UNDERSTANDING: The Doctor Saved My Life Twice

By J.K.Chua

I was a sales professional working for corporate America when I was diagnosed with Stage 1 kidney cancer. I journaled my whole experience in overcoming cancer to share my learnings with others. For many years, I was extremely fearful of death. It was not until reading the book, The Tibetan Book of the Living and Dying by Sogyal Rinpoche, that I became more at ease with death. In late 2013, I experienced the death of my mother. I described my experience in detail to learn from it and to make the right decisions. I contrasted how my father wrote about my paternal grandmother s death in 1976 with what I wrote of my mother s death thirty-seven years later. With over 30 years experience working for corporate America and as an entrepreneur, I mentor entrepreneurs and sales professionals to succeed by fast tracking their learning curve and avoiding common pitfalls. I help people to reinvent, reposition and reignite their career to reach their potential and I am also a motivational speaker.

• Language: English
• Publisher: Hillcrest Media Group
• Release date: Nov 8, 2014
• ISBN: 9781634135276

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Abstract

When faced with a life and death situation, I did what anyone would probably do. I reviewed my life and experienced flashbacks to significant and memorable moments of my life.

I remembered the inspiring stories that touched my heart — stories from and about my parents, my sister, my relatives, our neighbours and friends.

This book is about understanding some of the more important aspects of my life. I begin by explaining what I went through when I was first diagnosed with cancer of my right kidney in 2009.

When you read this book, you will understand my thoughts and emotions during that time. I share my experiences going through the surgery to remove my right kidney and what I did subsequently, during the recovery process. I also explain the healthy life I led to be cancer-free for the next five years.

I then describe my experience with a life-threatening non-viral liver hepatitis in 2005 and the diet I used to help me recover from the disease.

Later, I discuss the topic of life and death that remains a taboo subject to many. By relating to my mum’s last days in 2013 and the lessons I learnt from that, I feel enlightened to share my experiences with others.

Having experienced the death of a loved one, I now understand the importance of being prepared for death and making the necessary arrangements so as not to overburden the surviving relatives of the deceased.

I also feel that I should do more to contribute to the world-at-large by sharing more practical experiences and by way of writing this book.

I have written this book such that each of the chapters can be read on its own and independently from the others. That way, you can pick and choose which chapter you want to start with.

When I was young, I never imagined myself writing a book. In fact, I was averse to reading books. For some reason, I did not like to read fiction and barely read the popular fairy tales like Sleeping Beauty or Snow White and the Seven Dwarves. On the other hand, my younger sister was an avid reader; my mother would use my sister as an example for me to follow.

Luckily, my parents persisted and encouraged me to read storybooks. Fortunately, I was fascinated by the enchanting Wonderful World of Disney TV programmes of the 1960s and 1970s that encouraged me to read Disney storybooks. I still have fond memories of those TV programmes.

Strangely enough, I never read Alice in Wonderland until very much later. And, the reason I finally read the book was more out of curiosity than anything else.

Later, my parents managed to get me into the habit of reading when they subscribed to the Look and Learn magazine from the United Kingdom. I liked the magazine as I loved to read about general knowledge.

In later years, I toyed with the idea of writing my life story as a legacy for my family. Over time, I realized that there were more life and work experiences that I could share.

A few years ago, my godson approached me for help with his school assignment to write a mini-biography of a close relative. Coincidentally, we both thought of my father because he was English-educated and was an English and Mathematics teacher. He also had many interesting stories to share.

That moment sparked my efforts to write the book. It took me a few more years before I completed my first draft manuscript in 2013.

Thinking back, I might not have persisted to write this book if my godson had not approached me to help him with his school assignment. I might have even forgotten about any draft manuscript that I might have had.

Initially, I had planned to write a book to cover my personal life and corporate experience. But, after some thought, I decided to split the original manuscript into more books. Someone told me, Your manuscript is a book of many books.

I surreptitiously worked on the split before revealing the number of books to my wife and two boys. Up till that point, my two sons were trying to guess how I was going to split my book.

I decided to split the original book into six books. After much iteration, I decided on the following six book titles.

-Joy

-Kindred

-Corporate

-Heritage

-Understanding

-Adventure

I decided that my first book (which is this book!) would be UNDERSTANDING — The Doctor Saved My Life Twice.

________._.________

Visit my website at www.JadeiteBookSeries.com.

Facing Cancer

1. The Doctor Saved My Life Twice

I had just picked up my wife from work. On the way home, we decided to take away Hainanese Chicken Rice for dinner. Just as we were picking up our dinner, my mobile phone rang.

It was our family doctor’s clinic calling. I put on the hands-free kit and answered the call. The nurse told me that the doctor wanted to speak with me.

