Friday, July 30, 2010

Situation Report: July 30th, 2010

This post is to spare you from trying to catch up by reading through the morass of previous posts.

Today is July 30, 2010 - a little over six months since Lin checked into the Baptist Hospital in Hong Kong to have his operation for colon cancer.

It's five months since we returned to Singapore to start his adjuvant chemotherapy; and a month and a half since his first chemotherapy session. He's only had TWO (out of twelve) so far!

The trouble is that his White Blood Cells are not fully cooperating and so his ANC (Absolute Neutrophil Count - some 'joker' calls it the African National Congress) is below the level necessary for chemo. What this means is that the 'fighter' white blood cells are in short supply and so are working harder to stave off any infection. So he is in a weakened state as far as immunity to infection is concerned - although he feels fine.

We had a month's break between his first and second chemo sessions. And now, even on a reduced dosage, he is having an added week of enforced rest. We are trying again this coming Monday but it all depends on what his blood has to say about it.

Prof Wong (no relation to me) is going to reduce his dosage again, to see if that will help recovery from the chemo.

So far Lin has been fortunate with side effects; they are not as bad as we expected nor as bad as others have had it. His main grouse is that he has to carry a brick of an infusion gadget for 2 days and nights as one of the drugs is infused over 46 hours - he says it is heavy and clumsy and he does not sleep well because he is so conscious of it!

Those of you who have been following my ruminations on this blog will know that I have had plenty of time to chew the cud; unwittingly you have shared my thoughts and opinions on a range of topics that either tickle my fancy or stick in my craw!

Be forewarned that my range extends beyond what has appeared here thus far.

We have also had lots of time to think about food and drink. I don't know what you are doing about your diet and such, but we are trying to eat in a more healthy way. We have NOT become vegans, that would be impossible!

After reading article on the web and in books, we have acquired a Nikken Aquapour and a Nikken PiMag water optimizer and use that water for drinking. The premise is that cancer thrives in acidic conditions and sometimes we are (too much) in an acidic state.

(Read 'The Enyzyme Factor' by Hiromi Shinya from Amazon - it is very easy to read)

I also bought a Hurom Slow Juicer (after examining a friend's purchase) which I started to use this morning; it combines the best of both worlds, juice extracting and squeezing. 

If you use a blender like the Blendtec or Vitamix (which are claimed to be able to crush  cellphones!) you get a lot of pulp in the juice. So the end result is more of a sludgy 'smoothie' as the real health fanatics believe in putting their fruit and veggies in whole (skin, seed, everything).

We have a Blendtec in PVB and a Vitamix in Singapore and they are very similar except that the Blendtec has an electronic style pushbutton pad and the vitamix has conventional switches and a 'pusher' to push the fruit and veg down the feeder tube. At the speeds at which that operate you can make soups or ice cream without your cook top or your freezer/fridge!

My personal preference: I will use the blenders for food; I bought them to make soups and to blend his favourite foods (after cooking) so that he can drink them instead of having to chew if and when his mouth becomes too sore or he has mucositis.

The next thing I got was a juicer. I felt that was good, BUT the drawback is that so much of the fruit and veg is expelled as pulp (and wasted) unless one salvages some and stirs it into the juice. 

Or one can use the pulp for cooking as some people do. The disadvantage here is that I'd have to plan what to juice rather than do what I do now: pull stuff out of the fridge or fruit basket and juice a random selection.

So when I heard about the slow juicer and put it together for my pal, I decided to bite the bullet and buy one. It arrived yesterday.

The Hurom Slow Juicer works like an electric meat mincer; it has a big, fat 'screw' which squeezes the juice out of the fruit and vegetables you feed it. So it means that if you want wheatgrass juice you can squeeze it out as you should. Yet it also works on carrots, beetroots and other produce for which you would usually employ a juice extractor (juicer). Caveat: don't make it try to crack nuts or hard seeds otherwise you might do it a serious injury!

My concoction this morning (it depends on what I have at hand): watercress, chinese parsley, ginger root, turmeric root, carrots, celery, beetroot. The ginger and turmeric made it a little 'hot' as in spicy and the watercress gave it a slight bitter aftertaste. You can use less watercress, ginger and turmeric than I did; or add more carrots and some apple and it'll be sweet.

Remember these juices must be drunk within 20 minutes or the goodness disappears.

I've used bitter gourd (an Asian veg popular with Indians and Chinese), broccoli (one way around Lin who does not like it!), papaya, mango, fresh water chestnut and other produce that I cannot remember right now. I think you can juice just about any fruit or vegetable!

Here's the info on Hurom in Singapore:

We are also great believers in Vitamin D3 which only recently has been endorsed by mainstream medicine. Take at least 2000 iU a day, with calcium and magnesium citrate (both complement Vit D3 and help absorption of the D3). D3 strengthens the immune system.

