Thursday, April 19, 2007

Chapter One - The Diagnosis

Chapter One


The doctor predicted that Father would not survive more than six months, but deep in my heart, I was expecting that he might not even survive more than a month -- at most, two!

"YOUR FATHER IS suffering from lung cancer," the specialist at Tung Shin Hospital told me, when I dropped by his office one afternoon to ask about my father's condition.

"We are eighty percent sure it is the cancer of the lungs. Another twenty percent - it could be TB," he said, grimly.

"What does that mean?" I asked, anxious to know more about my father's health condition, which was deteriorating since he started coughing nearly one month ago.
"It means he is not going to survive more than six months," the specialist, Dr Yap, said abruptly. He later decided to discharge my father on September 23, knowing that there was nothing much that could be done for him.
A second opinion I got from another specialist at Subang Jaya Medical Centre confirmed there was hardly any hope for Father to survive more than six months. The doctor had indicated that there wasn't going to be any improvement to Father's condition even if he had taken up the case.

* * *

How It Began

Father was coughing for nearly one month before he was admitted to Tung Shin. A local general practitioner had done an X-ray scan of his lungs. The scan showed his lungs to be abnormal. By then, his cough had gone from bad to worse. He was also having breathing difficulties and started producing a lot of phlegmn.
There was not a night when he did not cough while sleeping.
Family members started advising him to go for a more thorough check-up. He was usually very reluctant to step into the hospital, but finally on Sunday, September 13 Father was admitted to Tung Shin, where the doctors later carried out Computer-Aided Topography (CAT) Scan of his lungs. Consultant Radiologist, Chong Ying Seong described his condition as having "multiple roundish nodules of varying sizes seen in the left upper and lower lobes as well in the right lung."
"A larger nodule is seen in the apical segment of the right lower lobe and it is likely for this to represent a primary lung tumour," the report read.
"Enlarged pre-tracheal nodes are also seen as well as mildly enlarged nodes in the anterior medistinum. No bony metastasis is demonstrated in the ribs nor in the thoracic vertebrae."
The radiologist's report concluded: "Appearances would be compatible with lung metastasis and a primary is most likely in the right lung."
With this conclusion, it was clear that Father's condition would not improve at all. My cousin, Dr Peter Ng, wrote in an electronic mail to me after reading the report :-

September 25, 1998

Dear Stephen

Thank you very much for your message. I reviewed the reports of the CT scan and looks like a straighforward case of secondary cancer spread to the lung. Dr Chong Ying Seong is an excellent radiologist from Tong Shin whom I know personally and is usually very accurate. Unfortunately his long term outlook is very bad. Your aim should be to make his life in the remaining few months that he has left to be as comfortable as possible.

Peter Ng

Dr Yap predicted that Father would not survive more than six months, but deep in my heart, I was expecting that he might not even survive more than a month -- at most, two! We knew that he had had heart problems for the past six years and had been on medication since. Once, he even survived a major heart attack while working in Kuantan.
I had poured over my reference books. The Home Medical Encyclopaedia explained:

"Normally, the growth of any particular part of the body is carefully regulated to meet with its requirements. When some part is injured, the cells of which it is composed multiply until the injury is made good, but the whole process is controlled.

"In the condition of cancer, for some reason, a group of cells start to multiply abnormally and continue to do so, disorganising the normal working of the body. Sometimes groups of these cells may be carried to distant parts of the body by the blood and there set up fresh tumours. If the process continues unchecked, some vital organ will eventually become so disorganised that life cannot continue.”

“If all the cancer cells are removed the condition will be cured. The smaller the tumour, the less chance it has had to spread, and the more likely is complete cure," I read.
On the contrary, I knew Father's CAT Scan had indicated that the tumour cells had spread throughout both lungs. Dr Yap had shown me the spread of the tumour cells.

“It is probably already in the advance stage,” said the doctor. As I stared into his eyes, I realised he was not very optimistic.

“Could he be operated?” I asked, still hopeful.

“It’s almost impossible,” replied the doctor.
I knew Father could not be operated on, as he had a weak heart. At the same time, if irradiation was to be done to both lungs to burn off the tumour cells, he would be left with nothing! It was a very delicate situation. Nothing appeared to be possible to sustain him.
To add to the complications, another diagnosis had put it that "the heart (was) enlarged with a transverse diameter of 17 cm." This, I believe, was largely due to the difficulty in breathing that he was experiencing prior to being admitted to Tung Shin. His poor respiration had caused his heart to work harder, which resulted in a weak heart becoming swollen.
I informed Mother about Father's prospect of recovery – she took the news, accepting whatever the outcome.
“I knew it all along,” she said, in a low tone. She recalled an advice given by a family physician many years back.
“The doctor had advised him to quit smoking,” said Mother. “But, he never took heed of the advice.”
By now, she was already prepared for the worst to happen. The rest of the family members were subsequently informed. We resolved to make his last days as comfortable as possible.
Coming home, I kept asking the Lord: "Why? Why should this happen to my father?"
A soft still voice spoke to me: "It's for my sake." I took it as a two-fold answer. "Yes, Lord, for Your sake, so that You can demonstrate the greatness of Your power. And, for my sake, so that I can get closer to my father," I whispered in a prayerful attitude.
The persistent prayer for the last eighteen years for my family members' salvation became an urgent prayer suddenly, concentrating mainly on my father. His salvation was top on my agenda because he now had an expiry date. I was prepared to slow down everything else to concentrate on taking good care of him.
Every day, without fail, I made it a point to visit him at the hospital, whether during lunch times whenever I was in the vicinity or after office hours. I felt every moment of the day I might just lose him.

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