I was curious as to why our doctor wanted to speak with me. Usually her nurse would speak with me, either to collect medical test results or to remind me of a medical appointment.

The first words from the doctor were, JK, we found a growth in your right kidney and it may be cancerous. In a flash, I thought, OH NO! NOT CANCER!

I feared the worst.

I was in SHOCK!

Shocked beyond utter disbelief.

My mind went blank.

It was like the whole world had come crashing down on me. I nearly cried in exasperation.

The doctor told me to stay calm and asked me to see her the next day. The drive home seemed arduous even though I was just eight hundred metres away from home.

I recomposed myself and related to my wife what the doctor said. My wife reminded me to keep calm even though she knew that I would. I have always been known for my calm demeanour. My wife did her best to be supportive and keep my spirits high.

I did not have an appetite and did not eat much for dinner. After dinner and a quick shower, I went on the Internet to research kidney cancer. I tried to be positive in the face of adversity. I prayed that the growth was not malignant.

I was in self-denial for a few hours. Then I began to fear the worst, but I decided to take it easy and sleep. Surprisingly, I managed to sleep through the night. I attribute this to my calm nature and my underlying philosophy of not worrying unnecessarily. When faced with life challenges, I believe that one should be brave and take on the challenges as they come.

I am neither a medical practitioner nor an expert in the field of medicine. I am a cancer survivor and in this book, I am speaking as a patient who has observed, researched and learnt from my experience with liver hepatitis and cancer. I am sharing what I have read and researched.

For a more accurate assessment of a similar condition that you may have, please consult a medical practitioner or specialist in the medical field. What I am sharing is only meant as a reference to guide you in your journey to better health.

LIFE LESSON

If you are faced with a life challenge and if you can do something to change or fix it, just do whatever it takes. But, if you cannot do anything about it, then just live with it and make the best out of the situation.

The Next Day

The next morning, I woke up earlier than usual. I prepared breakfast for my older son before he left for school on the school bus. My wife took urgent leave to accompany me to see the doctor. After I had my favourite breakfast of banana nut crunch cereal with milk, we were off to the doctor’s clinic.

We were early and it was just a short wait before I saw the doctor. She started off by assuring me that she would get the best urologist for me to consult with. She showed me the images of the ultrasound scan and explained the scan results. She showed empathy and told me not to worry too much.

Figure 1.1: Ultrasound of abdomen on 10 July 2009 revealing right kidney tumour.

My doctor highlighted the urgency of the situation and instructed her nurse to make an appointment for me to see a consultant urologist at Mount Elizabeth Hospital. By the time she finished discussing the next steps, her nurse had confirmed my appointment. I was thankful that it was done so quickly.

Seeing the Specialist

On 16 July 2009 (Thursday), I arranged to consult with a friend of mine who was a urologist for a second opinion. He concurred that I needed surgery.

On 18 July 2009 (Saturday), I saw the designated urologist to get an expert opinion. The diagnosis was not much different from my doctor’s. The urologist arranged for a Computer Tomography (CT) scan of my abdomen for a thorough assessment.

Figure 1.2: CT scan on 14 July 2009 with arrow pointing at right kidney tumour.

The specialist explained that surgery was required and that a biopsy would be done during the surgery. The biopsy would determine if the growth was malignant (cancerous) or benign (non-cancerous). He further explained that the decision whether to remove part of or the entire right kidney would depend on the biopsy results.

He asked me whether I had any concerns. I really did not know what to ask. I was too shocked.

At that point, I was just concerned whether I was going to survive the surgery and whether the cancer had spread. The specialist said that my cancer was either at Stage 1 or Stage 2 because of early detection. I did try to ask the doctor whether I needed chemotherapy. The doctor replied that he could not comment on the prognosis until after the surgery.

Figure 1.3: CT scan of abdomen on 14 Jul 2009 showing right kidney tumour.

Surgery was scheduled to take place the following Wednesday. I was still in a state of denial but I told myself to take it all in my stride and hope for the best. I felt reassured that a top urologist in Singapore was going to operate on me. I was later told that he was my doctor’s lecturer at the National University of Singapore’s School of Medicine.

I was wondering about the difference between a CT scan and an ultrasound scan, so I researched on the Internet. I found out that a CT scan provides more details than an ultrasound scan. A CT scan can generate two-dimensional images of a slice (or cross-section) that is spliced through a three-dimensional object like a human organ.

Figure 1.4: CT scan of right kidney tumour in detail.

Days Leading to the Surgery

During the days leading to the surgery, I experienced ups and downs in my mood. One minute I was shocked and the next minute, I was trying to think of what could have caused the cancer. I was very puzzled because I did not smoke or drink much alcohol, aside from the occasional social drink. I could not even identify a harmful substance that I could have consumed or been exposed to. I had not abused any substance or risked putting myself in a toxic environment.

