Friday, June 11, 2010

Steady as we go!

Waking up early is no longer my preferred cup of tea. It was different when I was riding horses, but then I used to fall asleep at the dinner table in those days!

Now I only wake up early for golf games and sometimes to catch a plane.

Fortunately, once I wake up I am alert and good to go, I do not need to take time to 'warm up' as Lin does (no matter what time he awakens). I also have the gift of easily getting back into bed and resuming my slumber.

This morning it was vital to wake up and to wake Lin up too. Not only that, I had to make sure he got to NUH in time to get a plug put in (not a line as I had thought).

The purpose of the plug is to enable a fast response to any call for an infusion of drugs during surgery - I learn AT LEAST one thing a day these days!

It took us about 15 minutes door-to-door and we arrived before the nurses in the chemotherapy centre; so we were escorted up to Level 4 for the plug and then down to the Day Surgery Admission and Ward on Level 2.

After the Admission formalities were taken care of and Lin was shown to his bed, I left him in the care of some attractive young nurses (origins: Singapore, Philippines, PRC). His procedure was scheduled to 10:30am but a backlog built up and the doctors did not receive him until 12:30pm.

A little after 2:30pm I received a call to say he had returned from the OT, so I made my way back to NUH. He was bright eyed and bushy tailed and champing at the bit to go home.

He had the portacath put in under local anaesthetic by a cosmopolitan team led by an Indian doctor. Another doctor was Chinese. The nurses were Filipinas. Everyone mumbled to themselves in their mother tongue but business was taken care of in English and everything went like clockwork. He was much impressed by the teamwork and the the way each person switched languages without a pause.

Anyway, no amount of cajoling could get the nurse in charge (originally from Shandong province and now - after more than ten years in Singapore - speaks like a Singaporean) to agree to release him before 5:00pm. We did slide out with al the nurses' blessings and well wishes a few minutes before 5!

At one point during our wait, a nurse came to check his blood pressure and I asked to have mine checked out too! As he'd been lazing around, his BP was a low 112/65; as he returned to normalcy it read 125/78 just before we left. Mine came out as 119/67 as I had been hanging around reading the newspaper.

Lin, who likes to sit up while reading, suggested we swop places so that I could catch 40 winks in his bed and he could sit up in the chair to read the newspaper. Tempting as it was, I did not dare in case this would get us both chucked out of the hospital!

As it happened, Prof. Wong's nurse clinician, Ednajoy, came at about 4:30pm to check on Lin and to tell us that his chemo session on Monday would be at 11:30am instead of 2:00pm. Good thing we did not sneak out early or exchange places.

I am not sure if he'll feel some pain tomorrow, but he's fine right now and is very happy that we eventually chose NUH and Singapore.

The good thing about the influx of immigrants and workers from all parts of the world is that English is our common language - sometimes not the King's English, but we understand each other. And what is more, I can read all the signs and posters and understand what they say!

Prof. Wong also had us check on whether Lin had a pneumonia vaccination within the last five years and this resulted in him receiving one while in the Day Surgery ward this afternoon.

Which brings me to comments on ibuprofen and paracetamol (a.k.a. acetaminophen) which were kindly contributed by friends and friends of friends.

A pithy one from a pal: "Panadol is bad for the liver that is already compromised. Hence never take it for a hangover headache, instant rot." Now you know what NOT to take the morning after!

A radiation oncologist chipped in with:

The chemotherapy drugs have to be eliminated from the body after they have done their work.  This is usually done by the liver and kidneys.  Any drug that can decrease the kidney function may allow the chemotherapy drug to stay longer in the body and cause more side effects. Some chemotherapy drugs, by themselves, can lessen kidney fucntion.  

Wow, I would never have known this, so am grateful for the input.

The bactroban will try to reduce the chances of getting a staph infection by controlling the staph bacteria that usually grow and live peacefully in the skin and nostrils of  humans.  When the immune strength of the person falls (in this case due to the chemotherapy effects on the normal white blood cells) the staph overgrows and causes blood infections that can be risky to the person undergoing chemotherapy. 

It certainly has helped our understanding as to why he has to apply Bactroban twice daily until Monday. Looks like the Prof. is covering all the bases here.

We are glad we are here and in good hands as we progress on this journey.


I found the following on a web site and thought of my pals who refuse to take any pills at all. If Ibuprofen lessens kidney functions and Panadol can damage your liver, best not to take any pain meds.

"Acetaminophen is converted into other chemicals by the liver, in the presence of liver enzymes and then eliminated from the body. Excessive acetaminophen ingestion, therefore, can result in liver damage or failure, especially when taken along with alcohol or drugs, that also contain acetaminophen or those that have an adverse effect on the liver. In such situations, even a lower than the maximum recommended dose can cause acetaminophen toxicity."

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