We have cut down somewhat on diary products (the poor cows and goats are shot full of antibiotics and hormones - and this is in the milk they produce, not to mention the meat). Chicken and turkey may be white meat, but supermarket chicken and turkey are chock full of hormones and antibiotics. My aversion to them is because they remind me of white cardboard!

I have not been put off by the videos of the way livestock - and fish - is bred, the conditions in which they are raised, the way they are treated and killed (the animal groups are into shock and awe videos); my concern is what is in their meat and what they produce (milk, eggs).

If Prof Wong had his way, Lin would be wrapped up in cotton wool! 

At out last consultation Lin was very enthusiastic and proud that he'd hit about 50 golf balls off the range and reported it to Prof. who put a dampener on things when he counselled Lin to take walks rather than risk hurting himself by pulling a muscle or falling.

We have also had long "to and fros" about sleeping aids. I can see where the Prof is coming from (he's had patients trip over, bitten by dogs and all manner of accidents) and we appreciate that anything can happen at any time no matter how much care we take.

Sleeping aids can slow down reaction time and maybe add to confusion especially when waking up to make a 'pit stop'; on the other hand, there are as many proponents of having a good night's rest.

Anyway, to paraphrase Minister Mentor Lee who said that he does not intend to stop working because he does not want to vegetate, we feel that Lin should maintain an interest in life and try to live as normal an existence as possible.

Thursday, July 29, 2010

Are We Speaking the Same Language?

Sometimes I wonder if the people I am trying to communicate with and I are speaking or writing in the same language!

So for some light relief, I am including the URL for a funny video about two Scots men and an elevator/lift (depending on where you are located) - it's from David and Frances Lomax's latest email. It would help if you have an ear for the Scots accent!!

This morning I received two phone calls. The first was from a gentleman at the NEA (National Environment Agency) who, before he directed my email to the appropriate person, wished to clarify a few things. It also gave me a chance to ask some questions of him.

We had a pleasant conversation in which I discovered that some car parks in Singapore come under the HDB, some under the Traffic Police and some under the NEA. 

My first ever complaint - about an inconsiderate Subaru WRX driver - who drove against the flow of traffic to pinch a car park space was handled by the TP.

So this time, I had directed my complaint about the Beetle to the TP (see previous post and also ). This time they said it was not under their purview and kindly forwarded it to the HBD (Housing and Development Board), who - after a while - reverted that this particular car park was not under their purview either! So, they, in turn, forwarded it to the NEA which is how I came to be having this chat.

By chance I also had  emailed the NEA about something else - vector control. Those of you in Singapore and Florida might know something about this because of malaria, dengue fever and the West Nile virus.

In Singapore many housing developments and condominium estates pay pest control companies who fog the grounds on a regular basis to control the presence of mosquitoes which might be carrying the dengue virus. 

I avoid being around when fogging takes place because I have an innate fear of breathing in the fumes no matter reassurances from the management of our condominium.

A few days ago, fogging came up in conversation with some friends and I heard that the NEA had issued advisories to some estates that fogging is an option, not a necessity (my own words). So I emailed them to enquire about it.

I will tell you what they have to say when I hear from them.

In the meantime my own searching on the internet confirms what I have heard - that fogging only affects those (adult) mosquitoes present and does not prevent breeding. Thus to be effective fogging should be done when mosquitoes prevail, dawn or dusk.

Besides, since most of us are indoors at those times, mossies like to feast indoors.

As almost every website I visited emphasizes the importance of preventing the mossies from breeding (eliminate standing, stagnant water), I wanted some official verification of the situation before going to the management of our condo and suggesting we save money on fogging.

Right now we are spending money on repairing the koi pond under this building. If friends' experience with deformed carp in their ponds after intense fogging is anything to go by, then we should curtail or cease fogging in our estate lest we cause our koi suffer the fallout. We'd also save money!

Moving to the topic of animals the local newspapers have reported two instances of deer running free. One lot were from the Night Safari and the other were wild deer - same species.

The last time (June) the media reported a break in a fence in Singapore, a Swiss graffiti artist was charged and then sentenced to five months' jail and three strokes of the cane. The irony is that his misdeeds would not have been discovered if not for a train enthusiast who filmed this MRT train and posted it on Youtube!

I personally think that we need to yank the chains of the highly paid executives in charge of the MRT and the security of its depots. Imagine two intoxicated expats with wire cutters and spray paint getting into a "secure" area and spray painting for a couple of hours. And no one noticing the strikingly sprayed trains for something like a week even though they were in service.

This is from Wikipedia: SMRT Corporation reported the incident to police only on 19 May, two days after the breach, because staff thought the brightly coloured graffiti was an advertisement. It was seen by many commuters and even recorded by a public transportation enthusiast and posted on YouTube.

And now for a last laugh:
This is an example of what we Singaporeans do to the English language; I often wish I had kept the more glaring mistakes.