The last ultrasound of my abdomen was done in 2005 and I figured out that I must have gotten cancer sometime between 2005 and 2009. There were no major changes in my lifestyle except for unusually high stress at work. I could, therefore, only point to stress as the cause of my cancer. I was still hoping and praying that my right kidney could be saved.

My mind flashed back to thirteen days earlier when I had debilitating abdominal cramps. It was the first weekend after we shifted into our new house. We had a small get-together on 5 July 2009 and invited our relatives for a pot luck party. We were enjoying the food when, out of the blue, I felt excruciating abdominal cramps.

I cringed at the thought that it was a recurrence of my liver hepatitis. I quietly prayed that it would not be so bad this time. It was close to midnight on Sunday when I drove myself to a nearby 24-hour clinic to get a Buscopan injection. I felt a sense of déjà vu that transported me back to 2005 when I had experienced similar pain. Although this time it was not as bad as what I had experienced in 2005, it was many hours before I felt any relief.

The next day, I had decided to consult our family doctor. My ever-alert doctor put me through a blood and urine test. My blood test results were normal and the liver function test results were in the normal range. However, my urine test results indicated traces of blood. The doctor decided to err on the conservative and recommended a precautionary ultrasound scan of the abdomen. When the report of the ultrasound scan came out, it revealed renal cell carcinoma in my right kidney.

Three Days before Surgery

During the three days leading to the surgery, I packed my bag as if I was going on a business trip for a week. In my bag, I had the following items:

-Three books that had been on my To Read list for quite some time

-My iPod nano, loaded with uplifting songs

-My 3G-enabled notebook computer

-My mobile phone and phone charger

-A recent issue of the Manchester United magazine

Before my surgery, I loaded the following selection of songs and Richard Clayderman’s music onto my iPod.

-You Raise Me Up, sung by Josh Groban

- The Prayer, sung by Andrea Bocelli

-Il Mondo, sung by Patrizio Buanne

-Unforgettable, sung by Nat King Cole

-What A Wonderful World, sung by Louis Armstrong

-My Cherie Amour, sung by Stevie Wonder

-Moon Represents My Heart, sung by Teresa Teng

-How Deep Is Your Love, sung by Bee Gees

Surgery

I was admitted to the hospital a day earlier and tried to stay calm before the surgery. I listened to music to distract myself from worrying. I did not sleep much but I kept calm. I prayed for a successful surgery and for a swift recovery.

The next morning I woke up and had a light breakfast that I had ordered the night before. I was reading the local newspapers when an article immediately caught my attention. It was describing how impoverished men in the Philippines had to resort to selling their kidneys to get out of the poverty cycle. The article had a photo of some men standing together to show surgery scars on their lower backs. (I later confirmed with my Filipino friends that selling kidneys was unfortunately quite prevalent.)

I was going to have that same scar after my surgery! It was ominously coincidental and ... S U R R E A L. What’s more, the date of my surgery in July 2009 was also our house number.

Soon I was called to prepare for my surgery. I was wheeled to the waiting area where the wait seemed like an eternity. I was not sure what was going to happen next. My mind flashed back to 1969 when I had my hernia surgery. I was only six years old at the time and as I entered the operating theatre, the surgeon and nurses led me to believe that I was going to the moon.

It was freezing in the operating theatre, and the stainless steel operating table was icy cold to the touch.

A short while later, the anaesthetist came and introduced himself. He told me that he was originally from the state of Sarawak in East Malaysia, but before I could tell him more about myself, I went into deep sleep. The last thing I remembered was that I was asked to turn and lie on the left side of my body.

When I regained consciousness, I was still in the holding area of the operating theatre. I felt drained and tired after the surgery. I tried to keep still while lying on the hospital bed. My lips were dry and I was feeling parched. Later, the nurse on duty helped me sip some warm water and Milo.

Figure 1.5: A Milo van at my son’s school charity walkabout.

The Milo drink brought back many memories. Around since 1934, it has stood the test of time.

During my primary school days, we would all look forward to the Milo van visiting our school. The vans offered free cold Milo drinks in small paper cups. We had unlimited servings as long as we queued up again. Recently, I saw a Milo van visit a charity walkabout event at my son’s school.

Today it remains an often-served hot drink to patients immediately after surgery.

A little while later, I was wheeled back to my ward. I felt a sense of relief that the surgery was over. I was told that it went well. The nurses around me were exceptional and kept reminding me to keep hydrated. Together with my hot cup of Milo, I was able to consume a piece of Jacob’s cream crackers.

Figure 1.6: Jacob’s cream crackers — the old and the new.

