” and all that “I’m so beyond caring what’s cool” rubbish. It’s cool to not be cool, haven’t you heard?

Anyway. Here’s what went down today, and recently! Gabriel‘s right. You don’t need to leave a hospital room to look for interesting things to talk about.

• Kaka, that most talented of footballers, has apparently left AC Milan. But not for England! I’d love to see him weekly in the Premier League, but rumours have him signing for Real Madrid. Poot.
• My Paypal transaction for a leather hobo handbag from Etsy finally went through! I have been through so much hell in the past week, trying to fix whatever was wrong with my Paypal (their system blocked my transaction and customer service couldn’t give me a specific reason why). Their solution: wait a few days and try again. Finally, it worked! Oh, and buying from indie artisans on Etsy is cheaper than buying from the shops. A similar handbag (of any brand) would probably have cost double.
• Muse are going on tour in October! They’re only doing UK and Europe though. Still, perhaps they’ll do an Asian leg. I’m dying (haha) to see them again. They were last here in January 2007.
• Windows 7 ships in October 2009! Which means I can probably buy myself a spanking new Win7 laptop for Christmas. *hugs Acer laptop* don’t get jealous, I still love you! (Jealous laptops have a higher rate of malfunction.) I’m keeping this Acer around though, I feel more secure with an XP machine as backup.
• My next movie outing will probably be Pixar’s “Up!”. It looks cute, and I’ve seen all the Pixar movies – can’t break my streak now.
• Fresh cherries are so very different from the glazed kind you get on cakes and in cocktails! Eating fresh cherries is like eating very small plums. Same tart flavour, texture, and pit in the centre.
• 101 days since I went into hospital. I swear, in all that time, I’ve not had a full, uninterrupted 8 hours of sleep. In hospital, the nurses come in to check on me. At home, I go to the toilet in the middle of the night (I have good night vision). The trick is to stay sleepy enough so you can go right back to sleep after the interruption.
• I love Internet banking. Lets me pay bills from my hotel hospital room. Gotta stay up-to-date on phishing scams though.
• I have HBO in hospital and am going to watch “The Other Boleyn Girl” tomorrow. Yay!
• I miss my food shows on Astro though. Watching Jamie Oliver cook is so inspiring. The amount of cheese he uses is quite frightening to behold.