PS: I use and abuse the English language as much as anyone. I misspelt 'cilia' (nasal hairs) as 'celia' in a previous post. As a matter of fact, I probably meant 'vibrissae' which is nearer the front of the nostril than 'cilia' which are further inside and finer!

Monday, July 26, 2010

'Rock Fever'

Today, Monday July 26th, 2010 we had another disappointing white blood count result; too few neutrophils (the cells that fight off the billions of bacteria that threaten our bodies) to have another session of chemo.

So we will try again in a week's time. Sigh.

These delays - resulting in not much to do and too much time to do it in - just advance the onset of 'Rock Fever' which every island dweller experiences, no matter how idyllic their little isle.

Singaporeans in Singapore are no exception. 

Most people take breaks from life here, whether it is for a weekend in Phuket or Bali, or to shop and eat in Johor Bahru. During our lifetimes, most of us would have contributed our fair share to Singapore Airlines' earnings.

However, for us, this antidote for 'rock fever' ceased to exist in May when we returned to Singapore for Lin's chemotherapy.

Feeling a little restless, Lin asked Prof Wong about taking a short trip in view of his enforced break from chemotherapy. This did not sit well and he said he really wanted Lin to be at most an hour from ER in case his temperature spiked. 

An hour from the hospital doesn't allow us to to leave the island in case we need to return in a hurry and there are traffic jams at the causeway. We could fly somewhere, but then check-in  and airport transfers make that a flight only in our fancy.

What's left to do? There is just so much reading or watching of tv that one can or wants to do.

Besides, after telling the Prof about hitting 40-50 golf balls on the range, Lin was warned that he should not - at his age - injure himself by straining or spraining a muscle.

Thus, at this rate, Lin is going to be as familiar with Daiso as I (because a gentle walk is permitted). Since he needs to avoid crowds, window shopping expeditions have to take place early, when there are no crowds and most certainly not on weekends.

At least I have been able to go to the movies or a play (the local production of the Full Monty was excellent)! But Lin has had to stay home most of the time and settle for lunch with some buddies on Tuesdays and Thursdays, at the golf club.

Sometimes I go to Tiong Bahru market to buy fish, fruit and veg. or to meet my Tuesday morning walking friends (they walk, I join them for aprés walk) for a cup of local coffee and tou fu fa (a bean curd dessert). 

I have tried going to market on Saturday and Sunday mornings, but find the whole place too crowded.

It follows that if one is late, parking is a problem and all the produce has been 'picked over'.

Strangely enough the HDB car park at Tiong Bahru market doesn't seem to turn away vehicles even when it should be overflowing; two Sundays ago I drove up and saw cars parked on any reasonably flat surface including those not marked for parking. And still cars kept coming up the ramp.

And only last Saturday I walked up the stairs to return to my car when I saw a VW Beetle parked smack bang in the middle of a walkway meant for pedestrians - as if the spot had been reserved for it.

At first I thought what a lovely parking spot, then I realised that it wasn't a parking space at all -because it was not marked for parking and did not have the customary wheel stops.

I immediately knew that 'Rock Fever' had set in because I was 'ticked' (and still am incensed)! 

Normally, I'd think "good for you, mate", because parking rules are not as stringently enforced as before - and it was not parked in a space reserved for Handicap/Special Needs Parking, or blocking anyone.

The constant irritation, 'rock fever' or not, is the blatant flouting of no waiting and no parking signs and road markings. This blocks roads and creates safety hazards.

Nowhere is it more apparent (because we live close by) is that well known entertainment hub, Orchard Towers.

There is a stand for one or two taxis (that's what is posted on an official sign) but routinely several are queued up - along double yellow zig zag lines. I think those double yellow zig zags denote a clearway, so it's been a waste of effort and tax payers' money since no one pays them a blind bit of notice.

During the Towers' busy night hours, taxis line up on Orchard Road itself. 

And on my way to Tiong Bahru market last Saturday there was a Silvercab pulled up (no driver in sight), effectively blocking one lane, at the junction of Claymore and Orchard roads. This was a first, but probably not my last sighting.

And all day long, the length of Claymore Road from Orchard Road to Claymore Hill is lined with cars and coaches - parked, double-parked and belching fumes. Often obstructing driveways and the view of drivers turning out of the condominiums.

Every now and again a smartly uniformed male or female 'officer' will come by on a scooter or motorbike and issue a few tickets, but clearly not often enough to make a difference.

In that sense Hong Kong's police and traffic wardens are far more aggressive and avaricious; they seem to be everywhere. Maybe they have better incentives.

And as for Ponte Vedra, there are usually more parking spaces than cars seeking spaces so it's a joy to drive and shop.

While Singapore is enhanced by an influx of immigrants and workers from around the region, some of their less attractive and desirable habits have also travelled with them.

Mind you, true blue Singaporeans are sometimes every bit as much to blame!