Initially I did not feel much pain and I thought to myself, Hey, the pain is quite manageable! The nurses kept reminding me to sip water regularly so as not to trigger coughs. It was not until much later that I realized why the nurses kept telling me not to cough.

My first cough after the surgery caused a lot of pain to my wound. I had never experienced greater pain in my life! It was not just a big OUCH, it was a humongous OWWWW!!! that made me almost scream out loud.

When I told the nurses that coughing was painful, they gave me a tip to use both my hands to cup over the wound firmly when I was going to cough. Over time, I realized that the harder I pressed on the wound, the less pain I experienced when I coughed. I wondered how it reduced the pain BUT it helped. When I was too slow to cup the wound, the pain was unimaginable. It felt as if my flesh was sliced and ripped apart with a knife.

Even the pain from my earlier venipuncture paled in comparison. Later, I found out that I was given an epidural injection to manage the intense pain.

Oh my God! I had an epidural! I exclaimed to myself. An epidural is typically administered to women experiencing a difficult childbirth to help them manage the intense labour pains. It is also administered to patients who have had a major surgery.

For the next twelve hours after the surgery, I had a false sense of security and comfort because of the epidural injection. I wondered when the epidural would lose its effectiveness. Initially I did not think that I needed strong painkillers, but as the effects of the epidural started to wear off, I had to beg to differ.

After experiencing sharp pains when coughing, I realized that I should have taken my painkillers much earlier, before the epidural lost its effectiveness. The painkillers took some time to take effect.

Before the surgery, I told myself that I was going to get out of bed after the surgery as soon as possible. I was reminded of my mother’s stay in the intensive care unit (ICU) when she was in a comatose state for three weeks in 1997. My mother was in her early sixties then and was weakened when she came out of the coma. It took a long time before she could get out of bed to walk again. She had to undergo a long period of rehabilitation and physiotherapy and she often had bedsores. That experience was enough to motivate me to get out of bed and start walking sooner rather than later.

As I lay in bed after the surgery, I was eagerly waiting to ask my surgeon when I could try to walk. I also tried to ask the nurses but they deferred to the surgeon. They advised me to lie in bed for at least one day.

As I was lying in bed, I felt fortunate to have survived the surgery. I was lucky that my kidney cancer was Stage 1 and had not spread. I remarked to myself, The Doctor Saved My Life TWICE! The first time she saved my life was when I had acute non-viral liver hepatitis.

Six Days after Surgery

The next morning, the surgeon dropped by to tell me that the surgery went well. He told me that the growth in my right kidney had developed into Stage 1 renal carcinoma and that the whole kidney had to be removed. The prognosis was good. The fact that I did not need chemotherapy was a REAL BLESSING!

The surgeon explained that he made a large surgical incision to prevent the cancer cells from accidentally spreading to the other parts of the body through an open wound. At that time, he did not tell me how long the scar was. I was also trying not to imagine how long it would be. With the epidural, I could manage the pain quite well in the first two days. However, from the third day onwards, I had to take strong painkillers and muscle relaxants to compensate for the epidural wearing off.

After realizing that I was left with one kidney, I was somewhat depressed but my wife consoled me and asked me to count my blessings that I survived cancer. She reminded me to consider myself fortunate that I did not need chemotherapy.

My good friends visited me and rallied behind me. Some shared anecdotes of their friends living on one kidney for many years. There was a man in his seventies who survived on one kidney for fifty years and was still alive at the time. Another man did not realize that one of his kidneys was damaged in an accident, and continued to live the last twenty-five years on one kidney without knowing the fact.

On the day after my surgery, my mother-in-law dropped by to visit. She was very surprised to see me sitting up on my bed. She was happy with my recovery.

On Day Three, I tried to walk slowly around my room. I felt uncomfortable using a catheter and it gave me further motivation to get up and start walking as soon as possible.

This was also when I started to sponge myself without supervision. For the first two days, the nurses would help me to sponge and wash my face. I did not realize that even washing my face and brushing my teeth would be a chore after a major surgery. The nurses helped me to get up whenever I wanted to ease myself in the bathroom. I only had to walk with the catheter on the second and third day.

On Day Four, I had my first taste of freedom without the need to have a catheter hooked to my bladder. Often, we take our body for granted and we forget to take care of it until we fall ill or contract a disease.

Many of my relatives and friends asked how I discovered my cancer. When I reflected on it, I realized the important role played by the medical fraternity. Our family doctor helped to diagnose my kidney cancer while the specialist confirmed the diagnosis. Finally, the surgeon helped to remove the renal cell carcinoma.

For the first few days, my wife spent time with me at the hospital. Later when she had to go back to work, I always looked forward to her visits in the evening after her work. I also