I was looking out of the front passenger seat the other day when I saw a female tourist wave a magazine or newspaper clipping at the taxi driver on my left. We were all stopped at the traffic lights at Shaw Centre/Wheelock Place/ION.

The taxi driver waved the woman into his taxi but, after scanning the piece of paper she proferred, asked her to leave. As she cracked open the door to disembark, she nearly collected two motorcyclists, one after the other!

My fear was that she would hit one of them and then they (motorcycle, rider, pillion and all) would fall against our car. But thanks to the motorcyclists' reactions and nimbleness this accident was averted.

The lights changed and they sped off, I don't know where. And we turned right onto Paterson Hill Road, unscathed. Whew, the stress of being on Singapore roads!

The local papers sometimes provide a distraction; one of them commented on an advertisement featuring a man picking his nose. It was meant to show us that our personal habits might not be attractive to visitors or something like that, I don't recall exactly.

What a contrast to the clean and green Singapore that people have come to picture whenever the name 'Singapore' is mentioned!

Yet it is not uncommon to see taxi drivers grooming themselves in their cabs. 

Just the other day we were stopped beside one who held a huge pair of scissors in his hand, a pair of shears really, and was trimming his celia (nose hairs). After he'd inspected his handiwork he proceeded to hold the blades against his chin and snip away (two handed - on on the handles and the other on the blades) as if he were trimming stray bits of wool from a sweater.

Unfortunately the lights changed so I could not see whether he attacked his sideboards next! 

Not so many years ago, it was not uncommon to see Singapore taxi drivers with ultra long nails on their little fingers (all the better for improving the hearing!),  Vicks inhalers dangling from their noses and coins stuck in their ears.

Whether they have improved or not I cannot say, but recently a taxi driver was charged in court and punished for kissing a female passenger's hand!

Sunday, July 18, 2010

A Picture is Worth a Thousand Words

Here is his Lordship reclining in his favourite chair with his new "Cuddle Blanket" - a gift from a beautiful young lady!

It only just occurred to me that some of you have not seen Lin in some time and might be wondering how he looks. 

Well, he doesn't look deprived or neglected despite my best efforts! Perhaps benign neglect is a wonderful healer.

This photograph was taken on Wednesday night (today is Sunday), after dinner, when he was relaxing in front of the telly. He'd had chemo on Monday and just been liberated from "The Pump" on Wednesday afternoon.

All in all he's feeling reasonably well and seems (keeping fingers AND toes crossed) to be tolerating the chemotherapy. This time (2nd), he was put on a reduced dosage and so we hope his WBC and ANC counts will return to normal (whatever that is) for him to adhere to the schedule of chemo followed by two weeks of rest in between.

Last night we went over to a friend's apartment where we had a most enjoyable preview of the aerial parts of Singapore's National Day (August 9th)  parade performance. The aircraft flew in from the south and directly over us and we had ringside seats for the fireworks.

In some ways it reminded me of the 'Sea and Sky Spectacular' that takes place in Jacksonville, Florida, in early November. This event alternates between Jacksonville Beach and the Naval Air Station (NAS Jax) and features aerial performances on both Saturday and Sunday of the weekend of the 'Sea and Sky'.

When in Ponte Vedra,  have been fortunate to have been invited to enjoy a good friend's hospitality. This emant we could keep warm while while watching various aircraft fly by and doing stunts. 

One memorable year the Stealth Bomber was there, and by golly it was truly stealthy. I could hardly hear it until it was upon us and, as far as sighting it goes, it was there for only a few seconds and then it vanished.

We had ringside seats on our friend's balcony and claimed that we could read the expressions on the faces of the Blue Angels (flying Boeing F/A-18 Hornets) aerobatic team as they flew by - right in front of us.

This team does some 70 shows a year throughout the USA and they fly in really close formation requiring practice, practice, practice, skill and rock-steady nerves. Even then there is a huge element of risk and they last lost one member in 2007.

But nothing I have seen in Florida can match Singapore's National Day fireworks display. This year's promises to be even more spectacular with the brand new Marina Bay Sands (resort and casino) providing the background.

Monday, July 12, 2010

Hip, Hip, Hooray!

What a relief for everyone involved including the nurses at the Cancer Center! Lin's ANC went up sufficiently to be able to get his treatment today. After three abortive attempts, it was fourth time lucky.

Thank you for all your prayers; we are totally convinced that they made all the difference because his counts were lower the last blood draw (before today's) than the one before it. So please keep talking to your God for Lin.

Lest I forget, I have some input about "Watermelon Frost" - I have it on good authority that it has a high mercury content and so can be poisonous.

On the other hand I have heard good things about L-Glutamine (it's explained here in layman's language: Your views are welcome.

It has been a good day in more ways than one; while he was lounging around at the Cancer Center I went in search of a sofa bed because we do need a bed or two for guests (should anyone deign to visit and stay). Or if I need to be in quarantine again.

I had seen one I particularly liked, but, as it is Italian and imported, it costs an arm and a leg. Even taking into account the sale price for GSS (the Great Singapore Sale which is on until July 25) plus an architect friend's trade discount.

Since then I had not met a sofa bed I liked. To assuage my despair and disappointment, I took myself off to a place called IMM (International Merchandise Mart?) where there is a big Daiso store (a Singapore $2 store or Hong Kong $20 store).

By chance, I stumbled upon lots of furniture stores - conveniently located on the same floor as the Daiso store. So on my way, I walked around the furniture displays.

And to my great delight I spotted a pair of chairs that resembled the Italian "sofa bed" that I had set my heart on (but not my pocket).

The salesman demonstrated the chairs and they had a similar mechanism. As chairs they could be twiddled and twirled to be back to back, face to face, in a v-formation or facing in different directions. You can keep one upright as a chair and the other opened up into a regular single bed.

And the price! (I could buy 4 of these and still have change from buying one of the real Italian job.)

Needless to say, when I said that the set must have been made in China there was no demur from the salesman. And when I asked if we could have a different colour than charcoal grey/black he produced two fabric swatches.

So I settled on what I am now going to call my 'China specials' which will be delivered tomorrow afternoon between 3:30 and 5:30. And a pair of covers in a much livelier colour - which will arrive around the end of the month.

So that was my second happy event of the day.

As things come in threes, I also received an SMS from Ann the home appliance sales lady at Best Denki (Ngee Ann location). She informed me that the new shipment of Hitachi washing machines was due in any time now and that she had been in touch with Hitachi who would call me and replace the door of my washing machine (some of you may recalI that I took issue with the opaque rather than clear pane on the door).

And so I waltzed in Daiso with a light heart.

There's nothing I love better than rummaging around $2 stores, stationery stores, book stores, DIY stores, hardware stores, sports stores, computer stores and kitchen stores. Judging by the number of people in the store on a Monday afternoon, it would seem that many other people share this past time with me (and I thought I was eccentric!). I guess bargains and junk turn some people on.

Having bought a piece of furniture earlier, I only spent $6 at Daiso.

Tonight is going to be the second time Lin has 'The Pump' (Lin thinks of it as a mill stone) as his sleeping companion for two nights. I will let you know if he gets on with it any better.

(I hope my chairs, when they arrive tomorrow, look like the ones on the left!)

PRICELESS..... !!!

Here is some light relief in a blog about a serious topic.

Lin and I were on our way out to collect his spectacles when I stopped so that he could post a letter for me at a post box very near our apartment.

(Exact location: outside the back door to Jasons Supermarket in Orchard Towers.)

He'd no sooner got out of the car when I noticed the ad. on the back of the bus.

On its own the ad. is not particularly significant, but those of you familiar with Singapore - and, in particular, Orchard Towers - might agree with me that this picture is priceless. Or at least worth a thousand words!

And if it weren't for the fact that it was Sunday afternoon, I would have been excused for jumping to the conclusion that smart alec adman had staged the scene!

For those of you who have not been to Singapore or have not sampled the night life on Orchard Road, suffice to say that there are some 'swinging' nightspots in this building and the juxtaposition of the bus to the building could not have been more ironic. Some might even say appropriate!

In a way, we are a study in contrasts: we enjoy a squeaky clean image and yet we have some dubious entertainment venues within a par four distance of some of Singapore's priciest residential developments, hotels and high end designer boutiques.

Sunday, July 11, 2010

Something Important To Share With Each and Every One of You

When we were in Hong Kong, a very dear friend lent us a book which became our reference for everything to do with cancer.
Recently, Lin received "Anticancer: A New Way of Life" from another good friend. Lin was planning to read it but I got to it first and found it compelling reading. 
The author has organised the many types of information we had received in one form or another, from one source or another. And as physician and neuroscience researcher (besides being a cancer survivor) he should know what he's writing about.
Many physicians pooh-pooh alternative medicine for reasons we do not need to discuss here, and they should read this book if at all interested in a holistic approach to treating cancer patients.
This is also a book for anyone who is healthy and cancer free. Much of the advice on eating, our minds and our lifestyle choices are relevant to each and every one of us.
You can read more about it on Amazon and elsewhere, but here is one review you might like to peruse.
A review of ANTICANCER: A NEW WAY OF LIFE by David Servan-Schreiber, MD, Ph.D.  Viking Penguin, 2008. (AMAZON)

Mind and heart come together in this remarkable book, making it a must read. As a person living with cancer I found it impossible to put down. Servan-Schreiber, a physician and neuroscience researcher, co-founder of the Center for Integrative Medicine at the University of Pittsburgh was diagnosed with brain cancer when he was 31 years old, received treatment and went into remission. Eventually though, he had a recurrence. After the recurrence he started to look into natural approaches to prevent or help treat cancer. The book is both a memoir and a riveting journey through recent developments in the ideas about cancer. We learn about his personal story and how he slowly transformed himself from a laboratory scientist mainly interested in writing papers into a proponent of an integrative approach to cancer treatment who is keenly interested in human beings. He does a marvelous job of connecting the dots in widely dispersed areas of knowledge-all relevant to his interest in cancer and our natural defense mechanisms. 

Key ideas presented are: 1) everybody has cancer cells in their bodies, but not everybody develops cancer; 2) we must include the concept of "terrain," our whole being, in any discussion about cancer; and 3) at this point in history, we cannot attempt to deal with cancer without the tools of conventional Western medicine. Based on these ideas, he presents an updated view on cancer growth and how to mobilize our vital mechanisms and use the resources of the body to defend ourselves. 

Chapter 4, "Cancer's Weaknesses," presents some of the current thinking about the immune system, inflammation, and angiogenesis. He discusses "natural killer" cells (NK cells), white blood cells that attack cancer cells, and activate their self-destruction. The more active NK cells are the more they can stop tumor's growth. It follows that we must do all we can to activate them through a healthy diet, clean environment, physical exercise, and stress reducing activities. 
The discussion on inflammation is clear and concise. Inflammation is the normal process that our bodies use to repair tissues after a wound. But, as it turns out, inflammation can be diverted to promote cancer growth, as if cancer were the outcome of a wound repair mechanism gone wrong. Cancer cells need to produce inflammation to sustain their growth and block the natural process of apoptosis-the suicide of cells. As Servan-Schreiber aptly puts it "Thanks to the inflammation they create they infiltrate neighboring tissues, slip into the bloodstream, migrate, and establish remote colonies called metastases" (page 37). Dietary imbalance in the ratio of essential fatty acids has led us to an incredibly higher consumption of omega-6s oils compared to omega-3s, which increases inflammation. 

Judah Folkman was a surgeon whose great contribution to cancer research was to highlight angiogenesis, the fact that tumors need new capillaries to feed themselves and expand. Tumors hijack blood vessels by producing a chemical substance that attracts them and stimulates them to grow new branches. Though it took quite a while for Folkman's ideas to be accepted, how to block angiogenesis is now one of the central areas of cancer research. There are some foods, spices, and herbs that reduce angiogenesis and diminishing inflammation will also prevent new vessel growth. 
Servan-Schreiber gives very practical suggestions about these three areas of knowledge, so that we can stimulate our defense mechanisms, while receiving conventional treatment. Just this chapter is worth the price of the book! 

In discussing the contribution of the environment to the cancer epidemic, Servan-Schreiber writes about the typical Western diet, the changes in farming and raising animals during the last century, and the chemical contamination of our planet since the forties. Sugar and white flours dominate our diet and raise rapidly the level of glucose. Insulin and IGF-1 (insulin Growth Factor 1, a powerful growth hormone) are released to allow glucose to enter cells. Insulin and IGF1 also promote inflammation. He argues convincingly that we should eliminate sugar and white flour from our diet. 

There is a detailed section about anticancer foods in daily practice. Servan-Schreiber has been influenced by the work of Richard Béliveau, at the University of Montreal. Béliveau, a cancer biologist working in medical pharmacology for twenty years, shifted to working on diet, through a series of interesting circumstances that I won't tell you about here. Read the book! It is a fascinating story and it has led to the concept of anticancer foods, like phytochemicals, components of some vegetables/fruits, which have antimicrobial, antifungal, insecticidal, and antioxidants properties. They also act as detoxifiers of the body. There is also a wonderful description of the research on traditional spices, like turmeric, by Professor Bharat Aggarwal at the M.D. Anderson Cancer Research Center. A key substance called nuclear factor-kappa B (NF-kappaB) is secreted by tumor cells, it promotes cancer cell growth and spread. The whole pharmaceutical industry is trying to find out drugs that inhibit NF-kappaB. Servan-Schreiber points out that two substances that do so are available easily, catechins, found in green tea and resveratrol, found in red wine. And as it happens, turmeric is also an antagonist to NF-kappaB. He also states that since the pharmaceutical industry and the food industry are not interested in any changes we badly need "... public institutions and foundations to finance human studies on the anticancer benefits of food" (page 115). Indeed! 

The book emphasizes the importance of a healthy mindset that will stimulate the will to live in cancer patients and the need to find support, to deal with emotions, and to find ways to relieve stress. There is a lot of work going on about the link between psychological factors and the immune system. White blood cells can detect the presence of stress hormones and react according to the levels of these hormones in the bloodstream by releasing inflammatory substances. Natural killer cells can be blocked by stress hormones, and become passive instead of reacting to viruses or cancer cells. Feelings of helplessness can influence directly our immune system. Meditation, yoga, and other practices that develop awareness and attention to the present moment can help the body's harmonious functioning and in so doing stimulate the life force that keeps us healthy. Our bodies need touch and physical exercise, we can benefit from massage, and we must increase our sense of connection with others that it is so important to give meaning and purpose to our lives. A holistic approach needs to take all the dimensions of living into consideration and Servan-Schreiber pushes us to leave nothing out of the picture and to pay attention to our inner selves so that we can live fully and gracefully. 

The book ends by stressing three points: the importance of our "terrain," the effects of awareness, and the synergy of natural forces. This last point is important. The body is a system in equilibrium, each function interacts with all the others. If we just change one of these functions the whole is affected. So, we can start with one thing, diet, psychological work, whatever makes sense to us and nourishes the will to live. Awareness in one area will automatically lead to progress in others, and little by little, the equilibrium will shift to greater health and will make changes easier. Finally, he addresses an important point, the worry that some oncologists have "not to give false hope." He turns this idea around, and points out that "...this comes down to restricting ourselves to a conception of medicine that withholds the power every one of us has to take charge of ourselves. As if we couldn't do anything to protect ourselves actively against cancer- before and after the disease. Encouraging this passivity creates a culture of hopelessness" (page 203). 

One reservation that I have about the book is that the discussion about chemical contamination of the environment seems weak in comparison to the depth with which other topics are discussed. This is an area where individually we can do very little. This needs to be addressed at a system level, and in fact it is beginning to happen. For instance, in Massachusetts, the Alliance for a Healthy Tomorrow, a coalition of over 160 organizations, has relentlessly pursued legislation that will require the use of Safer Alternatives, when feasible, to dangerous chemicals. This year, the Senate voted unanimously in support of this but the House did not get to vote. The law will be introduced again in the 2009 legislative session. Keep an eye on it. 

The book has eight pages in color on glossy paper that summarize visually the information about foods, inflammation, contamination in fruits and vegetables, effects of certain foods on specific cancers, detoxification, and an anticancer shopping list. And a list of ten precautions for cell phone use. Very useful! 

Wednesday, July 7, 2010

Murphy Continues To Be Unwelcome Guest

Well, we went along to NUH and had his blood tested again today (Wednesday, July 7). Still no go and so we are going in on Monday, July 12 at 9:00am.

So, in the meantime, we are hanging in the wind.

Thanks all of you who sent in your suggestions. Needless to say, I am suffering from information overload. It's quite easy to attempt to investigate all the supplements, foods, alternative therapies and medicines, but you soon realise it is going to be quite impossible to eat, drink and do everything that has been and will continue to be suggested.

For the time being we'll just stick to what little we know!

However, two items have piqued my curiosity. Here they are:

Has anyone heard of BIORESONANCE or BIO RESONANCE? Or tried it?

(Wikipedia: "is a form of alternative medicine belonging to the field of Electromagnetic therapy, invented in Germany in 1977")

Some of you might be interested in this snippet of info: "there's a Chinese medical powder called "Watermelon frost" that's great for mouth ulcers and sore throats. It's available at our Chinese medical halls." Sounds quite delicious to me!

Sometime last week I managed to misplace my slim card holder which contained my Tanglin Club, American Club and SICC membership cards as well as one or two other cards - fortunately none of them critical, like credit or ID cards.

We looked everywhere (a chance to do minor clearing of files, folders, bags, trays and drawers!) including a friend's and our car. I attempted to call CK Tang, a big department store which had held a "Member's Day" last Thursday when the heaven's poured down on Singapore.

After negotiating their prompts I finally reached an operator who said that lost and found property were the preserve of the Security department on the ground floor (Level 1 in Singapore); I asked if she could put me through and she hesitatingly said that she would try. No surprise that I could hear the call being transferred and then a loud engaged tone. So much for that - but maybe they were out patrolling the store as the crowds of shoppers acts like a magnet for pick pockets (friends have lost their wallets in there).

As I had made a couple of purchases I figured I must have dropped the card holder; but whoever picked it up did not have much cause for rejoicing as none of the cards could be used to buy things. A wag suggested that they could visit the clubs and eat and drink on our account, but I don't think anyone would want to impersonate me just for a free meal!

Anyway, I called the three clubs on Tuesday to find out about replacement procedures and then strolled over to the American Club first. I didn't even have to explain to the Security there that I was going in to get a replacement card - I flashed Lin's card at them (at the speed at which members flash their cards I don't think any details are discernible)!

It only took a jiffy to complete a form and get a new card - the cost Sin$10.

I bemoaned the fact that the loss of the cards paled in comparison to losing the card holder which was perfect for two to four cards. Taking pity on me the membership officer magically produced two card holders exactly like the one I had lost - one for me and one for Lin (which I have squirrelled away!). It made my day!

Then I trooped over to the Tanglin Club and prepared to flash (a membership card) again; but it was hardly necessary because the solitary Security guard was busy with someone who was driving in.

Reminiscent of the stiff upper lip old days (once upon a time the Tanglin was only open to Brits) a rather officious woman gave me the third degree when I approached her to enquire whether she had a replacement membership card for me. In any event she pulled out a thick deck of membership cards and found two which she handed over to me; one was for Lin and one for me and were in a new design so we might have missed an upgrading exercise during our time away.

I must mention that before she handed over the cards she asked me for my old card! I reminded her that the reason I was getting a replacement was that I had lost mine. However, as I also had Lin's membership card in hand, I surrendered his like the law abiding member that I am.

Then it came to SICC, once the most prestigious golf and country club in Singapore. My maternal and paternal grandfathers were founding members of one of the original clubs (the Royal Island Club) which were merged to form SICC.

There is a back story to that but it is rather long and involved. In any case, at some point in time SICC had to pay a much increased rent for its land and memberships became transferable upon payment of a fee. Having secured  transferable memberships many members sold their memberships.

The old system of carefully electing members and "black balling" anyone the Committee did not approve of gave way to a system whereby one could easily buy a membership. This opened the gates to a flood of new members; keen to play golf and use the facilities for which they had paid good money.

The 'tsunami' of members with little or no previous experience of club membership and the hallowed traditions of golf did the Club no favours and put pressure on an administration ill-suited to cope. Successive general committees have yet to get it back into shape; meanwhile other golf clubs have been developed - some of them (Sentosa, Tanah Merah) rather noteworthy.

Anyway, when I called SICC's membership office I was told they would fax me an application form and would charge Sin$15 for a new card. When the form arrived I was not sure if Lin (the principal member) had to authorise my application; I also had to submit a photograph which I was happy to do as I did not the old one.

And now I await the mail with the new card in it.

All in all it was not difficult; it would appear that losing one's membership card is a common occurrence!

Next time I have little news for you I shall bore you with my excursions into the supermarkets of Singapore and how it is hard to dash in and out (nothing to do with the selection of merchandise, I assure you).

Monday, July 5, 2010

Murphy Gatecrashes The Party

You are no doubt familiar with Murphy's Law or Sod's law. Well, the eponymous law is gatecrashing our chemo parties by keeping Lin's White Blood Count (WBC) and ANC low.

Yeah, I only learnt this afternoon of ANC and it has nothing to do with Africa. I first heard it when a PRC Chinese at the other end of the phone at NUH gave us the results of the blood test done on Lin this morning. She had said that the WBC had improved but the ANC was too low. However, she could not explain or even tell me what ANC stands for.

So I called the Cancer Hotline and discovered that ANC means Absolute Neutrophil Count! And got the standard advice about: keeping Lin away from crowds, getting him to practise good hygiene, not letting animals near him, not letting him indulge in any gardening, not letting him sustain cuts and thoroughly cooking his food.

What this means is postponing the chemo until Wednesday, July 7 provided his FBC (Full Blood Count) is satisfactory.

There are drugs to stimulate the bone marrow and boost the level of neutrophils, but the good Professor does not believe in "artificially" raising the levels for the period of the chemo and thus recommends against using them. (Please note these are MY interpretation and words) So we are going to wait.

So no painting the town and frequenting the pleasures of the flesh at Singapore's infamous Orchard Towers' nightspots although it is only a stone's throw away from our flat. Instead, it is eat, rest, exercise over and over again.

We also talked about his mysterious gout and the Prof is of the opinion that the chemo has so sensitised Lin's body that the wine he imbibed gave him a touch of gout. So there you have it, no wine for the period of the
chemo -  I had to explain to Lin that this meant from now until after he has completed all his courses. And not only for a week or so between chemo sessions!

Being good and abstemious is going to bore him to death because our cable provider, Starhub lost out in the bidding for some sports channels STAR Sports and ESPN and some football) and I cannot get Singtel MIO here to install their box until July 13.

This should give you the flavour of the urgency, efficiency and competitiveness of some businesses here; in some other places they would have ramped up their operations to meet the anticipated demand. And I only got that date after I'd given up trying to sign up with Singtel via their website - their emailed acknowledgement was that I had to wait 3 working days for a response to my online request!

So I decided that a little after 9:00am on a Sunday might be a good time to call as the mega churches would have called to the religious, leaving less people free to wait on the Singtel hotline! As it turned out, either I was lucky or I was right - I got through very easily.

It would seem that despite our much vaunted edge in technology the best way to do things (if you cannot do it in person) would be to take a tranquilizer or anti-anxiety pill, get onto the phone and work one's way through the maze of prompts. And wait for a customer representative.

Another grouch I have with Singtel is the execrable English on their website and forms. Singlish is acceptable in spoken form because that is part of the charm (or the inescapable inevitability of living here), but ungrammatical English is inexcusable.